Enacting Reproductive Justice

Abstract: How may reproductive justice be enacted in services and provider training to further the sustainable development goals of healthy lives and universal access to sexual and reproductive health and rights? We argue for careful baseline qualitative research infused with feminist and reproductive justice theory and, based on the findings of this research, the development and refinement of healthcare provider training through action research. We report on our implementation of this process in developing an in-service person-centered abortion counseling training course aimed at South African abortion healthcare providers. The baseline research consisted of recordings of abortion counseling sessions and interviews with healthcare providers and users. Several problematic directive and anti-abortion interactions were surfaced, which led to the development of a policy brief and step-by-step guidelines for providers. Subsequently, action research was employed to operationalize these guidelines into an in-service person-centered abortion counseling training course, and an iterative process enabled course improvement. Data collected for the course refinement included recordings of various sessions during the course, participants’ reflective journals, case presentations, and feedback forms, as well as interviews conducted two months post the first course. Comparing baseline findings with data collected as part of the action research shows some shifts in healthcare providers’ actions. We report on a shift in respecting bodily autonomy and encouraging autonomous decision-making. Structural and normative barriers continue, however. The enactment of reproductive justice through in-service training shows promise but must be supplemented with advocacy around other barriers.