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

华盛顿大学博士候选人艾莉森·海勒（Alison Heller）将在卡罗琳·萨金特（Carolyn Sargent）博士的指导下进行研究，研究在耻辱的来源被消除后，如何协商被污名化的身份的转变。这项研究将在寻求修复手术的妇女中进行，这些妇女在分娩过程中受伤，导致慢性失禁。与分娩有关的伤害被广泛认为是一种严重的耻辱性疾病，可以通过相对直接的外科手术得到高度治疗，尽管在历史上很难获得。这项研究将在尼日尔南部的两个诊所和周边社区进行。研究人员将调查妇女的术前和术后经验与分娩相关的伤害和他们的社会关系的动态。她还将收集有关在更广泛的社会中与分娩有关的伤害的陈述和各种地方利益相关者的观点的数据。40名妇女将接受至少两次采访：一次是在手术前在诊所，另一次是在手术后5至10个月在妇女的家乡村庄。为了丰富术后记录，将从这些妇女中抽取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，将纳入社会空间参与者的观点，如丈夫、共同妻子、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。该项目将整合定量和定性方法，包括：自由列表和排名排序练习、半结构化和生活史访谈、参与者观察、社会关系映射、扩展案例研究和视觉内容分析。这项研究很重要，因为之前很少有关于去污名化过程的民族志或理论研究。本项目旨在发展耻辱感理论这一未被充分探索的方面，从而更好地理解去耻辱感过程如何以及何时起作用，并产生去耻辱感的理论模型。本研究也具有一定的现实意义。尼日尔出现了大量侧重于预防和修复与分娩有关的伤害的组织和机构。然而，对于这些妇女离开诊所回家后会发生什么，或者她们被污名化的身份，人们知之甚少。这项研究将有助于填补这一重要空白。此外，支持这项研究也支持了研究生的教育。

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.