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

华盛顿大学博士生艾莉森·海勒将在卡罗琳·萨金特博士的指导下，研究在消除耻辱的根源后，如何通过谈判转变被羞辱的身份。这项研究将在寻求修复手术的女性中进行，这些女性在分娩期间受伤，导致慢性大小便失禁。分娩相关的伤害被广泛理解为一种令人深感耻辱的疾病，通过一种相对简单的、尽管历史上很难获得的外科手术程序，很容易得到治疗。这项研究将在尼日尔南部的两家诊所和周围社区进行。研究人员将调查女性手术前和手术后与分娩相关的伤害经历，以及她们的社会关系动态。她还将收集与分娩有关的伤害在更广泛的社会中的陈述以及当地各种利益攸关方的观点的数据。40名妇女将至少接受两次采访：一次在手术前在诊所，一次在手术后五到十个月后在妇女的家乡。为了丰富手术后的描述，将选择这些妇女中的一个子样本进行每月随访，并选择三名妇女进行深入的人种学案例研究。此外，还将纳入社会空间参与者的观点，如丈夫、妻子、亲属、临床医生、宗教领袖和参与消除分娩相关伤害倡议的当地非营利组织员工。该项目将结合定量和定性方法，包括：自由列出和排名排序练习、半结构化和生活史访谈、参与者观察、社会关系图谱、扩展的案例研究和可视化内容分析。这项研究之所以重要，是因为以前很少有关于去散列化过程的人种学或理论研究。该项目旨在发展污名理论的这一未被探索的方面，从而更好地理解去污名过程是如何以及何时起作用的，并产生去污名的理论模型。本研究也具有一定的现实意义。尼日尔经历了以预防和修复分娩相关伤害为重点的各种组织和机构的激增。然而，人们对这些女性离开诊所回家后会发生什么，或者她们被污名化的身份知之甚少。这项研究将有助于填补这一重要空白。此外，支持这项研究还可以支持研究生的教育。

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.