The required course Qualitative Research Methods seeks to give students the tools to carry out research rooted in personal narratives. Throughout the course of the semester, students work on a single group project. In my case, three classmates and I connected around a mutual interest in abortion narratives, particularly the experiences of folks marginalized due to their racial and gender identities, and embarked on an investigation from there.
Planning and Development Stages
We began by crafting a central research question. That question was:
“What is the connection between abortion experiences and social hierarchies? ”
Then we set about developing an interview protocol to guide our conversations with participants. We were intent on moving beyond a pro-choice vs. anti-choice conceptualization of abortion and towards a pro-voice framework, wherein a person's story is prioritized above inflexible political dichotomies. With this idea in mind, we pushed to create questions that would allow for and celebrate nuance, and most importantly, let interviews unfold organically. We landed on a very open-ended question to start each interview with:
“Where does your abortion story begin? ”
Recruitment and Interviews
Our opening question proved very effective, as it allowed the interviewee to set the tone and parameters of her story and our conversation. Interviewees often volunteered information on the personal, political, and social circumstances that led to their abortions—the very information we were most interested in. Some of our other questions included:
How did the cultural environment you grew up in impact your view on abortion?
Talk about your identity. Who are the people(s) you identify with?
Talk about any support you had.
What kind of knowledge did you have about reproductive health prior to the abortion?
Our research question evolved during the recruitment process, however, as we struggled to find people who met our target criteria. Our interviewees were going to be self-selecting, simply by agreeing to talk about their experiences with strangers. We ended up speaking to four female-identifying people, ranging in age from 35 to 85, several of whom defined themselves as activists. When we moved into analysis, we found the wording for our ultimate research question.
Data Analysis
Our project was in no way meant to unearth any overarching conclusions about abortion experiences. Rather, we were investigating overlapping themes across four particular narratives. Transcripts in hand, we conducted basic linguistic analysis as well as applied oral history theory to not only interpret the words but also everything in between, knowing that as much meaning lies in pauses as in verbalized sentiments. We practiced coding, assigning short phrases to snippets of language based on their content, e.g. “confusion of details”, “fierce independence”, “life readiness/timing”. The interview I conducted had recurring codes such as “shame” and “political vs personal”. Codes that were present in three or all of the interviews were “no regret,” “relief,” “support/network”, and “social norms”.
The research question moved from “What is the connection between abortion and social hierarchies?” to “What is the connection between abortion and social difference?” The historical context in which each woman had her abortion (for example, pre-Roe or post-Roe) had enormous bearing on her story, and familial dynamics were a powerful factor. Mentions of shame were prevalent in my interviewee’s narrative, and we hypothesized that the social norms and political structures of the time fed into that.
Eventually, we consolidated our codes into the following categories:
Community, Access, Agency, Power Dynamics, Processing, Physicality of Procedure, and Legacy/Lasting Impacts.
These in turn laddered up to four larger themes:
Community, Embodiment, Storytelling/Activism and Advocacy, and Power and Privilege.
Tying It All Together
In our culminating paper, we traced our journey through to our findings and rounded it out by analyzing the investigative experience itself. Reflecting on our research journey, we noticed our discomfort as we progressed from codes to categories to themes, worrying about the necessary flattening of each person’s story on the road to broader knowledge. We also learned a lot about our own perceptions of what abortion narratives should be, likely based on portrayals in the media and lack of nuance in public narratives around abortion, related to who has the power and privilege to tell their stories at all. We had planned to ask “What were the emotions that you were feeling before the procedure? During the procedure? After?” and used the emotions fear, shame and relief as probes, assuming that interviewees would express these emotions, yet relief ended up being the emotion that was conveyed across the board. To us, the repeated code “no regret” suggests that feeling regret is a broken assumption around the stereotypical abortion narrative and the extent to which pro-life propaganda can infiltrate the way we imagine this particular reproductive choice. We had to face that we brought our own biases to protocol development.
We co-wrote our final paper, and I closed it with a look at how qualitative research dovetails with narrative medicine:
As interviewers, we tapped into the listening skills we’ve cultivated over our time in the program, being careful to receive all stories without judgment, and asking clarifying questions without questioning the person’s experience. In our narrative medicine workshops, we also strive to ask questions that expand on what’s been said, without ever discounting anything.
Narrative medicine acknowledges and embraces the shades of gray that make up the world around us, and we practice designing workshops that demonstrate that grayness, while encouraging all interpretations. In qualitative research, right answers don’t exist. When our interviewees expressed hesitation or doubt that they were “giving us what we needed”, we responded as we would to workshop participants, bidding them to share as much as they were comfortable with, and reassuring them that no response was “wrong”.
We went in knowing that our research question would shift and evolve based on our fieldwork, resulting in an act of co-creation. Each of our interviews was a collaborative narrative in which we didn’t steer our questioning or analysis toward answering our initial research question, but allowed the exchange of story and intersubjective experience to determine the ultimate shape of our research question.
We also found the coding process to intersect with the act of close reading. Practitioners of narrative medicine regularly look for the tacit behind what's explicit. In analyzing interviews, we had to extract what was not said outright, while remaining constantly vigilant about using charged words or flattening the story.
Takeaways
While I was comfortable interviewing people through being a journalist and speaking to stakeholders in my writing and strategy work, I was particularly moved by this interviewing experience, as the woman I talked to was remarkably forthcoming with me about very personal experiences and struggles. She had spoken about one abortion publicly, but confided in me about a second one. I learned about everything from her family’s stance on abortion to what the clinic staff said to her in the exam room.
Throughout my narrative medicine schooling and training, I’ve seen classmates and workshop attendees open up about events and emotions that have shaped them or are shaping them. Sharing a difficult story can be the start of reframing it, but speaking it aloud to others calls for vulnerability. I still feel humbled to have received my interviewee’s story, and am so thankful for her candor with a stranger. And I realize that no matter how much I try to imagine others’ lives or spend intellectual energy processing the nuances of key social issues, hearing a single story firsthand can shake up all of that thinking. Such acts of testimony thicken the plot and complicate the relationship between the personal and the political. With my interviewee, her political stance on abortion didn’t align with the reality of her personal experiences, which were a tangle of complex situations and emotions. As conversations become increasingly framed in ideological terms, personal stories thwart easy conclusions, and have enormous power to re-center discussions so that they consider real people.