“It’s A Broken System That’s Designed to Destroy”: A Critical Narrative Analysis of Healthcare Providers’ Stories About Race, Reproductive Health, and Policy

• Main Author: Cusanno, Brianna Rae
• Format: Others
• Published: Scholar Commons 2019
• Subjects: Critical-cultural communication; Medical racism; Narrative inquiry; Physician identity; Qualitative research; Reproductive justice; Communication
• Online Access: https://scholarcommons.usf.edu/etd/7771; https://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=8968&context=etd

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.