Leigh Senderowicz, ScD, MPH
Reproductive and Population Health
Leigh Senderowicz is a social demographer and mixed-methods researcher. Her research focuses on rights-based approaches to international sexual and reproductive health, studying the role of quantification and other structural factors in the production of reproductive health outcomes. Dr. Senderowicz manages a diverse portfolio of mixed-methods research throughout the world, but her particular geographic area of interest is francophone West Africa. Dr. Senderowicz will explore patient-centered measures for reproductive health and develop new approaches to measurement and evaluation that promote reproductive autonomy.
|M.P.H.||Women's and Reproductive Health, Johns Hopkins University, Baltimore, MD|
|Ph.D.||Global Health and Population, Harvard University, Cambridge, MA|
Leigh Senderowicz, ScD, MPH, assistant professor in the Division of Reproductive and Population Health, published an article in Studies in Family Planning about a common indicator in global family planning programs.
In “Assessing the Suitability of Unmet Need as a Proxy for Access to Contraception and Desire to Use It”, Senderowicz and co-authors used survey data from Burkina Faso to understand whether the “unmet need” indicator in family planning programs mapped to peoples’ actual desire to use a method of contraception:
“Results show unmet need has low sensitivity and specificity in differentiating those who lack access and/or who desire to use a method from those who do not. These findings suggest that unmet need is of limited utility to inform family planning programs and may be leading stakeholders to overestimate the proportion of women in need of expanded family planning services.”
Read the whole study here!
Reproductive health care trends, norms and policies in the United States shape global reproductive health in a big way. UW Ob-Gyn Health Disparities Research Scholar Leigh Senderowicz, ScD, MPH joined the Women’s Healthcast to talk about the roots of international family planning programs, how to recognize reproductive coercion, and why we should pay attention to the way U.S. policies can affect individual health across the world.
Listen to Reproductive Health Worldwide now.
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Leigh Senderowicz, ScD, MPH, assistant professor in the UW Ob-Gyn Division of Reproductive and Population Health, is building a distinguished reputation as a leading scholar in contraceptive autonomy, with numerous publications and international presentations on the topic. Her 2020 article suggesting contraceptive autonomy as a novel family planning indicator even informed the 2021 Doctors Without Borders Contraceptive Guidelines toolkit!
In a new article published in Studies in Family Planning, Senderowicz and co-authors pilot a novel measure of contraceptive autonomy at two sites in Burkina Faso. “Measuring Contraceptive Autonomy at Two Sites in Burkina Faso: A First Attempt to Measure a Novel Family Planning Indicator” uses a cross-sectional, population-based survey of more than 3,900 reproductive-aged women to assess elements of the contraceptive autonomy evaluation tool:
“Rather than viewing the measurement approach assessed here as a final tool ready to be scaled up, we view this as an important step on a longer road toward a more rights-based and person-centered measurement agenda for the global family planning community. We caution that, even with considerable more development, some of the key elements of contraceptive autonomy may never be able to be measured well at the population level, since this survey approach necessarily limits our data to what our respondents know, and what they choose to share. This acknowledgment, however, should not be a deterrent to those seeking to address the vital need for new family planning indicators that measure people's own desires and trust them to be the experts on their own lives.”
Read the whole study here!
Leigh Senderowicz, ScD, MPH, assistant professor in the UW Ob-Gyn Division of Reproductive and Population Health, will share her research at the UW-Madison Science Outreach event Wednesday Nite @ the Lab at 7:00pm on February 1, 2023! More information about the event and how to attend is available here.
In the talk "I Was Obligated to Accept: Coercion and Autonomy in Contemporary Global Family Planning”, Senderowicz will explore the ways that the ideology of fertility reduction permeates the design and quantitative evaluation of contemporary family planning projects, 25 years after the International Conference on Population and Development called for an end to population control. The talk will draw from the Contraceptive Autonomy Study, a project designed to explore various dimensions of autonomy and coercion in family planning and to develop new theories about why and how adverse experiences with contraceptive coercion manifest. This presentation will focus especially on modes of measurement, and the challenges to designing new measures that better assess person-centered and justice-based approaches to contraceptive care.
Wednesday Nite @ The Lab is a free public science series offered every Wednesday night, 50 times a year, starting at 7:00 pm. WN@TL is a research seminar at which researchers share their work in a way geared for a public audience. Learn more and register here!
Senderowicz’s presentation at International Conference on Family Planning featured in Global Health Now
Leigh Senderowicz, ScD, assistant professor in the UW Ob-Gyn Division of Reproductive and Population Health, presented at the International Conference on Family Planning in Thailand in November. She presented “The effect of a postpartum IUD program on contraceptive method choice in Tanzania: Results from a cluster-randomized stepped-wedge trial” and was part of a session on contraceptive choice, coercion, and ethics.
