The unravelling of person-centred care
The value and necessity of analysing power relations in contraceptive services
Bibliographic Data
| ID | 4218307 |
|---|---|
| Authors | Tracy Morison (0000-0001-9088-1662, Massey University, corresponding author), Catriona Ida Macleod (0000-0003-0992-3525, Rhodes University), Yanela Ndabula (0000-0002-8436-8827, Rhodes University) |
| Year | 2025 |
| Volume | 30 |
| Issue | 2 |
| Pages | 214-234 |
| Publication date | 2025-04-30 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine (JOURNAL) |
| Journal identifiers | ISSN: 1363-4593 • E-ISSN: 1461-7196 |
| Publisher | SAGE Publications Inc (PUBLISHER) |
| DOI | 10.1177/13634593251336175 |
| PMID | 40305453 |
| OpenAlex | W4409963301 |
| Language | EN |
| Citations received | 2 |
| References cited | 43 |
Global research indicates ongoing challenges in delivering person-centred contraceptive care. Much of the contraceptive research investigates this issue using systems-focussed approaches to map institutional constraints (e.g. institutional or health system barriers to accessing contraception). The assumption underlying this research approach is that simply removing structural barriers can address issues and enhance contraceptive autonomy, but this is not the case. Our research shows how discursively constructed power relations undermine bodily integrity and contraceptive agency even as contraceptive providers endorse the principles of patient-centred care. Using a synthetic narrative/discourse approach to analyse provider interviews in South Africa and New Zealand, we draw on Foucauldian analytics of biopower to show how an idealised person-centred care narrative collapses under the weight of discourses of medicalised risk, protectionism, and biomedical expertise, signalling practices of power through confession, responsibilisation and surveillance. Our findings highlight an essential perspective frequently missing in systems-focussed research on contraceptive care: the crucial dimension of power and reproductive politics. Thus, we argue for the necessity of investigating this dimension, in addition to systemic challenges. Our work demonstrates the value of frameworks that illuminate power dynamics, such as the Foucauldian analytics of biopower we undertook. Expanding the range of research perspectives in contraceptive research can deepen understandings of how systems constraints and power relations together undermine relational person-centred contraceptive care
Autonomy · Biopower · Health care · Narrative · Political science · Politics · Public relations · Social science · Sociology · Global Maternal and Child Health · Intimate Partner and Family Violence · Law · Medicine · Reproductive Health and Contraception
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Long-acting reversible contraception
Patient-provider power relations in counselling on long-acting reversible contraception
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Foucauldian Feminism
Social Constructionism
Biomedicalization
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The "social" aspect of social-ecological systems
The limitations of patient-centered care
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| Unique citing works | 2 |
|---|---|
| Citations per year | 2 |
| Citation span | 2026 - 2026 (1) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 1 |