Resisting abortion stigma in situ: South African womxn's and healthcare providers' accounts of the pre-abortion counselling healthcare encounter

Abstract

Abortion providers and pregnant people who undergo abortion potentially face significant stigma. Researchers have started to explore how womxn respond to abortion stigma, usually focusing on individual strategies in managing or reducing stigma effects. Drawing on narrative data from research conducted on womxn’s and healthcare providers’ experiences of the pre-abortion healthcare encounter in the South African public health sector, we highlight how stigma may be resisted in social ways within this context. Everyday chatter and informal social support amongst womxn in the waiting room provided a counterpoint for health service providers’ ascription of shame to the womxn, and a sense of solidarity amongst the womxn. Health service providers narrated their decision to do abortion work through the socially affirming hero canonical narrative, and womxn described their counselling as helpful. These social and discursive practices resist the awfulisation of abortion and provide relief for the womxn and the healthcare providers in particular contexts.

Keywords:

• Abortion
• stigma
• resistance
• South Africa

Acknowledgements

This work would not be possible without the abortion seekers and healthcare providers who participated in this study and shared their stories, Nosihle and Kuhle who conducted some interviews, and Kayakazi Mkhosana who provided assistance with translating and transcribing data.

Disclosure statement

The authors declared no potential conflicts of interests with respect to the research, authorship and/or the publication.

Notes

1 The terms 'womxn' and ('mxn') disrupt normative assumptions about gender and sex, here taken to be socially constructed, which write gender and sex onto individuals. We foreground the invisibility and experiences of womxn of colour, womxn from/living in the global south, trans, queer and intersex womxn, and all womxn-identifying persons who have been excluded from dominant constructions of 'womanhood' and feminist praxis on the subject (Ashlee, Zamora, and Karikari 2017; Merbruja 2015). We do note, however, that this term does not include some gender non-conforming and non-binary pregnant persons.

2 The pre-abortion counselling was mostly pre-treatment but varied across sites and providers, with therapeutic counselling being used as well at site 2.

3 Township refers to underdeveloped urban living areas that, from the late 19^th century until the end of apartheid, were created and designated for ’non-white’ populations which served as labour to adjacent cities and towns.

4 Through back translation, transcribed data which had been translated into English were translated back to isiXhosa and the two versions compared.

5 The term Black is being used here broadly and politically to refer to those groups who were previously designated as ‘non-white’ and were racially and economically oppressed under colonial and Apartheid systems in South Africa. Although there are contestations around its usage, we have used it here as racial identity was not constructed or made relevant by participants in the narratives discussed here, and to acknowledge the contestations, and search for new ways of speaking, around categorisation and meanings of race and racial identity, both outside and inside academic and research spaces, currently taking place in South Africa.

Additional information

Funding

This work is based on research supported by the South African Research Chairs initiative of the Department of Science and Innovation and the National Research Foundation of South Africa [grant number: 87582].