DORA :: Browsing by Author "Weis, Christina"

Browsing by Author "Weis, Christina"

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Open Access
All the lonely people, where do they all belong? An interpretive synthesis of loneliness and social support in older lesbian, gay and bisexual communities.
(Emerald, 2019-08-14) Fish, Julie; Weis, Christina
Purpose: Loneliness is a phenomenon which affects people globally and constitutes a key social issue of our time. Yet few studies have considered the nature of loneliness and social support for older lesbian, gay and bisexual (LGB) people; this is of particular concern as they are among the social groups said to be at greater risk. Design/methodology/approach: Peer-reviewed literature was identified through a search of Scopus, PsycINFO and PubMed. A total of 2,277 papers were retrieved including qualitative and quantitative studies which were quality assessed using the Critical Appraisal Skills Programme (CASP) Findings: Eleven papers were included in the review and findings were synthesised using thematic analysis. The studies were conducted in five countries worldwide with a combined sample size of 53,332 participants, of whom 4,288 were drawn from among LGB communities. The characteristics and circumstances associated with loneliness included including living arrangements, housing tenure, minority stress and geographical proximity. Research limitations/implications: The review suggests that among older LGB people, living alone, not being partnered and being childfree may increase the risk of loneliness. This cohort of older people may experience greater difficulties in building relationships of trust and openness. They may also have relied on sources of identity-based social support that are in steep decline. Future research should include implementation studies to evaluate effective strategies in reducing loneliness among older LGB people. Practical implications: Reaching older LGB people who are vulnerable due to physical mobility or rural isolation and loneliness because of bereavement or being a carer are concerns. A range of interventions including individual (befriending), group-based (for social contact) in addition to potential benefits from the Internet of Things should be evaluated. Discussions with the Voluntary and Community Sector suggest that take up of existing provision is 85:15 GB men vs LB women. Originality/value: We sought to interrogate the tension between findings of lower levels of social support and discourses of resilient care offered by families of choice.
Open Access
Changing Fertility Landscapes: Exploring the Reproductive Routes and Choices of Fertility Patients from China for Assisted Reproduction in Russia
(Springer, 2021-01-11) Weis, Christina
Global reproductive landscapes and with them cross-border routes are rapidly changing. This paper examines the reproductive routes and choices of fertility travellers from China to Russia as reported by medical professionals and fertility service providers. Providing new empirical data, it raises new ethical questions on the facilitation of cross-border reproductive travel and the commercialisation of reproductive treatment. The relaxation of the one-child policy in 2014 in China, the increasing demand for ART exceeding the capacity of national fertility clinics and the difficulty of accessing treatment with donor eggs concomitant with a growing economic power of the upper–middle class are shaping the ART industry in Asia in new ways. A new development is Chinese citizens increasingly seeking ART treatment in Russia, which has a long-standing practice of ART governed by a liberal legislation. Furthermore, as China prohibits the export of gametes, Chinese fertility travellers rely on acquiring donor gametes once starting treatment abroad. Clinicians in Russia report three strategies amongst their Chinese patients: One group is using donor eggs of women of Asian appearance living in Russia or is hiring women of resembling appearance from third-party countries to donate their eggs in Russia to create resemblance in their offspring. Another group is buying white donor gametes to create Eurasian mixed children and thus ‘enhance’ their offspring. Providing novel empirical data, this article informs ethical deliberation and raises imminent questions for further research in this understudied geographic region and on cross-border reproductive treatment.
Open Access
Death and the Artificial Placenta
(Oxford University Press, 2024-06-24) Nelson, Anna; Roberts, Elizabeth Chloe; Adkins, Victoria; Weis, Christina; Kuberska, Karolina
Artificial Amnion and Placenta Technology (AAPT) – sometimes referred to as ‘Artificial Womb Technology’ – could provide an extracorporeal alternative to bodily gestations, allowing a fetus delivered prematurely from the human uterus to continue development while maintaining fetal physiology. As AAPT moves nearer to being used in humans, important ethical and legal questions remain unanswered. In this paper we explore how the death of the entity sustained by AAPT would be characterized in law. This question matters, as legal ambiguity in this area has the potential to compound uncertainty, and the suffering of newly bereaved parent(s). We first identify the existing criteria used to delineate the legal characterization of death which occurs before birth or during the immediate neonatal period in England and Wales. We then demonstrate that attempting to apply these in the context of AAPT gives rise to a number of challenges which make it impossible to reach a definitive conclusion as to the nature of death in AAPT using the current legal framework. In doing so, we demonstrate that the current legal framework in England and Wales may be unable to adequately capture the situation of an entity being sustained by AAPT.
