Dr Wendy Norton

Job: VC 2020 Senior Lecturer in Health and Social Care (Sexual Health)

Faculty: Health and Life Sciences

School/department: School of Nursing and Midwifery

Research group(s): Centre for Reproduction and NMRC

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

T: +44 (0)116 201 3810

E: wnorton@dmu.ac.uk

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

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Personal profile

Wendy Norton is a VC2020 Senior Lecturer in the School of Nursing and Midwifery at De Montfort University where she specialises in sexual and reproductive health and women’s health care. She worked as a Clinical Nurse Specialist in Assisted Reproduction for 14 years before moving into academia. Her research interests include gender, sexuality, sexual health and HIV, reproduction and experiences of ART use amongst members of LGBT communities.

Research group affiliations

Centre for Reproduction Research

Nursing and Midwifery Research Centre

Publications and outputs

Understanding the NICE Guidance on Endometriosis
Understanding the NICE Guidance on Endometriosis Norton, Wendy; Holloway, Debby Endometriosis is a long-term gynaecological condition where endometrial tissue forms lesions outside the uterus, resulting in internal bleeding, inflammation, fibrosis, and adhesion formation. The condition is estimated to affect between 2 and 10% of women within the general population, but up to 50% of infertile women, and can have a significant impact on women’s, and their partners’, lives. Endometriosis is often misunderstood and misdiagnosed, leading to reported lengthy delays in achieving a diagnosis. In 2017 and 2018, The National Institute for Health and Care Excellence (NICE) released guidelines and quality standards on managing endometriosis. Nurses working within primary care services play an important role in raising awareness of this condition and providing a holistic individualised care for women with endometriosis. 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.
Barriers and facilitators to fertility-related discussions with Teenagers and Young Adults with cancer: Nurses’ experiences.
Barriers and facilitators to fertility-related discussions with Teenagers and Young Adults with cancer: Nurses’ experiences. Norton, Wendy; Wright, Elaine Background Improvements in cancer survival rates for Teenagers and Young Adults (TYAs) have resulted in quality-of-life issues into survivorship becoming increasingly important. However, infertility is a potential late side-effect of cancer treatment which can negatively impact on quality-of-life. Advances in assisted reproductive technologies have resulted in increasingly effective fertility preservation options. Purpose This study aimed to explore nurses’ experiences and feelings of undertaking fertility-related discussions with TYA cancer patients aged 13-24 years. Method An Interpretive Phenomenological Analysis (IPA) approach was employed. Eleven purposively recruited nurses working on a specialist TYA cancer unit in England participated in semi-structured interviews. Data were analysed using IPA. Results Nurses experienced parents/family as self-appointed informal gatekeepers who were perceived to hold the ability to control nurses’ access to communicate with young people about fertility issues. Nurses adopted an on-going supportive role which was enhanced by the positive nature of their relationship with the TYA. Uncertainty was expressed over whether the TYA had been fully informed of their infertility risk and potential fertility preservation options. Conclusions Nurses should manage parental involvement sensitively if TYAs are to make informed decisions regarding their future reproductive health. Further research is needed to explore ways of engaging with parents to ensure TYA participation in discussions. There is a need for clear role delineation to ensure that TYAs are provided with the opportunity to discuss infertility risk and be referred to a specialist before initiating cancer treatment. Nurses should cultivate and optimise the nurse-TYA relationship to improve fertility care. 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.
Procreative Boundaries: Gay men navigating surrogacy
Procreative Boundaries: Gay men navigating surrogacy Norton, Wendy Gay men are increasingly using surrogacy to create biologically related families, yet little is known about how the socio-cultural context shapes UK resident gay men’s experiences. These data are drawn from a wider exploratory, qualitative study based on an interpretivist epistemology. The study explored the factors that influence UK resident gay men’s desire and motivation for parenthood, why men choose surrogacy over other family building options and their experiences as they navigate the surrogacy journey. Semi-structured interviews were undertaken with 21 gay men who had undergone surrogacy arrangements in the UK, USA and India and 15 key stakeholders (surrogacy organisations, legal and regulatory agencies, and healthcare professionals). Data were analysed using thematic analysis informed by concepts of procreative consciousness, procreative responsibility and procreative boundaries to analyse gay men’s meanings and experiences as they pursue surrogacy. Gay men face unique challenges in family formation, many of which are largely absent for other intended parents accessing reproductive technologies. They need to navigate, a range of boundaries: social, relational, institutional, and legal, which constitute a series of potential barriers to achieving parenthood. A focus on procreative boundaries highlights the importance of the socio-cultural, confines within which procreative consciousness and responsibility are enabled, shaped and enacted. The presentation analyses these boundaries and discusses the ways in which dominant discourses of family and kinship accentuate existing inequalities and reproduce practices based on heterosexism and gender bias within the realm of surrogacy. Conference abstract
