Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Doctor of Philosophy

Program

Gender, Sexuality & Women’s Studies

Supervisor

Polzer, Jessica

Abstract

Informed by reproductive justice theory and intersectionality, and drawing on the method of institutional ethnography, this dissertation investigates the effects of neoliberal and postfeminist discourses on young women’s experiences of accessing reproductive and sexual health (RSH) care in the City of Brantford and the County of Brant, Ontario. Like many other municipalities in Ontario, this area has been affected by cuts to public health services, including RSH care. I conducted semi-structured interviews with 14 young women (17 to 29 years old) and 4 key informants involved in RSH care provision, to examine the work (and “workarounds”) that young women engage in to secure RSH care. My analysis illustrates that young women engage in a great deal of work to access RSH care in Brantford and Brant County, including: (i) the work of becoming informed about RSH services (e.g., conducting internet searches, gaining knowledge through social relationships); (ii) working within/around institutional constraints (exercising persistence and adapt-ability to sudden changes at the systems level); and (iii) the work of waiting (demonstrating perseverance through waiting periods). I discuss these findings in relation to neoliberal and postfeminist constructions of responsible citizenship where young women are compelled to embrace the duties of self-determination and autonomy yet find themselves frustrated when they are presented with multiple barriers to finding and receiving the care they seek (e.g., contraception, abortion). This study complicates and contributes to understandings of access by making visible the work the young women must do to access RSH care as well as the ruling relations that organize this access work at translocal (policy) and local levels (stigma, secrecy). I suggest that the work required to secure care demonstrates deservingness within a resource-constrained context and I consider the intersectional dimensions of this deservingness. Finally, I explore the political dimensions of “waiting” for care whereby waiting is experienced as an anticipated and necessary inconvenience that women must “work through” to ensure that their RSH care needs are met. These findings illustrate the perseverance that young women must engage to secure access to contraception, abortion, and other forms of RSH care despite their rights to universal access.

Summary for Lay Audience

Access to appropriate, timely, and affordable reproductive and sexual health services is essential to the establishment of equity. Yet, some of the most vulnerable individuals, such as young women and those who live within the confines of poverty, still experience limited access to appropriate reproductive and sexual health care. This study involved interviewing young women in the City of Brantford and the County of Brant to explore how they access reproductive and sexual health (RSH) care. Fourteen young women participated in the study and shared their experiences of the work they did to access contraception, abortion and other forms of reproductive and sexual health care. The interviews revealed these women engaged in three types of work which include: (i) the work of becoming informed; (ii) working within and around institutional constraints; and (iii) the work of waiting. Along with these young women I interviewed four service providers about their role in providing or facilitating RSH care. My research provides insight into the barriers experienced by young women by highlighting the work that they were required to engage in to successfully access the RSH care they wanted and needed. These barriers include finding information about types of contraception and RSH care in the community, paying for contraception, arranging for help from friends and family, and finding ways to expediate wait times. This study also explores the role that health care providers and mothers play in helping (or impeding) young women’s access to RSH care. Furthermore, this research sheds light on how these barriers, and the work the women do to overcome them, are socially organized in small to mid-sized communities.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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