Rachel Rebouché

Bio: Rachel Rebouché is an academic researcher from Temple University. The author has contributed to research in topics: Abortion & Reproductive rights. The author has an hindex of 8, co-authored 22 publications receiving 174 citations. Previous affiliations of Rachel Rebouché include American University & Queen's University Belfast.

Northern Ireland's Abortion Law: The Morality of Silence and the Censure of Agency

Abstract: This article explores the context within which abortion law and discourse in Northern Ireland must be situated and understood, relying in part on post-modern insights into the wider and long-term implications of feminists engaging law and by examining the strategies employed in Northern Ireland around the issue of abortion. In 2001,the Family Planning Association (Northern Ireland) took legal action to force the devolved government to defend at a procedural level the unequal and uncertain form of common law abortion regulation for Northern Ireland. The authors examine the strategy of this review as well as the response of the High Court, suggesting that while it may begin to challenge the legitimacy of abortion law, feminists and pro-choice advocates must prepare for challenges beyond that, the greatest being the cultural challenge. The courts, legislators and other public and political institutions(including the Northern Ireland Human Rights Commission and the Northern Ireland Women's Coalition) consistently explain the law's lack of provision for women with reference to the `pro-life' majority views of Northern Irish people. The authors question the legitimacy of this claim in a cultural climate of intimidation against the expression of alternative views. Women will continue to be marginalised and devalued in this debate if the silencing of the pro-choice community and bodies responsible for protecting human rights is not redressed. A case is therefore made for a reconceptualisation of the abortion debate from the perspective of women's agency, which, alongside litigation and other strategies, is necessary to overcome the cultural censure that currently prevents meaningful dialogue.

Abortion Rights as Human Rights

Abstract: This essay maps how human rights have helped advance abortion rights, and it explores the relationship between human rights discourses and abortion access in jurisdictions with under-resourced health systems. The first part describes the incorporation of abortion rights in international human rights documents and in the opinions and reports of human rights bodies. The second part discusses why courts increasingly cite human rights texts in national opinions, noting courts’ invocation of universal values, consensus on limited abortion permission, and state duties to protect women’s rights. The third part examines on-the-ground obstacles to implementing court judgments and national abortion laws. This essay argues that human rights reasoning, rooted in claims to universalism and modernity, may minimize the problems that follow legal change, particularly in places with weak health-care infrastructures. The conclusion considers public health law research that keeps in view the differences among countries’ hea...

Noninvasive Fetal Sex Determination Using Cell-Free Fetal DNA: A Systematic Review and Meta-Analysis

Abstract: Context Noninvasive prenatal determination of fetal sex using cell-free fetal DNA provides an alternative to invasive techniques for some heritable disorders. In some countries this testing has transitioned to clinical care, despite the absence of a formal assessment of performance. Objective To document overall test performance of noninvasive fetal sex determination using cell-free fetal DNA and to identify variables that affect performance. Data Sources Systematic review and meta-analysis with search of PubMed (January 1, 1997-April 17, 2011) to identify English-language human studies reporting primary data. References from review articles were also searched. Study Selection and Data Extraction Abstracts were read independently to identify studies reporting primary data suitable for analysis. Covariates included publication year, sample type, DNA amplification methodology, Y chromosome sequence, and gestational age. Data were independently extracted by 2 reviewers. Results From 57 selected studies, 80 data sets (representing 3524 male-bearing pregnancies and 3017 female-bearing pregnancies) were analyzed. Overall performance of the test to detect Y chromosome sequences had the following characteristics: sensitivity, 95.4% (95% confidence interval [CI], 94.7%-96.1%) and specificity, 98.6% (95% CI, 98.1%-99.0%); diagnostic odds ratio (OR), 885; positive predictive value, 98.8%; negative predictive value, 94.8%; area under curve (AUC), 0.993 (95% CI, 0.989-0.995), with significant interstudy heterogeneity. DNA methodology and gestational age had the largest effects on test performance. Methodology test characteristics were AUC, 0.988 (95% CI, 0.979-0.993) for polymerase chain reaction (PCR) and AUC, 0.996 (95% CI, 0.993-0.998) for real-time quantitative PCR (RTQ-PCR) (P = .02). Gestational age test characteristics were AUC, 0.989 (95% CI, 0.965-0.998) ( 20 weeks) (P = .02 for comparison of diagnostic ORs across age ranges). RTQ-PCR (sensitivity, 96.0%; specificity, 99.0%) outperformed conventional PCR (sensitivity, 94.0%; specificity, 97.3%). Testing after 20 weeks (sensitivity, 99.0%; specificity, 99.6%) outperformed testing prior to 7 weeks (sensitivity, 74.5%; specificity, 99.1%), testing at 7 through 12 weeks (sensitivity, 94.8%; specificity, 98.9%), and 13 through 20 weeks (sensitivity, 95.5%; specificity, 99.1%). Conclusions Despite interstudy variability, performance was high using maternal blood. Sensitivity and specificity for detection of Y chromosome sequences was greatest using RTQ-PCR after 20 weeks' gestation. Tests using urine and tests performed before 7 weeks' gestation were unreliable.

Clinical integration of next generation sequencing: coverage and reimbursement challenges.

Abstract: Public and private payers face complex decisions regarding whether, when, and how to cover and reimburse for next generation sequencing (NGS)-based tests. Yet a predictable reimbursement pathway is critical both for patient access and incentives to provide the market with better clinical evidence. While preliminary data suggests that payers will use similar evidentiary standards as those used to evaluate established molecular diagnostic tests, the volume and complexity of information generated by NGS raises a host of additional considerations for payers that are specific to this technology.

Postcolonial Fragments: Representations of Abortion in Irish Law and Politics

Abstract: The Republic of Ireland has become infamous for its legal stance against abortion, especially since it went as far as stopping, albeit temporarily, a young rape victim from travelling abroad for an abortion in 1992. I argue that one of the rationales behind anti-abortion law is a post-colonial urge to mark Irishness distinctively by constructing it in exclusively ‘pro-life’ terms. I discuss examples of how Irish colonial experiences have been used to justify the effort to keep Ireland abortion-free, and to resist that effort. Representations of colonial history in the context of Irish abortion law and politics have changed over time and between groups. Such changes indicate a need for post-colonial critique to account for the fragmentation of colonialism as it is displaced, a need which the conceptualization of post-coloniality as a historical object can address.