DOCTORAL DISSERTATION RESEARCH: Negotiating Destigmatization Processes among Women with Childbirth-Related Injuries

Washington University, Saint Louis MO

Investigators

Abstract

Washington University doctoral candidate, Alison Heller, with the guidance of Dr. Carolyn Sargent, will undertake research on how the transformation of a stigmatized identity is negotiated after the source of stigma is removed. The research will be conducted among women who seek repair surgeries for injuries sustained during childbirth that result in chronic incontinence. Childbirth-related injuries, widely understood as a profoundly stigmatizing condition, are highly treatable through a relatively straightforward, although historically difficult to access, surgical procedure. The research will be conducted in two clinics and the surrounding communities in southern Niger. The researcher will investigate women's pre- and post-surgical experiences with childbirth-related injuries and the dynamics of their social relationships. She also will collect data on representations of childbirth-related injuries in the broader society and the perspectives of a variety of local stakeholders. Forty women will be interviewed at least twice: once at the clinic before surgery, and once five to ten months after surgery in the woman's home village. To enrich post-surgical accounts, a sub-sample of these women will be chosen for monthly follow-up visits, and three women will be chosen for in-depth ethnographic case studies. Additionally, perspectives of actors who comprise the social space, such as husbands, co-wives, kin, clinicians, religious leaders, and local nonprofit organization employees involved in childbirth-related injury eradication initiatives, will be incorporated. This project will integrate both quantitative and qualitative methods, including: free-listing and rank ordering exercises, semi-structured and life history interviews, participant observation, social relationship mapping, extended case studies, and visual content analysis. This research is important because there has been little previous ethnographic or theoretical research on processes of destigmatization. This project aims to develop this under-explored facet of stigma theory, resulting in both a better understanding of how and when destigmatization processes work, and the production of a theoretical model of destigmatization. The research also has practical significance. Niger has experienced a proliferation of organizations and institutions focusing on childbirth-related injury prevention and repair. However, little is known about what happens to these women, or their stigmatized identities, once they leave clinics and return home. This research will contribute to filling that important gap. In addition, supporting this research supports a graduate student's education.