Dr Olivia Engle

Abortion mobilities emerged within political geography and the reproductive mobilities scholarship to address extant theoretical and empirical gaps in these fields. This paper seeks to highlight and assess the abortion mobilities scholarship to date. Starting with a working definition of abortion mobilities, this paper argues for the relevance of abortion to political geography and outlines three key themes in political geography that abortion mobilities address: borders, states and anti-genderism, intersectional politics and reproductive justice, and activism and abortion pills.

Telemedicine abortion is not equally accessible in the United States. Prior to Dobbs v. Jackson Women's Health Organization (2022), state-level restrictions on telemedicine abortion meant that abortion seekers in 18 states could not access telemedicine abortion services within their state – reinforcing extant geographical inequity in abortion access. However, understanding the benefits of telemedicine abortion to increase the availability of abortion, abortion providers and seekers co-developed a strategy for access, which this paper calls cross-border telemedicine abortion (CBTA). Rather than access care remotely, as is typical of telehealth, patients physically travel across state borders to have a phone consultation and pick up their pills from the post office. This paper describes this phenomenon and nuances discussion of the potential of telemedicine and digital health to transcend distance and resolve rural health inequalities. This paper draws on a case study of telemedicine abortion provider Just The Pill and semi-structured interviews with staff and rural patients who accessed this abortion care pathway prior to Dobbs. It suggests that distance may not be the paramount barrier to care for rural women because they are still travelling long distances. Rather, the phenomenon of CBTA suggests that a combination of barriers influences abortion decision-making for rural women and that CBTA may present a viable spatial solution to these barriers.

Background Participatory analysis is increasingly conducted and documented as part of community-based participatory research (CBPR). Co-produced research necessitates involvement at all research stages. However, few studies offer practical insights into how participatory analysis can be planned and implemented, particularly with community researchers. Moreover, some scholars question the degree to which public contributors can make sense of qualitative data or theorise beyond their own lived experience. This study was conducted as part of a co-produced community-based participatory research project on employment support, work, and health and wellbeing. Staff members and volunteers from two voluntary and community sector organisations in Wakefield District (England) were trained to become community researchers. They then conducted interviews and focus groups with 41 participants between the two organisations. Community researchers were then invited to take part in two participatory analysis sessions. This is a methodological paper describing an adapted and extended approach to participatory analysis, focussing on how it was done, why, and what was the result. Methods In this CBPR project, we trialled participatory theme elicitation (PTE) (Best et al., 2017; 2022) as an approach to participatory analysis. PTE involves 5 stages: 1) capacity building, 2) data selection, 3) data sorting, 4) data grouping (using network methods), and 5) analysis of thematic groups. We adapted this method to be more suitable for the project and our community researchers, largely based upon feedback from previous participatory analysis approaches. We made key changes to stages 1, 2, 4, and 5. Another difference was that our overall methodological approach to PTE placed less importance on ‘reducing bias’ per se, and more importance on harnessing and documenting the power of lived experience voices. In addition to these adaptations, we also added two additional stages to the PTE method. These stages were 6) theme-led coding and 7) incorporating analysis into write-up. Although these extend beyond the ‘elicitation’ aspect of the PTE method, we feel that these stages are important to outline as they provide insight into how participatory analysis can support the achievement of research aims and objectives as well as support knowledge mobilisation activities. Results The adapted and extended PTE method was well-received by community researchers and was fit-for-purpose within the wider CBPR project, as it supported turning community-generated evidence into action. Conclusion This paper shows how we adapted the PTE method to be effectively used for inclusive and robust participatory analysis with community researchers from diverse backgrounds who have limited research experience and no prior training in analysis.

The advent of telemedicine abortion in 2020 in the United States meant that abortion care was increasingly pushed out of clinical settings and into the home. Yet, within the context of abortion inequalities and restrictions in the US, there is often more focus on provision of and access to medication abortion via telemedicine than there is on what happens after the abortion pills are acquired. This paper brings together and advances scholarship in abortion, care, and home geographies to address this empirical gap by exploring the material, temporal and spatial dimensions of telemedicine abortion care at home, and examining how these dimensions shape the embodied, emotional, and affective experience of abortion care. Telemedicine abortion allows individuals to self-manage the timing, symptoms, and space of their abortion, thereby creating a caring atmosphere. A geographical perspective on telemedicine abortion reveals that taking the abortion pills at home shapes the experience of abortion care.

The abortion road trip is a narrative device that has emerged in the last decade whereby the central plot of the story is the journey taken in search of an abortion. In this paper we analyze two young adult novels (Girls on the Verge and Unpregnant) and two films (Grandma and Never Rarely Sometimes Always) that follow adolescent girls traveling for abortions in the contemporary United States. Through the analysis of these four narratives, we argue that representations of the abortion road trip are novel for their focus on the barriers and politics of abortion access in the United States. While the representations do prioritize certain barriers over others, they mark an important shift in abortion discourse in popular culture. Instead of the ‘drama’ of the plot being the decision to have an abortion, it is increasingly other socio-politico-legal issues such as the lack of abortion clinics, the distance required to travel, legal rights for adolescents, the cost of the procedure, and the opinions of family and friends that take center stage. The focus on these structural, political barriers can help to educate audiences about the realities of abortion access in the US and move abortion discourse beyond the individual.

Over the past few decades growing attention has focused on the perceived challenge of adolescent pregnancy and the need for girls to make ‘smart choices’. This has generated considerable debate particularly because of the failure of many programmes and interventions to consider the structural constraints faced by young women in accessing sexual and reproductive health and rights (SRHR). Yet limited attention has been given to the views and experiences of girls’ parents and caregivers, many of whom were often adolescent parents themselves. We use data from the Real Choices, Real Lives longitudinal study conducted by Plan International to consider how the experiences of girls’ families shape their attitudes to teenage pregnancy in the Dominican Republic and El Salvador. Many families believe girls need to practise abstinence and avoid men and boys but given the lack of provision for SRHR faced by young women this response is not unexpected.