As International Women’s Day (March 8) approaches, the Maritime SPOR SUPPORT Unit is highlighting an MSSU Associate Scientist whose work centres the voices of women and gender diverse people whose experiences are often overlooked in health research.
Dr. Martha Paynter’s work focuses on access to abortion in the Maritimes and internationally, and sexual and reproductive health for people who are incarcerated.
In both areas, she says patient-oriented research is essential, not only from a justice perspective, but from a practical one.
“There’s a clear need for their voices to be included,” she explains, particularly in prison settings where people are “conceptualized as the patient” but often remain unheard.
Working in prisons adds layers of complexity
Access requires building relationships with both patients and “gatekeepers” inside prisons. It can involve what she describes as “this awkward dance” between advancing the human rights of prisoners and maintaining functional working relationships with institutions.
There are also realities that can’t be understood without lived experience guiding the research.
In sexual and reproductive health research, it is common to ask standard questions about pregnancy history or children. But in a carceral context, those questions can land very differently.
“Asking an incarcerated person about their children is a knife to the heart,” she says. “You don’t do that lightly.”
Without that patient lens, she notes, it is difficult to be “attuned” to the nuances of the carceral environment. Even after going into prisons for more than a decade, she says it still takes lived experience expertise “to have the accuracy that’s required to have relevant and meaningful research designs and findings.”
The same shift is happening in abortion research. For many years, she explains, research focused on providers and regulatory environments, with “much less on the patient experience.”
“We’ve so long stigmatized abortion and made it difficult to access that patients were incredibly difficult, slash reluctant, to be included,” she says.
That absence had consequences. When patient voices are not central, aspects of care such as cultural safety, gender inclusiveness, and reconciliation for colonial obstetric violence can be less visible in practice.
Paynter’s path into research began with community
She started by going into prisons to deliver sexual and reproductive health workshops.
“The work I was doing… was the entry point, and the research came later,” she says.
That grassroots beginning continues to shape her approach. She describes her work as emerging from “frontline, grassroots advocacy efforts” and being closely integrated with “the feminist practice of being in community with people.”
For researchers new to patient engagement, her advice is straightforward.
“You can’t just dive into a group and be like, ‘Hey, do you want to work with me?’” she says.
Instead, she works from a principle of reciprocity. She volunteers with organizations she partners with, including Elizabeth Fry Societies, so that when she seeks research collaboration, she does not feel she is “exploiting” or “parachuting” into a community.
MSSU support
MSSU supported her early in her academic journey through a doctoral scholarship. She describes that support as “validating” and “practically very important,” reinforcing that her approach to patient-oriented research “made sense.”
Today, she serves on MSSU’s Trainee Support Program selection committee and supervises students who are continuing this work, including a PhD student examining rural experiences following incarceration.
Across Canada, she sees increasing attention to patient engagement in research proposals and review processes.
“Having some patient engagement is definitely better than none,” she says.
For Dr. Paynter, the work remains deeply personal.
“It’s a real pleasure,” she says. “I’m very privileged.”
On International Women’s Day, her work is a reminder that advancing women’s and gender diverse health research means listening carefully, especially in places where their voices have historically been hardest to hear.
