narratives on abortion: psychosocial, ethical and religious considerations

332 Pages·2013·2.55 MB·English

NARRATIVES ON ABORTION: PSYCHOSOCIAL,
ETHICAL AND RELIGIOUS CONSIDERATIONS

by

INDIRA GILBERT (PILLAY)

A research dissertation submitted in fulfillment
of the requirements for the degree of

PhD (SOCIAL WORK)

in the

SCHOOL OF APPLIED HUMAN SCIENCES

FACULTY OF HUMANITIES

University of KwaZulu-Natal
Durban

Supervisor: Professor Vishanthie Sewpaul

2013

As the candidate’s supervisor I approve the submission of this thesis

Signed: ________________ Name: ______________________ Date: ______________
iii

DECLARATION - PLAGIARISM

I, INDIRA GILBERT (PILLAY), declare that this dissertation is my own work. It is
submitted for a PhD (Social Work) at the University of KwaZulu-Natal (UKZN). The
research described in this thesis was undertaken in the School of Applied Human Sciences,
University Kwa-Zulu Natal, Durban, from July 2010 to December, 2013 under the
supervision of Professor Vishanthie Sewpaul.

I declare that:

 The research reported in this thesis, except where otherwise indicated, is my original
research.

 This thesis has not been submitted for any degree or examination at any other university.

 This thesis does not contain other persons’ data, pictures, graphs or other information,
unless specifically acknowledged as being sourced from other persons.

 This thesis does not contain other persons' writing, unless specifically acknowledged as
being sourced from other researchers. Where other written sources have been quoted,
then:

a. Their words have been re-written but the general information attributed to them has
been referenced
b. Where their exact words have been used, then their writing has been placed in italics
and inside quotation marks, and referenced.

 This thesis does not contain text, graphics or tables copied and pasted from the Internet,
unless specifically acknowledged, and the source being detailed in the thesis and in the
References sections.

 A turnitin report confirms that there is no plagiarism in this thesis.

Signed ____________________ Date _____________________

Indira Gilbert (Pillay)
iv

ACKNOWLEDGEMENTS

I am deeply indebted to:

 friends and family who edited the various sections of the thesis
 the participants who willing gave off their time, and shared their innermost
thoughts and feelings with me;
 my husband Joshua, for affording me the opportunity to place my studies
above my family responsibilities;
 my supervisor Professor Vishanthie Sewpaul who offered constructive
criticism, constant support and guidance which extended to even the health
challenges I experienced during this time. My sincere thanks and appreciation
for walking the journey with me, and for your, motivation and encouragement
that sustained me to the end.

I am grateful to God, my creator and sustainer, for granting me the opportunity, the
courage, the strength, and the endurance to fulfill the goal I set, despite the personal
challenges along the way.
v

DEDICATION

To

My beloved parents who continue to be the source of inspiration in my life;

My brother Gops whose sacrifice, love and support has allowed me to aspire to and
achieve goals in life. Without his input in my life this would not have been possible;

My husband Joshua whose encouragement sustained me through the research;

and to

all participants - you have made an impression on my life.
ii

ABSTRACT

NARRATIVES ON ABORTION: PSYCHOSOCIAL, ETHICAL AND
RELIGIOUS CONSIDERATIONS

Keywords: ethical decision-making, feminism, pronatalism, pro-life/pro-choice dichotomy;
critical discourse analysis, structural constraints.

The introduction of the Termination of Pregnancy Act, No. 92 of 1996 was welcomed by
pro-choice groups but it did raise strong opposition from pro-life groups. The pro-life/pro-life
dichotomy reflects the polarization of extreme views and forms the basis of the intense
abortion debate with little opportunity to reconcile the views.

Although abortions are common in South Africa, not many studies have explored the
experiences of women, men and health professionals related to abortions. This study aimed at
fulfilling this gap. Adopting a qualitative paradigm and a feminist research design, it
explored the psychosocial, religious and ethical considerations which affect women’s
decision-making, and men’s and health professionals’ views on abortion. Analysis of the data
was carried out by means of critical discourse analysis and presented according to several
themes. The data challenges the conventional pro-life/pro-choice dichotomy. Despite
deciding on the abortion, the language used by the women reflected decidedly pro-life views.
None of them expressed the view that abortion was right. Their narratives reflected various
structural conditions that pushed them into making the abortion decision. Despite living in a
predominantly pronatalistic world, society generally prescribes the ideal conditions under
which pregnancy and childbirth should occur. Thus pregnancy outside of the institution of
marriage is frowned upon.

