Community Health Nursing for Pregnant Women at Crisis Centers
This paper examines community health nursing needs for pregnant women served by the JMJ Pregnancy Center, a Catholic pro-life crisis pregnancy center primarily serving low-socioeconomic-status women without health insurance. Drawing on a literature review of crisis pregnancy centers (CPCs), unintended pregnancy risk factors, and nursing care frameworks, the paper identifies key community health diagnoses, proposes evidence-based nursing interventions, and outlines an evaluation plan. Topics covered include the misinformation risks associated with CPCs, the socioeconomic determinants of unintended pregnancy, nursing priorities such as psychological support and health education, and the implications of state abortion policy for community health practice.
- Introduction: Purpose and population of the paper
- Literature Review: Crisis Pregnancy Centers and Health Inequities: CPC practices, misinformation risks, health disparities
- Assessment of the JMJ Pregnancy Center Population: Socioeconomic risk factors and population comparison
- Planning: Nursing Diagnosis and Priorities: Priority nursing diagnoses and care planning goals
- Intervention Strategies for Nurses: Concrete nursing actions and barriers to care
- Evaluation and Implications for Community Health Nursing: Outcome measurement, limitations, and nursing implications
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What makes this paper effective
- The paper grounds its clinical recommendations in a literature review that directly critiques the CPC environment, creating a coherent rationale for the nursing interventions proposed.
- It draws an explicit comparison between study data (the Iseyemi et al. CHOICE project) and the specific population at JMJ, strengthening the assessment section with evidence-based parallels.
- The structure follows the nursing process (assessment → diagnosis → planning → intervention → evaluation), giving the paper a logical, profession-specific framework that is easy to follow.
Key academic technique demonstrated
The paper demonstrates applied literature synthesis: rather than simply summarizing sources, it maps research findings onto a specific real-world population. The comparison between the Iseyemi et al. study sample and the JMJ center population is a clear example of using published evidence to validate a community assessment, a core technique in community health nursing scholarship.
Structure breakdown
The paper opens with a brief introduction identifying the population and purpose. Part 1 presents a literature review followed by an assessment that applies the literature to the JMJ population. Part 2 covers planning (priority nursing diagnosis), intervention (concrete nursing actions and barriers), and evaluation (outcome measurement and limitations). A final paragraph addresses implications for community health nursing practice before a full APA reference list closes the paper.
Introduction
Healthcare is a fundamental necessity for every individual, regardless of religion, race, sex, or socioeconomic background. The population examined in this paper is that of the JMJ Pregnancy Center, a Catholic pro-life crisis pregnancy center. This center was selected because it primarily serves women of low socioeconomic status who lack health insurance. This paper aims to identify and prioritize community health diagnoses for the women of this center so that a care plan can be developed to address their healthcare needs.
Literature Review: Crisis Pregnancy Centers and Health Inequities
Crisis pregnancy centers (CPCs) are non-profit, pro-life organizations that serve women experiencing unplanned pregnancies who are considering abortion (Holtzman, 2017). These centers are largely religious in orientation, seeking to mentor and counsel pregnant women to reconsider abortion and contemplate adoption or parenting. Unwanted pregnancies are most commonly seen among adolescents, particularly those from lower socioeconomic classes who have less access to quality medical services and health insurance (Yazdkhasti et al., 2015). The resulting increase in unplanned births strains government healthcare budgets and contributes to unequal distribution of healthcare resources, producing significant health disparities. Adolescents are especially vulnerable to health risks given their limited education and knowledge about pregnancy, compounding insurance and medical aid disparities.
Research has shown that CPCs frequently fail to provide accurate or adequate health information to pregnant women, as their ideological orientation is primarily religious (Rosen, 2012). Staff at these centers often assert that abortion is contrary to religious beliefs and that women should not pursue it. Common claims propagated by some CPCs include that abortion causes future pregnancy complications, increases the risk of breast cancer, and harms mental health. The Society for Adolescent Health and Medicine (SAHM) and the North American Society for Pediatric and Adolescent Gynecology (NASPAG) stated that crisis pregnancy centers do not provide essential health and sexual information critical to maintaining the health of pregnant women (SAHM & NASPAG, 2019). The reproduction of misleading health information, combined with insufficient attention to informed consent, creates serious health threats for women who are already without health insurance.
Such tactics are widely regarded as subtle forms of fraud, as CPC counseling can instill fear in women already experiencing the mental trauma of an unwanted pregnancy (Brown, 2018). In certain instances, state governments have collaborated with CPCs by compelling physicians to deliver inaccurate information to patients — a practice associated with so-called TRAP (Targeted Regulation of Abortion Providers) laws. While physicians may be legally pressured to convey misleading information as licensed professionals, CPCs generally cannot compel the same. This dynamic leaves women vulnerable to paradoxical and harmful treatment, both mentally and physically.
