A feminist anthropology of barriers to implementing the Choice on Termination of Pregnancy Act (CTOP)

Cox, Phyllida

A feminist anthropology of barriers to implementing the Choice on Termination of Pregnancy Act (CTOP)

Master Thesis

2007

Publisher

University of Cape Town

Department

Department of Sociology

Faculty

Faculty of Humanities

Abstract

This study aims to assess barriers within communities and at the community healthcare level that impede delivery of reproductive healthcare rights- in particular it focuses on the South African Choice on Termination of Pregnancy Act (CTOP), which came into effect in 1996. In their scoping study of abortion related research in South Africa Varkey and Fonn state that whilst there have been several studies on the barriers to implementing the CTOP Act at the health service level, few have addressed community barriers (2000). I conducted multi-sited fieldwork between two townships in Cape Town, South Africa on the urban periphery of Cape Town, South Africa. The inhabitants of these two communities are black Xhosa speaking South Africans who live in a mix of informal shack, government built as well as self- built housing. The marginal location of these communities in relation the Eurocentric metropolitan centre of Cape Town reflects the legacy of the racialised reordering of the Apartheid era. The socio-economic effects of this legacy are tangibly present in the poverty, criminality and gender based violence that impacts upon the health of these communities. I focused on reproductive health care services for these townships at the community based service delivery level. Although Varkey and Fonn (ibid) distinguish between studies that address health care and studies that address community barriers to healthcare I aim to show how the distinction between the spaces of the community as against the institutional space of public healthcare is somewhat arbitrary. Because this study focuses on the cultural politics of implementing the legislation on abortion, the issues that arise and are analysed encompass seemingly divergent levels and social fields of inter-relationality. These social fields of inter-relationality include in their scope law, policy, rights-based public health care implementation, domestic households and gendered relationships between men and, women;- mothers and daughters, nurses and young women and so on. How such intersecting and interpenetrating levels play out in the lives of individuals can be illustrated most effectively through the anthropological notion of "personhood" as it regulates and informs communal and individual notions of self in the public health care space. For example, as agents in community based health service delivery Nurses embody a personhood in the context of their professional role, which is inseparable from their identity as gendered persons with distinctive ethnic and racial identities within South African communities. These gendered, racial and ethnic identities are embedded in histories of Colonial and Apartheid State planning. A consistent theme in this paper are how these identities influence moral constructions of sexuality and the ambiguities that nurses feel about the women to whom they provide family planning in relation to their own values around appropriate female personhood.

Description

Includes bibliographical references.

Keywords

Sociology

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