Reproductive Anxiety: Understanding the experiences of LGBTQ individuals, young people, and those who have faced perinatal loss.

Part 2 of 2.

This episode delves into the multifaceted issue of reproductive anxiety. We hear from researchers and activists Sam Murphy, Jessi Winters and Mari Greenfield on their work with LGBTQ communities, young people and individuals who have faced perinatal loss.

In Part 2, the guests share their solutions and best practices for research in this space. They discuss the implications of reproductive anxiety on relationships, decision-making, and mental health, as well as the importance of trust and community engagement in research. The speakers conclude by emphasising the need for advocacy to raise awareness of reproductive anxiety and discuss the role of researchers in amplifying marginalised voices.

Jessi Winters is a social researcher with a keen interest in using participatory methods to understand complex health issues. While working at Brook, Jessi led the ⁠⁠EASY research⁠⁠ to better understand young people’s attitudes and behaviours towards condoms, contraception and sexual health. 

Dr. Mari Greenfield is a researcher at the Open University who specialises in working with marginalised groups on reproductive health issues. She usually uses qualitative and participatory methods to find out about people’s experiences.

Dr. Sam Murphy is a Senior Lecturer in Health Studies at The Open University. She has had a long-term interest in researching experiences of reproductive loss as well as, more broadly, the sociologies of human reproduction and death and dying.

Keywords: Reproductive anxiety; LGBTQ; perinatal loss; young people; contraception; mental health; research; advocacy; reproductive services.

Reproductive Anxiety: Understanding the experiences of LGBTQ individuals, young people, and those who have faced perinatal loss.

Part 1 of 2.

This episode delves into the multifaceted issue of reproductive anxiety. We hear from researchers and activists Sam Murphy, Jessi Winters and Mari Greenfield on their work with LGBTQ communities, young people and individuals who have faced perinatal loss.

Part 1 sets the scene for what reproductive anxiety might look like and draws on the challenges people face in deciphering reliable information from medical professionals and social media. The conversation highlights the intersectionality of reproductive anxiety, emphasising how identity and past experiences shape individuals' feelings and concerns. The guests discuss the stigma surrounding reproductive health decisions and the importance of accessible information and support.

Jessi Winters is a social researcher with a keen interest in using participatory methods to understand complex health issues. While working at Brook, Jessi led the ⁠⁠EASY research⁠⁠ to better understand young people’s attitudes and behaviours towards condoms, contraception and sexual health. 

Dr. Mari Greenfield is a researcher at the Open University who specialises in working with marginalised groups on reproductive health issues. She usually uses qualitative and participatory methods to find out about people’s experiences.

Dr. Sam Murphy is a Senior Lecturer in Health Studies at The Open University. She has had a long-term interest in researching experiences of reproductive loss as well as, more broadly, the sociologies of human reproduction and death and dying.

Keywords: Reproductive anxiety; LGBTQ; perinatal loss; young people; contraception; mental health; research; advocacy; reproductive services.

"Dignity means different things for different people, and it’s difficult to deny the importance of the notion in understandings of human existence. So when we use dignity as a given of a quality to being human, we need to dig into what human means and who grants what a human with rights is.”  Lisa Käll.

“Person-centred care is only reserved for some people entering healthcare systems, and not for others.” Sarah Hamed.

The question of human dignity is crucial in the fight for birthing rights for racially minoritised people in Sweden and the UK. Who is understood to be worthy of dignified care, what should dignified care look like and what is the responsibility of the health system? These troubling questions are discussed by our multidisciplinary panel from a philosophical, sociological and activist perspective in this powerful episode on Dignity in Maternity Care. In Part 1, speakers explore the concept of dignity and how it is used in research and practice. In Part 2, speakers review what their research shows about how black and brown people are treated in maternity care, what can be done to ensure that women and birthing people can maintain their rights, autonomy and a sense of dignity through supportive and caring communities. Speakers end with calls to learn from transformative justice and to build a collaborative movement to end mistreatment and harm in maternity care.

“We need solutions and pressure on government to think bigger and more radically about how to transform maternity care so that it becomes something that enables all women and birthing people to access life-affirming rights, respecting safe care.” Shanthi Gunesekera

For more information on topics raised in this episode:

• ⁠https://www.blackthrive.org/⁠
• ⁠Birthrights - your human rights during pregnancy and maternity care⁠

Biographies

Lisa Käll, Professor in Gender Studies at Stockholm University. Lisa is head of the department for Ethnology, History of Religion and Gender studies at Stockholm University, leads the Nordic network for gender, body and health, and writes and edits publications within her research interests of feminist philosophy, especially phenomenology and philosophy of subjectivity, body/embodiment theory and many other areas.  