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Egg donation in the age of vitrification: A study of egg providers’ perceptions and experiences in the UK, Belgium and Spain
(Wiley, 2022-11-28) Lafuente - Funes, Sara; Weis, Christina; Hudson, Nicky; Provoost, Veerle
IVF treatment involving donated eggs increases yearly. Numerous technical and commercial transformations have reshaped how eggs are retrieved, stored and managed. A key transformation is vitrification; a ‘fast freezing’ method that allows efficient preservation of eggs, and therefore more flexibility in use, giving rise to new commercial possibilities. There has been limited focus on egg providers’ experiences in the context of vitrification and related commercialisation. We report findings from a study in the UK, Spain and Belgium, where we interviewed 75 egg providers. Comparing experiences within different donation ‘regimes’ allows an exploration of how varying national practices and policies shape information-giving and women’s experiences. In the UK, a system of ‘informed gift-giving’ was described, where egg providers saw their actions as not-for-profit and felt relatively well informed. In Belgium, the system was presented as ‘trusted tissue exchange’: with less information-giving than in the UK, but clinics were trusted to act responsibly. In Spain, a ‘closed-door, market-driven’ system was described, whereby egg providers received little information and expressed concerns about generation of excess profit. Our findings extend understandings of how egg donation is managed at the national level and how donation regimes produce specific experiences, expectations and subjectivities amongst tissue providers.
Open Access
Egg providers' views on the use of surplus eggs in the UK, Spain and Belgium: implications for information giving and informed consent (POSTER)
(2019-06) Hudson, Nicky; Culley, Lorraine; Herbrand, C.; Weis, Christina; Coveney, C.; Goethals, T.; Lafuente, S.; Pavone, V.; Pennings, G.; Provoost, V.
Embargo
Emerging “repronubs” and “repropreneurs”: Transnational surrogacy in Ghana, Kazakhstan, and Laos
(Sage Journals, 2022-06-03) Whittaker, Andrea; Gerrits, Trudie; Weis, Christina
In this article, we offer an analysis of the development of “repronubs”: less-known locations offering small-scale, niche cross-border gestational surrogacy or surrogacy services for a regional market. This analytical category of “repronubs” is useful to describe the formation of the industry from small local sites to those offering cross-border services. Based on our work in these locations, we compare the markets, regulatory contexts, and organization of the industry in Ghana, Kazakhstan, and Laos, focusing on the “repropreneurs” or surrogacy facilitation agents as pivotal in the emergence of these sites. These “repronubs” highlight the surrogacy trade between countries of the Global South and are established next to or instead of the more well-known North–South destinations. We document how surrogacy itself is increasingly stratified between higher cost and better-regulated environments such as in certain states of the United States or Canada and lower cost, less well regulated, and regionally focused environments in the settings we describe. These locations are characterized by poor or liberal regulations, the existence of local in vitro fertilization (IVF) expertise, and the emergence of local repropreneurs driving the trade using their social networks. The growth of demand from China and the growing affluent middle class in Africa is creating further markets for such regional “nubs.” Studying surrogacy in such locations is made difficult by the secrecy and confidentiality surrounding it.
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The experience of counselling for UK egg providers
(Wiley, 2023-01-16) Loyal, Sasha; Hudson, Nicky; Culley, lorraine; Weis, Christina
Objective The aim of this study was to address current gaps in knowledge regarding the appropriateness and quality of counselling provided to egg donors in the UK. Methods The present study used a cross-sectional, qualitative design. Semi-structured interviews were carried out with 29 UK egg donors to explore their experiences of egg donation and the counselling received. Results Of the 29 participants, 24 had received counselling. The remaining five did not receive counselling because they were either not accepted as a donor (n = 4) or were offered, but chose not to take up the session (n = 1). The findings are presented in relation to five themes: feeling supported via counselling; feeling well-informed; welcoming an individualised approach; the counselling setting; and thinking about the future. Conclusion Egg donors in this study had varying experiences of counselling offered to them as part of the egg donation process in the UK. Implications The findings indicate that there are some aspects of counselling in the UK that could be improved, including the routine offering of counselling throughout the egg donation process and the tailoring of counselling to meet egg donors' individual needs.