Fertility
Fertility Norton, Wendy
Heterosexual partnered men’s experiences of becoming fathers through surrogacy
Heterosexual partnered men’s experiences of becoming fathers through surrogacy Norton, Wendy; Weis, Christina Increasing numbers of people are undertaking surrogacy as a means of creating a family. In heterosexual couples, surrogacy centres on a third-party female who facilitates the couple’s pregnancy, but is not the expectant father’s intimate partner. This may potentially add a level of complexity and tension to this pregnancy experience. Whilst recent healthcare policies highlight the importance of involving fathers throughout pregnancy, childbirth, and the transition to parenthood, it has been suggested that men are often side-lined in the organisation of surrogacy arrangements and participating in the pregnancy experience by the women involved; the intending mothers, and surrogates (Teman 2010:185). The limited research that exists on men’s experiences of surrogacy arrangements focuses mainly on single or gay men/couples (Norton, 2018; Smietana 2017, Riggs et al 2015). There is a dearth of literature on heterosexual partnered men’s experiences of fatherhood through surrogacy. This exploratory, qualitative study, based on an interpretivist epistemology, explores how heterosexual partnered men, who are fathers or are becoming fathers via surrogacy, experience their transition to fatherhood , their involvement in the pregnancy, how expectant fathers perceive and navigate the relationship with their surrogate, and the impact of this relationship on the father’s relationship with his intimate partner. This presentation reports the first findings, which suggest surrogacy is a complex and challenging route to fatherhood. To the authors’ knowledge, no other research has yet focused on heterosexual partnered men’s experiences of surrogacy. This research is therefore an important addition to the limited empirical knowledge base. Oral presentation at the British Sociological Association Human Reproduction Study Group Annual Conference. De Montfort University, Leicester, 12th June 2019.
Gay Men's Experiences of UK Maternity Care
Gay Men's Experiences of UK Maternity Care Norton, Wendy Objective: The number of same-sex parents in the UK has increased steadily over the years. Gay men are increasing seeking surrogacy to become parents and subsequently engaging with maternity services. Whilst there is a small body of literature on the care lesbian women receive within the maternity sector, to date, no studies have explicitly explored the experience of gay men within UK maternity services following successful surrogacy. Design: These data are drawn from a wider exploratory, qualitative study based on an interpretivist epistemology. The study explored the factors that influence UK resident gay men’s desire and motivation for parenthood, why men choose surrogacy over other family building options and their experiences as they navigate the surrogacy journey. Data were collected using semi-structured, face-to-face interviews with 21 gay men and 15 key stakeholders, for example surrogacy organisations, legal and regulatory agencies, and healthcare professionals. Method: The presentation centres on data from interviews with a purposive, self-selecting sample of 12 gay men who had become fathers via surrogacy, and whose surrogate delivered their baby within the UK maternity sector. Interviews were transcribed verbatim and analysed using thematic analysis. Results: This paper reports three key themes: (i) heteronormative barriers in maternity care, (ii) healthcare professionals’ unfamiliarity and inexperience with surrogacy arrangements and (iii) healthcare professionals’ lack of understanding of UK surrogacy law. Data suggest that institutionalised practices endorsing heteronormative and gendered norms still exist within UK maternity care, with little recognition of the needs of gay men as intended parents. Maternity staff lacked understanding and knowledge of surrogacy arrangements which often resulted in poor care. Participants reported that in order to challenge negative institutionalised practices and be viewed as legitimate parents, they had to educate healthcare professionals about the practicalities and legalities of surrogacy arrangements. Conclusions: The majority of participants reported negative experiences within maternity services. Despite significant changes in UK equality legislation, removing some of the structural boundaries to parenting for gay men, inequitable and discriminatory care is still occurring within the UK maternity sector. It is recommended that maternity staffs receive additional education on UK surrogacy law and reflect on current practices to ensure they are inclusive of all prospective parents. A contemporary surrogacy policy and protocol needs to be in place in all UK maternity units to ensure inclusive and responsive maternity care is provided for all those involved in surrogacy arrangements.
The Work of the Royal College of Nursing Women's Health Steering Group
