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Lack of confidence in the health-care system, hearsay about negative outcomes, and reports of poor treatment by hospital staff were commonly encountered in this study–phenomena that have also been described in other settings. We argue that such perceptions conceptualise and inform a group's common behaviour, gradually becoming incorporated in an embodied disposition that, on the one hand, is shaped by social differentiation and, on the other, further drives the process of reproducing it. Distrust in the health-care system was increased by perceptions of being mistreated and deprived of essential information, reinforcing preferences for home delivery. These factors strongly influence utilisation of antenatal and delivery care, as well as emergency obstetric care. Fear of caesarean sections, often rooted in distrust of medical practitioners, has been described as a major reason for women avoiding maternal care, with potentially devastating consequences by delaying essential surgery. The role health institutions play in shaping care-seeking behaviour needs further attention and it should be acknowledged that it is partly their responsibility to increase women's confidence in the services provided in order to counteract inequalities in utilisation.
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My day job is with an amazing organization called the International Women's Health Coalition (IWHC), which works to promote and protect the sexual and reproductive rights and health of all women and young people, particularly in Africa, Asia, and Latin America. I work in communications there, doing research, writing for the blog , and, of course, performing admin duties :-) I've been working there for a few months now, and one of the most interesting parts of my job, in my estimation, is identifying and outlining the parallels between the challenges women face in the United States and the challenges we face internationally. I'm constantly reminded of the interconnectedness of our struggles, but I don't know that this interconnectedness is always on the radar of all U.S. based feminists. To that end, I draw your attention to recent happenings in the Dominican Republic surrounding reproductive rights and health.
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Perhaps one of the greatest misconceptions about abortion providers is that we believe that abortion is the best option for all women all the time. I am forever astonished when I talk to people, patients especially, and they assume that I (or any abortion provider) would not support their decision if they chose to carry their pregnancy to term. When I do public speaking events (at high schools, colleges or local organizations) I always make sure to talk about the patients that we see who choose NOT to terminate their pregnancy. It doesn't happen a lot--we are, after all an abortion facility and the majority of women that we serve have already spent a great deal of time considering their options and feel confident in their decision when the come in for their appointment. But there are some women and girls that we see who are either undecided at the time of their appointment, or don't want to have an abortion at all, but are being pressured by others or don't have the support and resources available to figure out a way to continue their pregnancy. As pro-choice medical providers, it is our job to ensure that the women and girls that we see are given the tools and resources to know about reproductive health and to carry out whatever decision they feel is best for their lives. Sometimes that means scheduling a separate options counselling session or giving her some resources and tools to take home so that she can consider her options further. Other times it means that I spend my days figuring out how to help someone continue her pregnancy to term and parent or go through the adoption process.
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