The way in which women construct and experience their sexual and reproductive health is dependent on the cultural, historical and political context in which they are embedded. Research conducted in the West has primarily explored sexual and reproductive health from the perspectives of White, middle-class, educated women, with less research considering the beliefs and practices of women with other intersecting identities; including adult migrant and refugee women from diverse cultural and religious backgrounds. Increasing our knowledge of constructions and practices surrounding sexual and reproductive health is important in understanding the conditions that shape a woman’s embodied experience, particularly within the context of migrant and refugee diaspora. It is also of growing importance due to migrant and refugee women’s underutilisation of sexual and reproductive healthcare services.
The purpose of the research presented in this thesis was to explore how recent migrant and refugee women negotiate discourses and practices in relation to their sexual and reproductive health, when transitioning from countries where cultural constructions and practices associated with sexuality and reproduction may differ from those of their new countries of residence, Australia or Canada. Aspects of women’s sexual and reproductive health covered in this thesis are: menarche and menstruation, sexuality prior to marriage, sexual agency within marriage and women’s fertility and fertility control. In this study 78 individual interviews and 15 focus groups (with a total of 82 participants) were conducted with women who had migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. A material-discursive-intrapsychic theoretical framework was adopted, situated within a critical realist epistemological paradigm. Intersectionality was also drawn on to consider how categories of difference, such as gender, culture and religion intersect to shape women’s lives, practices and discourses. Constructions and experiences of sexual and reproductive health were analysed using thematic-decomposition.
Across each of the cultural groups who took part in this study, cultural and religious discourse intersected to regulate women through their sexual and reproductive bodies. Regulation began at the beginning of the reproductive life cycle, where a discourse of shame, secrecy and silence prohibited women from learning about their reproductive bodies at menarche, contributing to women’s negative attitudes towards menstruation. It continued through adulthood, with a virginity imperative serving to inhibit young women from exploring themselves as sexual beings prior to marriage. Cultural and religious discourse and practice shaped the way women entered into marital relationships and the manner in which women could express themselves sexually. It also strongly influenced women’s fertility practices and autonomy in relation to contraceptive choices. While patriarchal cultural and religious discourse did effectively regulate many participants’ sexual rights, subjectivity and agency, other women gave accounts that suggested they were challenging or resisting these hegemonic discourses to negotiate their own meanings and practices in relation to sexual and reproductive health. Women’s experiences were not static or monolithic, but complex and fluid, demonstrating heterogeneity in cultural and religious discourse and practices associated with women’s sexual and reproductive bodies, both across, and within, the cultural groups interviewed.
The findings of this thesis provide insight into the everyday lived experiences of migrant and refugee women’s sexual and reproductive health across significant aspects of their sexual and reproductive life-course. The broader implications of these findings suggest that migrant and refugee women need access to comprehensive sexual and reproductive health information and healthcare services that reflect their complex sexual and reproductive health needs. Implications of these findings for future research are also examined
