“We did not share our sob stories, we brought doctors to speak to the measure instead”: A narrative analysis of pro-choice testimony and legislative debate related to Georgia’s fetal “heartbeat” abortion ban Open Access

Abstract

In May 2019, Governor Brian Kemp signed HB 481 into law, banning abortion in Georgia upon detection of a “heartbeat.” Almost 100 early abortion bans have been introduced in 25 states since 2011. With the number of bills targeting women’s access to abortion increasing, it is more important than ever to understand the rhetoric and narratives employed by both the abortion rights and anti-abortion sides of the argument. The purpose of this study was to distinguish and characterize the arguments, tactics, and evidence used by legislators and community members in opposition to HB 481 and in support of reproductive rights. Verbatim legislative debate and community testimony from March 2019 was coded using a constant comparative method and analyzed using thick descriptions of frequently used codes to identify themes. Inductive codes included women’s rights, maternal mortality, and feasibility of enforcement. Three major themes emerged: the “negative hits” HB481 will have on the health outcomes of Georgia women; infringements of fetal “personhood” on the “fundamental rights of women”; concerns over feasibility and “flawed” implementation; and prioritization of narratives from doctors and other medical professionals. Testimony emphasized how HB481 would “worsen Georgia’s dismal” maternal mortality and exacerbate the “shortage of OBGYNs” in the state. Legislators discussed HB481’s “vague” enforcement and cost, as well as restricting women’s “freedom of choice” and its “disproportionate” effect on Georgia’s “most vulnerable women.” Opponents of HB481 relied heavily on testimony from medical professionals (74% of committee speakers) and described “listening” to physicians; finally, legislators frequently referenced professional organizations. Pro-choice argumentation included a strong focus on health and women’s rights with inattention to specific legal arguments. Supporters of abortion bans weave together legal and health arguments, therefore, new legal strategies to combat further gutting of abortion rights must do the same. 

Table of Contents

Table of Contents

1.    Introduction ……………………………………………………………………………....1

2.    Literature Review ………………………………………………………………………...4  

2.1 Abortion in the United States ………………………………………………………...4

2.2 Constitutional Context ……………………………………………………………….5

2.3 The Rise of Early Abortion Bans …………………………………………………….8

2.4 Living Infants Fairness and Equality (LIFE) Act – HB 481 ………………………10

2.5 Sexual and Reproductive Health in Georgia ………………………………………12

2.6 Health Effects of Abortion Restrictions ……………………………………………..13

2.7 Abortion Storytelling in Abortion Rights Advocacy ………………………………..15

3.    Methods………………………………………………………………………………….16

3.1 Population and Sample ……………………………………………………………...16

3.2 Research Design ……………………………………………………………………..17

3.3 Procedures …………………………………………………………………………17

3.4 Data Analysis ………………………………………………………………………..18

3.5 Ethical Considerations ……………………………………………………………19

4.    Results …………………………………………………………………………………19

4.1 Demographics ……………………………………………………………………….19

4.2 Testimony Analysis …………………………………………………………………21

4.2.1     HB 481 would negatively affect women’s health …………………………24

4.2.2     HB 481 threatens women’s rights …………………………………………26

4.2.3     HB 481 is unable to be operationalized ……………………………………..29

4.2.4     Opponents of HB 481 focused on narratives from healthcare providers ……31

5.    Discussion ……………………………………………………………………………….33

5.1 Study Limitations ……………………………………………………………………36

5.2 Conclusion …………………………………………………………………………..37

6.    Public Health Implications ………………………………………………………………38

6.1 Public Health Researchers …………………………………………………………..38

6.2 Abortion Rights Advocates…………………………………………………………..38

6.3 Abortion Providers …………………………………………………………………..39

6.4 Legislators …………………………………………………………………………39

7.    Works Cited ……………………………………………………………………………..40

Tables and Figures

Table 1: Demographic Characteristics of Legislators and Community Members

Who Spoke in Opposition to HB 481……………………………………………………20

           Table 2: Occupation of Community Members Who Spoke in Opposition to HB481 ......20

           Figure 1: Tactics Used by HB 481 Opponents ……………………………………….....22

           Table 3: Category of Abortion Narrative Shared in Anti-HB 481 Testimony ………….32

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	abortion law reproductive health policy
Committee Chair / Thesis Advisor	Dabney P. Evans, Emory University
Committee Members	Subasri Narasimhan, Emory University

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