Since the introduction of a new type of anti-abortion legislation in the United States which bans abortions after a fetal heartbeat can be detected, women’s options regarding abortion are being limited. How “problems” are represented or constituted in legislation shows that problems are time, place and context dependant. By using Carol Bacchi’s “What’s the problem represented to be?” approach to policy analysis, problem representations and subjectification effects in the heartbeat bills were identified. The problem representation of abortion as “lack of information” emerged as the central problem representation and the subject positions that were made available limits women’s choices regarding abortion. Fetal rights emerged as the core of the argumentation in the legislation, excluding women’s rights. How the problem of abortion is represented to be, the subjectification effects and the way rights are used and argued for in antiabortion legislation shows how they effectively limits women’s abortion choices.

This thesis utilizes a reproductive justice framework to discuss the impact of anti-abortion legislation and the anti-abortion movement on women of color and low-income women, arguing that reduced access to abortion is oppressive to minority women. Chapter 1 outlines the theoretical framework of this thesis, focusing on feminist Marxism, Intersectionality, Critical Race Theory, and radical and third wave feminist perspectives. Chapter 2 provides an overview of the anti-abortion movement and the major state and federal laws and court cases that have defined women's access to abortion in the United States, including Roe v Wade, the Hyde Amendment, Planned Parenthood v Casey, and TRAP laws. Chapter 3 discusses the oppressive effects of these laws by connecting anti-abortion legislation and the anti-abortion movement to larger historical systems of oppression and examining the effect of reduced access to abortion on women's reproductive choices and socioeconomic status. This chapter argues that reduced access to abortion is oppressive because it encourages sterilization among minority women who may have chosen other birth control options given the choice, and funnels minority women into an oppressive and exploitative US welfare system. Chapter 4 discusses minority women's potential to overcome this oppression and examines some real-world examples of reproductive rights activism. This thesis expands the current discussion on abortion access by centering the discussion on minority women and arguing that reduced access to abortion is systematically oppressive rather than simply discriminatory.

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Cette thèse aborde dans la première partie une revue panoramique des controverses historico-juridiques autour de l’avortement dans le monde, suivi par une analyse du contexte socioculturel des attitudes et des pratiques liées aux rapports sociaux de sexe, aux grossesses non désirées et à l’avortement non sécurisé. Enfin, nous examinons les articulations entre la médecine traditionnelle, coloniale et moderne au Gabon. Tout cela nous amène à notre étude sur les barrières à l’accès aux soins modernes chez les femmes en situation d’urgence médicale.L’objectif de cette thèse doctorale est d’élaborer et d’appliquer, dans sa deuxième partie, une méthodologie pour étudier le réseau des acteurs impliqués dans les pratiques liées aux avortements afin de mieux comprendre les résistances aux changements socio-cliniques et juridiques. Quel est le système de soins formel et informel chez les prestataires médicaux de soins en matière d'avortement et quels sont les obstacles que les praticiens et les femmes doivent franchir pour fournir (les praticiens) et obtenir (les femmes) ce service ? Spécifiquement une investigation des interactions sociales et institutionnelles en milieu hospitalier de Lambaréné et dans les zones rurales environnantes a été réalisée. Elle nous a conduit à déceler différentes barrières extra médicales et intra médicales à l’accès aux soins d’urgence suite aux complications des avortements non sécurisés. Ainsi, nous nous sommes concentrés, d’une part, sur les discours des professionnels de la santé, leurs pratiques et les contextes de soins ; et d’autre part, nous avons privilégié les récits des femmes sur les stratégies à interrompre les grossesses avec ou sans l'aide médicale et sur leurs stratégies d’accès aux soins modernes malgré les obstacles.Les résultats obtenus à partir des entretiens, après l’analyse de contenus, montrent qu’en pratique, il existe d'importantes barrières à l'accès aux soins d’urgences. Ces difficultés débutent dans leur environnement social avec la recherche des produits abortifs et les premiers traitements (automédication, aller en pharmacie ou chez le tradithérapeute). En cas de complications aggravées, les obstacles extra médicaux s’amplifient avec la distance géographique, les problèmes de transport et des moyens financiers. Par ailleurs, une fois ces obstacles plus ou moins franchis, les femmes doivent encore affronter les obstacles intra médicaux dans la prise en charge des urgences. Fournir un accès aux services d’avortement sans risque pour les Gabonaises est l’un des grands défis auquel nous devons faire face actuellement. Cette thèse contribue à dénoncer tout haut ce qui se passe de manière informelle dans la société gabonaise. Les femmes vivent des situations tragiques. / This dissertation begins with a broad overview of juridical and historical controversies surrounding abortion in the world followed by an analysis of attitudes and practices in diverse socio-cultural contexts linked to gender relations, unwanted pregnancy and unsafe abortion. We then examine articulations between traditional, colonial and modern medicine in Gabon. That panorama brings us to our study of the obstacles women with medical emergencies face in accessing modern health care.The objective of this doctoral research is to elaborate and apply a methodology for studying the network of actors involved in practices connected to abortion in order to better understand resistance to socio-clinical and juridical change. What is the formal and informal health care system of medical providers in matters related to abortion and what are the obstacles that providers and women must transverse to offer (providers) and obtain (women) this service? Specifically, an investigation of social and institutional interactions was conducted in urban hospital settings and in surrounding rural areas. That led us to detect different extra-medical and intra-medical barriers to emergency care access following unsafe abortion complications. In this way, we focused, on one side, upon the discourse, practices and medical contexts of health professionals while, on the other side, privileging the accounts women recited of their strategies for terminating pregnancies with or without medical help and for accessing modern care despite the obstacles.Content analysis of interviews revealed major barriers to emergency care access. Those difficulties start in the social environment with the search for abortion products and for initial treatments (self-medication and visits to the pharmacy or to traditional practitioners). In cases of advanced complications, extra-medical obstacles intensify with greater geographic distance, transportation problems and insufficient financial means. Moreover, once those obstacles are more or less overcome, women must then confront intra-medical obstacles within emergency care hospital units. Providing access to safe abortion for Gabonese women in current times is one of the great challenges we must confront. This dissertation contributes to a loud vocal denunciation of informal happenings in the society of Gabon. Women live tragic circumstances.