Shanthi Gunesekera, Co-CEO at Birthrights UK, the leading authority on the rights of women and birthing people during pregnancy and birth in the UK. Shanthi and her job share partner Janaki previously led the Greater London Authority’s policy and programmes delivered under the Mayor of London’s Social Integration Strategy. 

Sarah Hamed, Researcher in Medical Sociology at Kings College London and Head of Research and Evaluation at Black Thrive Global. Sarah focuses on migration and health inequalities, racism and racialisation in healthcare and is currently conducting a study on racism in maternity care in Sweden and the UK.  

“Dignity means different things for different people, and it’s difficult to deny the importance of the notion in understandings of human existence. So when we use dignity as a given of a quality to being human, we need to dig into what human means and who grants what a human with rights is.”  Lisa Käll.

“Person-centred care is only reserved for some people entering healthcare systems, and not for others.” Sarah Hamed.

The question of human dignity is crucial in the fight for birthing rights for racially minoritised people in Sweden and the UK. Who is understood to be worthy of dignified care, what should dignified care look like and what is the responsibility of the health system? These troubling questions are discussed by our multidisciplinary panel from a philosophical, sociological and activist perspective in this powerful episode on Dignity in Maternity Care. In Part 1, speakers explore the concept of dignity and how it is used in research and practice. In Part 2, speakers review what their research shows about how black and brown people are treated in maternity care, what can be done to ensure that women and birthing people can maintain their rights, autonomy and a sense of dignity through supportive and caring communities. Speakers end with calls to learn from transformative justice and to build a collaborative movement to end mistreatment and harm in maternity care.

“We need solutions and pressure on government to think bigger and more radically about how to transform maternity care so that it becomes something that enables all women and birthing people to access life-affirming rights, respecting safe care.” Shanthi Gunesekera

For more information on topics raised in this episode:

• https://www.blackthrive.org/
• Birthrights - your human rights during pregnancy and maternity care

Biographies

Lisa Käll, Professor in Gender Studies at Stockholm University. Lisa is head of the department for Ethnology, History of Religion and Gender studies at Stockholm University, leads the Nordic network for gender, body and health, and writes and edits publications within her research interests of feminist philosophy, especially phenomenology and philosophy of subjectivity, body/embodiment theory and many other areas.  

Shanthi Gunesekera, Co-CEO at Birthrights UK, the leading authority on the rights of women and birthing people during pregnancy and birth in the UK. Shanthi and her job share partner Janaki previously led the Greater London Authority’s policy and programmes delivered under the Mayor of London’s Social Integration Strategy. 

Sarah Hamed, Researcher in Medical Sociology at Kings College London and Head of Research and Evaluation at Black Thrive Global. Sarah focuses on migration and health inequalities, racism and racialisation in healthcare and is currently conducting a study on racism in maternity care in Sweden and the UK.  

In Part 2 of this episode, Open University researcher Elizabeth Ascroft invites guests Ashlee Beatrice-Burnett, Dr Rebecah MacGilleEathain and Isabel Steele to explore youth sexual reproductive health and rights (SRHR) in rural and island communities. This conversation explores the strategies for working in collaboration with communities in for the enhancement of SRHR. Drawing from their own work, the guest speakers discuss taking a whole-school approach to sexuality education, innovative contraceptive delivery services and online support platforms for young people. The guests also delve into the dynamics of being an ‘insider’ versus an ‘outsider’ in research initiatives or programme delivery services. Ultimately, the discussion emphasises the significance of creating safe spaces for youth engagement, and the necessity of destigmatizing conversations around sexual health.

Resources mentioned in the episode:

• ⁠Sexual well-being among young people in remote rural island communities in Scotland: a mixed methods study | BMJ Sexual & Reproductive Health⁠
• ⁠Cool2Talk⁠
• ⁠Famia Planea Aruba⁠

Biographies

⁠Elizabeth Ascroft⁠ is an ESRC-funded doctoral researcher at the Open University in partnership with Famia Planea Aruba and IPPF. Her current research explores ⁠arts-based, co-creative approaches⁠ to sexuality education with young people in Aruba, and her previous work ⁠investigated gender violence and sexuality education in Barbados.⁠ With a focus on small island contexts, Elizabeth’s research considers how the concept of ‘islandness’ moulds SRHR discourses in the international development sector. Elizabeth is a keen bean for learning and is most inspired when in a room with other activists, researchers and creatives working in the advancement of young people’s SRHR.