The Work of the Royal College of Nursing Women's Health Steering Group Holloway, Debby; Norton, Wendy As part of the professional arm of the Royal College of Nursing, the steering group is made up of nurses who undertake roles on a voluntary basis for terms of four years. The steering group links with other nursing forums on major pieces of college work such as the decriminalisation of abortion statement, whilst also maintaining its own work steam, FGM and modern slavery. This poster presents a snapshot of the work over the last two to three years. • Publications: the CNS in endometriosis, early pregnancy care, and nurse specialist in menopause are all aimed at providing guidance for nurses within these roles. These have all been written in conjunction with charities, patient groups and professional bodies and can also include information for women, such as the endometriosis publication. To increase awareness of women’s health and nursing practice amongst nurses who are not familiar with this subject area we have produced three series of pocket guides providing a basic reference for nurses • Annual conference • Representing nursing at All-Party Parliamentary Group (APPG) on women’s health • Representing nurses at the RCN congress and undertaking educational fringe events such as menopause at work, to highlight its impact on the nursing workforce • To highlight the role of nurses within women’s health care, and women’s health in general, we currently have an exhibition entitled ‘The Wandering Womb’, and parallel series of lectures in partnership with the RCN library. • We have an active closed Facebook page and twitter account • Internationally, two members of the steering group have represented the women's health forum as guest speakers at the International Women's Health Conference in Istanbul, Turkey, March 2018. • Some of the forum work has led to publications such as ‘Menopause at Work’, and the endometriosis CNS survey. From this, we are working with the BSGE to look at bespoke leadership courses for CNS in endometriosis. The background of the group is varied and changes; currently it is: • Debby Holloway - Nurse Consultant gynaecology • Dr Wendy Norton - Senior Lecturer in women’s and sexual health • Mandy Myers - Director of Nursing, BPAS • Katharine Gale - Nurse Consultant • Ruth Bailey - sexual health • Nikki Noble - specialist nurse The group is very active and has more work streams for coming years, responding to member questions and areas that arise from practice, and the development of the nurse’s role within women’s health.
Surrogacy
Surrogacy Norton, Wendy Third-party reproduction is commonly used by couples unable to reproduce in the traditional way. Medical and technological advances have revolutionised the field of reproduction, giving rise to growing numbers of people worldwide utilising surrogacy arrangements as a method of family building. Surrogacy provides an opportunity for individuals or couples to become parents in circumstances where carrying a pregnancy is biologically impossible or medically contraindicated (Shenfield et al, 2005). This chapter outlines the different types of surrogacy; the steps involved in a surrogacy programme, and other key factors to be considered when embarking on a surrogacy arrangement, such as the ethical and legal perspectives.
Working through the change: Supportive measures
Working through the change: Supportive measures Norton, Wendy; Tremayne, Penny All women will experience the menopause phase of their life; many of these will be working women. Some women may experience challenges during this time that may be exacerbated in the work environment. This article outlines the common symptoms of the menopause, examines how these symptoms may affect women’s working lives, and discusses how employers and managers can support their staff during this stage of their working lives. The file attached to this record is the author's final peer reviewed version.
An exploration of how women in the UK perceive the provision of care received in an early pregnancy assessment unit: an interpretive phenomenological analysis
An exploration of how women in the UK perceive the provision of care received in an early pregnancy assessment unit: an interpretive phenomenological analysis Furber, L.; Norton, Wendy Objective The objective of the study was to explore how women experience care within an early pregnancy assessment unit (EPAU) and how they are helped to understand, reconcile and make sense of their loss and make informed decisions about how their care will be managed following a first trimester miscarriage. Design This was a single centre, prospective qualitative study. An interpretive phenomenological analysis approach was used to interpret the participants’ meanings of their experiences. It is an ideographic approach that focuses in depth on a small set of cases to explore how individuals make sense of a similar experience. Setting An EPAU in a large teaching hospital in the Midlands that provides care to women in their early pregnancy, including those experiencing pregnancy loss. Participants A purposive sample of 10 women were recruited to this study. All of the women were either miscarrying at the time of this study or had miscarried within the previous few weeks. Results Six superordinate themes in relation to women’s experiences of miscarriage were identified: (1) the waiting game, (2) searching for information, (3) management of miscarriage: no real choice, (4) the EPAU environment, (5) communication: some room for improvement and (6) moving on. Conclusions This study found that improvements are required to ensure women and their partners receive a streamlined, informative, supportive and continuous package of care from the point they first see their general practitioner or midwife for support to being discharged from the EPAU. The provision of individualised care, respect for women’s opinions and appropriate clinical information is imperative to those experiencing miscarriage to help them gain a degree of agency within an unfamiliar situation and one in which they feel is out of their control.

