Article

Authoritative Knowledge and Single Women's Unintended Pregnancies, Abortions, Adoptions, and Single Motherhood: Social Stigma and Structural Violence

Massachusetts General Hospital, Harvard Medical School, USA.
Medical Anthropology Quarterly (Impact Factor: 1.3). 10/2003; 17(3):322-47. DOI: 10.1525/maq.2003.17.3.322
Source: PubMed

ABSTRACT

This article explores the sources of authoritative knowledge that shaped single, white, middle-class women's unintentional pregnancies and child-bearing decisions throughout five reproductive eras. Women who terminated a pregnancy were most influenced by their own personal needs and circumstances. birth mothers' decisions were based on external sources of knowledge, such as their mothers, social workers, and social pressures. In contrast, single mothers based their decision on instincts and their religious or moral beliefs. Reproductive policies further constrained and significantly shaped women's experiences. The social stigma associated with these forms of stratified maternity suggests that categorizing pregnant women by their marital status, or births as out-of-wedlock, reproduces the structural violence implicit to normative models of female sexuality and maternity. This mixed-method study included focus groups to determine the kinds of knowledge women considered authoritative, a mailed survey to quantify these identified sources, and one-on-one interviews to explore outcomes in depth.

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    • "None of these insights account for why birth mothers make the unique choice that they do. Anthropological research on stratified motherhood has suggested that birth mothers' pregnancy decisions are more likely to be influenced by external variables and the opinions of others, compared with women who terminate (who are more likely to be motivated by personal needs) and women who parent (whose decisions are determined by their instincts and moral beliefs) (Ellison, 2003). These findings suggest that birth mothers' pregnancy options are considered through a different decisionmaking lens. "
    [Show abstract] [Hide abstract] ABSTRACT: As the least-chosen option when faced with an unplanned pregnancy, adoption remains largely unexamined as a reproductive choice. Although the anti-abortion movement promotes adoption as its preferred alternative to abortion, little is known of birth mothers' pregnancy decision making and whether adoption was chosen in lieu of abortion. I conducted in-depth interviews with 40 women who had placed infants for adoption from 1962 to 2009. Participants were asked about all aspects of their adoption experiences, including their pregnancy decision making and thoughts on abortion. Interview transcripts were analyzed using grounded theory to find unifying themes speaking to reproductive choice. Participants' stories revealed widely varying ideas about abortion. Many were opposed to abortion, but a greater number supported abortion as a reproductive choice, although one they did not choose for themselves. Birth mothers were most often choosing between adoption and parenting, not adoption and abortion. Most participants would have preferred to parent, but did not because of external variables. Mixed experiences with adoption also influenced participants' long-term ideas about reproductive choice. Findings suggest that the anti-abortion framing of adoption as a preferable alternative to abortion is inconsistent with birth mothers' pregnancy decision-making experiences and their feelings about adoption. Reducing social barriers to both abortion and parenting will ensure that adoption is situated as a true reproductive choice. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
    Full-text · Article · Aug 2015 · Women s Health Issues
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    • "For those who already know the process of applying for, and then waiting to hear about, government-subsidised emergency medical care first-hand, the prospect of expanding mandated health coverage may raise the spectre of continued health-care delays. It is well-documented that pregnant women in poverty already encounter bureaucratic and economic obstacles while seeking reproductive health care in the United States, particularly when in need of abortion care (Boonstra 2007; Ellison 2003; Henshaw et al. 1999; Ostrach and Cheyney 2014). This is true even when state Medicaid programmes include provisions to cover abortion services for eligible women (Kiley et al. 2010). "
    [Show abstract] [Hide abstract] ABSTRACT: Women in poverty experience greater delays in the process of seeking abortion. Timely access to both safe abortion care and early prenatal care reduces morbidity and mortality among pregnant women. This article examines the impacts of a policy change intended to facilitate poor women's applications for pregnancy-related Medicaid (a federally funded, state-administered health coverage programme for the poorest Americans), in Oregon (Western U.S.). The mixed-methods data from this applied anthropology study demonstrate that though health coverage waiting times grew shorter on average, poor women and the clinic staff who cared for them continued to perceive delays in obtaining Medicaid coverage for abortion. Implementation of the Affordable Care Act in the U.S.A. (aka Obama-care) is now thought to be contributing to a return to greater delays in accessing prenatal care and abortion. More research and advocacy are needed to improve access to reproductive health care through state Medicaid programmes.
    Full-text · Article · Jan 2015 · Anthropology in Action
    • "These forms of socialized control over women's bodies were not only evident in the Medicaid eligibility verification delays and other logistical obstacles we documented, but also manifested in the physical presence of anti-abortion protesters outside the clinic. These protesters, operating from an agenda premised on their rights to influence what pregnant women do with their body rely on emotional manipulation and the intensification of social stigma (Cozzarelli et al., 2000; Ellison, 2003; Kumar et al., 2009). By serving as visible and audible reminders of expected gender roles, and the omnipresent risk of social sanctioning for women who resist these, the protesters at the clinic where we collected data intimidated women who were often already struggling with a lack of social support. "
    [Show abstract] [Hide abstract] ABSTRACT: Nearly half of all women in the United States will have at least one abortion during their lifetime, and many will encounter economic, logistical, and/or social obstacles while attempting to undergo the procedure. The purpose of this project was to examine the abortion-seeking experiences of a volunteer sample of Oregon women, to identify key barriers and the strategies women employed to overcome them. Using a mixed-methods approach combining survey and interview data with participant observation, we found that low-income women experienced structural and economic barriers to abortion even though abortion is covered by the state Medicaid program in Oregon. Social support helped women overcome obstacles, and a lack of support was itself experienced as an obstacle. Women of lower socioeconomic status also encountered more barriers and had a more difficult time overcoming them. Our findings indicate the need for improved advocacy to reduce structural delay, and to improve access to social support and other resources needed for timely abortion care.
    No preview · Article · Jun 2014 · Qualitative Health Research
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