Professor Lorraine Culley

Job: Emeritus Professor of Social Science and Health

Faculty: Health and Life Sciences

School/department: School of Applied Social Sciences

Address: De Montfort, University, The Gateway, Leicester, LE1 9BH.

T: +44 (0)116 257 7753

E: lac@dmu.ac.uk

W: http://www.dmu.ac.uk/hls

 

Personal profile

Lorraine Culley is a sociologist by background and a graduate of the Universities of Liverpool (BA, PhD) and London (MA). Her research is focused on social and political aspects of health and healthcare, with a particular emphasis on ethnic and gender inequalities, chronic conditions, social aspects of infertility, reproductive technologies and endometriosis.

Lorraine has particular expertise in qualitative methodologies and in research which explores user perspectives of health and healthcare.

She has held grants from several major funders, including the NIHR and the ESRC. Her work includes over 80 publications and has featured in programmes on BBC World TV, BBC Radio 4, 5 Live, and Asian Network. 

Lorraine has taught courses on sociological aspects of diversity and the sociology of health and illness on a wide range of programmes at DMU and has been a course leader at undergraduate and postgraduate levels. Her academic management experience includes several years as head of the Health Studies Division and she has held a number of faculty and university level appointments.

Lorraine is on the editorial board of the Journal of Research in Nursing.  She is a member of the Children’s Health Forum of the South Asian Health Foundation.

