title: Women’s Experiences of Seeking Healthcare at the Intersection of Pregnancy and Housing Instability
Creators: name: Locey, Claire
Publisher: name: Graduate Studies
Year: 2024
Subjects: subject: Women's Health
subject: Medical Education
subject: Gender and Homelessness
subject: Pregnancy
subject: Empathy
subject: Equity, Diversity, and Inclusion
subject: Women's Studies
subject: Public Health

description: Background. Women have historically and contemporarily been at the margins of health research due to a lack of qualitative and biomedical research emphasis on sex and gender. This thesis centred patient voice through interviewing 4 women (ages 19-37) about their experiences seeking healthcare in Alberta while unstably housed and pregnant. Guided by an intersectional feminist orientation to critical phenomenology and building upon relevant literature, this thesis sought to understand and uncover: 1. What are the health-seeking experiences of unstably housed women while pregnant in Alberta? 2. How are the experiences and perspectives of these women significant and meaningful to medical education? Methods. I spent five months conducting 7 interviews with 4 participants about their lived experiences of pregnancy and housing instability in Alberta. This entailed following participants at various stages of their pregnancy, with the exclusion of one participant who reflected on two previous pregnancies. Participants were selected through purposive and snowball sampling with Trellis Society and Alcove Recovery Centre for Women. In keeping with the critical phenomenological framework of this study, a smaller sample size was best suited for this project to prioritize depth of interviews and foster relationships with participants. Findings. While participants described that finding healthcare was relatively manageable, accessing and trusting the care they received and building relationships with their prenatal care providers was more complicated and ultimately impacted their healthcare experiences. Participants highlighted that healthcare experiences could be improved through an empathetic educational approach to patient care – with regards to both healthcare education and subsequently patient education. Additionally, participants found that trust, relationship-building, and allocating more time for appointments were important factors in their prenatal care. Conclusion. Participants’ relationships and rapport with their healthcare providers played a vital role in shaping their experience of pregnancy at the intersection of housing instability. This study found that the healthcare system acts as a social determinant of health (SDoH) in and of itself based on experiences of stigma, accessibility, and trust. Despite significant obstacles in their prenatal care journeys, participants expressed positive outlooks for change in healthcare systems and found pregnancy and motherhood to have an overall positive impact in their lives. Medical education would benefit from reflecting on its role, responsibilities, and obligations in shaping the future of care, particularly in addressing the needs and concerns of individuals facing health inequities. The importance of this work lies in illuminating the embodied epistemologies and interpreting the meaning of these women’s health-seeking experiences while at the intersection of pregnancy and housing instability.