Narrated experiences of the pre-termination of pregnancy counselling healthcare encounter in the Eastern Cape public health sector

Mavuso, Jabulile Mary-Jane Jace

Title: Narrated experiences of the pre-termination of pregnancy counselling healthcare encounter in the Eastern Cape public health sector
Creator: Mavuso, Jabulile Mary-Jane Jace
Subject: Abortion counseling -- South Africa -- Eastern Cape
Subject: Abortion -- Psychological aspects
Subject: Abortion -- Social aspects
Subject: Pro-choice movement -- South Africa -- Eastern Cape
Subject: Reproductive rights -- South Africa -- Eastern Cape
Subject: Women -- Sexual behavior -- South Africa -- Eastern Cape
Subject: Women -- South Africa -- Social conditions
Date Issued: 2018
Date: 2018
Type: text
Type: Thesis
Type: Doctoral
Type: PhD
Identifier: http://hdl.handle.net/10962/62928
Identifier: vital:28311
Description: Research that has been conducted about experiences of pre-abortion counselling tends to investigate either womxn's1 or healthcare providers' experiences separately, with research on womxn's experiences of abortion and abortion counselling dominating this area of research. Although some of the studies on womxn's abortion experiences have explored womxn's experiences of interactions between themselves and healthcare providers, these aspects have been underreported. To my knowledge, research that also explores womxn's interactions among themselves in the waiting room has not been done. Furthermore, research that explores the pre-termination of pregnancy healthcare encounter, where womxn's and healthcare providers' experiences of waiting room interactions and of pre-abortion counselling practices are seen as interrelated, has not been conducted. Research that has been conducted among womxn's experiences show that womxn have varying experiences of pre-abortion counselling, with some finding it useful while other womxn have found it to be lacking in relevance to their specific situation or needs. Research conducted among healthcare providers also points to varying experiences, with some healthcare providers stratifying womxn's reasons for abortion according to the acceptability of the request. This study explores health service providers’ and womxn’s narrated experiences of the pre-termination of pregnancy healthcare encounter (waiting room interactions and pre-abortion counselling) in the Eastern Cape public health sector. An African feminist post-structural approach, which enables analysis of how discursive structures and power relations may underpin African womxn's experiences of oppression and resistance, was used. Fusing this approach with a narrative-discursive analysis, enabled an exploration of the discursive resources drawn upon and the power relations referred to by participants when constructing micro-narratives and accounts of their experiences of waiting room interactions and pre-abortion counselling practices. This fusion enabled an understanding of the micro (individual) and macro (social) and how they interact and come to bear on experiences of the pre-abortion counselling healthcare encounter. Womxn's micro-narratives and healthcare providers' accounts were compared for convergences and divergences in the pre-abortion counselling practices they described. The implications of these convergences and divergences and of the power relations referred to by participants for pre-abortion counselling service provision are discussed. The research referred to in this study were conducted in contexts where abortion is legal, although the conditions under which it may be accessed differ across and within contexts. This present study is contextualised by the Choice on Termination of Pregnancy Act No. 92 of 1996 which legalises abortion and stipulates that abortion counselling should be made available to womxn but should be non-mandatory and non-directive. Data were collected at three abortion facilities located in public hospitals in the Eastern Cape. Open-ended, semi-structured interviews were conducted with 30 womxn after they received pre-abortion counselling, and four healthcare providers involved in abortion service provision. Data were analysed using an extended narrative-discursive approach which entailed exploring patterns in and across participants' talk. These patterns took the form of discursive resources (discourses and the subject positions they made available, and canonical narratives), power relations, and micro-narratives and accounts of their experiences of pre-abortion counselling practices and waiting room interactions. Participants described the following pre-abortion counselling practices: information-giving practices, consent practices, administering of LARCs, a waiting period and third-party involvement. In describing these processes, participants drew on an awfulisation of abortion discourse, moralising discourses, pronatalist discourses, and liberal discourses to construct (micro-)narratives in which liberal, pastoral and authoritarian counselling practices and power relations were constructed and referred to. In their micro-narratives, most womxn described the counselling as informative, beneficial and healing whilst also describing shock, hurt, pain and distress at the various kinds of information they received. Healthcare providers drew on discourses and canonical narratives (such as the hero and personal testimony) to justify liberal, pastoral and authoritarian counselling practices which were underpinned by constructing abortion and unintended pregnancy as problematic. The pre-abortion counselling practices that were described were directive in two ways: the coercion of contraceptive uptake post-abortion, and information provision practices which effectively work to delegitimise and persuade womxn against abortion.
Format: 346 pages
Format: pdf
Publisher: Rhodes University
Publisher: Faculty of Humanities, Psychology
Language: English
Rights: Mavuso, Jabulile Mary-Jane Jace

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Gender Action Forum (GENACT)

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