Publications and outputs 

  • Factors influencing the utilisation of free-standing and alongside midwifery units in England: A Qualitative Research Study
    Factors influencing the utilisation of free-standing and alongside midwifery units in England: A Qualitative Research Study Walsh, Denis; Spiby, Helen; McCourt, Christine; Grigg, Celia; Coleby, Dawn; Bishop, Simon; Scanion, Miranda; Culley, Lorraine; Wilkinson, Jane; Pacanowski, Lynne; Thornton, Jim Objective: To identify factors influencing the provision, utilisation and sustainability of midwifery units (MUs) in England Design: Case studies, using individual interviews and focus groups, in six NHS Trust maternity services in England Setting & Participants NHS maternity services in different geographical areas of England Maternity care staff and service users from 6 NHS Trusts: 2 Trusts where more than 20% of all women gave birth in MUs, 2 Trusts where less than 10% of all women gave birth in MUs and 2 Trusts without MUs. Obstetric, midwifery and neonatal clinical leaders, managers, service user representatives and commissioners were individually interviewed (n=57). Twenty-six focus groups were undertaken with midwives (n=60) and service users (n=52). Main Outcome Measures: Factors influencing MU use Findings: The study findings identify several barriers to the uptake of MUs. Within a context of a history of obstetric-led provision and lack of decision-maker awareness of the clinical and economic evidence, most Trust managers and clinicians do not regard their MU provision as being as important as their obstetric unit (OU) provision. Therefore, it does not get embedded as an equal and parallel component in the Trust’s overall maternity package of care. The analysis illuminates how implementation of complex interventions in health services is influenced by a range of factors including the medicalisation of childbirth, perceived financial constraints, adequate leadership and institutional norms protecting the status quo. Conclusions: There are significant obstacles to MUs reaching their full potential, especially free-standing midwifery units (FMUs). These include the lack of commitment by providers to embed MUs as an essential service provision alongside their OUs, an absence of leadership to drive through these changes and the capacity and willingness of providers to address women’s information needs. If these remain unaddressed, childbearing women’s access to MUs will continue to be restricted. The file attached to this record is the author's final peer reviewed version. open access journal
  • Re-thinking egg donation in Europe: expanding practice, extending boundaries.
    Re-thinking egg donation in Europe: expanding practice, extending boundaries. Hudson, Nicky; Culley, Lorraine; Coveney, C.; Herbrand, C.; Pavone, V.; Lafuente, S.; Pennings, G.; Provoost, V.; Weis, C. The expansion of the use of donor eggs in fertility treatment has been exponential. Whilst the majority of egg donation historically took place in the US, donor eggs are used in over 56, 000 cycles of fertility treatment per year in Europe and a number of European egg donation ‘hubs’ have emerged, for example in Spain and Cyprus. Growth in the use of donor eggs in part reflects a changing profile amongst users of assisted reproductive technologies, including growing numbers of older women, male same sex couples, and those at risk from genetic conditions. An increasing number of egg donor ‘intermediaries’ such as egg banks and agencies have also emerged in the European context, reflecting a general shift towards an increasingly commercialised landscape around fertility treatment provision. Despite these changes, few studies have specifically considered their implications. Drawing on an ESRC-funded study on the economic, political and moral configuration of egg donation in the UK, Spain and Belgium, we suggest that changes in the ways egg donation is provided in the European context are worthy of increased attention. Data from policy mapping and interviews with policy stakeholders and professionals illustrate significant shifts in professional and commercial practice. These changes are reshaping the intersubjective, political and social boundaries involved in egg donation in novel and complex ways. We suggest that the expansion and diversification of its use has implications for the policy and regulation of egg donation the European context.
  • Egg providers' views on the use of surplus eggs in the UK, Spain and Belgium: implications for information giving and informed consent (POSTER)
    Egg providers' views on the use of surplus eggs in the UK, Spain and Belgium: implications for information giving and informed consent (POSTER) Hudson, Nicky; Culley, Lorraine; Herbrand, C.; Weis, Christina; Coveney, C.; Goethals, T.; Lafuente, S.; Pavone, V.; Pennings, G.; Provoost, V.
  • Qualitative study to identify ethnicity-specific perceptions of and barriers to asthma management in South Asian and White British children with asthma
    Qualitative study to identify ethnicity-specific perceptions of and barriers to asthma management in South Asian and White British children with asthma Lakhanpaul, M.; Culley, Lorraine; Huq, T.; Robertson, N.; McFeeters, Melanie; Manikam, L.; Johal, N.; Hamlyn-Williams, C.; Hudson, Nicky; Bird, D.; Johnson, M.R.D. Objective This paper draws on the data from the Management and Interventions for Asthma (MIA) study to explore the perceptions and experiences of asthma in British South Asian children using semi-structured interviews. A comparable cohort of White British children was recruited to identify whether any emerging themes were subject to variation between the two groups so that generic and ethnicity-specific themes could be identified for future tailored intervention programmes for South Asian children with asthma. Setting South Asian and White British children with asthma took part in semi-structured interviews in Leicester, UK. Participants Thirty three South Asian and 14 White British children with asthma and aged 5–12 years were interviewed. Results Both similar and contrasting themes emerged from the semi-structured interviews. Interviews revealed considerable similarities in the experience of asthma between the South Asian and White British children, including the lack of understanding of asthma (often confusing trigger with cause), lack of holistic discussions with healthcare professionals (HCPs), an overall neutral or positive experience of interactions with HCPs, the role of the family in children’s self-management and the positive role of school and friends. Issues pertinent to South Asian children related to a higher likelihood of feeling embarrassed and attributing physical activity to being a trigger for asthma symptoms. Conclusions The two ethnicity-specific factors revealed by the interviews are significant in children’s self-management of asthma and therefore, indicate the need for a tailored intervention in South Asian children. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. Open access article