Open Access
Help-seeking and access to care for stroke and heart attack during the COVID-19 pandemic: a qualitative study.
(Wiley, 2024-08-23) Weis, Christina; Spiliopoulos, Georgia; Ignatowicz, Agnieszka; Conroy, Simon; Mannion, Russell; Lasserson, Daniel; Tarrant, Carolyn
In this paper we explore how people who experienced a stroke, transient ischaemic attack (TIA), or heart attack sought health care during the COVID-19 lockdown periods. Semi-structured interviews were conducted with 27 patients admitted to hospital between March 2020 and May 2021, and one carer, recruited from cardiac and stroke rehabilitation services in two large acute NHS trusts in England. Drawing on concepts of candidacy, illness and moral work, we discuss how people’s sense-making about their symptoms fundamentally shaped both their decisions about seeking help, and the impact of COVID-19 on help seeking. Risk perception and interactional ritual chain theory allow further exploration of constructing symbols of national identity in times of crises, managing risk and levels of acceptable risk, and critique of ambiguous national messaging over accessing healthcare services for people with emergency healthcare needs. Our findings have wider implications for supporting access into healthcare for those with life-threatening conditions under highly publicised strain on the health system, including winter pressure and staff strikes, also policy-making and public messaging.
Open Access
Heterosexual partnered men’s experiences of becoming fathers through surrogacy
(British Sociological Association Human Reproduction Study Group Annual Conference. De Montfort University, Leicester., 2019-06-12) Norton, Wendy; Weis, Christina
Increasing numbers of people are undertaking surrogacy as a means of creating a family. In heterosexual couples, surrogacy centres on a third-party female who facilitates the couple’s pregnancy, but is not the expectant father’s intimate partner. This may potentially add a level of complexity and tension to this pregnancy experience. Whilst recent healthcare policies highlight the importance of involving fathers throughout pregnancy, childbirth, and the transition to parenthood, it has been suggested that men are often side-lined in the organisation of surrogacy arrangements and participating in the pregnancy experience by the women involved; the intending mothers, and surrogates (Teman 2010:185). The limited research that exists on men’s experiences of surrogacy arrangements focuses mainly on single or gay men/couples (Norton, 2018; Smietana 2017, Riggs et al 2015). There is a dearth of literature on heterosexual partnered men’s experiences of fatherhood through surrogacy. This exploratory, qualitative study, based on an interpretivist epistemology, explores how heterosexual partnered men, who are fathers or are becoming fathers via surrogacy, experience their transition to fatherhood , their involvement in the pregnancy, how expectant fathers perceive and navigate the relationship with their surrogate, and the impact of this relationship on the father’s relationship with his intimate partner. This presentation reports the first findings, which suggest surrogacy is a complex and challenging route to fatherhood. To the authors’ knowledge, no other research has yet focused on heterosexual partnered men’s experiences of surrogacy. This research is therefore an important addition to the limited empirical knowledge base.
Open Access
Moral frameworks of commercial surrogacy within the US, India and Russia
(Taylor and Francis, 2021-03-01) Smietana, M.; Rudrappa, S.; Weis, Christina
In this paper, we draw on three ethnographic studies of surrogacy we carried out separately in different contexts: the western US state of California, the south Indian state of Karnataka, and the western Russian metropolis of St Petersburg. In our interviews with surrogate mothers, intended parents, and surrogacy professionals, we traced the meanings and ideologies through which they understood the clinical labour of surrogacy. We found that in the US, interviewed surrogates, intended parents and professionals understood surrogacy as an exchange of both gifts and commodities, where gift-giving, reciprocity, and relatedness between surrogates and intended parents were the major tropes. In India, differing narratives of surrogacy were offered by its different parties: whilst professionals and intended parents framed it as a win-win exchange with an emphasis on the economic side, the interviewed surrogate mothers talked about surrogacy as creative labour of giving life. In Russia, approaches to surrogacy among the interviewed surrogate mothers, professionals and intended parents overlapped in framing it as work and a businesslike commodity exchange. We suggest these three different ways of ethical reasoning about the clinical labour of surrogacy, including justifications of women’s incorporation into this labour, were situated in local moral frameworks. We name them “repro-regional moral frameworks”, inspired by earlier work on moral frameworks as well as on reproductive nationalisms and transnational reproduction. Building on these findings, we argue that any international or global regulation of surrogacy, or indeed any moral stance on it, needs to take these local differences into account.
