Whose bodies are they? Conceptualising reproductive violence against adolescents in Ethiopia, Malawi and Zambia

abstract

We use a violence lens to visibilise how adolescents who sought abortion-related care in three African countries are coerced, controlled and punished with regard to their sexual and reproductive health. We suggest the use of the concept of reproductive violence to characterise these diverse experiences. Our data come from a comparative study on adolescent contraceptive and abortion-seeking behaviours in Ethiopia, Malawi and Zambia. We conducted 313 interviews that generated both quantitative and qualitative evidence in each country (2018–2019). Our analysis shows how adolescent bodies are subject to reproductive violence by parents, partners and healthcare workers, situated within a broader framework of structural violence. Reproductive violence manifests in multiple ways, often within a single abortion trajectory, including coercion to accept post-abortion contraception after receiving facility-based abortion services; having few to no choices of contraceptive methods prior to or after pregnancy; parents and relatives coercing adolescents to not/use abortion or contraception; lack of decision-making regarding sexuality or sexual identity; sex and contraceptive use in relationships rooted in gendered and power dynamics with partners; and – ultimately – adolescents’ lack of control over their own bodies. We show how these experiences make adolescents vulnerable to the experience and perpetuation of reproductive violence.

keywords:

• reproductive violence
• coercion
• adolescents
• reproduction

Notes

1 We understand that the use of the term ‘unwanted’ has been problematised for denoting a liberal subjectivity where a range of choices and desires are possible, ignoring some of the reasons that make a pregnancy problematic (Chiweshe, Mavuso & Macleod 2017). We use it here as it is the term used when reporting fertility.

2 Post-abortion care is considered under consent to medical treatment.

3 Ethical review was obtained in Ethiopia (Ethiopian Public Health Institute: 154-2018), Malawi (National Health Sciences Research Committee: 2003), Zambia (ERES- 2017-Nov-005) and the UK (London School of Economics: 000606).

Additional information

Notes on contributors

Malvern Tatenda Chiweshe

MALVERN CHIWESHE is a Research Associate in Critical Studies in Sexualities and Reproduction at Rhodes University, South Africa. He holds a PhD in Psychology and an MA Clinical Psychology from Rhodes University, and a Master’s in Public Health with a concentration on Women’s and Reproductive Health and Certificates in Adolescent Health and in Maternal and Child Health from Johns Hopkins University, USA. His research interests are in African feminism, abortion, maternal and child health and adolescent health. He has published work in Feminism & Psychology, Journal of Health Psychology, Journal of Family and Reproductive Health, International Journal of Behaviour Medicine and Journal of Aggression, Conflict and Peace Research. Email: [email protected]

Tamara Fetters

TAMARA FETTERS is currently the senior research lead for research development and implementation efforts in humanitarian settings at Ipas. Her professional interests include programme and policy evaluation, maximising research impact, measurement of abortion morbidity and mortality, participatory learning and action research, human-centred design and sexual and reproductive health for refugees. She has co-authored articles in BJOG, Studies in Family Planning, Conflict and Health, International Journal of Gynecology and Obstetrics, International Perspectives on Sexual and Reproductive Health, and Global Public Health. Email: [email protected]

Ernestina Coast

ERNESTINA COAST is Professor of Health and International Development at the London School of Economics, UK. She holds a PhD in Anthropology from University College London. Her research focuses on sexual and reproductive health and rights, particularly contraception and abortion, drawing on multidisciplinary and multimethod approaches. She has published work in Social Science & Medicine, Sexual and Reproductive Health Matters, Demography, International Perspectives on Sexual and Reproductive Health, Studies in Family Planning, Contraception, and Global Public Health. Email: [email protected]