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Book part
Publication date: 22 November 2019

Siri Suh

To explore the politics of gender, health, medicine, and citizenship in high-income countries, medical sociologists have focused primarily on the practice of legal abortion. In…

Abstract

To explore the politics of gender, health, medicine, and citizenship in high-income countries, medical sociologists have focused primarily on the practice of legal abortion. In middle- and low-income countries with restrictive abortion laws, however, medical sociologists must examine what happens when women have already experienced spontaneous or induced abortion. Post-abortion care (PAC), a global reproductive health intervention that treats complications of abortion and has been implemented in nearly 50 countries worldwide, offers important theoretical insights into transnational politics of abortion and reproduction in countries with restrictive abortion laws. In this chapter, I draw on my ethnography of Senegal’s PAC program to examine the professional, clinical, and technological politics and practices of obstetric care for abortions that have already occurred. I use the sociological concepts of professional boundary work and boundary objects to demonstrate how Senegalese health professionals have established the political and clinical legitimacy of PAC. I demonstrate the professional precariousness of practicing PAC for physicians, midwives, and nurses. I show how the dual capacity of PAC technologies to terminate pregnancy and treat abortion complications has limited their circulation within the health system, thereby reducing quality of care. Given the contradictory and complex global landscape of twenty-first-century abortion governance, in which pharmaceutical forms of abortion such as Misoprostol are increasingly available in developing countries, and as abortion restrictions are increasingly enforced across the developed world, PAC offers important theoretical opportunities to advance medical sociology research on abortion politics and practices in the global North and South.

Open Access
Article
Publication date: 26 November 2018

Kittipong Saejeng, Unnop Jaisamrarn and Wanapa Naravage

The purpose of this paper is to understand women’s experiences, acceptability and outcomes of using the medical termination of pregnancy (MTP). The study is conducted at nine…

1667

Abstract

Purpose

The purpose of this paper is to understand women’s experiences, acceptability and outcomes of using the medical termination of pregnancy (MTP). The study is conducted at nine reproductive health and family planning clinics at university hospitals as well as regional and provincial hospitals located in Bangkok and the locations within Thailand.

Design/methodology/approach

This is a descriptive research recruiting healthy women with pregnancy up to 63 days since the last menstrual period (LMP) who opted for MTP during 2012–2014.

Findings

A total of 443 women who were referred from the reproductive health networks voluntarily participated in the study. Overall, 92.6 percent of participants had a complete abortion. No serious adverse events were found for cases using misoprostol at home or at clinic. More than 98.3 percent of the women felt satisfied or very satisfied with the method. More than 80 percent of participants thought that the side-effects of the method were as expected or less than expected. More than 95 percent of the women recommended having MTP available in Thailand.

Originality/value

The introduction of MTP that uses a mifepristone and misoprostol regimen (Medabon®) in pregnancies up to 63 days, since LMP demonstrates that misoprostol can be safely used by women at home or at clinic. The administration of misoprostol at home reduces the number of hospital visits, which saves time and costs for traveling from home to the facility. In addition, women have more privacy and control over their bodies by self-administering misoprostol. The MTP’s introductory results also show that MTP service provision is well integrated into reproductive health and family planning services. It is useful for stakeholders who would be involved in design and planning of health system services before the MTP is made broadly available throughout the country.

Details

Journal of Health Research, vol. 33 no. 2
Type: Research Article
ISSN: 2586-940X

Keywords

Book part
Publication date: 15 September 2022

Lucy van de Wiel

Although research on reproductive technologies such as IVF and egg freezing has traditionally been rather separated from the work on contraceptives and abortion, analysing…

Abstract

Although research on reproductive technologies such as IVF and egg freezing has traditionally been rather separated from the work on contraceptives and abortion, analysing reproductive and nonreproductive technologies together, as this volume proposes, can provide the basis for a broader contemporary politics of reproductive control. This chapter analyses this politics of integrating reproductive and nonreproductive technologies by focusing specifically on IVF-based fertility (preservation) treatments and (medical) abortion. More specifically, it explores both technologies' interrelated research trajectories and the financial and platformised dimensions of their clinical implementation. With a dual focus on egg freezing and medical abortion, this project seeks to explore how processes of platformisation and financialisation shape the clinical and commercial infrastructures that govern twenty-first-century reproduction. The chapter's broadened analytic scope that incorporates both reproductive and nonreproductive technologies highlights how a contemporary biopolitics of reproductive control may be expressed through these technologies' interrelated regulatory practices, shared politicised reference points (e.g. the embryo), opposite investment practices and mutually reinforcing social effects.

Details

Technologies of Reproduction Across the Lifecourse
Type: Book
ISBN: 978-1-80071-733-6

Keywords

Abstract

Details

Criminal Justice Responses to Maternal Filicide: Judging the failed mother
Type: Book
ISBN: 978-1-83909-621-1

Book part
Publication date: 15 September 2022

Rishita Nandagiri

Sterilisation in India (and globally) has a contentious and deeply politicised history. Despite this troubling legacy, India continues to rely on female sterilisation as the main…

Abstract

Sterilisation in India (and globally) has a contentious and deeply politicised history. Despite this troubling legacy, India continues to rely on female sterilisation as the main form of contraception and family planning. Abortion, which has been legal under broad grounds since 1971, intersects with sterilisation at different points over women's reproductive lifecourse. Drawing on three case studies exploring women's abortion trajectories in Karnataka, India (2017), this chapter examines sterilisation as a reproductive technology (RT) in women's abortion narratives. These include experiences of failed sterilisation necessitating abortion, as well as narratives around pre- and post-abortion counselling with sterilisation conditionalities. Women report healthcare workers shaming or scolding them for not being sterilised after their last pregnancy – demonstrating the prominence of sterilisation as an enforced social norm using ‘health’ frames. Using reproductive justice (RJ) as a lens, I analyse how sterilisation interacts with abortion and the narratives of shame and stigma that surround the two technologies and make visible the ways in which it results in the denial and restriction of women's reproductive freedoms.

