Strange expectations: Cameroonian migrants and their German healthcare providers debate obstetric choices

ABSTRACT

When Cameroonian women migrate to Germany, they expect a different obstetric experience than they would have met in Cameroon. They bemoan the loss of family support, but do not yearn for village midwives. These largely urban, educated women expect better and more easily accessible medical care, free of the shortages and corruption plaguing Cameroon’s public health system. Their expectations—that bearing children is medically easier but socially harder than in Cameroon—are shaped by obstetrical stories circulating among their fellow migrants. Most migrant mothers celebrate the medicalisation, thoroughness, and even bureaucratic tracking, of German perinatal health care. In contrast, German healthcare providers draw from two models imagining their African clients’ obstetric concerns and desires. Some combine a Western feminist critique of biomedicine with dehumanising stereotypes of Africans as ‘nature-near.’ Imagining that African women find highly regulated, medicalized German perinatal care alienating, these providers assume that their African clients have witnessed births in rural settings and share broad female knowledge of ‘natural’ childbirth. Other providers differentiate among African clients by nationality and education level to assess their comfort regarding medicalized prenatal and obstetric care. Cameroonian migrant mothers and German medical humanitarians confirm, reconfigure, and transform stereotypes of each other’s obstetric desires.

KEYWORDS:

• Obstetrics
• migration
• cultural misrecognition
• Cameroon
• Germany

Acknowledgements

My research in Cameroon, stretching from the 1980s to 2017, was supported by the U.S. Department of Education Fulbright-Hays Research Abroad Award under Grant No. 022AH50021; the National Science Foundation under Award No. SES-0074789; the Wenner Gren Foundation under Grant-in-Aid No. 4741; and numerous grants from Carleton College. My research in Berlin was supported by the Wenner Gren Foundation under Grant No. 8185; a Hewlett Mellon Fellowship; and a Faculty Development Grant from Carleton College. Fellowships from the Käte Hamburger Center for Advanced Study ‘Law as Culture’ (2013–14) and from the Stellenbosch Institute for Advanced Study (2018), as well as a period of residence at the Max Planck Institute for Social Anthropology, Halle (2019), have generously given me space for reflection, analysis, and writing. I received insightful comments on a previous version of this paper from Alma Gottlieb and other members of the session ‘New African Migrants in Europe and the US: Encounters with the Familiar and the Strange’ at the American Anthropological Association annual meetings in 2015. Participation in the University of Minnesota African Studies Initiative symposium on ‘Global Health and Geographies of Disparity in Africa: Knowledge, Creativity, Accountability’ in 2017 urged me to relate my findings to global health policy. I thank Shaden Tageldin for this opportunity, and two anonymous reviewers, Hansjörg Dilger, Sanyu Mojola, Elisha Renne, and most particularly Mandisa Mbali and Jessica Rucell for valuable feedback. Finally, this contribution would not be possible without the kind collaboration of the Cameroonian immigrants and German providers I encountered in Berlin. To them, to Elizabeth Beloe for her excellent research assistance 2010–11, and to my husband and colleague Joachim Savelsberg, I am eternally grateful.

Disclosure statement

The author has no conflict of interest and has received neither financial interest nor benefit from the direct applications of this research.

Notes

1 Microaggressions are subtle and covert forms of discrimination and part of commonplace daily interactions, both verbal and behavioural. Although they are often communicated without malicious intent, they may be interpreted by their targets as derogatory and demeaning, and thereby reinforce positions of privilege as well as victimization. They also weigh on targets’ mental health and accelerate biological ageing, as proposed by the weathering hypothesis (Geronimus et al., 2010). First coined by Chester Pierce (1970) and elaborated by Derald Wing Sue (2010), microaggressions feature prominently in debates on university campuses about trigger warnings and safe spaces (Campbell & Manning, 2018; Levchak, 2018), especially in North America over the past decade. In Berlin, a satirical portrayal of microaggressions against Afro-Germans was featured in the theatrical performance, “Heimat—Bittersüsse Heimat” (Home—Bittersweet Home), performed by the troupe Label Noir at the Ballhaus Naunystrasse theatre in April 2011.

Additional information

Funding

This work was supported by National Science Foundation: [Grant Number SES-0074789]; Wenner Gren Foundation: [Grant Numbers 4741, 8185]; U.S. Department of Education Fulbright-Hays Research Abroad Award: [Grant Number 022AH50021].