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Choice, Morality and Vulnerability: Young Women’s Discourses of Cervical Screening 

 

 

 

A thesis presented in partial fulfilment of the  

requirements for the degree of 

 

 

Master of Science 

in  

Psychology (Endorsement in Health Psychology) 

 

 

At Massey University, Albany 

New Zealand 

 

 

Holly Coulter 

2016  



YOUNG WOMEN’S DISCOURSES OF CERVICAL SCREENING
  1 

Abstract 

Cervical screening is a health surveillance tool used to prevent cervical cancer. In New 

Zealand, research into cervical screening has largely focused on barriers to participation. 

This type of research implicitly assumes that cervical screening is a desirable health 

behaviour for women to engage in, and does not explore how social and political factors are 

implicated in cervical screening behaviour. This research sought to explore women’s 

understandings and experiences of cervical screening. Ten women aged 20 to 30 were 

interviewed, their responses recorded and transcribed, and an interpretive analysis 

conducted. From the analysis, three broad webs of discourse surrounding cervical screening 

– choice, morality and vulnerability – were identified and discussed.  Each web of discourse 

was used to construct cervical screening in different ways. For choice, participants 

constructed cervical screening as an autonomous choice, routine, or an obligation. Morality 

was drawn upon for its role in cervical screening around ideas of individual and social 

responsibility, and sexual activity. Finally, vulnerability was explored through the fear of 

getting cervical cancer, the vulnerability experienced as part of screening, and the 

protection it was seen to offer. Choice, morality and vulnerability worked together to limit 

the available ways of experiencing and acting in relation to cervical screening, constructing 

compliance as the only option for women. Those who do not comply are positioned as 

problematic, irresponsible and immoral by women, their friends and families, and health 

professionals. This research highlighted the ways in which discourses produce realities 

which create and maintain power imbalances which govern and control women’s bodies. 

Rather than viewing cervical screening as a desirable yet morally neutral act which all 

women ought to participate in, it is a site where women may choose to comply or resist 

dominant discourses which exert power over women’s bodies.  



YOUNG WOMEN’S DISCOURSES OF CERVICAL SCREENING
  2 

Acknowledgements 

 

I am so grateful to the individuals and groups who made this project possible. Immense 

thanks to the amazing women who took part in the research, sharing their stories and 

experiences; to the New Zealand Federation of Graduate Women North Shore Branch for 

awarding me with their Scholar of the Year scholarship to make life infinitely less stressful; 

to my supervisor Kerry Chamberlain for the ongoing guidance and pushing me to challenge 

myself; to everyone at Women’s Health Action for their support and encouragement; to 

Sam for being my own personal cheerleader; to my family and friends for their endless 

patience with my stress and procrastination; and to Ernest Hemingway for the mantra that 

got me through this year: the first draft of anything is shit. 

  



YOUNG WOMEN’S DISCOURSES OF CERVICAL SCREENING
  3 

 

Contents 

Abstract ................................................................................................................................................... 1 

Acknowledgements ................................................................................................................................. 2 

Introduction ............................................................................................................................................ 5 

Background ......................................................................................................................................... 5 

Previous Research ............................................................................................................................. 10 

Critique .............................................................................................................................................. 14 

Theoretical Framework ..................................................................................................................... 18 

Methods ................................................................................................................................................ 23 

Methodology ..................................................................................................................................... 23 

Ethical considerations ....................................................................................................................... 24 

Protection of participant information and right to withdraw ...................................................... 24 

Participant and researcher safety ................................................................................................. 25 

Cultural Consultation .................................................................................................................... 25 

Participants, recruitment and selection............................................................................................ 26 

Participants ................................................................................................................................... 26 

Recruitment .................................................................................................................................. 28 

Selection ........................................................................................................................................ 28 

Sample ........................................................................................................................................... 29 

Interview Procedure ......................................................................................................................... 29 

Initial contact ................................................................................................................................ 29 

Interview setting ........................................................................................................................... 29 

Interview process .......................................................................................................................... 30 

Data Analysis ..................................................................................................................................... 32 

Transcribing ................................................................................................................................... 32 

Analysis ......................................................................................................................................... 33 

Findings & Discussion ............................................................................................................................ 36 

Choice ................................................................................................................................................ 36 

Cervical screening as an autonomous choice ............................................................................... 36 

Cervical screening as routine ........................................................................................................ 40 

Cervical screening as obligatory .................................................................................................... 42 

Drawing upon discourses of choice .............................................................................................. 45 

Morality ............................................................................................................................................. 49 

Individual responsibility ................................................................................................................ 49 



YOUNG WOMEN’S DISCOURSES OF CERVICAL SCREENING
  4 

Social responsibility....................................................................................................................... 52 

Sexual activity ............................................................................................................................... 54 

Drawing upon discourses of morality ........................................................................................... 57 

Vulnerability ...................................................................................................................................... 62 

Vulnerability to cervical cancer ..................................................................................................... 62 

Protection through cervical screening .......................................................................................... 65 

Vulnerability as part of cervical screening experience ................................................................. 66 

Drawing upon discourses of vulnerability ..................................................................................... 70 

Choice, morality and vulnerability .................................................................................................... 74 

Conclusion ............................................................................................................................................. 76 

References ............................................................................................................................................ 81 

Appendices ............................................................................................................................................ 88 

Appendix A: Participant Information Sheet ...................................................................................... 88 

Appendix B: Recruitment email sent to Women’s Health Action mailing list .................................. 90 

Appendix C: Facebook post to recruit participants - Massey University Extramural Community 
group ................................................................................................................................................. 91 

Appendix D: Facebook post to recruit participants - Auckland Women’s Centre page ................... 92 

Appendix E: Interview schedule ........................................................................................................ 93 

Appendix F: Participant consent form .............................................................................................. 95 

Appendix G: Interview questions (original version) .......................................................................... 96 

Appendix H: Cervical screening resources offered to participants ................................................... 98 

Appendix I: Interview questions (revised version)............................................................................ 99