RAARN Citations
Pages
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- "“They made me go through like weeks of appointments and everything”: Documenting women's experiences seeking abortion care in Yukon territory, Canada.
- Abortion has been legal without restriction in Canada since 1988 and is recognized as a medically necessary service. However, research indicates that women still face numerous barriers to accessing care, challenges that are amplified for women living in rural, remote and northern regions in Canada. This qualitative study aimed to document women's experiences seeking and obtaining abortion services while residing in Yukon Territory, identify financial and personal costs and explore avenues through which services could be improved.
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- A qualitative study exploring the determinants of maternal health service uptake in post-conflict Burundi and Northern Uganda.
- Armed conflict has been described as an important contributor to the social determinants of health and a driver of health inequity, including maternal health. These conflicts may severely reduce access to maternal health services and, as a consequence, lead to poor maternal health outcomes for a period extending beyond the conflict itself. As such, understanding how maternal health-seeking behaviour and utilisation of maternal health services can be improved in post-conflict societies is of crucial importance. This study aims to explore the determinants (barriers and facilitators) of women's uptake of maternal, sexual and reproductive health services (MSRHS) in two post-conflict settings in sub-Saharan Africa; Burundi and Northern Uganda, and how uptake is affected by exposure to armed conflict., This is a qualitative study that utilised in-depth interviews and focus group discussions (FGDs) for data collection. One hundred and fifteen participants took part in the interviews and FGDs across the two study settings. Participants were women of reproductive age, local health providers and staff of non-governmental organizations. Issues explored included the factors affecting women's utilisation of a range of MSRHS vis-à-vis conflict exposure. The framework method, making use of both inductive and deductive approaches, was used for analyzing the data., A complex and inter-related set of factors affect women's utilisation of MSRHS in post-conflict settings. Exposure to armed conflict affects women's utilisation of these services mainly through impeding women's health seeking behaviour and community perception of health services. The factors identified cut across the individual, socio-cultural, and political and health system spheres, and the main determinants include women's fear of developing pregnancy-related complications, status of women empowerment and support at the household and community levels, removal of user-fees, proximity to the health facility, and attitude of health providers., Improving women's uptake of MSRHS in post-conflict settings requires health system strengthening initiatives that address the barriers across the individual, socio-cultural, and political and health system spheres. While addressing financial barriers to access is crucial, attention should be paid to non-financial barriers as well. The goal should be to develop an equitable and sustainable health system., journal article, 2015, 2015 02 05, imported
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- A rollercoaster of policy shifts: global trends and reproductive health policy in The Gambia.
- Global trends influence strategies for health-care delivery in low- and middle-income countries. A drive towards uniformity in the design and delivery of healthcare interventions, rather than solid local adaptations, has come to dominate global health policies. This study is a participatory longitudinal study of how one country in West Africa, The Gambia, has responded to global health policy trends in maternal and reproductive health, based on the authors' experience working as a public health researcher within The Gambia over two decades. The paper demonstrates that though the health system is built largely upon the principles of a decentralised and governed primary care system, as delineated in the Alma-Ata Declaration, the more recent policies of The Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria and the GAVI Alliance have had a major influence on local policies. Vertically designed health programmes have not been easily integrated with the existing system, and priorities have been shifted according to shifting donor streams. Local absorptive capacity has been undermined and inequalities exacerbated within the system. This paper problematises national actors' lack of ability to manoeuvre within this policy context. The authors' observations of the consequences in the field over time evoke many questions that warrant discussion, especially regarding the tension between local state autonomy and the donor-driven trend towards uniformity and top-down priority setting., historical article, journal article, research support, non-u.s. gov't, 2014, imported
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- Abortion history, laws, women’s activism, and abortion on demand in Norway
- Norway had a broad political discourse on illegal abortions and abortion complications way back in 1913, with a well known feminist Katti Anker Møller raising the issue. We continued to have illegal abortions until after the World War 2, but them the situation changed somewhat. The first law that allowed abortions on medical grounds was passed in the 1960ies and on social grounds some ten years later. In the later part of the old abortion law practically everyone who applied for an abortion got one, but the case had to be presented in front of a panel. Feminists, novelists and historians alike raised the issue sharply, especially the issue about how humiliating it was for women to make a case for abortion in front of powerful people. A PhD on abortion documented the issue more broadly, and eventually, after one failed attempt, a law that granted abortion on demand until 12 weeks of gestation was passed in the late 1970ies. Abortion rates remained nearly the same, but the debate continued afterwards, both the issue of late abortion, health workers’ objection to conducting abortions, and mandatory counseling have been suggested, but not really made it into the laws. Care for abortion is free of charge, and access to care is good. Medical abortions and surgical abortions are available, but a new legal attempt to expand the objection paragraph to also include GP’s who do not want to refer to abortion counseling, has brought back a forceful debate on the moral grounds for having a clear abortion law, and clear politics at the same time as it is legally allowed to be against the law. The conflict between empathy and care for vulnerable women is in the forefront of the debate. I am a feminist, researcher and OB/GYN who has experienced the clinical and sociopolitical issues around abortion in Norway for a long time, since I started medical school in 1972. I have also worked on research on abortion in Burkina Faso and Cote d’Ivoir. I will discuss some of the issues that make this debate so complicated, and how it stops us from having a real debate about abortion dilemmas and its links with social context and living conditions of vulnerable women.
