Reproductive justice on campus: Female students’ experiences seeking and accessing hormonal contraception in northern British Columbia

Problem: Access to hormonal contraception is a critical component of reproductive autonomy, yet structural and social barriers persist. Undergraduate students experience unique considerations around contraceptive decision-making related to service availability, campus culture, and lifestyle changes. While the implementation of universal contraception coverage in British Columbia (BC) has removed financial obstacles, the lived experiences of students indicate that challenges beyond cost remain. This study explores undergraduate students' experiences of seeking and accessing hormonal contraception in northern BC to better understand the factors shaping reproductive decision-making and service utilization. Methods: Using a feminist relational discourse analysis (FRDA) framework, this study examines the interplay between individual experiences and societal discourse to uncover power dynamics that influence contraceptive decision-making and engagement with sexual and reproductive health (SRH) services. Semi-structured interviews were conducted with five undergraduate students from the University of Northern British Columbia (UNBC), each of whom had sought or accessed hormonal contraception from a healthcare provider within the past year. The study employed poststructuralist discourse analysis to identify recurring themes, discourses, and discursive patterns, followed by voice-centered analysis to center participant narratives within broader sociopolitical contexts. Findings: Findings reveal that participants valued reproductive agency, yet their decisions were shaped by intersecting influences, including gender norms, misinformation, patient-provider interactions, and accessibility of services. Two key discursive patterns emerged: a uterus is a credential a man cannot acquire: gender concordance as a driver of trust, which highlights students’ preference for female healthcare providers based on perceived experiential knowledge and greater empathy; and my body, my choice ... but also my responsibility: negotiating the gendered division of labour in contraception, which reflects the internalized societal expectation that pregnancy prevention is primarily the responsibility of women, despite the recognized inequity in this burden. Participants described difficulties navigating contraceptive counselling, concerns about procedural pain management, and lack of comprehensive SRH education, all of which contributed to gaps in knowledge and barriers to care. Conclusions: This study concludes that while financial access to contraception has improved with universal coverage, significant relational, educational, and systemic obstacles remain. Postsecondary institutions and healthcare systems must take proactive steps to challenge the feminization of contraceptive labour, improve SRH education, and engage in shared decision-making during contraceptive counselling. By addressing these barriers and centering the voices of contraception users, institutions can move toward genuine reproductive justice, ensuring that students have the autonomy and support to make informed decisions about their reproductive health.