Contextualising challenges of reproduction and motherhood in Florence, Italy: a qualitative study

Beyond "toxic bodies": Multiplied rationalities of women's reproductive health in a high-risk environmental area (Taranto, Italy)

This study investigates women's reproductive health concerns in Taranto, a steel town and a "high-risk environmental area" in Italy. It draws on participatory ethnographic research (body mapping, interviews and fieldnotes) and analyses political and social aspects of women's reproductive health in relation to pollution. I argue that in highly polluted environments, both political rationalities and women's health concerns over their bodies are multiplied, extending beyond a focus on their bodies as shaped by toxic exposure. Women make sense of knowledge about their reproductive health and questions of responsibility in relation not only to societal norms, but also through reference to the wider polluted environment and the political-economic structures they inhabit. By focusing on women's own experiences, the study contributes to our understanding of women's agency over their environment-health relations and seeks to complicate women's role as environmental subjects beyond "toxic bodies".

Cross-border reproductive healthcare attitudes and behaviours among women living in Florence, Italy

BACKGROUND

The number of women living in Italy and seeking cross-border reproductive care (CBRC), especially for medically assisted reproduction (MAR), has increased. The purpose of this study was to explore CBRC attitudes and behaviours among a cohort of reproductive-aged women who have never engaged in CBRC to gauge social and cultural perceptions and gain a deeper understanding of family planning discourse.

METHODS

In-depth interviews were conducted during May - June 2018 with 30 women aged 18-50 living in or around Florence, Italy and enrolled in the Italian healthcare system. Interviews offered in-depth insight into CBRC attitudes, behaviours, and experiences among a cohort of women living in Italy who had never engaged in CBRC. Researchers used an expanded grounded theory through open and axial coding. Emergent themes were identified via a constant comparison approach.

RESULTS

Three themes and two subthemes emerged from the data. Participants discussed how limitations in Italy's access to MAR can lead women to seek reproductive healthcare in other countries. Women had mixed feelings about the effect of religion on legislation and reproductive healthcare access, with many views tied to religious and spiritual norms impacting MAR treatment-seeking in-country and across borders. Participants perceived infertility and CBRC-seeking as socially isolating, as the motherhood identity was highly revered. The financial cost of traveling for CBRC limited access and exacerbated emotional impacts.

CONCLUSIONS

Findings offered insight into CBRC perceptions and intentions, presenting a deeper understanding of the existing family planning discourse among reproductive-aged women. This may allow policymakers and practitioners to address social and cultural perceptions, increase access to safe and effective local care, and empower women in their family planning decisions.

Translating policy to practice: theory-based formative research to improve messaging and over-the-counter access to emergency contraception in Florence, Italy

OBJECTIVES

Italy's 2015 emergency contraception (EC) policy made EC available without prescription for individuals aged 18 years and older; however, women living in Italy continue to face barriers to accessing EC. The purposes of this study were to understand EC knowledge, attitudes and behaviours among women living in Italy and explore the impact of the 2015 policy.

METHODS

Researchers conducted 30 interviews with women living in Florence, Italy, aged 18-50 years and using the Italian health care system. Researchers used an expanded grounded theory approach to understand women's EC experiences, with diffusion of innovations (DOI) serving as a conceptual lens. Researchers completed open and axial coding to identify emerging themes.

RESULTS

Participants had low awareness of the 2015 EC policy and suggested increased messaging in strategic locations to overcome this barrier. They held positive and negative attitudes towards EC: while some perceived the advantage of EC compared with unintended pregnancy, others expressed concerns about irresponsible behaviour and safety. Finally, conscientious objection impacted access, despite women's desire for autonomous EC decision making.

CONCLUSION

The findings offer practical recommendations to guide EC messaging in Italy to increase women's access to EC. Recommendations include using theory- and audience-based methods to overcome gaps in policy knowledge and real and perceived barriers to EC access. Incorporating DOI as a theoretical framework with women's voices presents a novel opportunity to enhance policy and EC dissemination.