Shannon M. Ward, Ph.D.

Project Dates: 2011-2013

Funding: Atkinson Opportunity Grant

Problem: Tibetan refugees enter India with complex health histories. In addition to a lack of healthcare in rural regions of Tibet, physical illnesses and psychological traumas endured during migration influence decisions around accessing health care in the new host society. Non-profit hospitals and clinics in Dharamsala, India, seek to expand maternal health care. However, decisions to access these health services are motivated by complex personal experiences of migration that require further inquiry.

Research Process: In order to understand decision-making regarding maternal health care, I conducted ethnographic interviews with 42 recent refugee women and health care providers in Dharamsala. I used discourse analysis to code and interpret interview material. I found that narratives about non-consensual birth control measures within China framed maternal health interventions as a site of violence. That is, women drew on broader political histories and the circulation of news about medical trauma to describe their motivations for avoiding maternal healthcare in India. This insight demonstrated an urgent need to shift how maternal healthcare is framed in India, in order to deliver culturally sensitive care that is decoupled from medical trauma endured in China.

Impact: This research suggested the urgent need for active outreach that emphasizes the consensual nature and quality of maternal healthcare in Dharamsala. Educational programs that center women’s decisions in family planning, position women as partners in their health care, and incorporate cultural knowledge about pregnancy and childbirth would enhance access to health services. This project was awarded the Society for Medical Anthropology’s Rivers’ Undergraduate Paper Prize, as well as the Association of Feminist Anthropology’s Sylvia Forman Prize. Results were published in Medical Anthropology Quarterly.