‘She does not speak enough Dutch for pills:’ A linguistic-ethnographic analysis of counselling practices concerning linguistic ineligibility for medical abortion

Abortion care can involve two treatment options: a medical abortion, using medicine, or a surgical abortion. This paper reports on linguistic-ethnographic data (including observations of 69 pre-abortion counselling sessions) collected at a Belgian abortion clinic, where, according to institutional policy, some abortion seekers are considered linguistically ineligible for medical abortion. The policy prescribes that clients who lack proficiency in the institutional language(s) cannot choose medical abortion because it involves communication. The linguistic-ethnographic analysis demonstrates that the professionals favour choice and client involvement when counselling clients who are linguistically eligible for a medical abortion, but that with linguistically ineligible clients they either do not disclose that a medical abortion is a treatment option or else they openly discuss their linguistic ineligibility with them. In the latter case, it was found that three (sometimes overlapping) interactional and discursive practices can prevent care providers and clients from reaching common ground, and may cause communicative tension: staff's incomplete explanation of the rationale for linguistic ineligibility; a companion interpreter's incomplete or zero renditions; and care providers’ discursive framing of clients’ linguistic ineligibility. The findings indicate tension between the abortion clinic's institutional and interactional orders, and it is suggested that this tension can be overcome with transparent communication and adequate language support.