Power dynamics in the provision of legal abortion : a feminist perspective on nurses and conscientious objection in South Africa

Abstract

Though hailed as one of the most exemplary laws on abortion, the 1996 Choice on Termination of Pregnancy Act of South Africa does not directly address conscientious objection. The consequences of such a gap serve as an obstacle to the efficacy of a liberal abortion law in practice. Where there are no clear laws or guidelines, the environment is conducive for healthcare providers acting within their ‘own’ interpretation of the law.

This thesis centres around nurses as the largest single group of health care providers in South Africa. Within this context, it explores the factors that shape how and why nurses exercise conscientious objection to the provision of abortion services. Understanding providers’ practices of power in the exercise of conscientious objection requires attention at the intersection between gender hierarchies and power arrangements. The thesis further examines the conditions and challenges of nurses’ contemporary role in abortion service provision. It focuses on the structural conditions in which abortion - providing nurses perform their abortion services.

The research conducted in this thesis provides an original contribution by employing feminist socio-legal methodologies to identify the complex and interwoven legal, political, and socio-cultural contexts. I utilised doctrinal and empirical research methods to draw conclusions of how we think about conscientious objection. Through in-depth interviews with nurses and information gathered from government officials, academics and members of civil society such as women’s rights organizations and litigators, this thesis determines a number on strategies to improve the transformative potential of sexual and reproductive health and rights of women and girls.

Keywords: abortion, conscientious objection, South Africa, nurses, African feminism