  • Women’s experience of social egg freezing: perceptions of success, risks, and ‘going it alone’
    Women’s experience of social egg freezing: perceptions of success, risks, and ‘going it alone’ Baldwin, K.; Culley, Lorraine Abstract Objective: To explore how female users of social egg freezing technology reported their experience of freezing eggs for ‘social’ reasons. Background: Very few studies have explored women’s experiences of social egg freezing. The limited primary research on this topic has suggested that users find the process of freezing eggs emotionally challenging. Methods: Semi-structured interviews were carried out with 31 women who identified as undergoing egg freezing for social reasons. Interviews lasted between 40 minutes and two hours, were audio recorded and transcribed verbatim. Data were analysed using thematic analysis assisted by Nvivo 10. Results: Women employed multiple concepts of egg freezing 'success'. They reported a lack of detailed discussion of post-freezing processes and outcomes in their encounters with clinicians, and, contrary to the recommendations of professional associations, were not given clinic or age specific information. Few perceived freezing as involving physical risks. However, many participants reported the process of egg freezing as emotionally challenging, primarily linked to feelings of isolation and stigma due to their single status Conclusion Participants were generally satisfied with the treatment they received from clinics. However, they expressed a desire for more detailed information about potential outcomes from egg freezing and suggested ways in which clinics might address the emotional challenges of undertaking this process as an unpartnered person. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
  • Materialising the perfect egg 'donor': examining the work of screening technologies in clinical, commercial and counselling practices
    Materialising the perfect egg 'donor': examining the work of screening technologies in clinical, commercial and counselling practices Hudson, Nicky; Coveney, C; LaFuente, S; Provoost, V; Culley, Lorraine; Herbrand, C; Pavone, V; Pennings, P Within Europe, fertility treatment using donor eggs is increasing, with demand coming from a diverse and growing number of recipients, including older women and gay male couples. Within the EU, the practice is governed by common regulation, which states that human tissue must only be provided within principles of voluntary unpaid donation. However country-level policies and practices vary, and it has been argued that due to increasing demand and varying levels of compensation, there is effectively an unofficial egg market emerging within Europe. Simultaneously, forms of clinical screening – both biomedical and discursive - mean that the reproductive potential of some women are given priority over others within this context. This paper explores how a range of screening and selection techniques work to produce the ideal egg donor. Drawing on policy mapping, marketing analysis, and interview data from clinicians and egg providers in the UK, Belgium and Spain, it considers how professional and policy rationalities, screening tools and the knowledges they produce, materialise a particular construction of the idealised, healthy, altruistic ‘donor’. This idealised donor is typically free from psychological and genetic ‘risks’ and expresses motivations in alignment with the principles of voluntary and unpaid donation and as enshrined within European law. We consider whether these tools and technologies may be part of a set of increasingly commercialised choreographies within egg donation in Europe.
  • Gifting, sharing, donating, helping: tracing discourses of altruism and medical need in clinics' recruitment of egg providers
    Gifting, sharing, donating, helping: tracing discourses of altruism and medical need in clinics' recruitment of egg providers Hudson, Nicky; Culley, Lorraine; Coveney, C.; Lafuente, S.; Herbrand, C.; Provoost, V.; Pavone, V.; Pennings, G. Fertility treatment using donor eggs is a growing phenomenon, with over 40,000 cycles performed across Europe per year. European regulations stipulate that in advertising for women to come forward as egg providers, promotional materials must uphold the principles of voluntary and unpaid donation (VUD). This is interpreted differently between countries with some permitting a range of advertising methods and others limiting or prohibiting any form of advertising relating to human bodily material. This paper examines how egg donation is framed in fertility clinic marketing and recruitment discourse as a particular form of bodily donation associated with the treatment of infertility. It draws on a sample of 58 fertility clinic websites across the UK, Belgium and Spain and analysed using a combination of content analysis and frame analysis. We examine the ways in which clinic marketing materials present a particular version of what egg donation involves and an image of the type of woman who acts as an egg donor. We suggest that clinic websites are important cultural spaces that manage the tensions of the market and the logics of altruism within the European context. We illustrate how the promissory potential of donor eggs and associated ‘cure narratives’ are drawn from a distinctly biomedicalised and individualised imaginary which renders egg provision as a noble and socially essential action. In this way egg donation can be framed as a culturally valued practice that should be separated from the logics of the market.
  • Conducting dyadic, relational research about endometriosis: A reflexive account of methods, ethics and data analysis
    Conducting dyadic, relational research about endometriosis: A reflexive account of methods, ethics and data analysis Hudson, Nicky; Law, Caroline; Culley, Lorraine; Mitchell, H.; Denny, E.; Raine-Fenning, N. Despite a growing literature on the value of relational data in studies of social phenomena, individuals still commonly constitute the basic unit of analysis in qualitative research. Methodological aspects of interviewing couples, particularly interviewing partners separately, and of conducting dyadic analysis have received scant attention. This article describes the experience of conducting separate interviews with both partners in 22 heterosexual couples (n = 44) in a study of the impact of the gynaecological condition endometriosis. In order to advance current methodological thinking regarding interviewing couples, we describe the dyadic, relational approach employed in designing the study and our specific method of dyadic analysis. We argue that utilising separate interviews with dyadic analysis rather than conducting joint interviews, while not without its ethical, practical and analytical challenges, offers considerable methodological benefits. Such an approach allows a unique relational insight into the impact of chronic illness on couples and how they navigate chronic illness by illuminating both shared and individual interpretations, experiences, understandings and meanings open access article