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- Abortion: History, Politics, and Reproductive Justice after Morgentaler
- When Henry Morgentaler, Canada’s best-known abortion rights advocate, died in 2013, activists and scholars began to reassess the state of abortion in this country. In Abortion, some of the foremost researchers in Canada challenge current thinking by revealing the discrepancy between what people are experiencing on the ground and what people believe the law to be after the 1988 Morgentaler decision. Grouped into four themes – History, Experience, Politics, and Reproductive Justice – these essays showcase new theoretical frameworks and approaches from law, history, medicine, women’s studies, and political science as they document the diversity of abortion experiences across the country, from those of Indigenous women in the pre-Morgentaler era to a lack of access in the age of so-called decriminalization. Together, the contributors make a case for shifting the debate from abortion rights to reproductive justice and caution against focusing on “choice” or medicalization without understanding the broader context of why and when people seek out abortions.
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- Bearing Witness: Medical Abortion Anastasia's story
- In this discussion a woman’s personal story of her experience with medical abortion will be shared with a view to understanding the processes that support and hinder safe medical abortion access. What can we learn about the better kinds of support to provide in order to facilitate a caring and compassionate health care model?, paper presentation
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- Breaking the silence on abortion: the role of adult community abortion education in fostering resistance to norms
- Meanings of abortion in society are constructed within sociohistorical and gendered spaces and manifested through myriad discourses that impact on the perception and treatment of the issue in that society. In societies with powerful oppressive anti-abortion norms, such as Northern Ireland, little is known as to how these norms are resisted by the adult population. This study uses a Foucauldian feminist approach to show how resistance to religious and patriarchal norms can be fostered through adult community abortion education. This resistance is multi-faceted and bolstered by a lived experience discourse, which does not necessarily involve eschewing religious notions held within society., article
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- Caesarean section by immigrants' length of residence in Norway: a population-based study.
- Immigrants to Europe account for a significant proportion of births in a context of rising caesarean rates. We examined the risk of planned and emergency caesarean section (CS) by immigrants' length of residence in Norway, and compared the results with those of non-immigrants., We linked population-based birth registry data to immigration data for first deliveries among 23 147 immigrants from 10 countries and 385 306 non-immigrants between 1990-2009. Countries were grouped as having low CS levels (<16%; Iraq, Pakistan, Poland, Turkey, Yugoslavia, Vietnam) or high CS levels (>22%; the Philippines, Somalia, Sri Lanka, Thailand). Associations between length of residence and planned/emergency CS were estimated as relative risks (RR) with 95% confidence intervals (CI) in multivariable models., In the immigrant group with low CS levels, planned, but not emergency, CS was independently associated with longer length of residence. Compared with recent immigrants (<1 year), the risk of planned CS was 70% greater among immigrants with residency of 2-5 years (RR 1.70, CI: 1.19-2.42), and twice as high in those with residency of ≥ 6 years. (RR 2.01, CI: 1.28-3.17). Compared with non-immigrants, immigrants in the low group with residency <2 years had lower risk of planned CS, while those with residency >2 years had greater risk of emergency CS. In the high group, the risk of planned CS was similar to non-immigrants, while emergency CS was 51-75% higher irrespective of length of residency., Efforts to improve immigrants' labour outcomes should target subgroups with sustained high emergency caesarean risk., journal article, research support, non-u.s. gov't, 2015 Feb, 2014 09 05, imported
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- Costs and consequences of abortions to women and their households: a cross-sectional study in Ouagadougou, Burkina Faso.
