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Introduction: This study characterized the extent to which (1) financial barriers and (2) abortion care-seeking within a person's country of residence were associated with delays in abortion access among those travelling to England and the Netherlands for abortion care from European countries where abortion is legal on broad grounds in the first trimester but where access past the first trimester is limited to specific circumstances. Methodology: We drew on cross-sectional survey data collected at five abortion clinics in England and the Netherlands from 2017 to 2019 (n = 164). We assessed the relationship between difficulty paying for the abortion/travel, acute financial insecurity, and in-country care seeking on delays to abortion using multivariable discrete-time hazards models. Results: Participants who reported facing both difficulty paying for the abortion procedure and/or travel and difficulty covering basic living costs in the last month reported longer delays in accessing care than those who had no financial difficulty (adjusted hazard odds ratio: 0.39 95% CI 0.21–0.74). This group delayed paying other expenses (39%) or sold something of value (13%) to fund their abortion, resulting in ~ 60% of those with financial difficulty reporting it took them over a week to raise the funds needed for their abortion. Having contacted or visited an abortion provider in the country of residence was associated with delays in presenting abroad for an abortion. Discussion: These findings point to inequities in access to timely abortion care based on socioeconomic status. Legal time limits on abortion may intersect with individuals' interactions with the health care system to delay care. Plain Language Summary: This paper explores delays in accessing abortion care associated with financial and medical system barriers. We focus on residents of countries in Europe where abortion is available on broad grounds in the first trimester seeking abortion care outside of their country of residence. This study demonstrates an association between difficulty covering abortion costs for people facing financial insecurity and in-country care seeking and delays in accessing abortion abroad. Policy barriers, medical system barriers, as well as financial barriers may interact to delay access to care for people in European countries with broad grounds for abortion access in the first trimester but restrictions thereafter, especially for people later in pregnancy. [ABSTRACT FROM AUTHOR]

Implementing effective health interventions in recent epidemics has been difficult due to the potentially global nature of their spread and sociocultural dynamics, raising questions concerning how to develop culturally-appropriate preventive measures, and how these health threats are understood locally. In Belize, health policy makers have only been marginally effective in managing infections and mosquito vectors, and Zika has been declared endemic in certain regions, particularly on the island of Caye Caulker. Based on ethnographic research conducted primarily in 2017, we examine how perspectives of Zika-related health consequences are shaped, and how state interventions to manage Zika are understood. We argue that despite its declared endemic status, Zika is not perceived as a true health concern for community members due to numerous neoliberal structural challenges. Moreover, the state’s restrictive form of reproductive governance which limits family planning services is forcing individuals to weigh conflicting conceptions of health consequences. This also contributes to an ambiguous healthcare environment for health practitioners, giving them an unclear picture of the scope of Zika as a public health concern. We also consider how critical medical anthropology and feminist analytical approaches are useful in exploring these questions and contributing to understandings of the health impacts of Zika. [ABSTRACT FROM AUTHOR]

This paper examines Polish women's use of the clandestine abortion underground and online networking as a form of resistance developed in response to severe reproductive rights restrictions in Poland since 1993. Rather than complying with the abortion ban, imposed unilaterally by postsocialist state and the Catholic church, Polish women's response has been to develop their own coping strategies to control fertility, including circumventing the legislation by pursuing illegal abortions and sharing this knowledge on the Internet. Based on long-term ethnographic research in Poland and an analysis of online discussion forums, I argue that this individualised and privatised form of resistance is a limited stopgap strategy for dealing with larger social and collective concerns about reproductive rights, health, as well as gender equality that should be addressed with collective policy solutions. Moreover, I consider these "anti-political" strategies in the context of the 2016 and 2018 mass protests to halt proposals for total abortion bans, and raise questions about the impact of different forms of mobilisation and resistance on reproductive rights and policies. [ABSTRACT FROM AUTHOR]