Click here to view a full listing of Wendy Norton's publications and outputs.

Research interests/expertise

Women’s Health Care
Gynaecology
Sexuality
Infertility and Assisted Reproduction
Contraception
Sexual Health and HIV

Areas of teaching

Sexual Health
Contraception
Assisted Conception
Gynaecology
Women’s Health
Complementary Therapies

Membership of external committees

Royal College of Nursing (RCN)

Membership of professional associations and societies

Committee memebr on the Women’s Health Forum Steering Committee (RCN)

Conference attendance

Norton, W, “An exploratory study of gay men seeking surrogacy to achieve parenthood – work in progress”. Reproduction Research Group Seminar Series. De Montfort University, Leicester, 3^rd June 2015

Hudson, N. Culley, L. Norton, W, “Bio-Sociality and the Negotiation of Diagnosis in Cross-Border Infertility Treatment" at the XVIII ISA World Congress of Sociology in Japan on July 13-19, 2014.

Culley, L; Hudson, N; Norton, W; Law C. Religion, Infertility and Infertility Treatment. Second Annual Conference on Medicine and Religion in Chicago on May 28-30, 2013.

Hudson N, Culley L, Norton W ‘Online communities of hope. Bio-sociality and the negotiation of overseas fertility treatment’, paper presented to the British Sociological Association Human Reproduction Study Group Annual Conference. Milton Keynes,15 June 2011

Woodward B J, Norton W J, Almeida P & Gilling-Smith C (2011) Inconsistencies in the treatment of patients with blood-borne viruses: an audit of British IVF clinics, oral presentation at the 27th Annual Meeting of ESHRE, Stockholm, Sweden, 3July – 6 July 2011

Woodward B. Gilling-Smith C. Almeida P, Norton W. Blood-borne Viruses: An audit of treating viral positive patients and perceived risks in UK fertility clinics. Oral presentation at Fertility 2011 Conference, Dublin, 4-6 January 2011

Woodward B. Gilling-Smith C, Almeida P, Norton W. Inconsistency in Processing Gametes from Viral Positive Patients in the UK. Poster to be presented at the British Andrology Society Annual Meeting, Macclesfield, 9-10 November 2010

Culley L. Hudson N. Blyth E. Norton W. Rapport F, Pacey A. Cross border reproductive care: The Research Evidence. Poster to be presented at the 13th Congress on Controversies in Obstetrics, Gynecology and Infertility (COGI), Berlin, November 2010.

Culley L. Hudson N. Blyth E. Norton W. Pacey A. Rapport F. ‘Travelling abroad for fertility treatment: an exploratory study of UK residents seeking cross-border care’ oral presentation at the 26th Annual Meeting of ESHRE, Rome, Italy, 27 June – 30 June, 2010

Culley, Hudson, Pacey, Rapport, Blyth, Norton ‘Fertility Tourism? Discourses of Cross-border Reproductive Care’, at the 10th Annual Interdisciplinary Research Conference "Transforming Healthcare through Research & Education" 4- 6 November 2009, Trinity College, University of Dublin.

Norton ‘Ethical Issues in Reproductive Health & Infertility’, paper delivered at the International Nursing Conference on Reproductive Health & Infertility, 23 – 26 September 2009, Las Vegas, Nevada, US.

Norton, Feehan ‘”Double Dutch”: making sex safer with education and practice’, poster presentation at the Royal College of Nursing Sexual Health Conference, June 2006, London.

Externally funded research grants information

The Sociology of Technologically Mediated Reproduction - Postgraduate Conference. The British Sociological Association. May 2014. Co-applicant with K Baldwin, C Law and C Weis (PhD students withing the Reproducrion Research Group). £1000.

Transnational Reproduction. An exploratory study of UK residents who travel abroad for fertility treatment (TRANSREP) ESRC, 1 March 2009 – 30 Nov 2010. Co- applicant with Culley, Hudson et al. £99,844.09

Internally funded research project information

ENDOPART 2: developing a knowledge exchange partenrship and improving support in endometriosis. DMU HEIF Fund. October 2015-July 2016. Co-applicant with L Culley, N Hudson, H Mitchell and C Law.

European network for research on men, in/fertilities and assisted conception. DMU Revolving Investment Fund. October 2011-July 2012. Co-applicant with L Culley & N Hudson.