‘If You Choose to Abort, You Have Acted As an Instrument of Satan’: Zimbabwean Health Service Providers’ Negative Constructions of Women Presenting for Post Abortion Care
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Health service providers play a crucial role in providing post abortion care in countries where abortion legislation is restrictive and abortion is stigmatised. Research in countries where these factors apply has shown that health service providers can be barriers to women accessing post abortion services. Much of this research draws from attitude theory. In this paper, we utilise positioning theory to show how the ways in which Zimbabwean health service providers’ position women and themselves are rooted in cultural and social power relations. In light of recent efforts by the Zimbabwean Ministry of Health and foreign organisations to improve post abortion care, we explore the implications that these positionings have for post abortion care.
As part of a larger study on abortion decision-making, the data featured in this article were collected using in-depth semi-structured interviews with six health service providers working in different facilities in Harare, Zimbabwe. Discursive and positioning thematic analysis was used to analyse the data.
Our analysis points to women who have abortions being positioned in negative terms, as transgressors of acceptable norms; irresponsible and manipulative; and ignorant. The health service providers drew from cultural, religious, gender and trauma discourses that portray abortion as evil and socially unacceptable. Reflexive positions taken up by the health service providers include positions as being experts, helpers and protectors of culture/religion, sympathisers and professional positions as health care providers.
The continued strengthening of post abortion services should be conducted in conjunction with dialogical interventions that challenge health service providers to reflect on the power relations within which women who terminate pregnancies are located, that contest their negative positionings of these women and that present alternative narratives and subject positionings for both the women who have abortions and the health service providers.
KeywordsAbortion Health service providers Post abortion care Positioning
We thank the health service providers who participated in this study. Thank you to the CSSR members for input on our work.
This work is based on research supported by the South African Research Chairs initiative of the Department of Science and Technology and National Research Foundation of South Africa (grant no. 87582) and Andrew W Mellon (grant no. 11100695).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Medical Research Council of Zimbabwe and the Rhodes University Psychology Department Research Projects and Ethics Review Committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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