Health Policy in a Time of Crisis is a vivid ethnographic account of women and providers navigating the Catalan health system to obtain and provide publicly funded abortion care.
Grounded in critical medical anthropology, the book situates access to publicly funded abortion care in the context of austerity and ongoing threats to recently liberalized laws, examining the actual levels of access in the region. In so doing, it examines the disparities experienced by immigrant and other women, documenting the diverse approaches adopted to overcome obstacles to care. Using accounts from both providers and women seeking care, Ostrach’s richly grounded analysis illuminates a healthcare system during a period of economic crisis and disagreement over reproductive governance. Researched against a backdrop of growing movements against austerity and for Catalan independence, the result is at once a study of true access to public health care in times of crisis and a compelling account of some women’s determination to go to any length to get the health care they need.
Engagingly written, it will make interesting reading for scholars and students of anthropology and public health, as well as policymakers and the general reader concerned with the politics of abortion and public health.
Table of Contents
1. People, Policy & Practice 2. Catalunya, Crisis, and Cuts 3. Uneasy Collaboration 4. Las Dones (The Women) 5. Enfrentando Obstáculos (Confronting Obstacles)
Bayla Ostrach is an Assistant Professor of Medical Anthropology and Cross-Cultural Practice, appointed in the Family Medicine Department at Boston University School of Medicine. An applied medical anthropologist by training, their research is designed to be returned to affected communities that seek to prompt changes in policy and practice.
"This exceptionally well-written and engaging ethnography... provides a unique example of engagement in medical anthropology... This promising first book will speak to a wide audience, offering insights for discussions in research methods and ethics classes from all disciplines, and the fields of medical and applied anthropology, women and gender studies, and public health and migration studies, to name a few."
Mounia El Kotni, Anthropology Book Forum (American Anthropological Association)
"Health Policy in a Time of Crisis is a compelling portrait of lived experiences following legal and economic reforms as recounted by those most affected. The voices of marginalized women echo throughout the narratives framing the paradox of expanded legal access and inclusion within the public health system against the reality of bureaucratic constraints that structure (and limit) access to care. Grounded in Critical Medical Anthropology’s call to unmask inequalities reproduced even in optimal settings, Ostrach explores what happens when women who are ostensibly guaranteed legal, funded abortions nevertheless encounter obstacles— economic, political, and social. Abortion care here functions as a lens through which we gain a broader understanding of the ways women navigate suboptimal and discriminatory health bureaucracies. Ostrach makes an important contribution to the anthropology of reproduction, with critical implications for other fields including feminist anthropology, gender and public health and health policy. I look forward to using it in my classes."
Melissa Cheyney, Oregon State University, USA