Making sense of sex: rethinking intentionality

Abstract

After 30 years of public health policy based on a rational‐choice model of behaviour, women in the USA continue to have sex, get pregnant and give birth to children in ways that do not conform to the behavioural prescriptions of family planning programmes. Traditionally, USA social science research has attempted to explain why women deviate from public health behavioural models. In this paper, narrative theory is employed to reorient the study of women's sexual behaviour. Specifically, reproductive life histories are analysed to illuminate how women interpret their reproductive experiences and how culturally available interpretative materials, in particular prescriptive ideals and explanatory narratives, may prospectively influence women's reproductive experiences.

Résumé

Aux USA, après 30 ans de politique de santé publique basée sur un modèle de choix rationnel de comportements, les femmes continuent d'avoir des rapports sexuels, de devenir enceintes, et de donner naissance à des enfants, sans respecter les prescriptions des programmes de planning familial. Traditionnellement, la recherche en sciences sociales américaine a tenté d'expliquer pourquoi les femmes s'écartent des modèles comportementaux de santé publique. Dans cet article, la théorie narrative est employée pour réorienter l'étude des comportements sexuels des femmes. Spécifiquement, les récits de vie évoquant la reproduction sont analysés pour éclairer la manière avec laquelle les femmes interprètent leurs expériences reproductives et celle avec laquelle le matériel interprétatif disponible en fonction des données culturelles, en particulier les idéaux prescriptifs et les récits explicatifs, peuvent prospectivement influencer les expériences reproductives des femmes.

Resumen

Después de 30 años de política de salud pública basada en un modelo de opción racional de comportamiento, las mujeres estadounidenses continúan teniendo relaciones sexuales, quedándose embarazadas y dando a luz sin cumplir las prescripciones de conductas que exigen los programas de planificación familiar. Los estudios sobre ciencia social en los EE.UU. han intentado tradicionalmente explicar por qué las mujeres se apartan de los modelos de comportamiento en la salud pública. En este artículo, empleamos la teoría narrativa para reorientar el estudio sobre la conducta sexual de las mujeres. En concreto analizamos las historias sobre la vida reproductora para resaltar cómo las mujeres interpretan sus experiencias reproductoras y cómo pueden repercutir los materiales interpretativos disponibles culturalmente, en particular los ideales prescriptivos y las narrativas explicativas, en las experiencias reproductoras futuras de las mujeres.

Keywords:

• reproductive health
• pregnancy
• prevention
• narrative theory
• USA

Acknowledgements

Special thanks to Gene Deerman, Susannah Dolance, Kathy Fessler, Tasleem Padamsee and the four anonymous reviewers for their insightful and helpful comments. I would also like to extend my gratitude to the women who generously shared their stories, without whom this research would not have been possible.

Notes

1. While there is a dominant paradigm in family planning, this does not mean that there is a singular model that controls all family planning efforts from national‐level policy to face‐to‐face clinical interactions. Women's sexuality has always been and remains a primary site of contention and control.

2. Abortion, per se, is not a problem. Rather, most women would prefer to prevent a pregnancy in the first place or to alleviate social conditions (e.g. poverty) that necessitate some abortions rather than have to terminate a pregnancy.

3. I do not mean to imply that the women lied about their experiences or are duped. All social life is culturally mediated.

4. Seven of the women were pregnant more than once, three with different outcomes.

5. The names used through this paper are pseudonyms.

6. Taking into consideration that sperm are viable for up to three days, there are six days a month that a woman can become pregnant. While in the aggregate women's cycles vary considerably, individual healthy women's cycles are relatively consistent.

7. For an interesting examination of explanatory narratives used to explain age‐related infertility and assisted reproduction, see Friese, Becker and Nachitigall (2006).