Examining clinical personnel’s roles in facilitating person-centered abortion care for minors in the Southeastern United States Restricted; Files Only

Cheng, Joyce (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/3t945s057?locale=en


Abortion care is extremely stigmatized in the United States. While abortion for adults is more commonly discussed in scientific literature, in comparison, abortion care for young people specifically may be overlooked. As clinical personnel play an important role in supporting young patients, this thesis sought to explore clinical personnel’s perspectives on their roles in providing person-centered care for young people seeking an abortion. More specifically, this thesis used secondary qualitative data on abortion providers’ narratives to answer the question: how do clinical personnel’s self-perceived roles, responsibilities, and interactions facilitate person-centered reproductive health equity for young people under the age of 18 seeking an abortion in the Southeastern United States? Findings highlight four key themes of person-centeredness that are facilitated by abortion providers: dignity/autonomy, privacy/confidentiality, communication, and support. Abortion providers play mediatory roles between young patients and parents to ensure that decisions are patient-led and free of coercion. Abortion providers also facilitate privacy for young patients by periodically separating patients and parents at the clinic. To ensure young patients can receive the care they desire, providers spend much of their time explaining parental involvement laws and providing logistical support so patients fulfill the requirements. This thesis argues that parental involvement laws impose challenges for person-centeredness in abortion care for both patients and providers and explores recommendations for facilitating person-centered care under the current political environment.

Table of Contents

Chapter I. Introduction 1

Abortion in the Southeastern United States 1

Problem Statement 2

Theoretical Framework 4

Research Goal and Question 5

Chapter II. Literature Review 7

Abortion Trends in the United States 7

Demographic Characteristics of People Receiving Abortions 8

Reasons for Abortion 10

Abortion Care Journey 11

Barriers to Seeking Abortion Care 13

Abortion Stigma 15

Abortion Care Environment 17

Chapter III. Student Contribution 20

Positionality Statement 22

Chapter IV. Journal Article 24

Title Page for Manuscript 24

Abstract 25

Manuscript 26

Introduction 26

Methods 29

Results 32

Discussion 45

Chapter V. Public Health Implications 49

Person-Centered Abortion Care 49

Abortion Care and Sexual and Reproductive Health Care 50

New Direction for Minor Abortion Laws 52

References 54

Tables 65

Table 1. Southeastern U.S. states abortion laws 65

Table 2. Southeastern U.S. states minor’s abortion laws 66

Table 3. Person-centered abortion care domains and definitions for young people 67

Table 4. Characteristics of study participants in percentage or average (N=34) 68

Table 5. Southeastern U.S. states consent to sexual and reproductive health services for young people 69

Figures 70

Figure 1. Parental involvement laws by U.S. state 70

Figure 2. Abortion hostility by U.S. state 71

Figure 3. Person-centered care in reproductive health 72

Figure 4. Person-centered care for provider-minor engagement in abortion care 73

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