Open Access
Moving through Motherhood: Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond
(MDPI, 2021-04-23) Salmon, Victoria; Rodgers, Lauren; Rouse, Peter; Williams, Oli; Cockcroft, Emma; Boddy, Kate; De Giorgio, Luana; Thomas, Ciara; Foster, Charlie; Davies, Rosie; Morgan, Kelly; Jarvie, Rachel; Weis, Christina; Pulsford, Richard
Information received by women regarding physical activity during and after pregnancy often lacks clarity and may be conflicting and confusing. Without clear, engaging, accessible guidance centred on the experiences of pregnancy and parenting, the benefits of physical activity can be lost. We describe a collaborative process to inform the design of evidence-based, user-centred physical activity resources which reflect diverse experiences of pregnancy and early parenthood. Two iterative, collaborative phases involving patient and public involvement (PPI) workshops, a scoping survey (n = 553) and stakeholder events engaged women and maternity, policy and physical activity stakeholders to inform pilot resource development. These activities shaped understanding of challenges experienced by maternity and physical activity service providers, pregnant women and new mothers in relation to supporting physical activity. Working collaboratively with women and stakeholders, we co-designed pilot resources and identified important considerations for future resource development. Outcomes and lessons learned from this process will inform further work to support physical activity during pregnancy and beyond, but also wider health research where such collaborative approaches are important. We hope that drawing on our experiences and sharing outcomes from this work provide useful information for researchers, healthcare professionals, policy makers and those involved in supporting physical activity behaviour.
Open Access
My emotions on the backseat. Heterosexually-partnered men's experiences of becoming fathers through surrogacy
(Journal of Diversity and Gender Studies (DiGeSt), 2021-02-23) Weis, Christina; Norton, Wendy
Surrogacy is a family building option for people unable to conceive or carry a pregnancy. In heterosexual couples seeking surrogacy, a woman who is not the intended father’s partner, facilitates this pregnancy. Whilst normative discourses reinforced by contemporary healthcare policies highlight the importance of involving fathers throughout pregnancy, little is known about heterosexually partnered men’s experiences of surrogacy. This qualitative study explores how surrogacy shapes men’s construction of their father identity and parenting expectations. Drawing on interviews with ten men (nine self-identifying as white and one as white-Asian; all employed in professional occupations) during or after their surrogacy arrangement, we explore their transition to fatherhood, interactions in the pregnancy, and relationship with the surrogate and their intimate partner. This is the first study explicitly focusing on heterosexually-partnered men’s experiences of surrogacy. The findings provide new insights into this unique form of family building, expanding understanding of men’s role preference and level of involvement in a triad surrogacy relationship.
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Re-thinking egg donation in Europe: expanding practice, extending boundaries.
(2019-08-20) Hudson, Nicky; Culley, Lorraine; Coveney, C.; Herbrand, C.; Pavone, V.; Lafuente, S.; Pennings, G.; Provoost, V.; Weis, Christina
The expansion of the use of donor eggs in fertility treatment has been exponential. Whilst the majority of egg donation historically took place in the US, donor eggs are used in over 56, 000 cycles of fertility treatment per year in Europe and a number of European egg donation ‘hubs’ have emerged, for example in Spain and Cyprus. Growth in the use of donor eggs in part reflects a changing profile amongst users of assisted reproductive technologies, including growing numbers of older women, male same sex couples, and those at risk from genetic conditions. An increasing number of egg donor ‘intermediaries’ such as egg banks and agencies have also emerged in the European context, reflecting a general shift towards an increasingly commercialised landscape around fertility treatment provision. Despite these changes, few studies have specifically considered their implications. Drawing on an ESRC-funded study on the economic, political and moral configuration of egg donation in the UK, Spain and Belgium, we suggest that changes in the ways egg donation is provided in the European context are worthy of increased attention. Data from policy mapping and interviews with policy stakeholders and professionals illustrate significant shifts in professional and commercial practice. These changes are reshaping the intersubjective, political and social boundaries involved in egg donation in novel and complex ways. We suggest that the expansion and diversification of its use has implications for the policy and regulation of egg donation the European context.
