This study explores how the complicated and nuanced identity theory, intersectionality, can be implemented as a communication strategy for sexual health professionals. From interviews with sexual health professionals in Oregon, this research indicates that through the adaptation of a reproductive justice lens professionals can practice intersectionality in their day-to-day work. Strategic communication has longed focused on the “cash value” of theory and suggested that theory is best when it can be applied in real world instances. This research identifies three strategies for application: the use of explicit language, the building of transformative coalitions, and the centering of marginalized voices, stories, and lived experience. This, in combination with an exploration into how sexual health professionals see their own professional and personal identities, indicates that there are very real world applications of intersectional theory that benefit practice.

Down syndrome, or Trisomy 21, is the most commonly occurring genetic condition, and yet there exists a great deal of misinformation and misconception about the lived experience and value of Down syndrome in society. Its construction as a disability is deeply intertwined with racist rhetoric and, despite changes in language, this construction of Down syndrome as a racialized disability category has immense implications in clinical and prenatal genetic counseling settings. This thesis seeks to examine the past and present of Down syndrome in conversation with reproductive justice, disability justice, and the current norms of practice in genetic counseling. In doing so, this thesis makes recommendations towards a disability-centered and actively counter-eugenic genetic counseling practice.

abstract: The stillbirth of a wanted baby is a devastating and life altering experience that happens more than 26,000 times each year in the United States, but the impacts and implications of this loss on families is rarely discussed in public spaces. While another kind of pregnancy ending, abortion, dominates political discourse about reproduction, the absence of talk about stillbirth prevention or support in those same contexts is worthy of further investigation. This project explores stillbirth as a communication phenomenon and draws upon narrative, performance and rhetorical articulations of testimony to extend our understanding of how narratives of stillbirth circulate in current conditions of discourse. A model for viewing how dominant and counter narratives circulate is explained (Narrative Loop Model) and a new model for illuminating the unique functions of testimony is given (Testimonial Loop Model). This dissertation employs performance and rhetorical methods to explore testimonies of stillbirth, both naturally occurring and solicited through interviews, in order to create several performance texts that put pregnancy-ending narratives in conversation with each other on stage. Analysis of the performance text and choices, as well as reflection on the embodied performance experience and member checking, yielded several findings. The discovery of somatic sentience and its influence on performance ethnography is discussed. Themes of relationality and temporality were found in the performance of testimonies of stillbirth. The implications of these findings add to the communication discipline’s understanding of how and why stillbirth testimony may circulate, its impact on conditions of discourse for pregnancy ending and its potential use as/in intervention, support, and advocacy. Ethical considerations and limitations are addressed. / Dissertation/Thesis / Doctoral Dissertation Communication Studies 2015

Constructions of race, reproductive health, and gender have been inextricably linked in the United States since the beginning of the nation. Today, these linkages remain evident in the marked racial and gender inequities in reproductive health outcomes that persist in the U.S. To better understand how these meanings and material outcomes are negotiated and produced by actors on the ground, this study asked: “How do reproductive healthcare providers (RHPs) communicate about the intersections of race, reproductive health, and policy?” I conducted semi- structures interviews with 24 RHPs, resulting in over 35 hours of recorded interviews. Drawing on critical-cultural communication, Reproductive Justice, Narrative Medicine, and Postcolonial theories, I developed a novel approach to narrative inquiry—Critical Narrative Analysis—to explore my data. Here, I present an in-depth analysis of 8 narratives shared by my participants. I conclude that participants communicated about race, reproductive health, and policy by engaging with dominant cultural narratives around these topics. While some participants contested dominant narratives, most upheld the foundational logics of oppressive systems in the stories they shared. To advance reproductive justice, I argue that new approaches to teaching clinicians, which engage with both narratives and sociopolitical structures affecting these narratives, are needed. By sharing my participants’ stories and contextualizing them within dominant narratives and social institutions, I aim to identify future research and practice opportunities for creating new stories about reproductive health and physician identity, stories which could suggest more equitable and just ways of doing reproductive health care.

