Contesting and Differentially Constructing Uncertainty: Negotiations of Contraceptive Use in the Clinical Encounter
Abstract
Most women of reproductive age have access to highly effective contraception, and all available methods are associated with side effects. Whether a woman will experience side effects is uncertain, however, which can pose challenges for clinicians who discuss the methods with patients. In this study, we analyze 102 contraceptive counseling visits to understand how clinicians discursively construct knowledge in the context of uncertainty. We find that while some present the uncertainty of side effects in a straightforward, patient-accessible way, others negotiate their predictions by (1) differentially constructing uncertainty, suggesting that positive side effects are likely and negative side effects are unlikely, and (2) contesting uncertainty, presenting the risk of serious side effects as controllable. In the end, these strategies deemphasize consideration of negative side effects in women’s contraceptive decision making. Our results demonstrate the importance of elucidating the translation, instantiation, and construction of medical uncertainty both in theory and in practice.
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Biographies
Krystale E. Littlejohn is an assistant professor in the Department of Sociology at Occidental College. She studies gender, race, and reproduction. Her research examines how everyday cultural constructions shape family processes, particularly at the nexus between embodiment and biomedical technologies. She is currently working on a book examining how understandings of men’s and women’s bodies shape gendered patterns of birth control use and inequality. Her work has been published in Demography, Gender & Society, and Family Relations.
Katrina Kimport is an associate professor and a research sociologist in the Advancing New Standards in Reproductive Health program at the University of California, San Francisco. Her research focuses on gender, sexuality, and social movements. Her work has been published in Gender & Society, Journal of Health and Social Behavior, and American Sociological Review. She is the author of Queering Marriage: Challenging Family Formation in the United States (Rutgers University Press, 2014).
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Article first published online: October 16, 2017
Issue published: December 2017
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PubMed: 29172767
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