Global Health Now, out of the Johns Hopkins Bloomberg School of Public Health, recapped Senderowicz’s presentation in the article “Contraceptive Coercion Still Happens.” The article describes the family planning community’s assumed shift away from coercive methods. But her research suggests otherwise:
“Senderowicz set out to hunt for evidence of ongoing contraceptive coercion, and to apply a reproductive justice lens to understand how communities make sense of it. Her team conducted 17 focus group discussions with 146 women in urban and rural settings in an anonymized sub-Saharan African country. (It was necessary to keep the country anonymized, she said, to avoid tying any negative associations of coercion to a single country.)
What they concluded: Contraceptive coercion was in fact very widely acknowledged in the communities they studied…”
Read the whole article here!
In a new study in Health Policy and Planning, Leigh Senderowicz, ScD, assistant professor in the UW Ob-Gyn Division of Reproductive and Population Health, evaluates postpartum intrauterine device (PPIUD) programs on outcomes related to contraceptive choice.
“The effect of a postpartum intrauterine device program on choice of contraceptive method in Tanzania: a secondary analysis of a cluster-randomized trial” surveyed eligible women on provider postpartum contraceptive counselling during pregnancy or immediately postpartum:
“Likelihood of receiving counselling on any non-IUD method decreased among those exposed, while the likelihood of being counselled on IUD alone was fourteen percentage-points higher among the exposed (95% CI:0.06, 0.22), suggesting this intervention increased IUD-specific counselling but reduced informed contraceptive choice. These findings underscore the importance of broad metrics that capture autonomy and rights (in addition to programmatic goals) at all stages of health program planning and implementation.”
See the study here!
In a new study in SSM – Qualitative Research in Health, Leigh Senderowicz, ScD, assistant professor in the UW Ob-Gyn Division of Reproductive and Population Health, uses focus group data to assess peoples’ experiences having long-acting reversible contraceptives (LARC) removed when desired.
In previous works, Senderowicz laid out a definition of contraceptive autonomy that includes being able to discontinue an undesired method as a necessary component of autonomy. In ““She told me no, that you cannot change”: Understanding provider refusal to remove contraceptive implants”, Senderowicz and co-author Al Kolenda found this measure of autonomy is not always respected:
“Showing that contraceptive coercion is commonplace at the time of desired method discontinuation for women, these results call for a sweeping shift away from family planning programs that conceptualize method discontinuation as a programmatic failure. The global family planning community must shift both the mentalities and the measurement approaches that characterize method discontinuation as a negative outcome, and instead view method removal as an essential part of any rights-based family planning approach (Senderowicz, 2020). Method discontinuation on request – for any reason or no reason at all – is a key component of contraceptive autonomy.”
Read the whole study here.
Assistant Professor Leigh Senderowicz, ScD, of the UW Ob-Gyn Division of Reproductive and Population Health, is lead author on a new study published in Contraception!
In “Contraceptive method denial as downward contraceptive coercion: A mixed-methods mystery client study in Western Kenya”, Senderowicz and co-authors analyze mystery client interactions, focus groups, key informant interviews, and more to estimate the frequency with which people are denied the contraceptive method of their choice in western Kenya. Method denial can be a barrier, in addition to financial and logistical barriers, to reproductive autonomy:
“Providers may impose unnecessary restrictions on contraceptive access that limit the ability of women to achieve their desired family size. Unwarranted method denial occurs in approximately one out of every 5 visits to public-sector facilities in Western Kenya and presents a major impediment to reproductive autonomy and justice.”
Read the whole study here.
A recent article in Good Housekeeping discusses several aspects of intrauterine device (IUD) experiences, including pain during the procedure, options for pain management, what removal looks like, and more.
In the article, UW Ob-Gyn Assistant Professor Leigh Senderowicz, ScD, of the Division of Reproductive and Population Health, offered a perspective on why pain with this procedure may not always be recognized:
“IUD insertion pain may be another example of the gender pain gap, an adjacent topic that has recently been experiencing a swell of attention. It’s based on the understanding that there is an implicit bias in health care rooted in sexism and racism that has led to the underserving of women in medical settings. Even if your practitioner is another person with a uterus, and a person of color, they are working within a system that still doesn’t adequately legitimize pain experienced by women or marginalized folks. “The pain gap is particularly pronounced when it comes to gynecological services, because for most of medical history, and up until now, women’s voices about what they are experiencing have been disregarded, minimized and trivialized,” says Leigh Senderowicz, a health disparities research scholar at the University of Wisconsin School of Medicine and Public Health.”
Read the rest of the article here!
A new study in the journal Perspectives on Sexual and Reproductive Health by UW Ob-Gyn Division of Reproductive and Population Health Director Jenny Higgins, PhD, MPH and Health Disparities Research Scholar Leigh Senderowicz, ScD examines connections between economic resources and sexual wellbeing.
“Sex, poverty, and public health: Connections between sexual wellbeing and economic resources among US reproductive health clients” used data from the HER Salt Lake study, a longitudinal cohort study of family planning clients. Researchers compared measures of economic health, including housing and food security, with measures of sexual wellbeing like sexual functioning and satisfaction and current sex-life rating, finding:
“Financial scarcity appears to constrain sexual wellbeing. To support positive sexual health, the public health field must continue to focus on economic reform, poverty reduction, and dismantling of structural classism as critical aspects of helping people achieve their full health and wellbeing potential.”
