Public health discourses often claim that delaying pregnancy is associated with social and economic benefits. Yet research suggests that, for young people, structural inequity is most influential in future outcomes, regardless of childbearing. We conducted in-depth interviews with 50 young women (ages 18–24) and their male partners (n = 100) and investigated the influence of structural inequity on pregnancy desires and plans. Three themes emerged, stratified by social advantage. In the “Things Will Be Different Later” theme, socially advantaged participants envisioned that their future lives would surely be different due to achievement of educational, professional, and economic goals; thus, their pregnancy plans aligned with their desires, often reflected in use of highly effective contraception. In the “I Don’t Have Everything I Need” theme, participants expressed delaying desired pregnancies (primarily through condom use) until they could contend with structural barriers. Their pregnancy plans, shifted by way of structural inequity, were not aligned with their desires. Under the “I’ll Never Have Everything I Need” theme, socially disadvantaged participants expressed significant doubt about ever realizing ideal circumstances for pregnancy preparedness; as pregnancy prevention was not salient, these participants used condoms or no contraception. This analysis indicates that structural inequities constrain reproductive self-determination in emerging adulthood, creating a chasm between desired and actual childbearing that was reflected in contraceptive decision-making. Public health narratives emphasizing the importance of pregnancy prevention for socially disadvantaged groups without addressing the manifestation of structural inequity in their lives perpetuate reproductive oppression vis-à-vis emphasis on contraceptive use to ensure future economic success.

公共卫生话语经常声称延迟怀孕与社会和经济利益有关。然而研究表明，对于年轻人来说，结构性不平等对未来结果的影响最大，与生育无关。我们对 50 名年轻女性（18-24 岁）及其男性伴侣（n = 100）并调查了结构性不平等对怀孕愿望和计划的影响。出现了三个主题，按社会优势分层。在“以后情况会有所不同”主题中，具有社会优势的参与者设想，由于实现了教育、职业和经济目标，他们未来的生活肯定会有所不同；因此，她们的怀孕计划与她们的愿望相一致，这通常反映在使用高效避孕药具上。在“我没有我需要的一切”主题中，参与者表示推迟想要的怀孕（主要通过使用安全套），直到他们能够应对结构性障碍。他们的怀孕计划因结构性不平等而改变，与他们的愿望不一致。在“我永远不会拥有我需要的一切”主题下，处于社会弱势地位的参与者对能否实现备孕的理想环境表示严重怀疑；由于怀孕预防不突出，这些参与者使用避孕套或不避孕。该分析表明，结构性不平等限制了成年后的生殖自决，在避孕决策中反映了预期生育和实际生育之间的鸿沟。公共卫生叙事强调了对社会弱势群体预防怀孕的重要性，而没有解决他们生活中结构性不平等的表现，相对于强调使用避孕药具以确保未来的经济成功，生殖压迫会永久存在。由于怀孕预防不突出，这些参与者使用避孕套或不避孕。该分析表明，结构性不平等限制了成年后的生殖自决，在避孕决策中反映了预期生育和实际生育之间的鸿沟。公共卫生叙事强调了对社会弱势群体预防怀孕的重要性，而没有解决他们生活中结构性不平等的表现，相对于强调使用避孕药具以确保未来的经济成功，生殖压迫会永久存在。由于怀孕预防不突出，这些参与者使用避孕套或不避孕。该分析表明，结构性不平等限制了成年后的生殖自决，在避孕决策中反映了预期生育和实际生育之间的鸿沟。公共卫生叙事强调了对社会弱势群体预防怀孕的重要性，而没有解决他们生活中结构性不平等的表现，相对于强调使用避孕药具以确保未来的经济成功，生殖压迫会永久存在。在避孕决策中反映的期望和实际生育之间的鸿沟。公共卫生叙事强调了对社会弱势群体预防怀孕的重要性，却没有解决他们生活中结构性不平等的表现，而相对于强调使用避孕药具以确保未来的经济成功，生殖压迫会永久存在。在避孕决策中反映的期望和实际生育之间的鸿沟。公共卫生叙事强调了对社会弱势群体预防怀孕的重要性，而没有解决他们生活中结构性不平等的表现，相对于强调使用避孕药具以确保未来的经济成功，生殖压迫会永久存在。