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      Emotional Health Work of Women With Female Genital Cutting Prior to Reproductive Health Care Encounters

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          Abstract

          We used institutional ethnography to explore the social relations that shaped the reproductive health care experiences of women with female genital cutting. Interviews with eight women revealed that they engaged in discourse that opposed the practices of cutting female genitals as a human-rights violation. This discourse worked to protect those affected by the practices, but also stigmatized female genital cutting, making participants anticipate experiencing stigmatization during health care. Women’s engagement in this discourse shaped their emotional health work to prepare for such encounters. This work included navigating feelings of worry, shame, and courage to understand what to expect during their own appointment; learning from family/friends’ experiences; and seeking a clinic with the reputation of best care for women with female genital cutting. It is important to strive for more inclusive health care in which women do not have to engage in emotional health work to prepare for their clinical encounters.

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          Most cited references92

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          The problem with the phrase women and minorities: intersectionality-an important theoretical framework for public health.

          Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). Public health's commitment to social justice makes it a natural fit with intersectionality's focus on multiple historically oppressed populations. Yet despite a plethora of research focused on these populations, public health studies that reflect intersectionality in their theoretical frameworks, designs, analyses, or interpretations are rare. Accordingly, I describe the history and central tenets of intersectionality, address some theoretical and methodological challenges, and highlight the benefits of intersectionality for public health theory, research, and policy.
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            Social and Structural Determinants of Health Inequities in Maternal Health

            Since the World Health Organization launched its commission on the social determinants of health (SDOH) over a decade ago, a large body of research has proven that social determinants—defined as the conditions in which people are born, grow, live, work, and age—are significant drivers of disease risk and susceptibility within clinical care and public health systems. Unfortunately, the term has lost meaning within systems of care because of misuse and lack of context. As many disparate health outcomes remain, including higher risk of maternal mortality among Black women, a deeper understanding of the SDOH—and what forces underlie their distribution—is needed. In this article, we will expand our review of social determinants of maternal health to include the terms “structural determinants of health” and “root causes of inequities” as we assess the literature on this topic. We hypothesize that the addition of structural determinants and root causes will identify racism as a cause of inequities in maternal health outcomes, as many of the social and political structures and policies in the United States were born out of racism, classism, and gender oppression. We will conclude with proposed practice and policy solutions to end inequities in maternal health outcomes.
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              Infant Mortality Statistics From the 2013 Period Linked Birth/Infant Death Data Set.

              This report presents 2013 period infant mortality statistics from the linked birth/infant death data set (linked file) by maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data.

                Author and article information

                Journal
                Qual Health Res
                Qual Health Res
                spqhr
                QHR
                Qualitative Health Research
                SAGE Publications (Sage CA: Los Angeles, CA )
                1049-7323
                1552-7557
                6 December 2021
                January 2022
                : 32
                : 1
                : 108-120
                Affiliations
                [1 ]Dalla Lana School of Public Health, Ringgold 274071, universityUniversity of Toronto; , Toronto, ON, Canada
                [2 ]Department of Anthropology, Ringgold 7938, universityUniversity of Toronto; , Toronto, ON, Canada
                [3 ]Department of Psychology, Ringgold 7938, universityUniversity of Toronto; , Toronto, ON, Canada
                [4 ]Department of Gender Studies, universityLinköping University; , Linköping, Sweden
                Author notes
                [*]Danielle Jacobson, Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, ON M5T 3M7, Canada. Email: dani.jacobson@ 123456mail.utoronto.ca
                Author information
                https://orcid.org/0000-0002-7792-8099
                https://orcid.org/0000-0002-9032-3959
                Article
                10.1177_10497323211049225
                10.1177/10497323211049225
                8739574
                34865565
                37a3ac59-b067-4a30-919a-20ac7de4fb6e
                © The Author(s) 2021

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Funding
                Funded by: Canadian Institutes of Health Research, FundRef https://doi.org/10.13039/501100000024;
                Categories
                Research Articles
                Custom metadata
                ts10

                Medicine
                minorities,cultural competence,emotion work,women’s health,gender,health promotion,users’ experiences,health care

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