Expanding the conversation about reproductive rights

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As a society, who do we think is fit to parent – and who gets to decide?
According to Rachael Eastham, a Senior Research Associate in Lancaster University’s Division of Health Research, UK provision of Long Acting Reversible Contraception (LARC) such as implants, IUD/IUS or injections falls short of globally agreed reproductive rights due to under-recognised discriminatory norms and practices. When an ESRC Impact Acceleration Account (IAA) gave her the opportunity to share the findings of her research, the project was to have a far broader impact than she anticipated.

The origins of the project
It all began with ethical concerns about intensive social service programmes that made the availability of support conditional on use of LARC. Working in partnership with the British Pregnancy Advisory Service and community-based organisations Decolonising Contraception and Shine Aloud UK, Rachael contributed to a report that looked at UK LARC provision from a human rights perspective and highlighted the challenges facing both users and providers of these services.

The report and the IAA project that came out of it are part of a bigger research initiative which seeks to illuminate the issue of how contraception is offered in a discriminatory way in practice settings, Rachael explains. “In countries like the USA, there’s a well-established critique of, and response to, what were effectively eugenic campaigns delivered by the state. Whereas in the UK we’ve done a good job of pretending we haven’t done that here – and I’d argue that’s not true.”

The project takes shape
With such a potentially far-reaching message to communicate, Rachael and her partners were keen to translate the research into more accessible formats. The IAA provided an ideal mechanism. The original intention was to share and codify the report’s indicative recommendations with targeted groups of stakeholders via a suite of engagement activities. However, it quickly became evident that the project would need to adapt and expand its horizons.

“When we ran our first event, addressing LARC in the criminal justice system, I had all these activities planned around sharing the research and all of that went completely out of the window! People had so much to say, including things that were really important in terms of social justice campaigning – an example being a circumstance in clinical practice where women who are leaving prison to have later stage abortions are having them while handcuffed – and there were other campaigning organisations in attendance who were able to take up a really important human rights issue because we were sharing it in that space.”

What Rachael realised is that while a focus on LARC can be useful for examining certain users’ experience, reproductive rights and reproductive justice are a bigger picture issue. So when other people volunteer insight into different aspects of their reproductive life courses, it serves the interests of the stakeholder group as a whole that they should be enabled to do so. Rather than simply serving the research, the project needed to become more dynamic and responsive – to its audiences and to the involvement of potential new partners – in order to achieve impact.

The flexibility built into the IAA was crucial to this evolution, Rachael says. “With other research funding opportunities, you have to make formal requests to change – be that partners or ideas – but working with community and charity/voluntary sector partners, the world just isn’t like that. What makes a big difference with the IAA being internally administered is that it can adapt to changing circumstances and it feels like you’re being helped and championed to achieve productive things.”

New partners, new possibilities...
The next IAA-funded engagement event, ReproFest in Preston, was designed around a broader theme of reproductive justice. This was to spawn new partnerships and outputs, as well as a new project with its own funding.

In addition to hosting creative workshops and a screening of the movie The 8th, which tells the story of the struggle to remove Ireland’s constitutional ban on abortion, ReproFest attracted speakers on a great variety of interrelated topics, such as award-winning feminist author and black reproductive rights activist Stella Dadzie, whose attendance, Rachael says, was “like a dream come true”.

It also allowed her to fill in gaps in the original research. While the report had examined how many people feel pressured and discriminated against when making decisions about their contraception because of their age, ethnicity or sexual orientation, the team wanted to speak to more people with learning disabilities to discover their experiences. ReproFest created the opportunity to do this, thanks to a new partnership with community interest company Inclusion North, who delivered workshops at the event with their experts by experience. This in turn led to the publication of an article in Community Living magazine, which has enabled Rachael to build further links across the charity/voluntary sector.

Among the many unexpected outcomes of the event was the creation of the ReproNorth collective, a network building capacity around reproductive health inequities in the North of England, which has received funding from the National Institute of Health and Care Research. As Rachael says: “The way the partnerships have evolved and overlapped into other nascent or ongoing projects – in effect becoming a big matrix – has really helped to build channels of communication and trust.”

Extending the project’s reach – the docufilm
During the project’s development it became clear that another valuable use of the IAA would be to fund the production of a documentary film. The dynamic adjustment that the team made, as Rachael highlights, was in evolving this docufilm into a more engaging assemblage of footage filmed at the events, including interviews with the expert speakers and more sensitive ways of presenting the voices of people with lived experience, such as via their contribution to the interactive workshops.

“Learning to create these visual and more accessible artefacts as ways of explaining what you care about, what you do and why your research might matter is a really helpful and important lesson that I hope to take with me throughout my academic career,” Rachael says.

She is excited by the potential not just to share understanding but to effect real change. “Having the film available online for interested people to access whenever they want, and having it taggable with the involvement of legends like Stella Dadzie, will be a massive benefit in terms of awareness-raising – and it’s entirely because of this impact award.”

The benefits of IAA funding to early career researchers
As Rachael says, the IAA-funded project has given her a wealth of experience, including in the management of projects, the production of a film, and new methods of engagement, especially with community organisations, which is the arena she is most passionate about. She stresses the advantages of having the funding to work fairly with organisations in this sector, rather than relying on the goodwill of people who have barely any resource to give in the first place.

She also highlights the value of getting to grips with the process of sharing content, not only in terms of skills development but also for the ability to collect feedback and to build relationships based on something tangible. “It’s a way for organisations to get a shorthand understanding of who we are as academics and whether they want to work with us – and that’s when things start to snowball.”

So would she recommend applying for an IAA?
“Absolutely, because of its versatility and the way it’s administered by very supportive people. That’s the key benefit and joy of it. My experience of higher education funding opportunities so far is that even for relatively small projects, you have to put a lot of time in, with partners and colleagues, even if you’re unsuccessful. By comparison, the application process for the IAA feels totally proportional, for what you can get. The whole vibe is much more approachable and responsive.”

Professor Mark Limmer, Head of the Division of Health Research and co-applicant on the IAA says: “The impact acceleration award came at a crucial time in the development of a wider programme of research. It has facilitated exploring the topic in a way that is responsive to our stakeholders. It has also allowed us to generate more outputs than originally expected which have and will be used to communicate about the topic with future research partners and the wider public in accessible ways.”