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Providers, Pills and Power: The US Mifepristone Abortion Trials and Caregivers’ Interpretations of Clinical Power Dynamics

Georgia State Universitywsimonds{at}gsu.edu

Charlotte Ellertson

Beverly Winikoff

Population Council

Kimberly Springer

Williams College

In this article, we examine retrospective accounts of health care workers who participated in the Population Council’s clinical trials of mifepristone (RU-486) between October 1994 and September 1995. We conducted focus group interviews with 78 health care providers at 17 sites around the USA, after the clinical trials of mifepristone (RU-486) were completed. We discuss providers’ reflections upon power dynamics between them and their clients during the clinical trials, as well as the implications of these changes on the future provision of non-surgical abortion. Caregivers tend to see mifepristone users as more ‘empowered’ than women having surgical abortions, and see themselves as losing power over their clients’ abortion experiences. They offer nuanced and ambivalent assessments of the role of empowerment in their clients’ motivations and experiences as mifepristone users. They tend to view the method as responsible for generating more egalitarian clinical interactions (and to endorse it as such), but the variation present in their evaluations demonstrates most clearly the power of caregivers’ interpretative work in shaping clinical interactions. In assessing their experiences with mifepristone, caregivers demonstrate their interpretative work ‘on’ clients, which is enmeshed with their sense of who they are as medical workers.

Key Words: abortion • RU-486 • medical abortion • medical work • mifepristone • women’s health care

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