Im/migration experiences, healthcare access, and impacts of the COVID-19 pandemic: Findings of community-based qualitative research with im/migrant women in British Columbia, Canada

This dissertation uses qualitative and community-based research to explore women's im/migration and healthcare experiences during and beyond the COVID-19 pandemic in the lower mainland of British Columbia, Canada. The research specifically focuses on the experiences of two populations that have been underrepresented in im/migrant health research: women with precarious im/migration status, and younger im/migrant women. More specifically, this dissertation interrogates the role of structures and processes of marginalization through three distinct studies of im/migrant women's lives. I do this by 1) examining how migration experiences shape women's access to healthcare; 2) exploring how im/migration shapes young women's experiences of pregnancy, motherhood, and marriage; and 3) investigating the impacts of shifts in health service delivery made early during the COVID-19 pandemic on young im/migrant women's access to sexual and reproductive healthcare. The research in this dissertation is conceptually underpinned by a framework that brings together intersectionality theory, a migration process framework, the structural determinants of health, and a framework for patient-centered healthcare access. I emphasize personal experience, interpretation, and knowledge shaped by im/migrant women who led, participated in, and collaborated on all stages of the research. Im/migrant women's descriptions of healthcare needs and experiences of seeking and using care for sexual and reproductive health, mental health, and chronic conditions illustrate how healthcare access is shaped by multiple experiences. These include experiences at origin, during travel, and in transit settings; experiences of unplanned pregnancies and unequal gendered power dynamics; and the transition to virtual health services and restricted in-person care early during the COVID-19 pandemic. Together, these findings present important understandings of im/migrant women's experiences and critical areas for action within Canada's im/migration, health, and employment systems. The research highlights the dynamic nature of im/migrant lives and the need for efforts that are context specific. Ultimately, this dissertation demonstrates that all people, including im/migrant women, deserve to live full lives, have their needs met, and thrive with optimal health and well-being.