Abortion in Asia

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Hiding or hospitalising? On dilemmas of pregnancy management in East Cameroon

Current international debates and policies on safe motherhood mainly propose biomedical interventions to reduce the risks during pregnancy and delivery. Yet, the conceptualisations of risk that underlie this framework may not correspond with local perceptions of reproductive dangers; consequently, hospital services may remain underutilised. Inspired by a growing body of anthropological literature exploring local fertility-related fears, and drawing on 15 months of fieldwork, this paper describes ideas about risky reproduction and practices of pregnancy protection in a Cameroonian village. It shows that social and supernatural threats to fertility are deemed more significant than the physical threats of fertility stressed at the (inter)national level. To protect their pregnancies from those social and supernatural influences, however, women take very physical measures. It is in this respect that biomedical interventions, physical in their very nature, do connect to local methods of pregnancy management. Furthermore, some pregnant women purposefully deploy hospital care in an attempt to reduce relational uncertainties. Explicit attention to the intersections of the social and the physical, and of the supernatural and the biomedical, furthers anthropological knowledge on fertility management and offers a starting point for more culturally sensitive safe motherhood interventions

Marginal motherhood The ambiguous experience of pregnancy-loss in Cameroon

There has been much international and scholarly attention for, on the one hand, 'overpopulation' or 'high fertility rates'; and, on [pregnancy-loss, abortion, Cameroon, aetiology, help-seeking behaviour, ambiguity, suffering, agency] From the 1950s onwards, population and fertility issues have gained much international attention. On the one hand, demographic statistics and trends warned for an

UvA-DARE (Digital Academic Repository) Pregnancy Pragmatics Unveiled: On Bodies, Bellies, and Power in Cameroon

Abstract Over the last few decades, anthropologists interested in reproduction hav

Marginal matters: Pregnancy loss as a social event

Studies on fertility in Africa have known a major paradigm shift when demographic concerns about 'overpopulation' came to be replaced by new ideas about reproductive health, rights, and choices during the 1994 International Conference on Population and Development (ICPD). Whereas this shift has allowed for more recognition of losses during pregnancy which had been virtually absent in previous demographic accounts of high fertility rates, the new discourse on rights and choices turns most of its attention to induced loss. Losses that spontaneously occur remain merely bound to the medical realm. Yet this paper shows that for many women in Africa and elsewhere, spontaneous pregnancy loss is a daily life reality which is inherently related to many social affairs, i.e. life and death, illness and suffering, marriage and kinship, the body and personhood. The rather reductionist biomedical discourse prevalent in the global health arena largely ignores these themes and social complexities - thus causing a gap between health policies and daily life realities for women. Drawing on eleven months of anthropological fieldwork in Cameroon in 2004 and 2008, this article explores the way in which socio-cultural insights could contribute to a better understanding of the experiences of women coping with pregnancy loss. The notions of 'vital conjunctures' and 'social bodies' will form an alternative approach to decision-making in case of reproductive mishaps. By applying these concepts to the personal story of an informant, their relevance and contribution to an interdisciplinary discussion on the topic become clear. The author argues for an integration of anthropological expertise in international reproductive health debates and explores how interdisciplinary work could make health policies on reproductive loss less marginal than is the case at present.Cameroon Pregnancy loss Reproductive health Decision-making Social bodies Vital conjunctures Interdisciplinarity

Self-care interventions for advancing sexual and reproductive health and rights – implementation considerations

Self-care refers to the ability of people to promote their own health, prevent disease, maintain health, and cope with illness and disability, with or without the support of a health or care worker. Self-care interventions are tools that support self-care as additional options to facility-based care. Recognizing laypersons as active agents in their own health care, the World Health Organization (WHO)’s global normative guideline on self-care interventions recommends people-centred, holistic approaches to health and well-being for sexual and reproductive health and rights. Examples of such interventions include pregnancy self-testing, self-monitoring of blood glucose and/or blood pressure during pregnancy and self-administration of injectable contraception. Building on previous studies and aligning with the WHO classification for self-care, we discuss nine key implementation considerations: agency, information, availability, utilization, social support, accessibility, acceptability, affordability, and quality. The implementation considerations form the foundation of a model implementation framework that was developed using an ecological health systems approach to support sustainable changes in health care delivery

The Unfortunate Sufferer: Discursive Dynamics around Pregnancy Loss in Cameroon

Pregnancy losses are ambiguous affairs in East Cameroon. Childbearing is not always people's primary aim within their fragile sexual and marital relationships, and it is often unclear to outsiders whether a pregnancy interruption is intended or unintended. Drawing on 15 months of fieldwork, I explore the discursive strategies Gbigbil women deploy while navigating such ambiguities. Suffering is central to their defensive discourses. Depending on the stakes in their relationships, women foreground the notion of suffering either to portray themselves as moral and innocent - and maintain social status or raise support - or to allude to or acknowledge their intention to terminate a pregnancy. This dynamic deployment of a suffering discourse reveals the interconnections of unintended and intended pregnancy losses, and of suffering (associated especially with the former) and agency (often associated with the latter)

‘Soothing My Child’s Soul and My Own’: Dealing with Pregnancy Loss in Post-communist Romania.

In Romania—where induced abortions were legally prohibited during communism and are now morally condemned by many—those who lose a pregnancy against their will have long been regarded with suspicion, confronted with a sense of culpability, and surrounded by silence. This ambiguity is reflected in the local terminology and the perceived etiology of loss. In this article, which is based on 15 months of fieldwork between 2012 and 2015, I illustrate the various meanings and manifestations of a silenced sense of culpability around involuntary pregnancy loss in the lives of women from Bucharest and a small town in Central Romania. I also show how many of these women attempt to break the silence around their lost fetuses and carve out a personal space of commemoration and consolation. Their informal use of forbidden religious rituals paradoxically allows them to confirm the existence of their lost little ones and to position themselves as caring, rather than culpable, mothers