Department of Sociology, Center for Demography and Ecology, University of Wisconsin-Madison, Madison, WI, United States; Collaborative for Reproductive Equity, University of Wisconsin-Madison, Madison, WI, United States.
Collaborative for Reproductive Equity, University of Wisconsin-Madison, Madison, WI, United States; Department of Social Inquiry, University of Wisconsin-Superior, Superior, WI, United States.
Contraception. 2024 Jan;129:110276. doi: 10.1016/j.contraception.2023.110276. Epub 2023 Aug 30.
Advocacy is an important part of the reproductive health care profession, but barriers to participating in the legislative process are not well understood. This study examines the barriers experts in reproductive health experience to testifying at state legislative committee hearings regarding abortion.
We conducted in-depth semistructured interviews with 40 experts in reproductive health, including obstetrician gynecologists (OBGYNs), midwives, pediatricians, nurses, primary care providers, and professional advocates. We analyzed the interview transcripts using an inductive coding process.
We identified four barriers to testifying at state legislative committee hearings regarding abortion. First, our interviewees described a tension between claiming expertise and stigma: those without direct experience in abortion care often felt too unqualified to testify, but representing oneself as an abortion provider came with stigma that made communicating with legislators difficult. Second, issues of power and identity informed interactions in committee chambers, as well as the structure of advocacy work more broadly. Third, institutional constraints shaped what experts could say and whether they could rely on their professional affiliations for support. Finally, fear of harassment and violence kept many of our interviewees from testifying, especially those who were active abortion providers.
These barriers appear unique to testifying on abortion and represent a complex web of hurdles that experts in reproductive health must navigate to participate in this part of the policymaking process.
Our findings suggest multiple strategies for improving the state of expert involvement in abortion policymaking, including expanding the pool of testifiers to include nonabortion providers and experts with a range of backgrounds, as well as supporting organizations that link experts to training and advocacy networks.
倡导是生殖保健专业的重要组成部分，但参与立法过程的障碍尚未得到充分理解。本研究调查了生殖健康专家在州立法委员会听证会上就堕胎问题作证时所面临的障碍。
我们对 40 名生殖健康专家进行了深入的半结构化访谈，包括妇产科医生、助产士、儿科医生、护士、初级保健提供者和专业倡导者。我们使用归纳编码过程对访谈记录进行了分析。
我们确定了在州立法委员会听证会上就堕胎问题作证的四个障碍。首先，我们的受访者描述了声称专业知识和耻辱感之间的紧张关系：那些没有直接堕胎护理经验的人往往觉得自己太没有资格作证，但代表自己是堕胎提供者会带来耻辱感，这使得与立法者沟通变得困难。其次，权力和身份问题影响了委员会会议厅内的互动，以及更广泛的倡导工作的结构。第三，制度限制塑造了专家可以说什么以及他们是否可以依靠自己的专业关系获得支持。最后，对骚扰和暴力的恐惧使我们的许多受访者无法作证，尤其是那些积极从事堕胎服务的人。
这些障碍似乎是针对堕胎作证的独特障碍，代表了生殖健康专家在参与这一政策制定过程的一部分时必须克服的复杂障碍网络。
我们的研究结果表明了多种策略可以提高专家在堕胎政策制定中的参与度，包括扩大作证者的范围，包括非堕胎提供者和具有各种背景的专家，以及支持将专家与培训和倡导网络联系起来的组织。
