Abortion in Tunisia after the revolution: Bringing a new morality into the old reproductive order

Abstract

The emergence of Islamist movements and religious symbolic repertoires in the aftermath of the Tunisian revolution has elicited the political, moral, and practical contestation of women's right to abortion. While, after several heated debates, the law was eventually not modified, several practitioners working in government family planning clinics have changed their behaviour preventing women getting abortions. Pre-existing state and medical logics, political uncertainties, and new religious and moralising discourses have determined abortion practices in the government health-care facilities generating unequal treatments according to women's marital status, class, and education. This paper will investigate the multiple logics affecting abortion practices in post-revolutionary Tunisia, focusing on the dissonant logics mobilised by health-care professionals as well as structural socioeconomic factors.

Dualities between Tunisian provider beliefs and actions in abortion care

“…4,5 Recent events, including the 2008 global financial crisis, the Arab Spring of 2010-2011, and the ensuing increase in political conservatism, have raised concern about the availability of reproductive health services, including abortion, in Tunisia. [6][7][8][9][10] Legally, elective first trimester abortion is available to women in Tunisia at no cost when prescribed by a physician and performed by a physician or midwife at authorised public facilities or in private clinics. 11 After the first trimester, abortion is permitted in cases of physical or mental health risks to the pregnant woman, or foetal anomaly.…”

“…Despite a relatively liberal law, women in Tunisia face increasingly significant challenges accessing legal abortion services. 10,12 A lack of data on abortion in both public and private settings makes it difficult to evaluate recent changes in abortion access since 2011. Anecdotal accounts suggest that budget cuts have led to a reduced number of facilities offering abortion services in the country.…”

“…Anecdotal accounts suggest that budget cuts have led to a reduced number of facilities offering abortion services in the country. 6,10 Further, advocates report that some Tunisian physicians are invoking a conscience clause, referring to the International Federation of Gynecology and Obstetrics' 2006 Resolution on Conscientious Objection in lieu of a national medical conscience clause. Refusal for religious reasons has become more common since the 2010-2011 revolution.…”

Family Life in Tunisia after the Revolution of 2011

“…Second, the decriminalization of abortion enacted by Tunisia’s first president in an effort to achieve the desired demographic goals of the independent state was and remains an object of religious, moral, and social contention in medical settings 19 . In Tunisia, as in many European countries where abortion has been legal for decades, women’s right to abortion is not unchallenged because pro-life groups, religious institutions, and nationalist pronatalist movements constantly threaten its legitimacy 20 .…”

“…We show that the existence of an abortion law is only one factor among many others affecting women’s ability to access abortion services; medical practices and women’s abortion itineraries are caught up within a complex configuration that entails multiple socioeconomic and cultural factors, political transformations, the variability of rules in medical and administrative institutions, and contradictory interpretations of the legal apparatus. Only by examining the interactions between all of these factors is it possible to understand why in Tunisia—where abortion has been legal for more than 40 years—many women experience physical and moral suffering when they want to abort, and many are forced to resort to illegal abortion 1 . In addition, because of the impossibility of accessing abortion services, more than 1,000 babies are abandoned every year by unmarried mothers 2…”