Luisa's Ghosts: Haunted Legality and Collective Expressions of Pain

The afterlife of "doing medicine": Birth planning, chronic illness, and regeneration among the Lisu on the China-Myanmar border

Between the late 1970s and 1990s, many indigenous Lisu people in the Nu River Valley, an Eastern Himalayan region of China bordering Myanmar and Tibet, underwent what they referred to as "doing medicine"-abortions, vasectomies, and tubal ligations-as part of China's Birth Planning Policy. Lisu, who endured these procedures, struggle with strength loss, nervousness, and pain. Government discourses diminish the Lisu experience, arguing that the policy was lenient toward them. Lisu themselves are reticent to share their experiences but have devised new practices to care for those affected. Drawing on long-term ethnographic fieldwork, I argue that these chronic illnesses and accompanying care practices constitute everyday forms of remembering through which Lisu give shape to their experiences of cultural loss under Chinese colonization while generating new social relationships. This analysis sheds light on Indigenous experiences of birth planning in China with broader implications for understanding the bureaucratic violence of medicine.

Dirty Work in Medicine: Understanding U.S. Physicians' Agency in Contested Medical Practices

Physicians who participate in abortion and medically assisted death in the United States work at the margins of institutionalized medicine. What motivates them to engage in such "dirty work"? This article uses ethnographic materials from two recent projects to analyze physicians' roles as gatekeepers to contested medical services. Abortion and medically assisted death share many similarities: They are both deeply stigmatized practices that are heavily restricted in many U.S. jurisdictions, and which many physicians are reluctant to participate in for moral, religious, or professional reasons. They both also confer medicine with the power to govern life and death decisions through the apparatus of state law. However, state laws operate quite differently on physicians in these two cases, with different outcomes. This comparative analysis demonstrates how dirty work in medicine enrolls the agency and subjectivity of physicians in distinctive ways that may be eclipsed by totalizing biopolitical frameworks. [abortion, medical aid in dying, physicians, agency, biopolitics, United States].

The production of ignorance about medication abortion in Tunisia: between state policies, medical opposition, patriarchal logics and Islamic revival

In Tunisia, medication abortion has been available in government reproductive and sexual health clinics since the early 2000s. Since its introduction, it has rapidly replaced the surgical method, and between 75% and 80% of abortions in the public sector were performed using the pharmacological protocol in 2016. In this article, I intend to discuss the various forms of ignorance about medication abortion that exist in Tunisia among several categories of actors in relation to the legal, medical and religious domains. I explore how the existing 'varieties of ignorance' are related to the specific political, social and economic positions of the involved actors, the dominant gender regime, specific institutional policies and economic interests. I also investigate how some forms of ignorance are wilfully produced by institutions and individuals, whereas others are the result of positionality or organizational features. I first describe when and how medication abortion was introduced in Tunisia and the forms of resistance it elicited; later, I examine the production of ignorance about this technology after the revolution of 2011. I mainly consider practices and discourses of health professionals, but also those of women seeking abortion care in the public sector, and those of the activists of a Tunisian non-governmental organization operating in the domain of women's health and rights.

Factors influencing abortion decisions, delays, and experiences with abortion accompaniment in Mexico among women living outside Mexico City: results from a cross-sectional study

Access to abortion throughout much of Mexico has been restricted. Fondo Maria is an abortion accompaniment fund that provides informational, logistical, financial, and emotional support to people seeking abortion care in Mexico. This cross-sectional study examines the factors that influenced decision-making and contributed to delays in accessing care and explores experiences with Fondo Maria’s support among women living outside Mexico City (CDMX). We describe and compare the experiences of women across the sample (n = 103) who were either supported by Fondo Maria to travel to CDMX to obtain an abortion (n = 60), or self-managed a medical abortion in their home state (n = 43). Data were collected between January 2017 and July 2018. Seventy-seven percent of participants reported that it was difficult to access abortion care in their home state and 34% of participants indicated they were delayed in accessing care, primarily due to a lack of financial support. The majority of participants (58%) who travelled to CDMX for their abortion did so because it seemed safer. The money/cost of the trip was the most commonly cited reason (33%) why participants who self-managed stayed in their home state. Eighty-seven percent of participants said Fondo Maria’s services met or exceeded their expectations. Our data suggest that people seeking abortion and living outside CDMX face multiple and overlapping barriers that can delay care-seeking and influence decision-making. Abortion accompaniment networks, such as Fondo Maria, offer a well-received model of support for people seeking abortion in restrictive states across Mexico.