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Medical technologies and abortion care in Eastern Uganda

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  • Kagaha, Alexander
  • Manderson, Lenore

Abstract

Manual Vacuum Aspirators (MVA), Dilation and Curettage (D&C), and medical abortifacients (Misoprostol, Mifepristone and Divabo) are available in clinical settings that offer abortion and post-abortion care in Uganda. While these technologies imply appropriate and safe abortion care, legal and policy ambiguities impact health outcomes. In this article, we draw on an ethnography of abortion care delivery practice conducted in one district in Eastern Uganda between August 2018 and March 2019, with data from interviews and observations, both of interactions and during quality of care improvement and training meetings. We illuminate how, in the context of a financialized healthcare system and legal restrictions, the meanings and use of medical technologies and abortion care vary across different health facility types. In public health facilities, health workers become state agents in the control of women's bodies. In private health facilities, they become transgressors, who use medical technologies to help women attain termination surreptitiously. Health workers offset risks associated with any involvement in termination, such that pecuniary interests dominate their motivation. Normalized and disciplinary power enact and reproduce unsafe and risky conditions, leading to poor abortion care outcomes. We illustrate the mechanisms of domination and tactics of resistance in abortion care, and expose conditions upon which unsafe and risky outcomes are contingent.

Suggested Citation

  • Kagaha, Alexander & Manderson, Lenore, 2020. "Medical technologies and abortion care in Eastern Uganda," Social Science & Medicine, Elsevier, vol. 247(C).
    • Handle: RePEc:eee:socmed:v:247:y:2020:i:c:s0277953620300320
    DOI: 10.1016/j.socscimed.2020.112813
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    References listed on IDEAS

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    1. Suh, Siri, 2014. "Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal," Social Science & Medicine, Elsevier, vol. 108(C), pages 20-33.
    2. Timothy Powell-Jackson & Rajib Acharya & Veronique Filippi & Carine Ronsmans, 2015. "Delivering Medical Abortion at Scale: A Study of the Retail Market for Medical Abortion in Madhya Pradesh, India," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-14, March.
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    Cited by:

    1. Ouedraogo, Ramatou & Juma, Kenneth, 2020. "From the shadows to light. Perceptions of women and healthcare providers of post-abortion care in Burkina Faso," Social Science & Medicine, Elsevier, vol. 260(C).

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