Abstract
Since the early 1990s, global treaties on maternal and reproductive health have obligated governments to ensure quality postabortion care: emergency obstetric care for women experiencing medical complications following abortion. While postabortion care is available in hospitals around the world, little is known about how this global model has been integrated into daily obstetric care in countries with restrictive abortion laws. Drawing on ethnographic fieldwork in Argentina and Senegal, we explore how health workers have adapted the global postabortion care model in ways that simultaneously challenge and reinforce national prohibitions on abortion. We use the term “subversive epidemiology” to describe how health workers adjudicate between allegedly legitimate and illegitimate cases of pregnancy termination or loss. In Argentina, these practices have expanded access to safe abortion in certain health facilities. In Senegal, these practices have redefined postabortion care as an intervention for the treatment of complications of miscarriage. Although the global postabortion care model aimed to depoliticize the problem of unsafe abortion, we find that health workers’ clinical and record-keeping decisions are decidedly political as they contribute to an epidemiological record that often does more to obscure than elucidate the incidence of abortion. Our research highlights the importance of cross-national microanalyses of health workers’ experiences and practices in understanding how reproductive governance unfolds at the intersection of global and national health policies and proposes applying the reproductive justice framework to abortion politics in the global South.