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Redefining Bioavailability through Migrant Egg Donors in Spain
(Sage Journals, 2023-03-18) Nahman, Michal; Weis, Christina
This article utilises feminist technoscience studies’ notions of bodily ‘materialisation’ and ‘ontological choreographies’, offering a cyborg feminist account of ‘bioavailability’ as embodied becomings, rather than a fixed ontological state of being. Drawn from 2 years’ ethnographic study in in vitro fertilisation clinics in Spain with migrant women who provided eggs to the cross-border in vitro fertilisation industry, this work explores how global understandings of race and inequalities, clinical practices and women’s own emotional and physical labours collectively produce bioavailability. Through examples from observations and interviews in in vitro fertilisation clinics, we examined women’s embodied stories to understand the ways in which bioavailability becomes. The article demonstrates a novel way in which to think about ‘bioavailability’, a concept which has already been of enormous use to the social sciences since its introduction by Lawrence Cohen. We examine recent configurations of bodily extraction in the reproduction–migration nexus that help us rethink the concept of bioavailability.
Open Access
Reproductive Migrations: Surrogacy workers and stratified reproduction in St Petersburg
(De Montfort University, 2017-09) Weis, Christina
Surrogacy is an arrangement whereby a woman conceives in order to give birth to child or children for another individual or couple to raise. This thesis explores how commercial gestational surrogacy is culturally framed and socially organised in Russia and investigates the roles of the key actors. In particular it explores the experiences of surrogacy workers, including those who migrate or commute long distances within and to Russia for surrogacy work and the significance of their origin, citizenship, ethnicity and religion in shaping their experience. Ethnographic fieldwork was carried out in St Petersburg between August 2014 and May 2015 and involved semi-structured interviews, (participant) observations, informal conversations and ethnographic fieldnotes with 33 surrogacy workers, 7 client parents, 15 agency staff and 11 medical staff in medical and surrogacy agency facilities. Data were analysed using inductive ethnographic principles. A reflexive account, which includes a consideration of the utility of making one’s own emotional responses a research tool, is also included. Drawing on and expanding on Colen’s (1995) conceptual framework of stratified reproduction and Crenshaw’s (1989) analytical framework of intersectionality, this research shows that surrogacy in Russia is culturally framed and therefore socially organised as an economic exchange, which gives rise to and reinforces different forms of intersecting reproductive stratifications. These stratifications include biological, social, geographic, geo-political and ethnic dimensions. Of particular novelty is the extension of Colen’s framework to address geographic and geo political stratifications. This was based on the finding that some women (temporarily) migrate or commute (over long distances) to work as gestational carriers. The thesis also demonstrates how an economic framing of surrogacy induced surrogacy workers to understand surrogacy gestation as work, which influenced their relationships with client parents. Given the rapid global increase in the use of surrogacy and its increasingly internationalised nature, this research into the social organisation of commercial gestational surrogacy in Russia is timely and has implications for users, medical practitioners and regulators, as well as researchers concerned with (cross-border) surrogacy and reproductive justice.
Open Access
Situational ethics in a feminist ethnography on commercial surrogacy in Russia: Negotiating access and authority when recruiting participants through institutional gatekeepers
(Methodological Innovations, 2018) Weis, Christina
In this article, I discuss methodological and ethical dilemmas that arose when I was recruiting participants with the help of medical and institutional gatekeepers during my ethnographic fieldwork on commercial surrogacy in St Petersburg, Russia. Using four selected case studies, I argue for the use of situational ethics. Ethics that are approved by institutional advisory boards prior to data collection are important to ensure that researchers do their best to identify potential ethical issues and offer deontological safeguards. However, as empirical researchers we are familiar with the unanticipated that is bound to happen once we commence data collection. I argue that in such cases, when the proposed and approved ethical conduct is no longer appropriate and researchers must make new ethical choices, situational ethics that take the immediate context into consideration are crucial. I further argue that situational ethics must not only be an extension of procedural ethics when the latter are no longer suited in situ, but an alternative option to procedural ethics from the beginning in order to make the research more ethical, empowering, and transformative of existing disadvantaging power relations. With this article, I encourage fellow (feminist) ethnographers to think outside the tick boxes for institutional advisory boards and contribute to the growing body of literature that argues in favour of situational ethics.