⁠Ashlee Burnett⁠ is a Trinbagonian educator, organiser, and researcher, serving as ⁠IPPF’s⁠ Global Lead on Comprehensive Sexuality Education; leading on CSE partnerships, evidence generation, and supporting MA-led initiatives like the Centre of Excellence on CSE to deliver innovative programmes and youth-centred care. She holds an MSc Education Policy and International Development from the University of Bristol and has been awarded the Colin Robinson Hard Head Award fortransformational activism in Trinidad and Tobago. Socials: ⁠Instagram⁠ and⁠ X⁠

Dr Rebecah MacGilleEathain is a Senior Specialist Lead at the ⁠National Centre for Remote and Rural Health and Care⁠, hosted by National Health Service (NHS) Education for Scotland. Rebecah has a background in working within PublicHealth and Heath Improvement in clinical, third sector and academic research settings. Rebecah’s specialist research subject focuses on reproductive and sexual health, sex education curriculum in schools, and access to sexual wellbeing support for underrepresented communities and young people in remote, rural and island areas.

Isabel Steele is a Senior Health Improvement Office in the ⁠Public Health Department of the National Health Service (NHS) Western Isles⁠. She is local to the Outer Hebrides and has lived there most of her life and has worked with young people for over 35 years. She has been employed by the NHS in the Western Isles for 30 years in various roles around sexual health, Blood Born Viruses, young people and substance misuse. She has gained her MSc in Health Improvement & Public Health and enjoys engaging in learning and research around issues that affect young people. She is very passionate about young people’s rights and supports the principles of the UNCRC to ensure that children & young people have the information they need to keep themselves safe. 

In Part 1 of this episode, Open University researcher Elizabeth Ascroft invites guests Ashlee Beatrice-Burnett, Dr Rebecah MacGilleEathain and Isabel Steele to explore youth sexual reproductive health and rights (SRHR) in rural and island communities. The guests share insights from their work in the Scottish Hebrides and Western Isles, Aruba, Barbados and Trinidad and Tobago. The conversation highlights the unique challenges faced by young people in contexts where “everyone knows everyone”. The guests outline the diversity of local cultures between islands, and advocate for tailored strategies to improve SRHR education and access.   

Resources mentioned in the episode:

• Sexual well-being among young people in remote rural island communities in Scotland: a mixed methods study | BMJ Sexual & Reproductive Health
• Cool2Talk
• Famia Planea Aruba

Biographies

Elizabeth Ascroft is an ESRC-funded doctoral researcher at the Open University in partnership with Famia Planea Aruba and IPPF. Her current research explores arts-based, co-creative approaches to sexuality education with young people in Aruba, and her previous work investigated gender violence and sexuality education in Barbados. With a focus on small island contexts, Elizabeth’s research considers how the concept of ‘islandness’ moulds SRHR discourses in the international development sector. Elizabeth is a keen bean for learning and is most inspired when in a room with other activists, researchers and creatives working in the advancement of young people’s SRHR.

Ashlee Burnett is a Trinbagonian educator, organiser, and researcher, serving as IPPF’s Global Lead on Comprehensive Sexuality Education; leading on CSE partnerships, evidence generation, and supporting MA-led initiatives like the Centre of Excellence on CSE to deliver innovative programmes and youth-centred care. She holds an MSc Education Policy and International Development from the University of Bristol and has been awarded the Colin Robinson Hard Head Award fortransformational activism in Trinidad and Tobago. Socials: Instagram and X

Dr Rebecah MacGilleEathain is a Senior Specialist Lead at the National Centre for Remote and Rural Health and Care, hosted by National Health Service (NHS) Education for Scotland. Rebecah has a background in working within PublicHealth and Heath Improvement in clinical, third sector and academic research settings. Rebecah’s specialist research subject focuses on reproductive and sexual health, sex education curriculum in schools, and access to sexual wellbeing support for underrepresented communities and young people in remote, rural and island areas.

Isabel Steele is a Senior Health Improvement Office in the Public Health Department of the National Health Service (NHS) Western Isles. She is local to the Outer Hebrides and has lived there most of her life and has worked with young people for over 35 years. She has been employed by the NHS in the Western Isles for 30 years in various roles around sexual health, Blood Born Viruses, young people and substance misuse. She has gained her MSc in Health Improvement & Public Health and enjoys engaging in learning and research around issues that affect young people. She is very passionate about young people’s rights and supports the principles of the UNCRC to ensure that children & young people have the information they need to keep themselves safe. 

