Providing the option to look: Independent clinic workers' approaches to fetal viewing practices

"Background: More than one million surgical abortions are performed annually in the United States, resulting in an equal number of fetal tissues that are handled in the clinic setting. To date, only one study has assessed patient and provider experiences with fetal viewing after surgical abortion, even though evidence suggests that patients sometimes request to view the post-abortion tissue. Purpose: The overall purpose of this dissertation was to understand how products of conception (POC) viewing occurs at independent abortion clinics in the United States, and how clinic workers experience this aspect of their jobs. Methods: Three studies explored POC viewing though a mixed-methodological approach, informed by feminist standpoint theory and community-based participatory research frameworks. Study 1 piloted the approach of investigating POC viewing with 7 clinic workers (CWs). Interview data was analyzed qualitatively into key themes. Study 2 utilized community-building and knowledge-sharing to develop and implement a survey that examined if, when, where, and how POC viewing occurred at independent abortion clinics. Descriptive and comparative statistics described trends among respondents. Study 3 built on the previous two studies by visiting clinics that participated in the survey and interviewing clinic workers about their POC viewing strategies and experiences. Qualitative thematic analysis and descriptive, comparative, and correlation statistics described trends among respondents. All three studies were then analyzed together for common trends and relevance to previous studies. Results: These studies yielded interview data from 25 clinic workers and survey data from 22 clinics. Qualitative and quantitative analyses revealed common themes across studies and participants, indicating saturation of knowledge about clinic workers' POC viewing experiences at independent clinics. These common themes include: 1) Patients' reasons for viewing POC; 2) CW comfort with POC and fetal development; 3) POC viewing as quality abortion care; and 4) Clinic policies, practices, and training. Themes were put into conversation with an existing fetal development guide's author (Derenge, 2016) and an abortion worker and scholar's call for witnesses of the ""the things we cannot say"" (Ludlow, 2008), illuminating the realities, benefits of, and barriers to POC viewing at abortion clinics. Significance: This dissertation is the first to explore the breadth of POC viewing in the United States, and is the first to examine the phenomenon solely from the perspective of clinic workers. The studies within this dissertation have laid the groundwork for new fetal understandings, professional development for clinic workers, and challenges to abortion stigma. Themes from this dissertation can and will be used to develop a comprehensive and adaptable best practices guide for clinic use."

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Community Health

Grantor

University of Illinois at Urbana-Champaign

Year dc:date

2016

Author dc:creator

• Hann, Lena

Contributors dc:contributor

• Littlefield, Melissa M.
• Ludlow, Jeannie
• Clancy, Kathryn
• Huhman, Marian
• Sydnor, Synthia

• Products of Conception
• Fetal Tissue Viewing
• Abortion
• Clinic Workers

Statement dc:rights

• Copyright 2016 Lena Rose Hann

Language dc:language

en

Handle dc:identifier

http://hdl.handle.net/2142/93055

OAI record oai:identifier

https://www.ideals.illinois.edu/oai-pmh?verb=GetRecord&metadataPrefix=etdms&identifier=oai%3Awww.ideals.illinois.edu%3A2142%2F93055