What is PATH
The PATH questions are used to talk to people about reproductive desires in a way that is person-centered and builds trust and rapport between people and their health care professionals.
“Do you think you might like to have (more) children at some point?”
“When do you think that might be?”
“How important is it to you to prevent pregnancy (until then)?”
Comprehensive sexual and reproductive health rests on the belief that all people can and should have agency over their own sexual and reproductive lives.
Choices with regard to sexuality and reproduction, while having implications for health and health care needs, are not inherently medical issues. Certainly, part of our role as health care professionals involves helping people prevent or manage adverse outcomes associated with sex and reproduction, but this should not distract us from the principle that a core part of free will is having control over sexual and reproductive choices.
Reproductive Justice Principles
The Reproductive Justice (RJ) movement was started by Black women activists in the 1990s as a direct response to racist and discriminatory policies that affected people's sexual and reproductive health. RJ emphasizes the fundamental human right to have children, not have children, and raise the children people have in safe and sustainable communities. Today, the legacy of structural and individual racism in sexual and reproductive health care looms large over our healthcare landscape. Many ongoing practices and policies perpetuate inequities and undermine efforts to fully realize RJ principles.
Health care providers can work towards acknowledging this history and preventing future harm by providing non-stigmatizing inclusive care that centers the patient. An important component of this is to to listen as patients identify what they want and then help them get it.
Person-centered care requires that providers and policy makers incorporate the lessons learned from how the health care field has too often failed and traumatized patients and communities. A principle of person-centered care is listening to the person’s stories with respect and trusting their lived experiences.
The Purpose of PATH
Support a person's reproductive autonomy and agency.
Help people gain clarity about what they want in terms of reproduction so they can make choices that are aligned with their desires.
Allow space for people to talk about their reproductive desires in the context of their lives.
Let the person know that your priority is helping them figure out what is important to them.
Build rapport by letting them know you are listening.
Inform the provider about the direction of the visit (offering to discuss pre-pregnancy care, fertility support, and contraception).