The goals of this project are twofold. The first goal is to articulate my sense making of reproductive health for Women of color in the United States as a postcolonial condition; one that I trace back to the logics of elimination of settler colonialism (Wolfe, 2006) and frame as maintained through the colonial institutions, or racial projects (Omi & Winant, 2015), of the Prison Industrial Complex, the welfare system, and the health care system which create and perpetuate dominant cultural narratives of “the welfare queen”, “the negligent Black mother”, and “the wily patient”. I show how these narratives colonize the minds of health care providers and contribute to the current stratification of health care. My second goal with this project is to show how postcolonial interpretive ethnography can be used as a narrative medicine educational intervention for providers. Currently, Narrative Medicine asks providers to read themselves, their patients, and their interactions as literature to emphasize the personal and interpersonal tensions that are often lost in the fast paced biomedical world (Charon, 2001). With this project I aim to expand the field of Narrative Medicine to consider the ways patient-provider interactions are postcolonial, and how analyses of these interactions can be a method of decolonization. I do so by analyzing three interpretive ethnographic narratives that I have created which story my interactions with three Women of color: Tiffany, Rose, and Jane. I then analyze each of these interactions for colonizing and decolonizing sense making.

Whether it is social stigma or state policy, abortion seekers are facing an intense amount of obstacles when it comes to accessing their abortion in Texas during the pandemic. To better understand how COVID-19 affected the landscape of abortion access, it was necessary to listen to the experiences of abortion seekers during the pandemic. Experts in the field of abortion advocacy were also interviewed to provide perspective on the trajectory of abortion access during COVID-19. Abortion seekers were screened through a survey to ensure they met the criteria of getting an abortion, living in Texas, and being 18+ while experts in the field were contacted through my personal activist network. COVID-19 exacerbated challenges that already existed in the landscape of abortion access in Texas. Misinformation and managing the tentative scheduling of clinics are two of the most prominent exacerbated challenges abortion seekers experience. This is followed by an increase in exposure to unsupportive families as well as the expenses that come with traveling to appointments. The additional COVID-19 related restrictions created consequences that embodied themselves as delays in receiving abortion care, a much lonelier process, and tentative employment. A positive outcome of COVID-19 is the potential of abortion care being integrated into Telehealth services that would severely decrease the public harassment abortion seekers and providers experience from antis standing outside of clinics, travel expenses, and the lack of privacy some might feel when going into a clinic.

No description available.

Improving the quality of abortion care can reduce stigma, increase access, and enhance knowledge about pregnancy prevention and reproductive health. Midwifery-led medication abortion is considered effective, efficient, accessible, person-centred, equitable, and safe in alignment with the World Health Organization’s framework on quality abortion care. As research on client-centred access to healthcare recommends, Ontario’s expanded midwifery care models are improving the ease with which people can find and use sexual and reproductive services most appropriate to their unique needs. The expanded midwifery care presented in this study demonstrates how midwifery-led medication abortion provides high-quality services, decreases stigma, and improves access to safe, acceptable, and client-centred abortion care, particularly for commonly underserved populations deserving of health equity and Reproductive Justice. / The World Health Organization, the International Confederation of Midwives, and the Canadian Association of Midwives advocate for the inclusion of comprehensive abortion care within midwifery practice. International evidence shows positive outcomes in terms of efficacy, safety, acceptability, and post-abortion contraception uptake when midwives provide abortion services. In Canada, midwifery services are available across various populations, including urban, rural, remote, and Northern areas, suggesting a potential to enhance access and quality of abortion care, particularly for underserved people. Expanding the role of Canadian midwives to include comprehensive abortion care could improve accessibility, address gaps in service provision, support community needs, ensure professional sustainability, foster interprofessional collaboration, and offer continuity of care. Since 2017, the Ontario Ministry of Health has funded Expanded Midwifery Care Models to support midwifery integration, interprofessional collaboration, and delivery of midwifery-led sexual and reproductive care that is not funded under the current payment model. This research explores the individual and shared experiences of midwifery-led medication abortion delivered through Expanded Midwifery Care Models across three distinct regions in Ontario. The study employs interpretive description methodology to understand how midwifery influences the experiences of medication abortion for midwives, collaborating healthcare professionals, and clients. The methodology focuses on exploring how integrating a midwifery model of abortion care supports medication abortion services and promotes Reproductive Justice within primary care settings. By gathering insights from multiple perspectives, the findings hope to inform clinical practice, interest policymakers, and identify outcomes valued by midwives, clients, and healthcare professionals for future research on midwifery-led abortion care. / Thesis / Master of Science (MSc) / Quality abortion care improves the lives, health, and wellness of reproductive-aged people. Abortion is time-sensitive and people face barriers to this care. Reproductive-aged people benefit from healthcare systems that make abortion simple, safe, and effective. Internationally, midwives play a significant role in abortion care by delivering comprehensive services within sexual and reproductive healthcare. In Canada, however, the potential of midwifery in providing abortion care has not been fully realized. As an exception, Ontario’s Expanded Midwifery Care Models (EMCMs) - innovative sexual and reproductive healthcare delivery programs - have made it possible for midwives to provide abortion services. Midwifery-led abortion care in EMCMs includes providing early abortion care in ways that make it easier for people who find it difficult to access care. This research explores and compares the personal and professional experiences of medication abortion care delivered by midwives across three regions in Ontario.