“Intersectionality has been hailed as one of the most transformative theoretical developments in critical legal studies, political theory, feminist and critical race studies and its influence is felt in a range of policy areas: social work and social justice, education, urban studies. Intersectionality emerged out of activist movements and continues to be shaped by activism. So intersectionality as a theory is indivisible from intersectionality as an activist stance and approach to real-world instances of injustice and inequality.”

But what is intersectionality?

In this episode, Open University Professor Peter Keogh invites guests Fiona de Londras and Naomi Connor to explore the concept of intersectionality in the context of abortion law reform in the North and South of Ireland. Tracing the roots of intersectionality, the speakers offer a definition of the term and then explore how and why intersectionality is needed to contexualise abortion services in Ireland, identify the faultlines in reproductive health and rights and forge solidarities across movements.

”In a truly intersectional space, your colleagues will force you to stop and think again about what you think the answers must be, and how that can be rooted in the structures that are deeply oppressive” (Fiona de Londras).

”We are hailed as having the best abortion law in perhaps the world, but it’s the application of that is where the intersections fall away” (Naomi Connor).

Biographies

Suggested reading and links

Shreya Atrey (2019) Intersectional Discrimination - Shreya Atrey - Oxford University Press (oup.com)

Fiona Bloomer and Emma Campbell (2022) Decriminalizing Abortion in Northern Ireland: Legislation and Protest: Fiona Bloomer: Bloomsbury Academic

“Intersectionality has been hailed as one of the most transformative theoretical developments in critical legal studies, political theory, feminist and critical race studies and its influence is felt in a range of policy areas: social work and social justice, education, urban studies. Intersectionality emerged out of activist movements and continues to be shaped by activism. So intersectionality as a theory is indivisible from intersectionality as an activist stance and approach to real-world instances of injustice and inequality.”

But what is intersectionality?

In this episode, Professor Peter Keogh invites guests Fiona de Londras and Naomi Connor to explore the context of abortion law reform in the North and South of Ireland. Tracing the roots of intersectionality, the speakers offer a definition of the term and then explore how and why intersectionality is needed to contexualise abortion services in Ireland, identify the faultlines in reproductive health and rights and forge solidarities across movements.

”In a truly intersectional space, your colleagues will force you to stop and think again about what you think the answers must be, and how that can be rooted in the structures that are deeply oppressive” (Fiona de Londras).

”We are hailed as having the best abortion law in perhaps the world, but it’s the application of that is where the intersections fall away” (Naomi Connor).

Biographies

Suggested reading and links

Shreya Atrey (2019) Intersectional Discrimination - Shreya Atrey - Oxford University Press (oup.com)

Fiona Bloomer and Emma Campbell (2022) Decriminalizing Abortion in Northern Ireland: Legislation and Protest: Fiona Bloomer: Bloomsbury Academic

This episode is produced in collaboration with the Sex, Research and Resistance Podcast and ⁠the Centre for Study of Global Development⁠ at the Open University.

Martha Nicholson (facilitator), Dr Joyce Wamoyi, Dr Kevin Deane, and Professor Peter Keogh discuss research on the social determinants of sexual and reproductive health. Drawing from different disciplines, research contexts and institutions, we explore how sexual and reproductive health is managed and negotiated in the context of structural inequality and complex social worlds. Research shows that where we live, the education and work opportunities we have access to and the gender norms we grow up with may all shape people's ability to negotiate risks and manage a disease like HIV.

In part 2, we explore the social determinants that may make someone more likely to engage in risky behaviours and contract a sexually transmitted disease. Peter, Joyce and Kevin present solutions to the challenges of research on social determinants. We end part 2 of this episode with proposals for a bold and multidisciplinary research agenda for the future.

Bios

Joyce Wamoyi: Social and Behavioural researcher at the National Institute for Medical Research, Tanzania. Joyce has an MSc in community health and a PhD in social and Behavioural Sciences. For over 20 years, Dr. Wamoyi has worked on: Adolescents and Young people’s Sexual and Reproductive Health (SRH) behaviour; Structural drivers of SRH risk; HIV/AIDS prevention and treatment; Parenting/ families and child outcomes; stigma and discrimination in access to SRH services; and qualitative and participatory research methods. In her work, she has explored the dynamics of transactional sex in adolescents and young women's sexual relationships in sub-Saharan Africa. She is currently working on the evaluation of the quality of implementation for the scale up of the Parenting for Lifelong Health programme in Tanzania. She is a member of the WHO Behavioural Insights Technical Advisory Group and UNICEF Advisory Board for a multi-country project.

