An Exploratory Analysis of Legal Abortion Access in Oaxaca, Mexico, Three Years Post-Decriminalization Pubblico

Abstract

In 2019, the state of Oaxaca became the first state, and second federal jurisdiction, in Mexico to decriminalize voluntary abortion within the first trimester of a pregnancy. Nearly three years later, however, there is limited data to suggest that access to legal abortion services (knows as Interrupción Legal de Embarazo, or ILE) has improved. This objective of this study was to qualitatively describe the experiences of women who have utilized ILE services in the past and the self-perceived barriers of women who may avail of services in the future. The research team conducted nine qualitative interviews with women in Oaxaca City and the rural community of Santo Domingo Tonala, ages 21 to 37 years. Participants described a limited availability of trained abortion providers across the state and inconsistencies in the quality of medical care from public and private healthcare facilities. Outside of abortion care, there were several accounts of overbearing and assertive contraceptive counseling. Abortion stigma appeared to be pervasive at a cultural, religious, and interpersonal level. Findings from this exploratory study provide valuable first-hand accounts of utilization and perceptions of safe, legal abortion services in Oaxaca and serve as a foundation for future interdisciplinary research on reproductive healthcare in the region, as well as to inform policy and structural interventions to improve health outcomes for millions of women in Oaxaca, Mexico. 

Table of Contents

Chapter 1: Introduction 1

Rationale 1

Problem Statement: 1

Purpose Statement: 1

Significance Statement: 1

Chapter 2: Comprehensive Review of Literature 2

Global Abortion Overview 2

Abortion in Latin America and the Caribbean (LAC) and the Green Wave 2

Mexican Healthcare Systems 3

Reproductive Health Estimates in Mexico 4

Decriminalization of Abortion in Mexico City 5

Abortion Travel 6

Decriminalization of Abortion in the Other Parts of Mexico 7

Overview of Sexual and Reproductive Health Needs in Oaxaca, Mexico 8

Decriminalization of Abortion in Oaxaca 9

Gaps in the Literature: 10

Chapter 3: Manuscript 11

Abstract: 13

Introduction: 14

Methods 15

Results 18

Discussion 24

Manuscript References: 29

Chapter 4: Conclusion and Public Health Implications 32

References: 34

Appendix 1: Semi-Structured Interview Guide (Spanish) 38

Appendix 2: Translated Quotations 42

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Latin American Studies Gender Studies Health Sciences, Public Health
Parola chiave	Mexico Sexual and Reproductive Health Abortion Legal Abortion Abortion Policy Qualitative Research
Committee Chair / Thesis Advisor	Rochat, Roger, Emory University

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