A narrative-discursive analysis of abortion decision-making in Zimbabwe

Most research on abortion decision-making has looked at the factors or influences that are seen to affect abortion decision-making and thus take a health determinants approach. However, this approach is rarely able to account for the complex, multi-faceted nature of abortion decision-making, and it is often not located within a framework that can unpick the complex array of power relations that underpins the process of abortion decision-making. Research on abortion decision-making has rarely examined how women who undergo a termination of pregnancy (TOP) construct micro-narratives of the decision to terminate the pregnancy and also how these women are positioned by the service providers who interact with them. Using a Foucauldian postcolonial feminist approach and narrative-discursive analysis, this study explores abortion decision-making narratives in a Zimbabwean context where abortion laws are restrictive. In this study I elicited the narratives of women who had undergone an abortion about how they came to make the decision and proceeded to terminate the pregnancy. I highlight the discourses employed in constructing these narratives and how women position themselves in these narratives and discourses. These are then compared to the subject positions enabled in health service providers’ narratives on the same topic. These narratives are then linked to the social discourses and power relations that work to enable or constrain reproductive justice. The data were collected from three sites in Harare, Zimbabwe. The three sites were Harare Hospital, Epworth and Mufakose. An adapted version of Wengraf’s (2001) narrative interview was used to elicit narratives from 18 women who had terminated pregnancies (six at each site). Semi-structured interviews were conducted with six service providers (two nurses at Harare Hospital, two village health workers in Epworth and two nurses in Mufakose). All the service providers interviewed have experience working with women who have terminated pregnancies. In narrating their stories about their abortions, the women employed discursive resources around shame, stigma, religion, health and culture. These discursive resources were drawn upon in the construction of the women’s micro-narratives. The women spoke in a socially sanctioned manner where stories were enabled and constrained by particular religious, cultural and gendered discursive resources. In these stories, cultural constructions, gendered understandings of motherhood and femininity constrained reproductive justice for women who have terminated pregnancies. Comparisons of the way women positioned themselves and how they were positioned by health service providers point to the existence of social discourses and power relations that work to constrain reproductive justice. While the women saw themselves as having ‘unsupportable pregnancies’, the service providers positioned them as being evil, selfish and irresponsible. The negative positions deployed by the service providers point to the vilification and blaming of women who have undergone a termination of pregnancy. In these positions, the woman is at fault and there is silence on the role of men in abortion decision-making. In the women’s narratives and the health service providers positioning of the women a ‘reproductive rights’ discourse was absent. This was significant as much of the activism around abortion has centred on the woman’s rights to her body. Where rights were mentioned, it was in reference to foetal rights (using cultural, moralistic religious understandings of abortion as killing). The missing ‘reproductive rights’ discourse points to a need to move from a reproductive rights framework to a reproductive justice framework that can be applied through local understandings of hunhu/ubuntu. By doing this, abortion is not seen as a ‘choice’ that a woman makes but rather as involving broader social and environmental circumstances that make a pregnancy ‘unsupportable’