Western University Scholarship@Western Electronic Thesis and Dissertation Repository 8-13-2019 2:30 PM Strategic and Subversive: The Case of the Disappearing Diaphragm and Women’s Information Practices Sherilyn M. Williams The University of Western Ontario Supervisor McKenzie, Pamela The University of Western Ontario Graduate Program in Library & Information Science A thesis submitted in partial fulfillment of the equirr ements for the degree in Doctor of Philosophy © Sherilyn M. Williams 2019 Follow this and additional works at: https://ir.lib.uwo.ca/etd Part of the Library and Information Science Commons Recommended Citation Williams, Sherilyn M., "Strategic and Subversive: The Case of the Disappearing Diaphragm and Women’s Information Practices" (2019). Electronic Thesis and Dissertation Repository. 6437. https://ir.lib.uwo.ca/etd/6437 This Dissertation/Thesis is brought to you for free and open access by Scholarship@Western. It has been accepted for inclusion in Electronic Thesis and Dissertation Repository by an authorized administrator of Scholarship@Western. For more information, please contact [email protected]. Abstract Birth control options for women have advanced significantly over the past century. Barrier methods such as diaphragms became readily available in the first half of the 20th century, while hormonal contraceptives such as the birth control pill have defined advances in the latter half. While the diaphragm is still contextualized in modern sexual health discourse as an accessible birth control option, women in North America, and across the globe, are finding it increasingly difficult to obtain. This is partly because the skill of fitting a diaphragm is disappearing in medical practice, and also due to pharmaceutical influence on medicine that promotes hormonal methods and IUDs (intrauterine devices) as being more efficacious and profitable. However, many women eschew hormonal and IUD options in favour of less invasive ones such as barrier methods like diaphragms or cervical caps. These women must navigate learning about the devices and where to obtain them, finding practitioners who will fit them, and learning about their own anatomy to properly use cervical barriers. Thus, numerous information practices are at work, in the contexts of information sharing, information- seeking, and embodied knowledge. While feminist scholars suggest that women have historically, and presently continue to carve their own spaces in medicine to account for embodied knowledges and women’s experiential approaches to health, these knowledges have nevertheless been marginalized and subjugated in favour of a masculinized medical expertise that prioritizes the scientific method. Thus, it is important to evaluate these women-centred epistemologies as conduits for information sharing and seeking behaviour, and to analyze the information strategies women undertake when the necessity of circumventing barriers put forth by mainstream medical practice emerges. Using a feminist qualitative methodology, data was collected from semi-structured interviews, as well as from four editions of the feminist health text Our Bodies, Ourselves spanning nearly four decades. To analyze the data, constant comparison and thematic analyses were utilized. By examining how subversive information seeking and sharing occur in contexts of marginalized health knowledges and investigating how women subvert boundaries to keep information flowing, this project helps illuminate how women who ii choose diaphragms and cervical caps exchange information. Keywords Diaphragm; cervical barrier; contraceptives; birth control; information; authoritative knowledge; embodied knowledge; subversive information strategies; women’s information practices iii Summary for Lay Audience Birth control options for women have advanced significantly over the past century. Barrier methods such as diaphragms became readily available in the first half of the 20th century, while hormonal contraceptives such as the birth control pill have defined advances in the latter half. While the diaphragm is still contextualized in modern sexual health sources as an accessible birth control option, women in North America, and elsewhere, are finding it increasingly difficult to obtain. This is partly because the skill of fitting a diaphragm is disappearing in medical practice, and also due to pharmaceutical influence on medicine that tends to promote hormonal methods and IUDs (intrauterine devices). However, many women prefer less invasive forms of birth control such as barrier methods like diaphragms or cervical caps. These women must navigate learning about the devices and where to obtain them, finding practitioners who will fit them, and learning about their own anatomy to properly use cervical barriers. Thus, numerous information practices are at work, in the contexts of information sharing, information-seeking, and embodied knowledge. While feminist scholars suggest that women have historically, and presently continue to carve their own spaces in medicine to account for embodied knowledges and women’s experiential approaches to health, these knowledges have nevertheless been marginalized and repressed in favour of a masculinized medical expertise that prioritizes the scientific method. Thus, it is important to evaluate these women-centred knowledges as means of information sharing and seeking behaviour, and to analyze the information strategies women undertake when the necessity of circumventing barriers put forth by mainstream medical practice emerges. Using a feminist qualitative methodology, data was collected from semi-structured interviews, as well as from four editions of the feminist health text Our Bodies, Ourselves spanning nearly four decades. To analyze the data, constant comparison and thematic analyses were utilized. By examining how subversive information seeking and sharing occur in contexts of marginalized health knowledges and investigating how women subvert boundaries to keep information flowing, this project helps illuminate how women who choose diaphragms and cervical caps exchange information. iv Acknowledgments I would like to extend thanks to the participants in this project who so generously contributed to the work presented in this dissertation by sharing their stories and experiences with me. Without their ethos of sharing, this project would not be possible. Profound gratitude goes to my wonderful supervisor, Pam McKenzie. I thank Pam immensely, not only for her amazing academic support, but also for giving me so many opportunities and for continuing to believe in me when I struggled to believe in myself. Special mention goes to my partner Filip Stasiak, whose encouragement and support helped me to stay motivated to complete this journey. Similarly, I could not have done this without the support of my wonderful friends – Patti Luedecke, Morgan Brittan van Wyk, Michael Aloisio, and Rachel Melis – their positive words meant so much to me at times when optimism seemed out of reach. Finally, but by no means least, thanks go to my parents Donna and Art Williams for relentless words of support and morale-boosting, as well as financial assistance. I dedicate this thesis to them. v Table of Contents Abstract ......................................................................................................................... ii Summary for Lay Audience ......................................................................................... iv Acknowledgments......................................................................................................... v Table of Contents ......................................................................................................... vi List of Tables ................................................................................................................ x 1 Introduction .............................................................................................................. 1 1.1 Overview ........................................................................................................... 2 1.2 Context .............................................................................................................. 3 1.3 Background ....................................................................................................... 5 1.4 Outline............................................................................................................... 9 2 Framework and Literature Review......................................................................... 11 2.1 Introduction ..................................................................................................... 11 2.2 Information Behavior ...................................................................................... 13 2.3 Information Barriers, Circumvention, Agency & Subversion ...................... 25 2.4 Authoritative Knowledge – Women’s Knowledges vs. Experts .................... 33 2.5 The Medicalization of Women’s Bodies ........................................................ 36 2.6 Embodied Knowledge ..................................................................................... 39 2.7 Gender Essentialism........................................................................................ 43 2.8 LIS and Birth Control Information ................................................................. 46 2.9 Conclusion .....................................................................................................