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Using Normalisation Process Theory (NPT) to develop an intervention to improve referral and uptake rates for self-management education for patients with type 2 diabetes in UK primary care
(BMC Health Services Research, 2022-09-27) Turner, Jessica; Martin, Graham; Hudson, Nicky; Shaw, Liz; Huddlestone, Lisa; Weis, Christina; Northern, Alison; Schreder, Sally; Davies, Melanie; Eborall, Helen
Background Referral and uptake rates of structured self-management education (SSME) for Type 2 diabetes (T2DM) in the UK are variable and relatively low. Research has documented contributing factors at patient, practitioner and organisational levels. We report a project to develop an intervention to improve referral to and uptake of SSME, involving an integrative synthesis of existing datasets and stakeholder consultation and using Normalisation Process Theory (NPT) as a flexible framework to inform the development process. Methods A three-phase mixed-methods development process involved: (1) synthesis of existing evidence; (2) stakeholder consultation; and (3) intervention design. The first phase included a secondary analysis of data from existing studies of T2DM SSME programmes and a systematic review of the literature on application of NPT in primary care. Influences on referral and uptake of diabetes SSME were identified, along with insights into implementation processes, using NPT constructs to inform analysis. This gave rise to desirable attributes for an intervention to improve uptake of SSME. The second phase involved engaging with stakeholders to prioritise and then rank these attributes, and develop a list of associated resources needed for delivery. The third phase addressed intervention design. It involved translating the ranked attributes into essential components of a complex intervention, and then further refinement of components and associated resources. Results In phase 1, synthesised analysis of 64 transcripts and 23 articles generated a longlist of 46 attributes of an embedded SSME, mapped into four overarching domains: valued, integrated, permeable and effectively delivered. Stakeholder engagement in phase 2 progressed this to a priority ranked list of 11. In phase 3, four essential components attending to the prioritised attributes and forming the basis of the intervention were identified: 1) a clear marketing strategy for SSME; 2) a user friendly and effective referral pathway; 3) new/amended professional roles; and 4) a toolkit of resources. Conclusions NPT provides a flexible framework for synthesising evidence for the purpose of developing a complex intervention designed to increase and reduce variation in uptake to SSME programmes in primary care settings.
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Whose eggs? Egg providers' perspectives on the creation and utilisation of eggs in the reproductive bio-economy.
(2019-09-04) Hudson, Nicky; Weis, Christina; Lafuente, S.
As part of the expansion of global fertility markets and an increasingly neo-liberal framing of reproduction, egg donation has undergone a number of technical, political and commercial transformations. Its use by a growing and diverse range of social groups, complex national changes in donor identification and compensation practices, and more recently the dawn of vitrification technologies have fundamentally reconfigured the process. This method of ‘fast freezing’ allows clinics increased flexibility in the storage, export, and import of eggs thereby opening up potential for increased commercialisation. Whilst existing research has focused on egg providers’ motivations and experiences or on the social processes contributing to these wider shifts, less attention has been given to women’s perceptions of contemporary developments and changing practices in what has been referred to as the new reproductive bio-economy. This paper draws on interviews with egg providers in the UK (n= 27) and Spain (n=25) carried out as part of the EDNA project (ESRC grant ref: ES/N010604/1). The interviews included questions designed specifically to generate data on values and principles relating to the use, storage, and distribution of eggs. We identified two themes from the accounts present in both countries. First, positivity towards the use of eggs for the treatment of several recipients, thus ensuring the eggs do not ‘go to waste’; and second, a generalized concern regarding what is perceived as the over-commercialization of eggs by clinics. Egg providers’ ideas and reasoning about the use of their eggs need to be taken into account as new techniques and protocols emerge for the clinical and commercial management of donated tissue. Decision-making and informed consent processes should also be reviewed in light of these shifts and incorporated into the wider policy context.

Browsing by Author "Weis, Christina"

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