  • A comparative analysis of marketing materials used to recruit egg donors in Belgium, Spain and the United Kingdom (Poster).
    A comparative analysis of marketing materials used to recruit egg donors in Belgium, Spain and the United Kingdom (Poster). Culley, Lorraine; Hudson, Nicky; Coveney, C.; Herbrand, C.; Lafuente, S.; Pavone, V.; Pennings, G. Study question: How is egg donation framed in clinic marketing material used to recruit and/or inform potential egg donors in (Dutch speaking) Belgium, Spain and the UK? Summary answer: In Belgium, egg donation (ED) was constructed as an engagement that required considerable investment and entailed clear risks in contrast to Spain and the UK. What is known already: Across Europe, ED recruitment is performed in different ways. Some countries permit a range of advertising methods while others limit or completely prohibit any form of advertising relating to human bodily material (e.g. Belgium). Much of the existing research on recruitment of gamete donors comes from the US where market forces shape practice more directly. This paper focusses on Belgium, Spain and the UK – three countries that hold a stake in the growing global reproductive bio-economy and share features of technological innovation and expertise, but have adopted different regulatory positions in relation to the governance and marketing of ED. Study design, size, duration: An interdisciplinary team of researchers (bioethics, political economy, sociology) conducted a content analysis (including high frequency words analysis) as well as a comparative thematic analysis to consider ‘framing’ of egg donation in the data. Interdisciplinary auditing was used to challenge constructed categories and the conceptual framework at several points in the analysis. The findings were compared with country laws and informed consent rules and the implications for informed consent were studied. Participants: In Belgium, all Dutch language websites of centres were included compared to around 20 clinic websites in both Spain and the UK. For the latter countries, maximum variation sampling was used taking into account geographical location, number of cycles, and sector (public/private). In Belgium, ED is almost entirely situated in the publicly funded system whereas in Spain and the UK it is mainly performed in the private sector. Main results and the role of chance: In all three countries, ED recipients were presented as women whose fertility problems were no fault of their own, constructing a clear need for the donor to fulfil. Descriptions of medical profiles included ‘early menopause’ while natural menopause was absent. With regard to the act of donating, in Spain and the UK, words such as ‘sharing’, and ‘helping’ were considerably more frequently used compared to the Belgian data. Especially in Spain, ED was constructed as a form of solidarity between women nonetheless with a clear emphasis on the compensation. In Belgium, where clinic advertising is strictly regulated, ED was presented as requiring a considerable investment of time and energy from the donor. Potential egg donors in Belgium were repeatedly warned that the act was ‘not straightforward’ and ‘something to reflect about very carefully’. The Belgian material also appeared to be more focussed on risks and side effects than the Spain and UK material. The data were analysed within the policy context of the countries. We will discuss the possible impact of the public/private sector setting and of the Belgian ban on advertising for the way ED is framed and the implications of the differences in marketing material for informed consent. Limitations, reasons for caution: The results are limited to three countries, and to a (well considered) selection of clinics, therefore precluding generalisation to whole countries. Further research will be needed on the effects of recruitment discourses on potential donors in order to generate more general conclusions and recommendations. Wider implications of the findings: These results can contribute to a more complete understanding of the recruitment of egg donors as a practice that depends on specific discourses and is embedded in particular policy contexts. The identification of problematic framing of marketing material is crucial in terms of safeguarding true informed consent of donors.
  • Running out of time: Exploring women’s motivations for social egg freezing
    Running out of time: Exploring women’s motivations for social egg freezing Baldwin, K.; Hudson, Nicky; Culley, Lorraine; Mitchell, H. Objective: Few qualitative studies have explored women’s use of social egg freezing. Derived from an interview study of 31 participants, this paper explores the motivations of women using this technology. Methods: Semi-structured interviews were conducted with 31 users of social egg freezing resident in the UK (n= 23), USA (n=7) and Norway (n=1). Interviews were face to face (n=16), through Skype and Facetime (n=9) or by telephone (n=6). Data were analysed using interpretive thematic analysis. Results: Women’s use of egg freezing was shaped by fears of running out of time to form a conventional family, difficulties in finding a partner and concerns about ‘panic partnering’, together with a desire to avoid future regrets and blame. For some women, use of egg freezing was influenced by recent fertility or health diagnoses as well as critical life events. A fifth of the participants also disclosed an underlying fertility or health issue as affecting their decision. Conclusion: The study provides new insights in to the complex motivations women have for banking eggs. It identifies how women’s use of egg freezing was an attempt to ‘preserve fertility’ in the absence of the particular set of ‘life conditions’ they regarded as crucial for pursuing parenthood. It also demonstrates that few women were motivated by a desire to enhance their career and that the boundaries between egg freezing for medical and for social reasons may be more porous than first anticipated. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.

