The Indian Health Service (IHS)–a federal agency obligated by treaty to provide healthcare to Indigenous people in the US–has a history of colonialist practices and reproductive abuse that is continued by its promotion of long-acting reversible contraceptives (LARCs), denying Indigenous patients fully informed consent and, as a result, access to reproductive justice. I analyzed the IHS “2021 Formulary Brief: LARC” and IHS “2016 Formulary Brief: Contraception” and compared the directives given to clinicians with the language of the Center for Disease Controls and the Health and Human Services Office on Women’s Health. I compared the information IHS offers for each contraceptive method in these formulary briefs with their respective FDA warning labels. I analyzed and coded results for “birth control” on the IHS website search engine to determine what information patients could find about contraceptives and whether contraceptives were promoted, omitting extraneous results. I found that IHS clinicians are encouraged to “Engage in shared decision making to select the most appropriate contraceptive for each individual patient,” unlike similar government agencies, and are offered information that asserts the superiority of LARCs and contradicts FDA warning labels. I found 50% of the search results for “birth control” yield information that promotes LARCs.
Access to Reproductive Justice through the Indian Health Service: Contraceptives and Colonialism
- Fellow: Kathryn Lee
- Advisor: Cynthia Daniels