"No one likes an abortion provider until they need one": Examining Abortion Providers Perspectives on the Contextual Challenges and Opportunities Affecting their Recruitment and Retention to the Southern United States Open Access

Chowdhary, Pari (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/2227mq47q?locale=en


Following the landmark 1973 Roe v. Wade decision to legalize abortion in the United States, there has been significant movement to stem the accessibility and provision of abortion services in the southern United States. By adopting abortion-restrictive legislation, limiting abortion training, and forcing abortion provision into freestanding clinics, southern states and institutions have created and perpetuated abortion-hostile environments. Whereas the consequences of such abortion-restrictive environments on service provision is widely-recognized, the personal and professional implications of the southern United States' context on abortion providers is less known. State restrictions such as targeted regulation of abortion providers, certification requirements, facility standards, etc. affect providers' ability to practice and engage with their communities. As a means of informing strategies for provider recruitment and retention to combat the existing dearth of providers in the region, this study seeks to focus research attention on abortion providers working in the South. To explore abortion providers' perspectives on their recruitment and retention to the southern United States, in-depth interviews were conducted with current providers and with medical students who have intentions of providing abortions in the future. Between February and April 2015, ten interviews with abortion providers and eight interviews with medical students were completed, with participants representing eight southern States (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Texas). In-depth interviews were designed to understand the challenges that the abortion context of the South places on current and future abortion providers, and the potential for opportunities for improved provider recruitment, retention and support within this context. Abortion providers in the South identified a multitude of personal and professional challenges that we grouped into four categories: legislation; organizational/structural barriers; personal life and safety; and professional practice and development. Underlying each of these were pervasive challenges of stigmatization and isolation. Given these challenges, possible recommendations include the development of networking and training opportunities for providers, and improved cooperation among and engagement in abortion advocacy by pro-choice organizations. Study findings could inform organizational strategies for provider recruitment and retention, and serve as the foundation for future exploratory research to address abortion providers' needs in the South.

Table of Contents

Abstract 3

Literature Review 5 - 27

History of Abortion in American Politics 5

Situational Context of the American South 8

Abortion Provision in the South 11

Repercussions of Abortion-Restrictive Environments for Providers 16

Shortage of Abortion Providers 17

Anti-Abortion Violence 19

Stigmatization of Abortion Providers 20

Justification for this Research 25

Importance of Provider Perspectives 26

Research Objectives 27

Introduction 28 - 32

Issue at Hand 28

Contextual Background 29

Research Objectives 31

Research Significance 32

Methodology 33 - 36

Population & Sample 33

Ethical Considerations 34

Study Procedures 35

Data Management & Analysis 36

Methodological Limitations 36

Results 38 - 77

1.0 Motivations to Practice in the Southern United States 38

2.0 Challenges for Current and Future Providers in the Southern United States 41

2.1 Legislation 41

2.2 Organizational and Structural Issues 46

2.3 Personal Life and Safety 52

2.4 Professional Practice and Development 57

3.0 Overarching Implications for Personal and Professional Lives of Providers 61

4.0 Opportunities for Recruitment, Support and Retention of Providers to the South 66

5.0 Conceptual Framework: Challenges, Impacts and Opportunities 68

Discussion 70 - 83

Recommendations for Abortion Provider Recruitment and Retention 73

Implications of Research Findings 76

Strengths 78

Limitations 79

Directions for Future Research 81

Conclusion 84

Literature Referenced 85

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