{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:50:53Z","timestamp":1787241053750,"version":"build-2736575974"},"reference-count":20,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","award":["87582"],"award-info":[{"award-number":["87582"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2024,5,9]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Research on abortion counselling generally uses retrospective interviewing regarding providers\u2019 and users\u2019 experiences. In this article we explore how requests for abortion are made and received in real time in (officially non-mandatory) pre-abortion counselling conducted by nurses and counsellors in South African public abortion clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To capture turn-by-turn interactions, we recorded, using consecutive sampling, 28 sessions at three abortion clinics in 2017\/2018. No researcher was present. Conversation analysis, based on an ethnomethodological paradigm, was used to understand the conversational projects of the sessions and to outline how the provider and user oriented to the request for an abortion as a conversational task.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Establishing reasons for the abortion featured in most individual counselling sessions. Through posing directive questions, providers required users to justify their request to access abortion. Users complied by providing multiple reasons. These reasons were often followed by a provider question demanding accountability in relation to contraceptive (non)use, thus establishing poor usage as the\n                      <jats:italic>real<\/jats:italic>\n                      reason.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      As abortion is legal\n                      <jats:italic>on request<\/jats:italic>\n                      in the first trimester in South Africa, no reason for presenting for an abortion is needed. The demand for users to perform \u2018doctorability\u2019 \u2013 that is, to present their situation as worthy of a health professional\u2019s (in this case abortion provider\u2019s) time \u2013 served as a precursor to discipline the abortion seeker for assumed poor contraceptive usage. Providers should be trained in user-centred care that supports pregnant people\u2019s autonomy in accessing legally induced abortion. A limitation of this study is its restriction to three abortion clinics in one region of South Africa.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjsrh-2023-202020","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T13:22:14Z","timestamp":1718025734000},"page":"278-284","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Demanding doctorability for abortion on request: a conversation analysis of pre-abortion counselling in public hospitals in the Eastern Cape, South Africa"],"prefix":"10.1136","volume":"50","author":[{"given":"Ryan","family":"du Toit","sequence":"first","affiliation":[{"name":"Critical Studies in Sexualities and Reproduction, Rhodes University, Makhanda, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0992-3525","authenticated-orcid":false,"given":"Catriona Ida","family":"Macleod","sequence":"additional","affiliation":[{"name":"Critical Studies in Sexualities and Reproduction, Rhodes University, Makhanda, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,6,10]]},"reference":[{"key":"2025090512083362000_50.4.278.1","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1080\/13691058.2019.1604995","article-title":"Experiences with abortion counselling in Mexico City and Colombia: addressing women\u2019 s fears and concerns","volume":"22","author":"Keefe-Oates","year":"2020","journal-title":"Cult Health Sex"},{"key":"2025090512083362000_50.4.278.2","doi-asserted-by":"crossref","DOI":"10.1111\/nin.12330","article-title":"Contradictions in women\u2019s experiences of pre\u2010abortion counselling in South Africa: implications for client\u2010centred practice","volume":"27","author":"Mavuso","year":"2020","journal-title":"Nurs Inq"},{"key":"2025090512083362000_50.4.278.3","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1177\/1363459320988873","article-title":"'Bad choices\u2019: unintended pregnancy and abortion in nurses and counsellors\u2019 accounts of providing pre-abortion counselling","volume":"25","author":"Mavuso","year":"2021","journal-title":"Health (London)"},{"key":"2025090512083362000_50.4.278.4","first-page":"326","article-title":"Abortion counselling according to healthcare providers: a qualitative study in the Lisbon metropolitan area, Portugal","volume":"15","author":"Beja","year":"2010","journal-title":"Eur J Contracept Reprod Heal Care"},{"key":"2025090512083362000_50.4.278.5","first-page":"44","article-title":"Is counselling necessary? Making the decision to have an abortion. A qualitative interview study","volume":"18","author":"Brown","year":"2013","journal-title":"Eur J Contracept Reprod Heal Care"},{"key":"2025090512083362000_50.4.278.6","doi-asserted-by":"publisher","DOI":"10.1080\/08351813.2019.1631056"},{"key":"2025090512083362000_50.4.278.7","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1080\/13691058.2016.1257738","article-title":"Articulating reproductive justice through reparative justice: case studies of abortion in Great Britain and South Africa","volume":"19","author":"Macleod","year":"2017","journal-title":"Cult Heal Sex"},{"key":"2025090512083362000_50.4.278.8","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/03057070.2016.1133086","article-title":"The culture of illegal abortion in South Africa","volume":"42","author":"Hodes","year":"2016","journal-title":"J South Afr Stud"},{"key":"2025090512083362000_50.4.278.9","doi-asserted-by":"crossref","unstructured":"Jefferson G . Glossary of transcript symbols with an introduction. In: Lerner GH , ed. Conversation analysis. Amsterdam, The Netherlands: John Benjamins Publishing Company, 2004: 13\u201331.","DOI":"10.1075\/pbns.125.02jef"},{"key":"2025090512083362000_50.4.278.10","unstructured":"Speer SA . Gender talk: feminism, discourse and conversation analysis. Hove, UK: Routledge, 2005."},{"key":"2025090512083362000_50.4.278.11","first-page":"23","article-title":"The conjugalisation of reproduction in South African teenage pregnancy literature","volume":"29","author":"Macleod","year":"2003","journal-title":"PINS"},{"key":"2025090512083362000_50.4.278.12","doi-asserted-by":"publisher","DOI":"10.1080\/03637758809376177"},{"key":"2025090512083362000_50.4.278.13","doi-asserted-by":"publisher","DOI":"10.1207\/s15327027hc1902_1"},{"key":"2025090512083362000_50.4.278.14","unstructured":"Heritage J . Negotiating the legitimacy of medical problems: a multiphase concern for patients and physicians. In: Brashers D Goldsmith D , eds. Communiting to manage health and illness. New York, NY and London, UK: Routledge, 2009: 161\u201378."},{"key":"2025090512083362000_50.4.278.15","doi-asserted-by":"crossref","unstructured":"Heritage J , Robinson JD . Accounting for the visit: giving reasons for seeking medical care. In: Heritage J , Maynard JW , eds. Communication in medical care: interaction between primary care physicians and patients. Studies in Interactional Sociolinguistics. Cambridge, UK: Cambridge University Press, 2006: 48\u201363.","DOI":"10.1017\/CBO9780511607172.005"},{"key":"2025090512083362000_50.4.278.16","unstructured":"World Health Organization (WHO) . Abortion care guideline. Geneva, Switzerland WHO; 2022.170. Available: https:\/\/apps.who.int\/iris\/handle\/10665\/349316"},{"key":"2025090512083362000_50.4.278.17","doi-asserted-by":"crossref","first-page":"62","DOI":"10.70256\/895363ityosf","article-title":"The abortion counseling experience: a discussion of patient narratives and recommendations for best practices","volume":"3","author":"Ely","year":"2007","journal-title":"Best Pract Ment Heal"},{"key":"2025090512083362000_50.4.278.18","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1111\/soc4.12256","article-title":"Abortion counselling in Britain: understanding the controversy","volume":"9","author":"Hoggart","year":"2015","journal-title":"Sociol Compass"},{"key":"2025090512083362000_50.4.278.19","doi-asserted-by":"crossref","unstructured":"Perrucci A . Decision Assessment and Counseling in Abortion Care: Philosophy and Practice. Washington, DC: Rowman and Littlefield, 2012.","DOI":"10.5040\/9798881815608"},{"key":"2025090512083362000_50.4.278.20","unstructured":"Mavuso J , du Toit R , Macleod CI , et al . Abortion counselling in South Africa: a step-by-step guide for providers. Grahamstown, South Africa Critical Studies in Sexualities and Reproduction, Rhodes University; 2018. 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