Read the whole study here!
This study was conducted with funding from: Collaborative for Reproductive Equity (CORE) at the University of Wisconsin-Madison, Grant/Award Number: P2C HD047873; Center for Clinical and Translational Sciences, Grant/Award Number: 8UL1TR000105; Building Interdisciplinary Researchers in Women's Health, Grant/Award Number: K12 HD085852; The William and Flora Hewlett Foundation; The Society of Family Planning Research Fund; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Grant/Award Numbers: R01 HD095661, T32HD049302, K24 HD087436, P2C HD047873, K12 HD085852
We are thrilled to announce that Leigh Senderowicz, ScD, MPH will join the UW Ob-Gyn Division of Reproductive and Population Health in August 2022 as assistant professor! Senderowicz will be jointly appointed with the UW-Madison Department of Gender and Women’s Studies (75%) and the Department of Ob-Gyn (25%).
She has been part of our department since 2019, when she joined us as an NICHD postdoctoral fellow with the UW Ob-Gyn Health Disparities Research Scholars program. Senderowicz earned a Master’s in Public Health from Johns Hopkins University and ScD from the Harvard University T.H. Chan School of Public Health. Her research focuses on rights-based approaches to international sexual and reproductive health.
Please help us welcome Dr. Senderowicz to her new role in the Department!
Health Disparities Research Scholar Leigh Senderowicz, ScD is lead author on a new publication in the journal Population and Development Review!
In “Supply-Side Versus Demand-Side Unmet Need: Implications for Family Planning Programs”, Senderowicz summarizes different critiques of the “unmet need” measure, suggests a modification to the indicator, and uses data from the Demographic and Health Surveys in seven countries to demonstrate the modification.
Read the whole article here. Incredible work, Dr. Senderowicz!
Health Disparities Research Scholar Leigh Senderowicz, ScD, recently shared an incredible example of academic work having real-world impact – in this case, world-wide impact!
Senderowicz is an accomplished researcher with a particular interest in contraceptive autonomy: the idea that people should have free, full, informed choice about whether to use contraception, and which method they choose. She developed a framework to measure global family planning program outcomes in terms of free, full, informed consent – read more about it in Studies in Family Planning.
That incredible framework helped inform the Medecins Sans Frontieres/Doctors Without Borders Contraceptive Guidelines toolkit, launched in 2021 for use in MSF’s global health efforts. We would like to congratulate Dr. Senderowicz on this terrific use of her work! You’re changing lives around the world, truly!
Take some time to learn more about Dr. Senderowicz’s research: read some of her recent articles in BMJ Global Health, Social Science & Medicine, and Studies in Family Planning. And listen to her interview on the Women’s Healthcast: Reproductive Health Worldwide. Congratulations, Dr. Senderowicz!
Health Disparities Research Scholar Leigh Senderowicz, ScD, MPH published a new study in BMJ Global Health!
The article “‘I haven’t heard much about other methods’: quality of care and person-centredness in a programme to promote the postpartum intrauterine device in Tanzania” used in-depth, qualitative interviews with pregnant people seeking antenatal care at five Tanzanian hospitals and satellite clinics. The study found:
“The intervention led providers to emphasise the advantages of the IUD through biased counselling, and to de-emphasise the suitability of other contraceptive methods. Respondents reported being counselled only about the IUD and no other methods, while other respondents reported that other methods were mentioned but disparaged by providers in relation to the IUD. A lack of trained providers meant that most counselling took place in large groups, resulting in providers’ inability to conduct needs assessments or tailor information to women’s individual situations.”
Read the whole article here!
Health Disparities Research Scholar Leigh Senderowicz, ScD, MPH shared insights on the history of reproductive coercion in the United States in an article from The Lily about revelations from Britney Spears’ conservatorship hearing.
In the article, Senderowicz discussed the different levels at which reproductive coercion can occur, with a focus on the systemic:
“Reproductive coercion, the act of controlling someone else’s reproductive health, has a long history in the United States, Senderowicz said. The medical and legal systems, she said, have worked together to try to control women’s reproductive choices, especially the choices of women deemed less worthy or capable of having children, including women of color, disabled women and women with mental health conditions.
“It’s not happening because of individual doctors or nurses or individual conservators,” she said. “The idea that some people should reproduce and some people shouldn’t is baked into our institutions.”"
Read the whole article here!
UW Ob-Gyn Health Disparities Research Scholar Leigh Senderowicz, ScD, MPH, earned a grant from the UW-Madison Prevention Research Center for the project “Understanding Structural Barriers To Contraceptive Autonomy Among Low-Income Black African Women In The Global South: An Exploratory Study.” The grants support research regarding maternal and child health, and health equity.
With the grant, Senderowicz will use “in-depth interviews and focus group discussions…to generate a nuanced understanding of contraceptive autonomy among low-income Black African women of reproductive age living in a Global South setting. The analysis will focus on multiple dimensions of choice and access to rights-based reproductive health care.”
Congratulations, Dr. Senderowicz!