Research Focus: Leigh Senderowicz

Leigh Senderowicz is a postdoctoral researcher in the Health Disparities Research Scholars (HDRS) program—an interdisciplinary training program based in the Department of Obstetrics and Gynecology in the School of Medicine and Public Health. Senderowicz is a social demographer and mixed-methods researcher whose work focuses on rights-based approaches to international sexual and reproductive health.

Senderowicz’s research revolves around the principle of reproductive autonomy, drawing from critical race, critical development, postcolonial/decolonial, and transnational feminist theories to study the role of quantitative indicators and targets in public health. With the understanding that what we measure impacts how we understand the social world, she explores health indicators as a politicized form of knowledge production, focusing in particular on the implicitly colonial, racialized, and gendered dimensions of family planning metrics. Her research examines how the ideologies of eugenics and fertility control inform contemporary reproductive health policies, how these ideologies are imbued into global health and development targets, and how these targets lead to stratified reproduction and limits to reproductive autonomy, often in the name of “women’s empowerment.” This work includes a strong critique of the scientific racism and misogyny that subtly permeate global health metrics, but also goes beyond just critique. In her work, Senderowicz also focuses on the development and validation of alternative indicators for reproductive health, characterized by rights-based and person-centered approaches to measurement. The goal of these new measures is to expose and systematically document the kinds of reproductive inequities (stratified by race/ethnicity, nativity, disability, gender, and other axes of structural exclusion) for which, until now, there is only sporadic, anecdotal evidence.

The centerpiece of Senderowicz’s work is the Contraceptive Autonomy Study. This project began with the recognition that most global reproductive health indicators have remained unchanged since the population control era, retaining that era’s tacit ideology of fertility reduction, to the exclusion of reproductive health and rights. Seeking to generate evidence of the harm these indicators have caused, and to develop a new definition of success for family planning programs based on the concept of contraceptive autonomy, Senderowicz collaborated with a team of colleagues to conduct a sequential mixed-methods study at two research sites (one rural, one urban) in Burkina Faso. This study began with a formative, qualitative phase that included in-depth interviews with women of reproductive age, focus group discussions, key informant interviews, and cognitive interviews with respondent debrief. She then used these findings to develop and pilot novel survey questions, which she incorporated into a population-based survey with nearly 4000 respondents. The survey has produced a remarkably rich dataset that has already led to important new findings in contraceptive research and the development of a methodology to calculate a novel indicator of contraceptive autonomy.

Senderowicz has also published empirical findings of overt contraceptive coercion in mainstream global family planning programs in an anonymized sub-Saharan African county in Social Science and Medicine. In the article, Senderowicz elaborated a comprehensive theory of contraceptive coercion that argues that coercion is routine, structural, and bi-directional. Other analyses currently underway include 1) a deep exploration of provider refusal to remove contraceptive implants on request; 2) an analysis of community perceptions of provider coercion (what makes respondents feel it is sometimes justified, and what makes them consider it wrong); 3) an examination of the narratives around birth spacing and maternal health, and how these are used against women to compel them to use contraception they do not really want. She also plans to publish at least one methodological piece on her use of focus group vignettes to stimulate remarkably nuanced conversations about these complex and polarizing topics.