The Choice on Termination of Pregnancy Act (CTOP Act 92 of 1996) is perhaps the most revolutionary piece of legislation internationally ever to have been promulgated to regulate abortion and as such women’s reproductive lives. Abortion research tends to focus on the experiences of women and thus cast abortion as solely a territory that represents women’s reproductive concerns and the power to choose to procreate. While the CTOP Act safeguards women’s right of choice and a form of determination relating to what happens to their bodies, it also fails to recognise or even make pronouncements about the role that a man plays in the choice to terminate a pregnancy as well as how abortion affects a man’s life. This therefore implies that legally, men do not have a stake to influencing the decision to terminate a pregnancy. This qualitative study was undertaken to explore how young unmarried males whose partners have undergone an abortion construct abortion and the meanings that they attach to the experience of abortion. Interviews were conducted and the data was analysed using discourse analysis. Some of the young men knew about the woman’s decision to have an abortion and others did not know. Common findings include a sense of helplessness due to feeling that the decision is ultimately that of the woman, anger for those who did not know about the decision to abort and a lack of forgiveness towards their partners. / Psychology / M.A. (Clinical Psychology)

The Choice on Termination of Pregnancy Act (CTOP Act 92 of 1996) is perhaps the most revolutionary piece of legislation internationally ever to have been promulgated to regulate abortion and as such women’s reproductive lives. Abortion research tends to focus on the experiences of women and thus cast abortion as solely a territory that represents women’s reproductive concerns and the power to choose to procreate. While the CTOP Act safeguards women’s right of choice and a form of determination relating to what happens to their bodies, it also fails to recognise or even make pronouncements about the role that a man plays in the choice to terminate a pregnancy as well as how abortion affects a man’s life. This therefore implies that legally, men do not have a stake to influencing the decision to terminate a pregnancy. This qualitative study was undertaken to explore how young unmarried males whose partners have undergone an abortion construct abortion and the meanings that they attach to the experience of abortion. Interviews were conducted and the data was analysed using discourse analysis. Some of the young men knew about the woman’s decision to have an abortion and others did not know. Common findings include a sense of helplessness due to feeling that the decision is ultimately that of the woman, anger for those who did not know about the decision to abort and a lack of forgiveness towards their partners. / Psychology / M. A. (Clinical Psychology)