 

Click here for a full listing of Lorraine Culley's publications and outputs.

Research interests/expertise

  • Social aspects of infertility and reproductive technologies.
  • Diversity, health and healthcare (gender and ethnicity).
  • Endometriosis.
  • User perspectives on health/care.
  • Chronic Illness.
  • Qualitative research methods.

Qualifications

  • BA (Hons) Social Studies University of Liverpool
  • MA (Area Studies) University of London
  • PhD Sociology University of Liverpool

Conference attendance

       Recent keynotes and plenaries:
  • Fertility preservation in the context of delayed childbearing. The Who and Why of ‘social egg freezing’.  Keynote presentation to the Fertility Society of Australia, Annual Conference, Adelaide, Australia, October 2017.
  • Marginalised reproduction and culturally sensitive care. Psychosocial Session. Invited keynote. Fertility Society of Australia Annual Conference, Adelaide, Australia, October 2017.
  •  In/fertility and Uncertainty: the impact of endometriosis on couple relationships. Keynote. Australia and New Zealand Infertility Counsellors Association and Fertility Nurses of Australia Joint Conference. Adelaide, Australia, October 2017.

Consultancy work

Consultancy can be provided in the following areas:

  • Social aspects of infertility and assisted conception
  • Cross border reproductive care
  • Involving users in research
  • Qualitative methods in health research
  • Working with minority ethnic communities

Externally funded research grants information

  • Egg donationEgg Donation in the UK, Belgium and Spain: an interdisciplinary study. Hudson (PI) with Culley, Herbrand, Pennings, Provoost, Pavone. ESRC.  £494,350. April 2017-March 2020. Grant ref. ES/N010604/1.
  • Factors influencing the utilisation of free-standing and alongside midwifery units in England: A Mixed Methods Research Study. 

    Dec 2015 – 2018, NIHR HS&DR Project: 14/04/28 £477,277. 

    Chief investigator: Dr Denis Walsh; Co-investigators: Dr Simon Bishop (University of Nottingham), Emeritus Professor Lorraine Culley (De Montfort University), Dr Miranda Dodwell (City University London), Professor Christine McCourt (City University London), Professor Helen Spiby (University of Nottingham), Professor James Thornton (University of Nottingham), Ms Sonia Byers (North East Ambulance Service NHS Foundation Trust), Dr Jane Wilkinson (NHS West Cheshire CCG), Mrs Lynne Pacanowski (Guys & St Thomas' NHS Foundation Trust).

