In order to further spread awareness on issues within women’s health, it is highly important to discuss fascinating work being done by professionals as they make tangible contributions to improving the lives of numerous women.
Today, I am excited to share an interview that I had with Dr. Martha Ann Terry, a cultural anthropologist and former professor at the University of Pittsburgh School of Public Health, who graciously gave up her time to discuss several highlights of her career.
Meet the Expert
Name: Dr. Martha Ann Terry
Title: Associate Professor Emeritus, University of Pittsburgh School of Public Health
Background Information:
Dr. Terry is a trained cultural anthropologist with experience conducting field work with women in Mexico as well as with women exposed to HIV in two communities within Pittsburgh. Currently, she is a retired faculty member at the University of Pittsburgh School of Public Health.
Why did Dr. Terry become a cultural anthropologist?
After having her two children, Dr. Terry found out that her father had saved away money so that she would be able to afford to go back to school and receive a college degree. The first class that Dr. Terry took at her college was cultural anthropology, which immediately sparked her interest in the field.
She recalls that the professor of that class was just so excited and passionate about his work, even at his older age. Before this course, Dr. Terry had been unaware that anthropology even existed as a discipline. She remembers thinking, “holy crap. This is everything that I love.”
As she continued college and eventually received her master’s degree, Dr. Terry reflected that the work she had done within the field of anthropology was focused on living people, which made her realize that she was meant to become a cultural anthropologist.
Later on, after Dr. Terry earned her PhD, she became a faculty member at the University of Pittsburgh School of Public Health.
What made her decide to focus on women’s reproductive health?
Dr. Terry can still vividly remember when one of her professors told her that, “all you ever write about is contraceptives, family planning, sexuality – all of that kind of stuff”. She recalls that, “it was like almost literally the light bulb went on,” as she realized women’s reproductive health was the exact area of passion that she wanted to work in.
When asked why she decided to apply her cultural anthropology training to the field of public health, Dr. Terry stated, “To be honest, I can’t imagine doing anything else. My training as an anthropologist is really suited for doing critical and meaningful work in public health. I am trained to be mostly objective and at least to recognize biases, my prejudices, my filters, and be able to step back from those and be respectful of the way other people think.”
“To be honest, I can’t imagine doing anything else. My training as an anthropologist is really suited for doing critical and meaningful work in public health. I am trained to be mostly objective and at least to recognize biases, my prejudices, my filters, and be able to step back from those and be respectful of the way other people think.”
Dr. Terry’s Work in Mexico
What is some background information on Dr. Terry’s fieldwork in Mexico?
Dr. Terry conducted her field work in both a village and a city within the state of Tlaxcala, Mexico. Dr. Terry had the opportunity to stay in the house of one of her professors in the small village of Santa Maria Atzitzimitítlan de Belén. She interacted with the women residing there to collect data on their family planning decisions, interviewing 51 women in total.
At this time, Mexico was the ideal place to work in the family planning arena. The country had created a program dedicated to voluntary family planning that had been put into law since the early 1970s. Due to this, Dr. Terry did not have to worry about cost or accessibility as factors in Mexican women’s family planning decisions, as this program was spread out throughout the entire country and was free. Since these factors were controlled for, she was able to examine the other economic, social, and political factors that impacted women’s decisions about family planning in greater detail.
On top of spending a large amount of time in Belén, Dr. Terry also conducted interviews with women in La Ciudad de Tlaxcala, the capital city of the state, in order to get a better comparison of family planning decisions across different regions of the country. Here, she interviewed a total of 29 women.
What did her work in Mexico look like?
Dr. Terry spent the first three months of her time in Belén “getting the lay of the land”. This meant that she engaged in daily life activities such as discovering where to buy her groceries, understanding who her neighbors were, and learning where to catch the bus. She went to church, to the town square, to the school, and overall showed herself as a trustworthy figure within the community. Dr. Terry says that she just tried to be part of the town in addition to talking to women about their family planning decisions.
Within her first three months, she met a woman in Belén who had been married to the mayor of the town before he passed away. The woman owned a convenience store and was in the midst of raising five children by herself. She became an ally of Dr. Terry’s. The woman’s six-year-old daughter became Dr. Terry’s guide, taking her to the homes of women that her mother helped Dr. Terry recruit.
Her friend, who owned the store, or Dr. Terry herself would approach resident women of the town and ask them if she could interview them about their family planning decisions.
Dr. Terry tape recorded all of the discussions that she had with these women. Then, she would go back home and write up all of those field notes at night.
These interviews were a lot more than just saying “tell me about your family planning perspectives.” She was anthropological in how she came at those questions in a roundabout kind of way. Dr. Terry was looking at the broader circumstances of that particular woman’s life, such as how she made a living, what her parents thought about having children, and how many children were in the family that she grew up with. She wanted to ensure that her questions did not come off in a threatening sort of way.
