Developing a Medication Abortion Advocacy Toolkit with Community and Policy Groups: A Special Studies Project Open Access

Shah, Priya (Summer 2022)

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Background: Medication abortion (MA) is safe and effective. Telemedicine for MA has the potential to increase access to abortion care; however, many state-level restrictions seek to ban telemedicine for abortion, disproportionately affecting marginalized communities. Reproductive Justice (RJ), a framework and social movement started by Black feminists, emphasizes the human rights to have children, not have children, and parent one's children with health and dignity free of coercion.

Purpose: The purpose of this special study project is to 1) participate in community-led research on medication abortion and 2) collaborate with RJ and policy advocacy groups to respond to emergent policy needs. This will support the safety of telemedicine and medication abortion while amplifying the voices and experiences among Black and Latinx women in Atlanta, GA.

Methods: The Georgia Medication Abortion (GAMA) study led by HIV and RJ organization SisterLove seeks to explore MA experiences and perceptions among Black and Latinx women. This special studies project conducted a secondary analysis of GAMA data on abortion stigma. This project expanded to incorporate participant observations at a Georgia Senate hearing on telemedicine for abortion and develop an advocacy toolkit for policymakers informed by RJ leaders.

Results: Findings from GAMA show that abortion stigma among Black and Latinx women in Atlanta, GA is a complex, intersectional phenomenon contextualized by the history and intergenerational trauma of social and racial injustice, reproductive and economic oppression, and sexual exploitation. Participant observations concluded that abortion stigma is evident in the abortion policy-making process and reinforces negative connotations about people who have or support abortion. The advocacy toolkit provided talking points and a comprehensive literature review on the evidence of telemedicine abortion safety and was delivered to all Georgia Senators and Representatives. The proposed bill did not pass.

Discussion: Access to safe abortion is critical more than ever. Despite abundant evidence, stigmatizing and unscientific policies are still being introduced. To achieve RJ and destigmatize abortion, intersectional frameworks that center marginalized communities' lived experiences and perspectives are needed. Public health researchers, local RJ organizations, and other advocacy groups must collaborate to bridge the gap between policy, evidence, and experiential knowledge.

Table of Contents

Chapter 1: Introduction 1

Introduction and Rationale 1

Problem Statement 3

Purpose Statement 4

Significance Statement 5

Definition of Terms and Abbreviations 7

Chapter 2: Literature Review 9

Reproductive Justice 9

Abortion Stigma 11

Medication Abortion 13

Telehealth for Medication Abortion 14

Chapter 3: Methodology 16

The Georgia Medication Abortion (GAMA) Study 16

Participant Observation of Health & Human Servies Committee Hearing 19

Developing the Toolkit 20

Chapter 4: Results 21

4.1 GAMA Study Findings 21

4. 2 Participant Observation Results 26

Toolkit Product 28

Chapter 5: Discussion 29

Strengths and Limitations 33

Public Health Implications and Recommendations 34

Conclusion 35

References 37

Appendices 40

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