Assessment of the JMJ Pregnancy Center Population
The selected population consists of pregnant women at the JMJ Pregnancy Center, a pro-life facility serving women who are planning to end their unplanned pregnancies. The women are predominantly adolescents from low socioeconomic backgrounds who lack health insurance, which imposes significant costs on the public health system as described in the literature review above.
A comparable population was examined in a study that investigated the effect of low socioeconomic status on unintended pregnancy as a risk factor (Iseyemi et al., 2018). Socioeconomic variables such as age, ethnicity, education level, eligibility for public health assistance, and self-reported difficulty paying for healthcare were recorded for the St. Louis region of the United States. More than nine thousand participants were included; among them, unintended pregnancy was most prevalent among Black women with limited college education, who were obese, belonged predominantly to low socioeconomic classes, and largely lacked health insurance — conditions closely mirroring those of the JMJ center population.
When the JMJ crisis pregnancy center population is compared to the study sample described above, both groups share conditions that are unfavorable for a healthy pregnancy. Because prenatal care requires a healthy diet and regular monthly medical examinations, both populations remain deprived of these services due to financial constraints associated with low socioeconomic status. The literature also indicates that physicians may be pressured by state governments to provide inappropriate pregnancy information to pro-life pregnant women, contributing to mental stress and fear. These circumstances are evident in both populations, and the comparison reveals substantially similar outcomes.
Restrictive state abortion policies — including directing physicians to discourage abortion — effectively increase the likelihood of unplanned pregnancies continuing to term. The concept of rational choice theory suggests that when the perceived costs of unprotected sex rise, women may be compelled to seek alternative birth control methods (Medoff, 2012). Access to accurate information and genuine alternatives is therefore a critical factor enabling women to make informed, autonomous decisions about their reproductive health.
Nursing diagnoses and interventions for CPC-served women should include education on fundamental pregnancy health practices such as nutrition, light exercise, walking, adequate sleep, and avoidance of smoking and alcohol. Disease prevention and management support may also be needed — for example, for women experiencing anemia, abnormal bleeding, or allergies they are ill-equipped to manage (Esquillo, 2017). Nurses can conduct assessments addressing each woman's emotional state, the mental trauma of an unexpected pregnancy, lack of family support, and indicators of complications in pregnancy or delivery. Monthly check-ups, mentorship related to decision-making, and ongoing psychological support are all essential components of care.
References
Brown, T. R. (2018). Crisis at the pregnancy center: Regulating pseudo-clinics and reclaiming informed consent. Yale Journal of Law and Feminism, 30(2), 221–274.
Esquillo, J. (2017, January 19). NCLEX: Health promotion and maintenance, nursing care of the childbearing family. Brilliant Nurse. Retrieved from https://brilliantnurse.com/nclex-health-promotion-and-maintenance-nursing-care-of-the-childbearing-family-iv/
Holtzman, B. (2017). Have crisis pregnancy centers finally met their match: California's Reproductive FACT Act. Northwestern Journal of Law and Social Policy, 12(3), 78–110.
Iseyemi, A., Zhao, Q., McNicholas, C., & Peipert, J. F. (2018). Socioeconomic status as a risk factor for unintended pregnancy in the contraceptive CHOICE project. Obstetrics and Gynecology, 130(3), 609–615.
Medoff, M. H. (2012). Unintended pregnancy and abortion access in the United States. Hindawi: International Journal of Population Research, 2012, 254315.
Rosen, J. D. (2012). The public health risks of crisis pregnancy centers. Perspectives on Sexual and Reproductive Health: A Journal of Peer-Reviewed Research, 44(3), 201–205.
Society for Adolescent Health and Medicine (SAHM) and North American Society for Pediatric and Adolescent Gynecology (NASPAG). (2019). Crisis pregnancy centers in the US: Lack of adherence to medical and ethical practice standards. Journal of Adolescent Health, 65, 821–824. https://doi.org/10.1016/j.jadohealth.2019.08.008
Taylor, D., & James, E. A. (2012). An evidence-based guideline for unintended pregnancy prevention. Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN, 40(6), 782–793. https://doi.org/10.1111/j.1552-6909.2011.01296.x
Yazdkhasti, M., Pourreza, A., Pirak, A., & Abdi, F. (2015). Unintended pregnancy and its adverse social and economic consequences on health system: A narrative review article. Iranian Journal of Public Health, 44(1), 12–21.
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