Women's rights to legal abortion in the United States are now facing their greatest social and legislative challenges since its 1973 legalization. Legislation restricting rights and access to abortion care has been passed at state and federal levels at an unprecedented rate. Given the renewed vigor of anti-abortion movements, we call on anthropologists to engage with this shifting landscape of reproductive politics. This article examines recent legislation that has severely limited abortion access and maps possible directions for future anthropological analysis. We argue that anthropology can provide unique contributions to broader abortion research. The study of abortion politics in the United States today is not only a rich opportunity for applied and policy-oriented ethnographic research. It also provides a sharply focused lens onto broader theoretical concerns in anthropology and new social formations across moral, medical, political, and scientific fields in 21st-century America. [ABSTRACT FROM AUTHOR]

Drawing on qualitative and quantitative data collected during a 5-year multi-disciplinary European research project, in this article we show how restrictions on access to legal abortion, and particularly gestational age (GA) limits at the end of the first trimester of pregnancy, negatively affect women and pregnant people living in European countries where abortion is legal on request or on broad grounds. First, we examine why most European legislations establish GA limits, and illustrate how abortion is framed in national laws and in the current national and international legal and political debates on abortion rights. We then show, based on research data we collected during our 5-year project and contextualized with existing data and statistics, how these restrictions force thousands of people to travel across borders from European countries where abortion is legal, delaying access to care, and increasing pregnant people's health risks. Finally, we explore, from an anthropological perspective, how pregnant people who travel across borders for abortion care conceptualize abortion access, and the relationship between the right to abortion care and the GA restrictions that limit this right. Our study participants criticize the time restrictions established by the laws in their countries of residence as failing to meet pregnant people's needs, highlight the crucial importance of easy, timely access to abortion care even beyond the first trimester of pregnancy, and suggest a more relational approach to the right to access safe, legal abortion. Abortion travel is also a matter of reproductive justice because access to care depends on specific resources including finances, information, support, citizenship status, and social networks. Our work contributes to scholarly and public debates about reproductive governance and justice, by shifting the locus of attention to GA limits and its impact on women and pregnant people, particularly in geopolotical settings where abortion laws are deemed liberal. • Legal gestational age (GA) limits make equitable safe abortion access impossible. • GA limits clash with social/bodily time forcing people to travel abroad for care. • GA limits delay access to abortion, putting people's health at risk. • Abortion travel is a matter of reproductive justice, as it deepens inequalities. • The human rights framework does not grant easy or equal access to abortion. [ABSTRACT FROM AUTHOR]

Polish birthrates during the state socialist period, 1948–1989, stayed above replacement level but since 1989 fell dramatically to one of the lowest in Europe, at 1.29 in 2010. The Polish Catholic Church and the newly-elected nationalist government of Lech Wałęsa reacted by escalating pronatalist rhetoric calling on women to increase childbearing in the name of economic and nationalist causes. Reflecting the renewed dominance of the Church, Wałęsa implemented restrictions on family planning, including abortion, contraception, and sex education, justifying them in moral and demographic terms. Plummeting fertility has been portrayed by the Church, media, and state as dangerous and unreasonable – a sign of Polish women's rejection of motherhood and the embrace of selfish priorities. Simultaneously however, the state cut back motherhood-friendly policies established by the socialist regime, including subsidized childcare, maternity leave, and healthcare. This paper draws on 19 months of fieldwork between 2000 and 2007, using interviews with 55 women in four healthcare clinics in Gdańsk area, and participant-observation at the social services offices in Krakow. This paper shows that far from irrational rejection of motherhood, Polish middle-class women are guided by pragmatic reasons when delaying parenthood in order to navigate the new political landscape marked by job insecurity and gendered discrimination in employment. Yet, rather than implementing work-family reconciliation policies that have stimulated fertility elsewhere in Europe, the Church and state insist on blaming women for ‘irrational’ non-reproduction, thus betraying a lack of political commitment to gender equity in employment, reproductive health, and in the family. [ABSTRACT FROM PUBLISHER]

