The production of ignorance about medication abortion in Tunisia: between state policies, medical opposition, patriarchal logics and Islamic revival

Abstract

In Tunisia, medication abortion has been available in government reproductive and sexual health clinics since the early 2000s. Since its introduction, it has rapidly replaced the surgical method, and between 75% and 80% of abortions in the public sector were performed using the pharmacological protocol in 2016. In this article, I intend to discuss the various forms of ignorance about medication abortion that exist in Tunisia among several categories of actors in relation to the legal, medical and religious domains. I explore how the existing 'varieties of ignorance' are related to the specific political, social and economic positions of the involved actors, the dominant gender regime, specific institutional policies and economic interests. I also investigate how some forms of ignorance are wilfully produced by institutions and individuals, whereas others are the result of positionality or organizational features. I first describe when and how medication abortion was introduced in Tunisia and the forms of resistance it elicited; later, I examine the production of ignorance about this technology after the revolution of 2011. I mainly consider practices and discourses of health professionals, but also those of women seeking abortion care in the public sector, and those of the activists of a Tunisian non-governmental organization operating in the domain of women's health and rights.

Keywords: Healthcare providers; Ignorance; Law; Medication abortion; Opposition; Tunisia.