The social construction of 'reproductive vulnerability' in family planning clinics

hayter m. (2005)  Journal of Advanced Nursing51(1), 46–54
The social construction of 'reproductive vulnerability' in family planning clinics

ABSTRACT

Aim. The aim of this paper is to report a study exploring the discursive construction of contraceptive use within nurse consultations with women in family planning clinics.

Background. This paper takes as its starting point the lack of a contraceptive 'strand' to the literature on the discursive construction of the female body generally, and the female reproductive system specifically, within health care practice. The literature in this field concentrates on pregnancy, menstruation and menopause, and the manner in which contraceptive use is discursively constructed is under-explored. Furthermore, the literature on nurse–women consultations in family planning clinics is also limited, with the current literature concentrating on assessing clinical skills rather than discourse.

Methods. Using a grounded theory methodology to explore how nurses educate women about contraception in family planning clinic, 49 consultations were audio-taped in two large family planning clinics in the United Kingdom (UK).

Findings. Open coding and subsequent axial coding resulted in the emergence of three elements of contraceptive education. One concerned reproductive anatomy, another reproductive physiology and a third education about contraceptive functioning. These three axial codes were formed into a core category: 'body education/reproductive vulnerability'. Within the consultation, nurses linked the 'vulnerable' reproductive system with the requirement for contraceptive 'protection'. This approach seems linked to ensuring women's future contraceptive use.

Conclusion. The discourse employed by nurses differs from the body discourse aimed at menopause and menstruation. These areas of women's health were constructed as disintegrating, malfunctioning and failing, whereas reproductive vulnerability suggests a fully functioning, active system, in need of restraint. However, this discourse still constructs the female body as fundamentally weak and unstable, requiring contraception to protect it and prevent transgression.