Peter Keogh: Professor of Health and Society at the School of Health, Wellbeing and Social Care at the Open University. Peter’s background is in community-based research and knowledge co-creation in the areas of HIV, LGBT+ health and rights and reproductive justice. Peter’s research focuses on the role of intimacy, embodiment, affect and materiality in people’s experiences of their sexual and reproductive health and rights. He engages critically with contemporary SRHR epistemologies drawing on biomedicalization, post-colonial and Marxist theory. Peter is involved in many projects which involve the co-creation of useful and applied knowledges with, by and for key communities.

Kevin Deane: Senior Lecturer and interdisciplinary specialist in Economics, Political Economy and International Development. Research interests focus on the political economy of health with an application to the HIV epidemic in Eastern and Southern Africa. Kevin has worked on a range of topics related to HIV including gender, migration, workplace programmes, HIV testing and the relationship between socio-economic status and HIV. He is also interested in the political and social determinants of malaria. Kevin is primarily a qualitative researcher with experience of conducting fieldwork in East Africa.

Martha Nicholson (facilitator): PhD Student in the Reproduction, Sexualities and Sexual Health research group at the Open University in the UK. Current research is a feminist ethnography on how nurses and midwives learn about abortion care in Northern Ireland. Working with a group of nurses and midwives, Martha is mapping out how abortion knowledge is produced, and how centres of learning and work may distort, silence and challenge access to that knowledge through dialogues, processes, and organisational texts.

This episode is produced in collaboration with the Sex, Research and Resistance Podcast and the Centre for Study of Global Development at the Open University. 

Martha Nicholson (facilitator), Dr Joyce Wamoyi, Dr Kevin Deane, and Professor Peter Keogh discuss research on the social determinants of sexual and reproductive health. Drawing from different disciplines, research contexts and institutions, we explore how sexual and reproductive health is managed and negotiated in the context of structural inequality and complex social worlds. Research shows that where we live, the education and work opportunities we have access to and the gender norms we grow up with may all shape people's ability to negotiate risks and manage a disease like HIV.

In part 1, we critique the WHO definition of the social determinants of health, drawing from examples to show the importance of including social determinants in research on sexual and reproductive health. They share experiences of researching HIV in the UK and Tanzania and discuss how the disease has evolved from an ‘individual’ to a ‘social’ issue, relevant to social scientists as much as medical professionals.

Bios

Joyce Wamoyi: Social and Behavioural researcher at the National Institute for Medical Research, Tanzania. Joyce has an MSc in community health and a PhD in social and Behavioural Sciences. For over 20 years, Dr. Wamoyi has worked on: Adolescents and Young people’s Sexual and Reproductive Health (SRH) behaviour; Structural drivers of SRH risk; HIV/AIDS prevention and treatment; Parenting/ families and child outcomes; stigma and discrimination in access to SRH services; and qualitative and participatory research methods. In her work, she has explored the dynamics of transactional sex in adolescents and young women's sexual relationships in sub-Saharan Africa. She is currently working on the evaluation of the quality of implementation for the scale up of the Parenting for Lifelong Health programme in Tanzania. She is a member of the WHO Behavioural Insights Technical Advisory Group and UNICEF Advisory Board for a multi-country project.

Peter Keogh: Professor of Health and Society at the School of Health, Wellbeing and Social Care at the Open University. Peter’s background is in community-based research and knowledge co-creation in the areas of HIV, LGBT+ health and rights and reproductive justice. Peter’s research focuses on the role of intimacy, embodiment, affect and materiality in people’s experiences of their sexual and reproductive health and rights. He engages critically with contemporary SRHR epistemologies drawing on biomedicalization, post-colonial and Marxist theory. Peter is involved in many projects which involve the co-creation of useful and applied knowledges with, by and for key communities.

Kevin Deane: Senior Lecturer and interdisciplinary specialist in Economics, Political Economy and International Development. Research interests focus on the political economy of health with an application to the HIV epidemic in Eastern and Southern Africa. Kevin has worked on a range of topics related to HIV including gender, migration, workplace programmes, HIV testing and the relationship between socio-economic status and HIV. He is also interested in the political and social determinants of malaria. Kevin is primarily a qualitative researcher with experience of conducting fieldwork in East Africa.

Martha Nicholson (facilitator): PhD Student in the Reproduction, Sexualities and Sexual Health research group at the Open University in the UK. Current research is a feminist ethnography on how nurses and midwives learn about abortion care in Northern Ireland. Working with a group of nurses and midwives, Martha is mapping out how abortion knowledge is produced, and how centres of learning and work may distort, silence and challenge access to that knowledge through dialogues, processes, and organisational texts.