Healthy Women, Healthy Families is a survey collection and story sharing project spearheaded by NARAL Pro Choice Texas. The reproductive justice based project asks survey respondents to rate how urgently their community needs a variety of health care services. While all Texas women are invited to participate, special attention was paid to targeting low income and minority women. In this report, I analyze the survey data and make both policy and internal recommendations for NPCT. Overall the survey results show that while all of the services in question are needed by women in Texas, there are differences in the strength of this need based on race and income. General health care services were most valued by all demographics, but NARAL’s priority services were valued most by upper class white women, while low income and minority women were more likely to support services aimed at specific populations (non-English speakers, women in prison, undocumented immigrants, those without transportation, etc.). Based on these survey results, I recommend that NARAL conduct follow up surveys as a way of illuminating some still unanswered questions. In addition, I recommend that NARAL reach out to coalition partners who advocate for the most needed services, expand outreach into low income and minority communities, and use outreach and messaging to try and frame NARAL’s services in a larger, more general health care context. / text

Citizens of the Aamjiwnaang First Nation fight for justice with their bodies at the frontlines of environmental catastrophe. This dissertation employs a biopolitical and interpretive analysis to examine these struggles in the polluted heart of Canada’s ‘Chemical Valley’. Drawing from a discursive analysis of situated concerns on the ground and a textual analysis of Canada’s biopolitical ‘policy ensemble’ for Indigenous citizenship, this dissertation examines how citizens and public officials respond to environmental and reproductive injustices in Aamjiwnaang. Based upon in-depth interviews with residents and policy-makers, I first document citizens of the Aamjiwnaang First Nation’s activities and practices on the ground as they cope with and navigate their health concerns and habitat. Second, I examine struggles over knowledge and the contestation over scientific expertise as the community seeks reproductive justice. Third, I contextualize citizen struggles over knowledge by discussing the power relations embedded within the ‘policy ensemble’ for Indigenous citizenship and Canadian jurisdiction for on-reserve environmental health. From an interpretive lens, inspired by Foucault’s concepts of biopower and governmentality, the dissertation develops a framework of “ecological citizenship”, which confronts biopolitics with a theoretical discussion of place to expand upon existing Canadian citizenship and environmental studies literature. I argue that reproductive justice in Aamjiwnaang cannot be separated from environmental justice, and that the concept of place is central to ongoing struggles. As such, I discuss “ecological citizenship’s double-edge”, to contend that citizens are at once bound up within disciplinary biopolitical power relations and also articulate a radical form of place-based belonging.