Social Science & Medicine 2020(January);245. Article 112686(Not open access)
The private use of abortion medication outside of the formal healthcaresetting is an international phenomenon. Despite new and expanding pathways toabortion access, we know little about how women’s perceptions and experiencesof abortion may also be changing. This study examines the embodied experienceof 68 women who sought abortion services in Northern Ireland and the Republicof Ireland. Social stigma and restrictive abortion laws were major barriers tocare at the time of study, providing the opportunity to explore the waysbiological, social, and structural factors shape embodiment. Those who obtainedan abortion either travelled abroad for clinical care or self-managed amedication abortion at home. Participant’s perceptions of pain, the fetus, themethod (medication vs. surgical), and environment in which they sought abortioncare (at home vs. in a clinic) were shaped by structural stigma. Women gainedgreater experiential knowledge through medication self-management, allowingthem to relate abortion to other natural bodily processes and redefine theirbeliefs about pregnancy and the fetus. Preferences and attitudes about theenvironment of abortion care were informed by stigma and differentialperceptions of risk. Those who travelled most often emphasized legal andmedical risks of abortion at home, while those who self-managed emphasizedsocial, financial, and emotional risks of pursuing clinical abortion careabroad. Given the increase in reproductive self-care alternatives, thesefindings situate self-managed abortion in the literature of (de)medicalizationand reveal the ways technology and structural factors shape perceptions andbeliefs about pain, the fetus, method, and environment. For some, self-managedmedication abortion may be a preferred pathway to care. Policies that considermedication self-management as part of a spectrum of legitimate options canimprove abortion access for marginalized groups while also offering an improvedabortion experience for those who prefer medication abortion and anout-of-clinic environment.
PHOTO: © Simon Graham, Amnesty International, Euronews, 24 October 2019