The fall of state socialism in Poland in 1989 constituted a critical moment which redefined policies on reproductive health care and access to family planning, influenced by the renewed power of the Catholic church. Poland also embarked on neoliberal economic reforms that resulted in major cutbacks in social services and state health care coverage. The confluence of the elimination of contraceptive subsidies, privatisation of health care, and the intensification of bribes to underpaid health care providers created new challenges for women in accessing services. Furthermore, the 1993 ban on abortion resulted in a nearly total privatisation of this service, which is currently available clandestinely at a high price. Drawing on anthropological research in the Gdańsk metropolitan region in 2007, this paper examines the restrictions on access to family planning, abortion, maternity care, assisted reproduction and other gynaecological services. It draws attention to the urgent need for state-subsidised family planning and other reproductive health services, the reform of abortion law, and regulation of privatised services. Higher wages for public sector health professionals and better public health provision would curb informal payments. The state should support the legitimacy of women's health needs and reproductive and sexual autonomy. La fin du socialisme d'État en Pologne en 1989 a déclenché une redéfinition des politiques sur les soins de santé génésique et de l'accès à la planification familiale, influencée par le pouvoir accru de l'Église catholique. La Pologne a aussi entrepris des réformes économiques néolibérales qui ont abouti à des coupes sombres dans les services sociaux et la couverture sanitaire étatique. La confluence de l'élimination des subventions aux contraceptifs, la privatisation des soins de santé et l'intensification des pots-de-vin versés aux prestataires de soins de santé sous-rémunérés a créé de nouveaux obstacles empêchant les femmes d'accéder aux services. De plus, l'interdiction de l'avortement en 1993 a provoqué une privatisation presque totale de ce service, qui est actuellement disponible clandestinement à un prix élevé. Se fondant sur une recherche anthropologique dans la région métropolitaine de Gdańsk en 2007, cet article examine les restrictions de l'accès à la planification familiale, à l'avortement, aux soins maternels, à la procréation assistée et à d'autres services gynécologiques. Il montre qu'il est urgent de disposer de services de planification familiale et autres soins de santé génésique subventionnés par l'État, de réformer la loi sur l'avortement et de réguler les services privatisés. Des salaires plus élevés des professionnels du secteur public et de meilleures prestations de santé publique diminueraient les paiements informels. L'État devrait soutenir la légitimité des besoins de santé des femmes et leur autonomie génésique. La caída del socialismo en Polonia en 1989 constituyó un momento crítico, que redefinió las políticas referentes a los servicios de salud reproductiva y el acceso a la planificación familiar, en las cuales influyó el poder renovado de la Iglesia católica. Polonia también emprendió reformas económicas neoliberales, que produjeron considerables recortes en los servicios sociales y en la cobertura estatal de los servicios de salud. La confluencia de la eliminación de subsidios para anticonceptivos, la privatización de los servicios de salud y la intensificación de los sobornos a profesionales de la salud mal remunerados, creó nuevos retos para las mujeres en cuanto al acceso a los servicios. La prohibición del aborto en 1993 resultó en la privatización casi total de este servicio, el cual actualmente se ofrece clandestinamente a un precio muy caro. Basado en una investigación antropológica realizada en 2007 en la región metropolitana de Gdańsk, este artículo examina las restricciones al acceso a los servicios de planificación familiar, aborto, atención materna, reproducción asistida y otros servicios ginecológicos. Destaca la necesidad urgente de servicios de planificación familiar y otros servicios de salud reproductiva subsidiados por el Estado, la reforma de la ley de aborto y la regulación de los servicios privatizados. Los pagos extraoficiales se pueden reducir mediante sueldos más altos para profesionales de la salud del sector público y una mejor prestación de servicios de salud pública. El Estado debería apoyar la legitimidad de las necesidades de salud de las mujeres y su autonomía reproductiva y sexual. [ABSTRACT FROM AUTHOR]