Advancing Abortion Justice: An Ethnography of Gender-Based Violence and Contentious Politics at Clinics

Abstract

Abortion access is at a crisis point in the United States, and achieving equitable reproductive futures requires examining our past. At the time of writing, thirteen states are enforcing abortion bans following the Dobbs decision to reverse Roe and Casey. State restrictions forced sixty-six clinics in fifteen states to stop providing abortion care in the first 100 days after Dobbs Kirstein et al. (2022). In the absence of national abortion protections, over 200 abortion clinics may be forced to permanently close nationwide, with a near-total loss in the South and Midwest (ANSIRH, 2022). The clinic featured in this ethnography is located in one of five states where injunctions are allowing care to continue as the courts decide if a ban can proceed. The story of abortion provision and policy in South Bend, Indiana, from 2015 to 2023 provides a case study in the evolution of and resistance to gender-based violence from contentious politics at the end of the Roe era.

One in four women in the United States will have an abortion in their lifetime, and all experience harm from a society that does not value the full spectrum of reproductive care and agency (Jones & Jerman, 2019). The number of policies enacted by states to restrict abortion has vastly outnumbered the laws to protect access to care in the last twenty years (Nash, 2019). Abortion clinics are a primary site of hostility directed toward reproductive freedom from movement activity, government regulation, and negative depictions that reinforce clinics as volatile and illicit places (Grimes et al., 1991; Kimport et al., 2012; Russo et al., 2012). Since Roe, anti-abortion operatives have committed 11 murders, 42 bombings, 196 arsons, 491 assaults, and thousands of reported violence and disruption incidents at clinics (NAF, 2022). This research joins the discourse on the conflict between those seeking vital care and the violent opposition meeting them before the clinic doors (Bader & Baird-Windle, 2015; Cohen & Connon, 2015; Cohen & Joffe, 2020; Foster, 2020; Shah, 2020). Abortion bans and restrictions result from effective collaboration between conservative-controlled state governments and the anti-abortion movement (Doan & Schwarz, 2020; Herd & Moynihan, 2019; Reingold et al., 2021). Before Dobbs, hostile states rendered abortion “unchoosable” by implementing regulations that leverage structural barriers such as increased costs, time, and travel (Kimport, 2021). Many of these states moved to ban abortion following the reversal of Roe. Abortion provision is determined by contested political geographies that reinforce or resist gendered power relationships (Calkin, 2019). Patients, providers, and volunteers are resilient to anti-abortion violence, but this harm is costly and damaging in a multitude of ways.

The monograph tells the story of abortion provision in a contentious community and offers policy recommendations to advance gender equity. This detailed case study on the opening and operations of Whole Woman’s Health South Bend illustrates a causal chain through the practice of political ethnography and autoethnography. The investigation uses a “from-within” ethnographic approach to generate knowledge as research immersed in a social process (Schatz, 2013; Smith et al., 2021). The case study draws from the author’s movement experience, participant-observer fieldwork, interviews with pro-abortion participants, and archived materials. The dissertation uses a multi-methods approach. Descriptive data from multiple sources provides national, state, and local contexts. This strategy measures and traces the complex process and systems producing and responding to harm.

I propose anti-abortion violence is a form of gender-based violence mechanized by contentious politics observed in “entrenched contention.” Gender-based violence is harm directed at someone because of their gender. Abortion clinics are targets of violence because of the gendered services they offer. Contentious politics are public actions by groups making political claims. These sustained collective actions respond to changing opportunities and resource limits (Sidney G. Tarrow, 2011). Entrenched contention refers to social movement activity spatially fixed at a particular location. The study site, Whole Woman’s Health of South Bend, features a variety of spatial characteristics, which include proximity to supportive and hostile communities, a built environment regulated by local authorities, and resource constraints. Locations of entrenched contention have rooted circumstances such that actions are often repetitive or routinized. Repetitive interactions and prolonged conflict in contested spaces behave like classic “repertories” - amenable to a “repertoire of contention” approach proposed by Charles Tilly.

This project contributes to abortion policy scholarship by placing into conversation the theoretical frameworks of gender-based violence and contentious politics. Clinics operate in irreducibly complex structures that call for a combination of deeply normative and methodologically careful social-scientific sensibilities. To understand conflict at clinics, we must interrogate the imbalance of power that allows violence to rule. Gender-based violence is an analytical approach that prioritizes and privileges the perspectives of the most impacted in investigations of frameworks of power, politics, and struggle. The contentious politics "school" lends a greater emphasis on social science methodology to address substantive problems in a real-world context. Contentious politics provides gender-based violence scholars with tools for the empirical study of specific mechanisms to then generalize about the causes and consequences of gendered harm in any local context. For movement scholars, gender-based violence can offer a normative social and gender justice perspective that motivates the study of interlocking forms of injustice to help people rectify oppression with social change. Contentious politics explains the mechanisms of harm, while gender-based violence conceptualizes and motivates the study of harm and guides the consideration of possible responses. These approaches aggregate multiple layers of analysis to understand how anti-abortion violence and policy produce physical, sexual, psychological, economic, cultural, and social harm.

Abortion care defies the interlocking political system of “imperialist white-supremacist capitalist patriarchy” by offering essential reproductive freedoms (hooks, 2010). I examine the complexities surrounding violence at clinics and abortion bans through the lens of intersectionality and multi-intuitional politics to account for outcomes embedded in patriarchy, racism, heteronormativity, and federalism. Aligned with previous scholarship that problematizes anti-abortion violence in the context of real lives and not a political debate, this dissertation will draw from the experiences of providers, patients, and supportive community members (Foster, 2020). As such, this study seeks to center the lived experiences and wisdom of people who have experienced gender-based violence to reduce harm from anti-abortion violence.

We must navigate toward a just future in systems of violence and repression. Reproductive freedom is care without barriers, fears, interference, or violence. Reproductive freedom extends beyond the right to choose and emphasizes equality and bodily autonomy (Petchesky, 1980). This orientation of justice means centering the self-determination of pregnant people and their right to govern their own bodies free of coercion. It is freedom from structural violence and allows people the capacity to decide if and when they have children and under what conditions those children are raised (Roberts, 2015; Ross, 2017). Reproductive freedom is the guiding star of the abortion justice movement and this research.