Implicit Bias in Counseling for Permanent Contraception: Historical Context and Recommendations for Counseling

Health Equity. 2020 Jul 17;4(1):326-329. doi: 10.1089/heq.2020.0025. eCollection 2020.

Abstract

We provide an overview of the causes, manifestations, and potential mitigating steps regarding implicit bias in counseling for permanent contraception. The historical context of sterilization abuses and the implications of these on society's notions of fitness for parenthood are reviewed. We present contemporary examples of contraceptive coercion and discuss the impact of implicit bias from health care providers. Finally, we outline steps for ensuring a patient-centered shared decision-making ethical approach to permanent contraceptive counseling.

Keywords: contraception; contraceptive counseling; ethics; implicit bias; permanent contraception; sterilization.