By Monica R. McLemore
I believe that together, reproductive justice and research justice should result in health justice.
I am choosing to focus on research because it is the evidence base that is foundational to clinical care provision and because teaching is generated by research.
Thus, research serves as one root cause of harm associated with clinical care and teaching, and a potential barrier to realizing health justice, which has been outlined as a comprehensive approach to resolve the social determinants of health and develop jurisprudence toward health equity. Research justice is critical to the conceptualization, development and implementation of these measures.
However, the law cannot establish health justice without reproductive justice, at least not for pregnant-capable people. Reproductive health, rights, and justice have been the proverbial canaries in the coal mine when considering the loss of bodily autonomy and human rights.
As a public health trained nurse researcher, I have used community engagement, molecular, qualitative, and quantitative research methods to answer important research questions specific to sexual and reproductive health.
I have been accused of being “intellectually promiscuous” for attempting to become a methodologist, when the truth was, I wanted to be positioned to design research studies that would test interventions with, for, and by the most burdened people with poor health outcomes: Black women. This requires multi-modal approaches and novel methods.
I needed to defy the existing rules specific to research, which were predicated upon the need to carve up pregnant-capable people into body parts and disease states. Collecting meaningful data about the health of Black people that were not grounded in stigma, shame, judgement or blame narratives requires an intersectional approach to research justice.
Research justice transforms the production of knowledge and the process of conducting research. One principle that underlies research justice is the notion that data are community-defined, generated, prioritized, and disseminated. Research designed according to justice principles cannot and should not be separated from the communities from which data are collected. Community members’ roles and expertise as co-researchers are acknowledged in any and all projects. Importantly, community engagement is essential to all aspects of research. As co-researchers, community members are involved in the process from the beginning, including grant writing, idea generation, study design and methods, budgeting, and ethics review.
I use this research justice approach alongside my focus on reproductive justice, which is the theory, praxis, framework, and lens that guides my work.
As I explain with my co-authors in the Harvard Law & Policy Review, “Reproductive justice posits that: (1) every person has the right to decide if and when to become pregnant, and to determine the conditions under which they will birth and create family; (2) every person has the right to decide they will not become pregnant or have a baby, as well as have accessible and available options to prevent or end pregnancy; (3) individuals have the right to parent children they already have with dignity, with the necessary social supports, in safe environments and healthy communities, and without fear of violence from individuals or the government; and (4) individuals have the right to disassociate sex from reproduction as healthy sexuality and pleasure are essential components to whole and full human life.”
Reproductive justice can and should be combined with research justice when considering knowledge production, the design and testing of interventions, and community engagement in the conduct of research.
By connecting reproductive and research justice, we move toward the elimination of scientific racism, structural racism, and the historic exclusion of community wisdom that underpin the current evidence base for clinical care, teaching, and policy measures to address the social and structural determinants of health.
If we are serious about operationalizing health equity, it will be essential to combine the analytic and actionable power of reproductive justice and research justice.
Monica R. McLemore, PhD, MPH, RN, FAAN is a tenured associate professor in the Family Health Care Nursing Department at the University of California, San Francisco, an affiliated scientist with Advancing New Standards in Reproductive Health, and a member of the Bixby Center for Global Reproductive Health.