  • Nurture Early for Optimal Nutrition (NEON) study Jan 2015 – 2019; Principal investigator: Professor Monica Lakhanpaul, University College London
    Partners and collaborators involved: University College London; London Borough of Tower Hamlets; The Parent and Family Support Services in Tower Hamlets; UCL Partners; British Heart Foundation and Newcastle University.

  •  Endometriosis: Improving the well-being of couples (Endopart) Culley (PI), Mitchell, Hudson, Denny, Raine-Fenning (University of Nottingham). ESRC ES/J003662/1. 2012-13.
  • Embedding structured self management education programmes for Type 2 diabetes in a multi-ethnic primary care setting. NIHR Programme Development Grant. Davies (PI), Brennan, Baker, Carey, Culley, Daly, Elster, Gray Johnson, Khunti, Mather, Patel, Speight, Sturt. 2012-13.
  • Research in Children’s Health. Culley, Lakhanpaul, Hudson. University of Leicester/University College London 2011-2012.
  • Transnational Reproduction an exploratory study of UK residents who travel abroad for fertility treatment (Transrep):. Culley (PI), Hudson, Pacey, Blyth, Norton, ESRC RES 000-22-3390. 2009-2011. Collaboration with Universities of Sheffield, Swansea, Huddersfield. See www.transrep.co.uk.
  • Endometriosis and Cultural Diversity (Endocul): improving services for minority ethnic women. Denny, Culley, Papadopoulos, Mann. Department of Health, Research for Patient Benefit Programme. 2007-10. www.endocul.co.uk. Collaboration with Birmingham City and Middlesex Universities, Birmingham Women’s Hospital.
  • Educational experiences of young people with sickle cell disease. ESRC RES 000-23-1486. Dyson (PI), Culley, Atkin, Demaine. 2006-2011. Collaboration with Universities of York and Loughborough.
  • Contextualising patient-centre professionalism in nursing practice: consulting with patients, professionals and stakeholders. Rapport, Doel, Culley, Mooney, Jones, Evans, Maggs, Hutchings. GNC Trust. CI 2009-2010 Collaboration with University of Swansea.
  • Management and Interventions for Asthma in South Asian Children. NIHR Health Services Research 2009-2012 Lakhanpaul, Culley, Johnson, McFeeters, Robertson, Bird. Wilson. Collaboration with University of Leicester and Leicester City PCT.
  • Asthma and South Asian Children; Systematic Review. Asthma UK 2010-2011. Lakhanpaul, Culley, Johnson, McFeeters, Robertson, Bird. Collaboration with University of Leicester and Leicester City PCT.
  • Department of Health, Pacesetters Programme. Evaluation for the East Midlands Region. Johnson, Culley, Fleming 2008-2009. Collaboration with Leicester PCT and Department of Health.
  • Public Perceptions of Gamete Donation in British South Asian Communities (GAMDON). ESRC. 20005-6. Lorraine Culley (PI), Johnson, Rapport, Bharadwaj. RES-160-25-0044. (please link title to http://www.esrc.ac.uk/my-esrc/grants/RES-160-25-0044/read)

Professional esteem indicators

  • Editorial Board Reproductive Biomedicine and Society
  • Editorial Board, Journal of Research in Nursing
  • ESRC Peer Review College
  • ESRC Rapporteur End of Award Reports
  • Reviewer of bids for a wide range of organisations including national charities (eg Wellcome Trust, Diabetes UK, Cancer UK ); Research Councils (ESRC, MRC) and the National Institute for Health Research – Health Services Research, Service Delivery and Organisation and Research for Patient Benefit ProgrammesAssessor for external Professorial and Readership appointments
  • Reviewer for international journals including:
  1. Social Science and Medicine
  2. British Medical Journal
  3. Journal of Advanced Nursing
  4. Ethnicity and Health
  5. Qualitative Health Research
  6. Journal of Research in Nursing
  7. Human Fertility
  8. Human Reproduction
  9. Reproductive Health Matters
  10. Journal of Medical Humanities
  11. Journal of Reproductive and Infant Psychology
  12. Diversity in Health and Care.
Lorraine Culley

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