- Little is known about the costs and consequences of abortions to women and their households. Our aim was to study both costs and consequences of induced and spontaneous abortions and complications. We carried out a cross-sectional study between February and September 2012 in Ouagadougou, the capital city of Burkina Faso. Quantitative data of 305 women whose pregnancy ended with either an induced or a spontaneous abortion were prospectively collected on sociodemographic, asset ownership, medical and health expenditures including pre-referral costs following the patient's perspective. Descriptive analysis and regression analysis of costs were performed. We found that women with induced abortion were often single or never married, younger, more educated and had earlier pregnancies than women with spontaneous abortion. They also tended to be more often under parents' guardianship compared with women with spontaneous abortion. Women with induced abortion paid much more money to obtain abortion and treatment of the resulting complications compared with women with spontaneous abortion: US$89 (44 252 CFA ie franc of the African Financial Community) vs US$56 (27 668 CFA). The results also suggested that payments associated with induced abortion were catastrophic as they consumed 15% of the gross domestic product per capita. Additionally, 11-16% of total households appeared to have resorted to coping strategies in order to face costs. Both induced and spontaneous abortions may incur high expenses with short-term economic repercussions on households' poverty. Actions are needed in order to reduce the financial burden of abortion costs and promote an effective use of contraceptives., journal article, research support, non-u.s. gov't, 2015 May, 2014 05 14, imported
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- Cultures of Abortion and the Female Fetish: Popular Culture, Abortion, and Political Imagery in post 9-11 America
- The 2013 Democratic Texas senator Wendy Davis made national headlines with her eleven hour filibuster to delay the passage of a Texas bill dismantling abortion clinics, and as such, access throughout the state. Among the many points of the law, part of it stated that the Morning After Pill must be administered by a doctor and all abortions must be performed within an ambulatory care facility (i.e. a full-fledged hospital). Davis’s stand is certainly not the longest filibuster in history, but its purpose captures the essence of the moment aptly. The Roe v Wade decision theoretically protected a woman’s right to an abortion, but it did not mandate access. Thus, in a de facto grassroots manner local and state legislatures are aggressively finding creative ways to dismantle not only Roe v Wade but women’s choices in general. As abortion rights are being legally chipped away in the United States, Hollywood has emerged as a platform for the vocalization of concern. Contemporary films such as Revolutionary Road (2008), The Cider House Rules (1999),Vera Drake (2004), among others, are increasingly challenging the erosion of abortion rights in the United States by conveying the horrors and social, racial, and sexual injustices of the criminal period. These films, primarily set in thepost-World War II period (but before Roe),serve as forms of protest reminding audiences of life during the illegal period. In Revolutionary Road the abortion subject takes on the form of suicide, the loss of a dreamer, and the imagery of abortion is juxtaposed against the backdrop the traditional and ideal family. While the movies here show a counter to illegal access, clips of fetuses with an overlapped laughing baby infiltrating television shows (one example, The Drew Carey Show) permeate with a clear message of pro-life. Thus, this discursive debate demands a critical examination as the access and defining of women’s bodies remains a topic at large with legislative mandates serving as portals of fetish desire and regulation., abortion, feminism, access, women’s rights, popular culture
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- Emergency Contraception in Post-Conflict Somalia: An Assessment of Awareness and Perceptions of Need
- In conflict-affected settings such as Somalia, emergency contraception (EC) has the potential to serve as an important means of pregnancy prevention. Yet Somalia remains one of the few countries without a registered progestin-only EC pill. In 2014, we conducted a qualitative, multi-methods study in Mogadishu to explore awareness of and perceptions of need for EC. Our project included 10 semi-structured key informant interviews, 20 structured in-person interviews with pharmacists, and four focus group discussions with married and unmarried Somali women. Our findings reveal a widespread lack of knowledge of both existing family planning methods and EC. However, once we described EC, participants expressed enthusiasm for expanding access to post-coital contraception. Our results shed light on why Somalia continues to be a global exception with respect to an EC product and suggest possible politically and culturally acceptable and effective avenues for introducing EC into the health system., article
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- Exploring Canadian women's knowledge of and interest in mifepristone: results from a national qualitative study with abortion patients
- Although Canada decriminalized abortion in 1988, significant disparities in access to services and an uneven geographic distribution of providers persists. Health Canada registered mifepristone, the gold standard of medication abortion, in July 2015. Our study explored Canadian women's knowledge of, interest in, and perspectives on mifepristone prior to registration., article