The Development of the Framework of Integrated Reproductive and Sexual Health Theories (FIRSHT) to Contextualize Indigenous Women's Health Experiences.

Introduction: Indigenous women experience extensive reproductive health disparities and reproductive oppression. Theoretical frameworks for understanding the complex intersection of factors that contribute to these experiences are needed, especially those that highlight the resilience of Indigenous peoples throughout settler colonialism. The purpose of this article is to explore the empirical development of the Framework of Integrated Reproductive and Sexual Health Theories (FIRSHT) to contextualize and understand the reproductive and sexual health experiences of Indigenous women. Methods: The FIRSHT was developed through a qualitative descriptive research study with 31 Indigenous women from a Gulf Coast tribe. Interviews were conducted in 2018 and 2019. The first author partnered with a community-advisory board throughout the research project, and in the dissemination of results to tribal members. Results: After presenting a snapshot of the overarching results, we discuss how the FIRSHT incorporates key components of the reproductive justice, resilience, Indigenous critical theory, life course and eco-systemic theoretical frameworks. The proposed framework conceptualizes the interrelationship of factors that impact women's reproductive and sexual health experiences. Discussion: This research fills a gap in the need for holistic understandings of Indigenous women's reproductive and sexual healthcare required for the development of interventions that not only address social justice issues and weaknesses in the healthcare system but also promote the existing strengths and resources in Indigenous communities. Policy Implications: This theoretical framework may be useful for researchers interested in studying the reproductive and sexual health experiences of Indigenous women, who desire a holistic and strengths-based framework.