Circumstances resulting from dominant pronatalistic and patriarchal discourses and practices
that have made women unequal partners in society, force women to opt for decisions such as
abortion. While the focus is on the fulfilment of women’s rights, from an individual liberal
perspective, there is a general failure to appraise the structural conditions that fail women,
thereby rendering women’s choices to be constrained by their social and financial
circumstances. Based on the results of the study proposals are made with regard to future
research on abortion, and policy and practice.
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TABLE CONTENTS
Abstract .................................................................................................................. ii
Declaration ................................................................................................................. iii
Acknowledgements ..................................................................................................... iv
Dedication ................................................................................................................... v

CHAPTER ONE - INTRODUCTION AND BACKGROUND
1.1 Introduction 1
1.2 Problem identification 1
1.3 Context of the study 3
1.4 Rationale for the study 4
1.5 Main aim of the research 5
1.6 Objectives of the study 5
1.7 Underlying assumptions 6
1.8 Anticipated value 6
1.9 Theoretical framework 7
1.10 Definition of terms used 12
1.11 Structure of the report 13

CHAPTER TWO - ABORTION: BACKGROUND, HISTORY,
POLICIES AND STATISTICS
2.1 Introduction 16
2.2 History of abortion 17
2.3 Abortion policies 21
2.4 Abortion statistics 30
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CHAPTER THREE - MEDICAL ASPECTS OF ABORTION
3.1 Abortion 33
3.2 Abortion 33
3.3 The consequences of abortion 39
3.4 Conclusion 41

CHAPTER FOUR: ABORTION: RELIGIOUS, CULTURAL,
ETHICAL AND BIOETHICAL CONSIDERATIONS
4.1 Introduction 42
4.2 Religious and cultural considerations 43
4.2.1 The Abrahamic religions 43
4.2.2 Oriental religions 45
4.2.3 African traditional religions and culture 47
4.2.4 Religion and abortion: concluding comments 50
4.3 Moral and ethical considerations 51
4.3.1 Women 52
4.3.2 The foetus 54
4.3.3 Men 56
4.3.4 Health professionals 57
4.3.5 The legalising of abortion 61
4.4 Bioethical considerations 66
4.4.1 When does life begin? 66
4.4.2 When does personhood begin? 68
4.4.3 The unborn and the right to life 69
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4.5 Ethical decision-making 69
4.6 Feminist views on abortion 73

CHAPTER FIVE: ABORTION: PSYCHOSOCIAL
CONSIDERATIONS
5.1 Introduction 77
5.2 Why abortion 77
5.2.1 Woman-focused reasons 77
5.2.2 Other-focused reasons 78
5.2.3 Material-based reasons 79
5.2.4 The status of adoption in South Africa 81
5.2.5 Discourse on motherhood 82
5.2.6 Gendered constructions of fatherhood and the phenomenon of absent fathers 83
5.3 Structural determinants of the oppression of women 88
5.4 Consequences of abortion 100
5.4.1 Psychological and emotional consequences of abortion 100
5.4.2 Social relationships 103
5.4.3 Consequences for men 103
5.5 Pre- and post-abortion care 105

CHAPTER SIX: RESEARCH METHODOLOGY
6.1 Introduction 108
6.2 Research questions 108
6.3 Research method and design 109
6.4 Sampling 112
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6.5 Data collection 115
6.5.1 In-depth interviews 117
6.5.2 Telephonic interviews 121
6.5.3 Questionnaires 122
6.5.4 The interview guide 122
6.5.5 Observation 123
6.6 Ethical considerations 124
6.7 Recording of data 127
6.8 Data analysis 127
6.9 Validity and reliability 130
6.10 Challenges and limitations 132
6.11 Summary 133

CHAPTER SEVEN: ANALYSIS AND DISCUSSION OF RESULTS
7.1 Introduction 134
7.2 Profile of participants 135
7.2.1 Profiles of the women 135
7.2.2 Profiles of the men 142
7.2.3 Profiles of the nurses 144
7.2.4 Profiles of the doctors 145
7.3 Analysis and discussion of results 147
7.3.1 Demographic data of all participants 147
7.3.2 Demographic data of health professionals 151
7.3.3 Thematic analysis of the data 153
7.3.3.1 The abortion decision 153
x

Abandonment/absent fathers 153
Still studying 156
HIV status 157
Partner is married 158
Coercion 158
Small baby or too many children 160
Relationships 160
Support 163
Stigma 164
Religious and cultural values 168
Constructs of parenthood 171
Abortion: a time-bound decision 176
Poverty and unemployment 178
Health professionals’ major reasons for providing abortion services 179
Summary 182

CHAPTER EIGHT: ANALYSIS AND DISCUSSION OF RESULTS
8.1 Introduction 183
8.1.1 Demonisation of women 183
8.1.2 Dichotomy of pro-life and pro-choice arguments 186
8.1.3 Structural constraints 189
Economic 190
Poor quality reproductive health care services 192
Patriarchy 193
Lack of pre-abortion care 195