Providers’ Perspectives of Georgia’s 22-Week Abortion Ban and its Sociocultural and Political Implications Open Access

Abstract

Background: In 2015, the Georgia legislature passed House Bill 954 (HB954) which implements a gestational age limit on abortion at 22 weeks from last menstrual period. This study sought to analyze the social, cultural and political contexts and consequences of HB954 from the perspective of abortion clinic personnel in Georgia.

Methods: 20 semi-structured, in-depth interviews were conducted with a diverse set of service delivery stakeholders from 4 abortion clinics in Georgia. Using an iterative process, and principals of grounded theory, transcripts were annotated and coded in MAXQDA. The analysis used both inductive and deductive approaches.

Results: Participants reported a disconnect between the medical and legal communities, particularly due to the presence of medically inaccurate language in HB954, as well as lawmakers’ insertion of their own personal beliefs and ideas of morality. Participants also described the stigma they experienced within a hostile service delivery environment. Participants expressed that HB954 disregards patients’ bodily autonomy and intrudes into the provider–patient relationship. The state’s intrusion into the provider-patient relationship created a heavy emotional and mental burden on participants because they reported having to deny some patients care and/or refer patients to other states.

Conclusion: Providers viewed HB954 as posing a threat to patients’ bodily autonomy, perpetuating and legally codifying medical misinformation, and contributing to mental and emotional burnout among personnel. Future research is needed to further evaluate abortion providers role in legislation and the impact recent restrictive abortion regulation creates on patients as a study population.

Table of Contents

Table of Contents

Chapter 1: Introduction

Introduction & Rationale

Research Question

Chapter 2: Background and Literature Review

Reproductive Health, Rights & Justice

Global Health Context of Abortion

History of Abortion Legislation in the United States

State-level Abortion Restrictions in the United States

Abortion in the Southeastern United States and Georgia

Evidence-based Patient Care

Chapter 3: Methods & Results

Study Population, Sample Size, and Data Collection

Ethics

Data Analysis

House Bill 954 is not a scientific evidence-based policy

HB954 is a Threat to Patients’ Bodily Autonomy

After HB954, Providers Turn Away Patients with Great Consequence

After HB954, Providers Experienced More Emotional and Mental Burden

Chapter 4: Discussion

Summary of Findings

Legislative Interference

United States Political Environment

Abortion Stigma

Strengths & Limitations

Chapter 5: Conclusion and Recommendations

Policy & Program Recommendations

Future Studies

Conclusion

Appendices

Appendix 1: In-Depth Interview Guide

Appendix 2: Codebook

Literature Referenced

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	Health Sciences, Public Health
Keyword	HB954 Reproductive Health Abortion Abortion Providers House Bill 954
Committee Chair / Thesis Advisor	Roger Rochat, MD, Emory University
Committee Members	Sophie Hartwig, MPH, Emory University

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