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I EXAMINATION of the SANCTUARY: USES of a MEDITATIVE SPACE in a WOMEN's HEALTH CLINIC by Anna Vitriol BA, University of Pittsb

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I EXAMINATION of the SANCTUARY: USES of a MEDITATIVE SPACE in a WOMEN's HEALTH CLINIC by Anna Vitriol BA, University of Pittsb EXAMINATION OF THE SANCTUARY: USES OF A MEDITATIVE SPACE IN A WOMEN’S HEALTH CLINIC by Anna Vitriol BA, University of Pittsburgh, 2006 Submitted to the Graduate Faculty of the Graduate School of Public Health in partial fulfillment of the requirements for the degree of Master of Public Health University of Pittsburgh 2010 i UNIVERSITY OF PITTSBURGH Graduate School of Public Health This thesis was presented by Anna Vitriol It was defended on April 15, 2010 and approved by Thesis Advisor: Martha Ann Terry PhD, Assistant Professor, Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh Committee Member: Sara Goodkind, PhD, MSW, Assistant Professor, School of Social Work, University of Pittsburgh Committee Member: Robin E. Grubs, PhD, CGC, Assistant Professor, Co-Director of the Genetic Counseling Program, Human Genetics, Graduate School of Public Health, University of Pittsburgh ii Copyright © by Anna Vitriol 2010 iii EXAMINATION OF THE SANCTUARY: USES OF A MEDITATIVE SPACE IN A WOMEN’S HEALTH CLINIC Anna Vitriol, MPH University of Pittsburgh, 2010 Abortion, much like pregnancy, can play a significant role in the course of a woman’s life. Even so, abortion is complicated by a number of barriers – legal, financial, emotional, spiritual, religious, and physical -- with which women and men struggle beyond the mere complexity of undergoing a surgical procedure. Although abortion can be pivotal in a woman’s life, every individual is remarkably different, and for that reason so is every abortion experience. For over 30 years, Allegheny Reproductive Health Center (ARHC) has embraced a holistic approach that seeks to understand and address the needs of women and men seeking termination services. In 2008, ARHC erected a space, the Sanctuary, designed specifically to encourage personal reflection and quiet meditation among patients and abortion providers coping with the complex issues surrounding abortion. Thus, in order to understand the impact of the Sanctuary, this exploratory study investigates the various uses of the meditative space. Qualitative research was conducted through the use of semi-structured interviews with clinic workers and by asking visitors to the meditative space to respond to a short questionnaire, which upon completion was placed in a secure box installed within the Sanctuary. From the results, four overarching themes were identified: 1. To work within the abortion field is both complex and important; 2. The next step in abortion care is a holistic approach that addresses a patient’s specific needs; 3. The development of the Sanctuary is a step toward advancing abortion care for women and men; and iv 4. To establish an understanding of how the space is used by patients and clinic workers. These results imply that applying a holistic approach in abortion care, through the use of a space such as the Sanctuary, is respectful of the varability in women’s and men’s experiences related to pregnancy termination. Moreover, the findings indicate that participants support the placement and use of the Sanctuary, for themseleves as well as patients. In terms of public health relevance, professionals within the field can utilize this research to advance the understanding of how to assist women and men in managing the complexities of abortion. v TABLE OF CONTENTS PREFACE ..................................................................................................................................... X 1.0 INTRODUCTION ........................................................................................................ 1 2.0 THE FRAMEWORK FOR ABORTION .................................................................. 5 2.1 A BRIEF HISTORY OF ABORTION .............................................................. 5 2.2 ABORTION: WHO, WHAT, WHERE AND HOW ........................................ 7 2.2.1 The Characteristics of Women Obtaining Abortions ................................ 7 2.2.2 The Constructs of Unintentional Pregnancy .............................................. 9 2.2.3 Accessibility to Abortion ............................................................................ 11 2.2.4 The Abortion Procedure............................................................................. 12 2.3 A TIMELINE OF ABORTION LEGISLATION ........................................... 14 2.3.1 Federal Funding of Abortion ..................................................................... 15 2.3.2 Abortion Restrictions in the States ............................................................ 16 2.3.3 Anti-Abortion Violence .............................................................................. 17 2.4 UNDERSTANDING ABORTION ................................................................... 18 2.4.1 Religious Discourse ..................................................................................... 19 2.4.2 Social Context .............................................................................................. 22 2.4.3 Abortion Perspectives: Why Women and Men Choose Abortion .......... 24 2.5 GAPS IN THE LITERATURE ........................................................................ 25 vi 3.0 METHODOLOGY ..................................................................................................... 27 3.1 SAMPLING ........................................................................................................ 27 3.2 RECRUITMENT ............................................................................................... 28 3.3 INTERVIEWS ................................................................................................... 28 3.4 SANCTUARY BOX ........................................................................................... 29 3.5 TRANSCRIPTION ............................................................................................ 30 3.6 THEMATIC ANALYSIS .................................................................................. 31 4.0 RESULTS ................................................................................................................... 33 4.1 CHARACTERISTICS OF INTERVIEWEES AND BOX RESPONDENTS .............................................................................................................................. 33 4.2 EMERGING THEMES ..................................................................................... 34 4.2.1 Theme #1: The Environment of An Abortion Clinic ............................... 34 4.2.1.1 External Factors Impacting the Work of an Abortion Clinic ......... 35 4.2.1.1 The Emotional Complexity of Working in an Abortion Clinic ...... 36 4.2.1.2 The Importance of Abortion Work ................................................... 38 4.2.2 Theme #2: A Holistic Approach to Abortion Care .................................. 39 4.2.2.1 The Approach ...................................................................................... 39 4.2.2.2 Connecting with Patients .................................................................... 41 4.2.2.3 Unique Methods of Assisting Women ............................................... 42 4.2.3 Theme #3: The Meaning Behind the Sanctuary ....................................... 44 4.2.3.1 Development of the Sanctuary ............................................................ 44 4.2.3.2 Advantages of the Sanctuary .............................................................. 47 4.2.3.3 Challenges of the Sanctuary ............................................................... 49 vii 4.2.4 Theme #4: Uses of the Sanctuary ............................................................... 51 4.2.4.1 Clinic Worker Uses of the Sanctuary ................................................. 51 4.2.4.2 Patient Uses of the Sanctuary ............................................................. 53 4.2.4.3 Sanctuary Box Responses .................................................................... 56 5.0 DISCUSSION ............................................................................................................. 59 5.1.1 Theme #1: The Environment of an Abortion Clinic ................................ 60 5.1.2 Theme #2: A Holistic Approach to Abortion Care .................................. 61 5.1.3 Theme #3: The Meaning Behind the Sanctuary ....................................... 62 5.1.4 Theme #4: Uses of the Sanctuary .............................................................. 63 6.0 IMPLICATIONS AND CONCLUSIONS ............................................................... 66 6.1 IMPLICATIONS FOR ABORTION PROVIDERS ...................................... 66 6.2 STUDY LIMITATIONS AND FUTURE RESEARCH ................................. 68 6.3 CONCLUSION .................................................................................................. 69 APPENDIX A: PHOTOGRAPHS OF THE SANCTUARY .................................................. 71 APPENDIX B: INSTITUTIONAL REVIEW BOARD APPROVAL LETTER ................. 76 APPENDIX C: INFORMED CONSENT SCRIPT ................................................................ 78 APPENDIX D: RECRUITMENT SCRIPT ............................................................................ 80 APPENDIX E: BOX SPEECH ................................................................................................. 82 APPENDIX F: SHARING DOCUMENT ................................................................................ 84 APPENDIX G: INTERVIEW QUESTIONS .........................................................................
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