My body, but not my decision: reproductive burdens among college women of color experiencing unplanned pregnancy in the U.S. South.

backgroundUnplanned pregnancy remains a critical reproductive health and social equity issue in the United States, disproportionately affecting women of color. In the U.S. South, where cultural conservatism and restrictive reproductive policies are prevalent, these experiences are further shaped by intersecting systems of race, gender, and power. Despite extensive public health focus on prevention and behavior, limited attention has been given to how women of color in higher education interpret and navigate unplanned pregnancy within these racialized and gendered contexts. This study explores how college women of color experience unplanned pregnancy and how intersecting social dynamics influence their perceptions, emotions, and decision-making.

methodsThis qualitative study used a phenomenological design to capture the lived experiences of eleven self-identified college women of color who experienced an unplanned pregnancy while enrolled in undergraduate programs in the U.S. South. Guided by the Social-Ecological Model, semi-structured interviews were conducted via a secure video-conferencing platform. Transcripts were analyzed using Braun and Clarke's six-phase thematic analysis. Research rigor was ensured through triangulation, reflexive bracketing, and collaborative coding.

resultsFour key themes emerged: (1) Emotional and gendered burdens-participants described fear, shame, and stigma rooted in moral and gender norms; (2) Gendered contraceptive responsibility-contraception and prevention were viewed as women's duty, with minimal partner accountability; (3) Partner influence and power in pregnancy decisions-relationships often reflected unequal emotional and decision-making dynamics; and (4) Cultural and racialized expectations-religious beliefs, family reputation, and community respectability shaped silence and internal conflict. Collectively, these experiences reflected intersecting gendered and racialized pressures that limited autonomy and support.

conclusionUnplanned pregnancy among college women of color in the U.S. South is shaped by intertwined gendered and racialized burdens that constrain reproductive agency. These findings highlight the need for universities to implement culturally responsive, equity-centered reproductive health policies and support services that actively address stigma, power imbalances, and structural barriers affecting pregnant students.