How did Dr. Terry record qualitative data on these interviews?
Dr. Terry had three journals while she was living in Mexico:
One was dedicated to the interviews themselves and the notes that went along with those interviews.
The second was a daily journal of broad-based field notes. This included notes on what the weather that day was like or what people were doing while she was out in town.
Lastly, Dr. Terry kept a personal reflection journal, somewhat like a diary, where she reflected on how she was feeling or her reactions to what she was seeing.
“Qualitative work is really important for understanding how to create and implement effective public health programs. Without the stories that explain why you have certain numbers and statistics in your data, those numbers make no sense.”
What differences did Dr. Terry notice between the women she interviewed in the village versus the ones that she talked to in the city?
Dr. Terry says that women in the city were much more likely to be on modern contraception and, by and large, favored and supported family planning. These women were mostly college-educated. They were professionals such as lawyers, dentists, doctors, and engineers. Additionally, women in the city were much more open to talking about their family planning preferences.
In the small town of Belén, there was much more variation. Women used religion to justify their decision to have a greater number of children. If they were involved in family systems that required a lot of cooperation, they were much more likely to have a greater number of children because children served as connections within those networks.
Occasionally, she met couples who only wanted two children because they understood that while education is the future, it is also extremely expensive. This way, they could invest in their children going to college so that those kids could later come back and support their parents once they were grown.
What made the women in Belén willing to talk to Dr. Terry?
Dr. Terry says that “women in the village, I think, talked to me because they understood what I was there to do. They were being asked to cooperate by this woman [the store owner], who they admired because she was a widow, she was raising her five kids, and because of my advisor, the man whose home I lived in. He had done work in that village for about twenty-five years. He was incredibly well respected. He also donated money to the town. They were willing to talk to me, I think, a lot because of him.”
What was one major point that Dr. Terry took away from her time in Mexico?
When asked to provide one main lesson that Dr. Terry learned from her time interacting with women in Mexico, she stated that “if you want to get women who are not using contraceptives to use contraception, you have to first of all understand why they’re not. People make decisions because to them, they are rational decisions for the situation that they’re in.”
“If you want to get women who are not using contraceptives to use contraception, you have to first of all understand why they’re not. People make decisions because to them, they are rational decisions for the situation that they’re in.”
Dr. Terry’s Work With HIV
What is some background information on Dr. Terry’s work with women exposed to HIV?
Upon returning from Mexico, Dr. Terry began working with a five-year CDC-funded HIV prevention project in 1992. This project, aimed at women at high risk for HIV infections, was designed by the CDC as a community-based project with five intervention “prongs”. Both qualitative and quantitative data collection methods were utilized. This meant that each year, usually around ten months of qualitative work in the community was conducted. Then, two months of survey work was done in the two intervention communities and two non-intervention communities. As part of this initiative, Dr. Terry was hired as the urban ethnographer for five years at the University of Pittsburgh School of Public Health. Dr. Terry worked in two largely African American public-housing communities in Pittsburgh.
Local community members were hired to conduct the interviews and implement intervention strategies. Due to working with these local members, Dr. Terry and other professionals were part of this project to gain credibility. Plus, the professionals working on the CDC project were able to ask these local community members what their desired intervention strategies were. These community members wanted action taken in ways such as holding small group activities where people felt comfortable discussing HIV and creating print material to disseminate information on the disease throughout the neighborhood. These strategies aligned with the CDC’s vision of intervention methods that were originally part of the project’s plan.
What was the outcome of this project?
By the end of the five years, Dr. Terry and her co-workers discovered that this five-pronged intervention method significantly impacted their two outcome measures. These were how many women used male condoms in their sexual encounters and how many women talked to their male partners about using condoms.
How did Dr. Terry’s work with HIV compare to her work in Mexico? Did her work in Mexico influence her behavior when working with women at risk of contracting HIV?
Dr. Terry reflects that one major way that her experience in the field in Mexico aided her later work with HIV was being able to listen and ask non-threatening questions. She also says that her experience in Mexico allowed her to be better at figuring out why women were knowingly putting themselves at risk for contracting HIV. Most of all, it also allowed her to see the bigger systemic and structural picture and look at the context in which a situation is occurring.
Final Thoughts
What does Dr. Terry see as the next major issue within women’s health that public health professionals and people in my generation should start to focus on?
According to Dr. Terry, the next major area of focus is “in this country, at this moment, the whole arena of choice.”
She then goes on to explain that “women have been getting abortions for as long as we’ve been human. The thing that Roe v Wade did was make it safe for women to do that. If women cannot get abortions safely, they will get them unsafely. I worry about your ability to legally control your body.”
Thank you for reading today’s post and I hope you were just as fascinated and inspired as I am by Dr. Terry’s admirable contributions to the field of women’s health.
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