Reproductive Bodylore: the role of vernacular knowledge in women's contraceptive decision-making

Unintended pregnancy remains a Public Health concern, yet we still do not know enough about the influences on women's contraceptive choices. Existing research calls for more insight about the influences of women's informal social networks on contraceptive choice. That is - stories, anecdotes, 'friend of a friend' tales, rumor, personal experience narratives and other informal communications. This project is highly significant in that it explores vernacular knowledge about the reproductive body and contraception through drawing together folklore studies and health research. An approach which is uniquely innovative and novel - there is at present no existing study on the topic in the UK and only very limited international focus.

The project addresses the question: How does vernacular knowledge influence women's contraceptive choices and mediate their experiences of reproductive control?
It has a number of aims: 1) To explore and document the greatest possible range of vernacular knowledge about the reproductive body and contraception 2) To offer an interpretation of this data, analysing and theorising how vernacular knowledge about contraception is transmitted between friendship and kinship groups, and how it may influence attitudes, behaviour, and experience 3) To engage with policy and practice and to enhance practitioner understandings about women's vernacular knowledge of the reproductive body, and to make appropriate suggestions for improving services.

In seeking to address these aims a multistrand approach comprising two Work Packages and a dissemination stage will be employed.

Work Package 1 will involve re-analysis of project data from a number of previous studies Victoria Newton (PI) and Lesley Hoggart (Co-I) have undertaken on women's contraceptive use and reproductive control (as listed in the case for support). This re-analysis will inform the development of the topic guides for the gathering of new qualitative data in WP2. In this way, the new research will be firmly grounded in research undertaken in the UK since 2010. It will provide a solid platform from which to develop robust and informed research tools (the 'prompt topics') for WP2.

Work Package 2 is a placement for the PI (VN) at Public Health England (PHE). This strand involves participatory research and will involve consulting with, including and working together with up to 20 lay researchers, who will be recruited via PHE's networks. Volunteer researchers will undertake interviews and focus groups among their own friendship/kinship and social networks. They will also search for media/social media stories stories. Data from this strand will be made available digitally via the Open University's Open Access Data Archive (ORDO).The placement will also involve sharing findings and implications for practice via 6-8 focus groups with clinicians at clinic sites across the UK. WP2 will culminate in a one-day symposium at The Folklore Society.

Dissemination: The project will culminate in a Public Engagement exhibition co-hosted in a public space in London - the geographic location of project partners (Public Health England and The Folklore Society). The exhibition will be designed and curated by The Liminal Space. The Reproductive Bodylore exhibition will be interactive and visitors will be invited to contribute their own thoughts and stories about contraception around the theme of 'I heard that....' The aim of the exhibition will be to demystify stories of contraception and invite engagement. The exhibition will also be showcased at sexual health practitioner conferences - eg, FIAPAC and RCOG to promote debate around informal communication, misinformation and individual contraceptive choice.

The project has been designed collaboratively with key stake holders and project partners and will have impact on a number of communities beyond academia. Our advisory group will provide multiple routes for stakeholder engagement.
Women as users of contraception: On an individual level, the project will enhance the wellbeing of women through a number of different avenues. The main output of the project - the public engagement exhibition - will facilitate discussions about contraceptive use. The event will be a 'living exhibition', where visitors will be able to contribute their own stories and anecdotes to the project. The exhibition will also be an opportunity for common misperceptions to be addressed. Universal contraceptive choice will be at the heart of the exhibition, and all viewpoints will be valued. The aim of the event is not to encourage use of one type of contraceptive over another. Rather it is intended to value and highlight women's different contraceptive decision-making pathways without judgement. By making obvious the different stories about contraception (and women's concerns) the project will address and challenge stigma about the contraceptive choices women make, showcasing the different processes and values involved in an individual's choice. We hope that visitors to the exhibition will broaden their views and awareness about different methods of contraception. Evaluation: Following a model established with previous public engagement projects, the project team will undertake a formative evaluation process. We will collect visitor feedback (written and interview); interview volunteers; monitor social media and Press reception. We will then share our learning by: speaking at medical conferences; writing peer-reviewed publications and Press-releases; and running a social media campaign.
Participant and Public Involvement: The project contains a large component of participatory research, where lay researchers are involved in the collection and analysis of research data. The participatory methods benefit these communities by providing an opportunity to contribute towards and inform research that makes a difference to how other women's contraceptive choices and decision-making are supported. The participatory research will also upskill participants and give them experience in research methods and analysis techniques, which may be beneficial to CV development and future employability. The lay researchers' may also benefit from increased confidence as their contribution will directly inform the concept development of the Public Engagement exhibition.
Clinical partners who deliver contraception services: The project will provide an evidence base for the public health concern of unintended pregnancy and will facilitate the development of interventions and resources to support women in their contraceptive choices. During the placement at Public Health England, the PI will work with practitioners to develop new resources to support contraceptive consultations. These may include interventions such as an 'aide mémoire' for asking women about their preferences and concerns about a particular type of contraceptive.
Impacts will also extend beyond individual organisations to UK national bodies: The exhibition will be showcased at practitioner conferences such as the Faculty of Sexual and Reproductive Health and the Royal College of Obstetricians and Gynaecologists. Engaging with these national professional bodies is key to promoting growth in both awareness and activity around vernacular contraceptive knowledge. Collective efforts to explore vernacular knowledge has benefits for the wellbeing of women, and for contraceptive care providers. The project will highlight how arts and humanities research can be applied to a public health setting and break down barriers between academia and practice, leading to possible further interdisciplinary collaborations to tackle difficult and yet unaddressed research problems.