ASSESSING UNMET REPRODUCTIVE HEALTH NEEDS FOR WOMEN IN SHELTERS Kathryn J. Luchok, PhD+*, Shannon Staley, LMSW*, Kerry McLoughlin, MA# +University of South Carolina Arnold School of Public Health, *South Carolina Access Initiative, #University of South Carolina at Sumter Department of Sociology Background and Significance Results Women’s Narratives Conclusions There is growing interest in the intersection between intimate partner violence (IPV) and reproductive health. The Guttmacher Institute reports how abusive partners go beyond physical and sexual violence to assert reproductive control through: Forced sexual activity Intentionally exposing partners to STIs Restricting access to and sabotaging contraception Forcing pregnancy continuation or termination Denying paternity This control can manifest in STIs , unintended pregnancies, and poor health outcomes for women and their children. Despite the prevalence of these issues, women seeking shelter from IPV find access to reproductive information and services is severely limited. Taking control of one's reproductive destiny can be a first step to taking back control from an abuser. Assessing clients' unmet needs and barriers to services as well as shelter staffs' understanding of women's needs and barriers can lead to better services for these women and healthier lives for them and their families. “I think they provide like condoms and stuff. They should [laughs]. I went to them to ask them the other day, because I was with my ex-boyfriend and I wanted to make sure, just in case we do it. My first time ever going to ask anybody if they provide them, and the staff said that she was going to look in it. She was like, she ain’t sure because she ain’t never had a client come to her and ask, but I’d rather be safe than sorry.” Reproductive coercion is common but unrecognized as abuse. Shelters are missing an opportunity to address reproductive health since many women will return to their abuser or start new relationships and could be better equipped with strategies to control their fertility. Options for fertility control are a key part of a woman's autonomy and overall health, yet are often ignored. Stemming from this research SCAI has developed a resource guide to help shelter staff better connect women to supportive services, and has partnered with SCCADVASA on a statewide training on IPV and a series of regional workshops to assist staff in meeting the reproductive health needs of their clients. : Sample was evenly distributed between rural and urban sites. Interviewed 10 African-American, women, 5 White and 1 Hispanic. 5 staff were African-American, 4 white and 1 Hispanic Each woman reported all of her pregnancies were unintended. Women reported a general lack of reproductive control . Significant number have had tubal ligations or hysterectomies. Many reported difficulty remembering to take birth control pills. Many were concerned about STIs. Many had trouble getting partners to use condoms Reported long waits for health services Lack of reproductive information Staff Issues Barriers to addressing reproductive needs Time Other priorities Lack of information Assumption needs are met by other providers Methods “I was pregnant three times, all were miscarriages-stress and fighting caused them.” “My husband refuses to wear a condom…and he sleeps with other women…I got an STD and he…still refused to wear a condom…I felt like I had no control over my body…or health….” “I didn’t know about the female condom…My niece [told me about it]. Matter of fact, I went somewhere and I asked that question…. I don’t know whether it was the drug store or the Health Department…And they, they didn’t know about it.” The South Carolina Access Initiative (SCAI) collaborated with the SC Coalition against Domestic Violence and Sexual Assault (SCCADVASA) to conduct a state-based needs assessment of women in shelters. We conducted in-person semi-structured interviews with rural and urban women using shelter services (16) and shelter staff (10) from 6 South Carolina shelters. Shelters were invited to participate and interviews continued until we met saturation (no new information). Interviews were transcribed verbatim, and entered in NVIVO, a textual data management system. Transcripts were coded, with comparative cross-analyses to find common themes, present a narrative of women's experiences, and look for divergence and agreement from the perspectives of women and shelter staff. Acknowledgements Vicki Bourus, MSW, LISW, ED of SCCADVADSA, retired Melissa Moore, SCAI Women and shelter staff Guttmacher Institute and Family Violence Prevention Fund “I don’t know where we would refer someone for a termination. Women don’t get GYN services, like…regular Pap smears…don’t know where they would get emergency contraception….”