Bearing Witness: Researcher Emotion and Ethical Reflexivity in Adolescent Maternal Health Research
By: Amber Hussain; Tanya Park; Zahid Memon; Salima Meherali
As a PhD student working in maternal and adolescent health, I have often found myself not just collecting data but sitting with the raw emotions of the people I interview. During fieldwork in Sindh, Pakistan, I spoke with adolescent girls navigating early pregnancy many as a result of child marriage. These interviews revealed not only the social and medical challenges of young motherhood, but also the deep emotional currents running beneath: fear, isolation, shame, and resilience. The interviews conducted with adolescent mothers in rural Pakistan illustrate these emotional realities. The narratives conveyed by these adolescents expose not only public health concerns but also psychosocial fractures that are seldom addressed in formal maternal care systems. As I listened to these stories, often told with quiet composure but carrying unbearable weight; I found myself overwhelmed. I recall pausing my notes, my throat tight, my eyes filling with tears. These were not just stories. They were lived pain, and I carried them with me long after I left the field. Their stories left an imprint on me, shaping how I understand care, vulnerability, and the ethics of research itself.
Adolescent motherhood remains a pressing global health issue, with approximately 12 million girls under the age of 18 giving birth each year, primarily in low- and middle-income countries (LMICs). In settings such as Pakistan, child marriage continues to be widespread, leading to early pregnancies with limited social or emotional preparation. While much research has focused on structural determinants, poverty, education, and gender inequality, the emotional dimensions of young motherhood are often underexplored.
Recent findings in maternal mental health further support the need to integrate emotional insights into research. In a 2024 qualitative study based in Sindh Pakistan, adolescent mothers expressed profound distress and self-blame for complications during childbirth. The stigma associated with maternal mental health, particularly among adolescents, resulted in emotional isolation and limited disclosure. Despite high rates of postpartum anxiety and depression in these populations, access to mental health services remains rare, and discussions of emotional wellbeing are often discouraged within households.
The emotional labor involved in collecting such narratives is frequently rendered invisible within academic discourse. Yet scholars have argued that emotion plays a critical role in field-based qualitative research. Their notion of “embodied reflexivity” draws attention to how researchers interpret data through their own social positions, cultural backgrounds, and emotional states. Emotional responses, rather than being dismissed as subjective bias, can serve as analytical cues to relational dynamics and hidden layers of meaning.
The ethical dimensions of researcher emotion deserve critical attention. As argued by England (1994), the emotional terrain of qualitative research is not peripheral, it is central. Fieldnotes that include emotional reactions can offer insight into power imbalances, moments of discomfort, and unexpected ruptures. In maternal health research involving adolescents, such responses are not anomalies; they are part of the terrain of inquiry. This emotional engagement is especially relevant in the field, where researchers often witness intersecting vulnerabilities such as early pregnancy, social stigma, and limited agency that can evoke strong affective responses. Emotional reactions can highlight ethical tensions that may otherwise go unnoticed in formal transcripts. In studies involving adolescent mothers, researchers frequently encounter stories that stir feelings of protectiveness, distress, or even guilt, all of which demand ethical reflexivity. As highlighted by Caliva et al. (2025), emotional responses helped uncover silences in the lived experience of a young mother navigating early pregnancy. Similarly, emotional dimensions of fieldwork are central to ethical integrity in maternal and adolescent health research, as they guide researchers in making sensitive, human-centered decisions throughout data collection and analysis.
Despite increased interest in intersectionality in global health, emotional labor remains under-theorized. A persistent emphasis on quantifiable indicators tends to marginalize experiences that resist numeric translation. Yet for adolescent mothers, emotional narratives are often the clearest expressions of vulnerability, agency, and resilience. When these are excluded from analysis, entire dimensions of reproductive health are erased.
There is also a need to support researchers who engage in emotionally charged fieldwork. The integration of trauma-informed practices into maternal health research protocols, including emotional debriefing and reflective supervision can ensure ethical integrity and protect the mental wellbeing of researchers. In contexts where researchers and participants share cultural or geographic ties, these supports are especially critical.
Adolescent motherhood exists at the nexus of gender, age, and structural inequality. Research in this space must account for emotion not only as data but as a condition of the research encounter. Humanizing maternal health inquiry requires more than documentation; it calls for a reframing of evidence to include empathy, vulnerability, and relational ethics. As Nkurunziza et al. (2024) argue, emotionally grounded research with adolescent mothers demands an ethical orientation that recognizes how deeply practitioners and researchers become immersed in participants’ lives, especially when working in contexts of poverty, social exclusion, and trauma. Another study has shown that researchers and healthcare providers alike “carry the emotional residue” of these encounters, shaping both their personal reflections and professional obligations . Emotionally grounded inquiry has the capacity to inform not only policy, but also a more just and inclusive understanding of maternal care. This also requires recognizing the emotional toll carried by researchers who become witnesses to these stories, who carry the tears, silences, and painful moments of others into their own emotional and ethical landscapes.