Details

Technologies of Reproduction Across the Lifecourse
Type: Book
ISBN: 978-1-80071-733-6

Keywords

Book part
Publication date: 9 February 2023

Cheryl Green

Entrance into the world should not be weighted by a pregnancy having been planned or unplanned. All life is precious and priceless, deserving of quality healthcare from conception…

Abstract

Entrance into the world should not be weighted by a pregnancy having been planned or unplanned. All life is precious and priceless, deserving of quality healthcare from conception to birth. The decision to give birth is one that is an individual one and requires much contemplation, and not the influence of others. For the person who has to ultimately live with their decision to have an abortion for the remainder of their life, space and time must be provided in absence of judgment. Support made available to persons considering abortion, as well as information about potential complications involving the mental and physical impact, is necessary and important.

Details

Social Justice Case Studies
Type: Book
ISBN: 978-1-80455-747-1

Abstract

Details

Criminal Justice Responses to Maternal Filicide: Judging the failed mother
Type: Book
ISBN: 978-1-83909-621-1

Article
Publication date: 6 May 2021

Nibedita Shankar Ray-Bennett, Denise Marsha Jeanor Corsel, Nimisha Goswami and Maqbul Hossain Bhuiyan

The quality and availability of sexual and reproductive health care are key determinants to reducing maternal mortalities and morbidities in disaster settings; yet, these services…

Abstract

Purpose

The quality and availability of sexual and reproductive health care are key determinants to reducing maternal mortalities and morbidities in disaster settings; yet, these services are often lacking in developing countries. Reducing maternal mortality and morbidity is currently the main targets of the UN’s Sustainable Development Goal (SDG) 3. The purpose of this study was to develop an intervention package called RHCC (Reproductive Health Kit 8; Capacity building; Community awareness), and to implement and evaluate it in three primary health-care (PHC) facilities in Belkuchi, Bangladesh, in order to improve the quality and availability of post-abortion care (PAC) during the 2017 floods.

Design/methodology/approach

This research used both quantitative and qualitative methods to develop, implement and assess the RHCC in three flood-prone PHC facilities in Belkuchi.

Findings

The RHCC was implemented during the floods of 2017. The findings pre- and post-intervention suggest it led to an increase in skilled management among health workers, an increase in the quality of care for clients and the availability of PAC at three PHC facilities during floods.

Originality/value

Due to its geographic location, Bangladesh is exposed to recurrent floods and cyclones. Evidence-based integrated intervention packages, such as the RHCC, can improve the quality and availability of reproductive health care during disasters at PHC level and, in doing so, can promote the UN’s agenda on “disaster resilient health system” to achieve the SDG 3, and the WHO’s campaign on universal health coverage.

Details

International Journal of Human Rights in Healthcare, vol. 14 no. 4
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 5 March 2018

Antony John Tomlinson, Elizabeth Martindale, Karen Bancroft and Alexander Heazell

Each year approximately 3,200 women have a stillbirth in the UK. Although national evidence-based guidance has existed since 2010, case reviews continue to identify suboptimal…

Abstract

Purpose

Each year approximately 3,200 women have a stillbirth in the UK. Although national evidence-based guidance has existed since 2010, case reviews continue to identify suboptimal clinical care and communication with parents. Inconsistencies in management include induction and management of labour and the frequency of investigation after stillbirth. The paper aims to discuss these issues.

Design/methodology/approach

An audit of stillbirths was performed in 2014 in 13 maternity units in the North West of England, this confirmed variation in practice described nationally. An integrated care pathway (ICP) was developed from national guidelines to enable optimal care for the management of stillbirth, reduce variation, standardise investigations and coordinate patient-focussed care. This was launched in 2015 and updated in 2016 to resolve the issues that were apparent after implementation.

Findings

Each participating unit had commenced using the ICP by May 2015. Following implementation there were changes in care, most notably from diverse methods for the induction of labour to guideline-directed induction of labour. There were trends towards better care in terms of information given, choices offered, more appropriate analgesia in labour and improved post-delivery investigation for cause. Staff feedback about the ICP was positive.

Practical implications

The use of this ICP improved care for women who had a stillbirth and their families. Issues with implementing a changed care pathway meant that further iterations were required, ongoing improvement is expected following the refinement of the ICP.

Originality/value

ICPs have been used for various clinical conditions. However, this is the first example of their use in women who had a stillbirth.

Details

International Journal of Health Governance, vol. 23 no. 1
Type: Research Article
ISSN: 2059-4631

Keywords

Content available
Book part
Publication date: 9 February 2023

Cheryl Green

Abstract

Details

Social Justice Case Studies
Type: Book
ISBN: 978-1-80455-747-1

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