Centre for Cultures of Reproduction, Technologies and Health

Publications

by members of the centre

Podcast #GenderGaps | Jashodhara Das Gupta | Women and Health: Concerns during COVID 19


IMPRI Impact and Policy Research Institute

Women and Health: Concerns during COVID 19

More details: Access the podcast

Thrombotic risk in COVID-19: a case series and case–control study

Simon M Stoneham, Kate M Milne, Elisabeth Nuttal, Georgina H Frew, Beattie R Sturrock, Helena Sivaloganathan, Eleni E Ladikou, Stephen Drage, Barbara Phillips, Timothy JT Chevassut and Alice C Eziefula
Clinical Medicine Journal, May 2020

A study by Brighton and Sussex Medical School (BSMS) has supported the use of blood thinners to treat some COVID-19 patients. The disease is associated with a high incidence of venous thromboembolism, blood clots in the venous circulation, according to the research. Co-author, Dr Chi Eziefula, CORTH Co-director and Senior Lecturer in Infection at BSMS, said: “Identifying which patients have a risk of, and clinical evidence of, a venous thromboembolism in COVID-19 is highly important for two reasons. Firstly, because venous thromboembolism is linked to a risk of death and secondly because it is treatable with anticoagulant medications.”

More details: Thrombotic risk in COVID-19: a case series and case–control study

Ethics of Neighborly Intimacy among Community Health Activists in Delhi

Medical Anthropology

Emilija Zabiliute,  Centre for Medical Anthropology, Social Anthropology, University of Edinburgh
Medical Anthropology, May 2020

What makes community health activism an ethical undertaking? I examine how, among Accredited Social Health Activists (ASHAs) in an urban poor neighborhood in Delhi, health work is underscored by relational sensibilities. By primarily situating the inquiry into the everyday lives of ASHAs, and beyond the formal trajectories of their work, I show how their care work and relational commitments exceed the forms of care foregrounded in public health program protocols. ASHAs operate through an ethics of neighborly intimacy – relational knowledge and acts, guided by ethical obligations toward their neighbors, and underscored by existing dependencies and care, and the detachments and differentiations of relationships.

More details: Ethics of Neighborly Intimacy among Community Health Activists in Delhi

Silent politics and unknown numbers: Rural health bureaucrats and Zambian abortion policy

Marte E.S.Haaland, HaldisHaukanes, Joseph Mumba Zulu, Karen Marie Moland, Astrid Blystad
Social Science & Medicine Volume 251, April 2020

Social Science & MedicineThis article addresses the gaps between knowledge, policy and practice in reproductive health by exploring the processes involved in translating Zambian abortion policy from paperwork to practice in a predominantly rural province. Central to these processes are rural health bureaucrats, who are tasked with administering and monitoring a myriad of reproductive health policies and programmes. The articles is based on eleven months of ethnographic fieldwork in Zambia from September 2017 to August 2018, including in-depth interviews with rural health bureaucrats and participant observation in health management and policy meetings. It examines how health bureaucrats deal with the abortion-related challenges they face. Our findings reveal a complex landscape of reproductive health politics and moral double-binds and give insight into the gap between Zambia's seemingly liberal abortion policy and the lack of access to abortion services in rural areas. Despite the bureaucrats' knowledge about abortion policy, none of the hospitals in the study province offer legal abortion services. While many bureaucrats consider abortion to be a public health issue and see the need to offer legal services to abortion-seeking women, they often bypass abortion-related issues and treat them with silence in policy meetings and public settings. The silence corresponds with the lack of data on abortion and post-abortion care in district and provincial health offices and should be understood in relation to both the dominant moral regime of the Zambian state and global pressure towards specific reproductive health targets. This article calls for increased focus on politics and power dynamics in the state apparatus in order to understand the gaps between knowledge, policy and practice in sexual and reproductive health.

More details: Silent politics and unknown numbers: Rural health bureaucrats and Zambian abortion policy

From Ebola to COVID-19: 4 Lessons China Can Apply to its Response in Africa

Rosie Wigmore
March 2020

Over the last few weeks, we have seen various Chinese actors launch significant campaigns in Africa to help tackle COVID-19. So far, the Chinese government has created numerous online resources to share its experience; sent 12,000 testing kits to multiple African countries and organized videoconference sessions with health leaders from 20 African countries. The Chinese billionaire and founder of Alibaba, Jack Ma, has also distributed 20,000 test kits, 100,000 masks and 1,000 protective suits to each of the 54 African states.

However, this is not China’s first aid campaign in Africa, nor is it, so far, the biggest. In 2014, China joined the international health response to the Ebola outbreak in Guinea, Liberia and Sierra Leone. In total, the Chinese government pledged around $125 million to UN agencies, the WHO and other organizations, sent almost 1,500 health workers, constructed a treatment center with 100 beds, a biosafety lab that conducted 40-60 tests per day, operated a mobile testing lab that treated 900 patients and sent additional supplies, including ambulances, medical equipment and food aid to the West African region. Additionally, existing Chinese Medical Teams (CMTs) in the region trained thousands of local health workers and community-level social mobilizers on Ebola prevention measures. Overall, this was a massive contribution considering the fact that this was China’s first major humanitarian aid campaign abroad.

Read more: Available on Development Reimagined and on China Africa Project

Arbitrating Abortion: Sex-selection and Care Work among Abortion Providers in England

Ben Kasstan, Maya Unnithan
Medical Anthropology, February 2020

Medical Anthropology

Translator disclaimer Full Article Figures & data References Citations Metrics Reprints & Permissions Get access ABSTRACT The UK’s on-going sex-selective abortion (SSA) controversy remains a major obstacle to the liberalization of national abortion governance, and is an issue broadly attributed to a “cultural” preference for sons among South Asian women. We conceptualize how healthcare professionals “arbitrate” requests for SSA by exploring the tension between its legal status and how requests are encountered by abortion providers. SSA is framed in this article as a legitimate care service that can support providers to meet the diverse reproductive health needs of women to the full extent of the law.

More details: Arbitrating Abortion: Sex-selection and Care Work among Abortion Providers in England

CLOCK: A Transformative Experience

Maria Moscati
Amicus Curiae, Series 2, Vol 1, No 1, 103-07, Autumn 2019

Recognizing the difficulties that litigants in person4 often face in going to court and inspired by the principles of access to justice as well as in reaction to some of the negative consequences of the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LASPO), CLOCK was established to support litigants in person in court. CLOCK was first created by Jane Krishnadas and launched in 2012 by the School of Law at Keele University.

Read more: CLOCK: A Transformative Experience [PDF 171.87KB]

Making bodies kosher: the politics of reproduction among Haredi Jews in England

Making bodies kosher: the politics of reproduction among Haredi Jews in EnglandBen Kasstan
Berghahn Books, June 2019

For Haredi Jews, reproduction is entangled with issues of health, bodily governance and identity. This is an analysis of the ways in which Haredi Jews negotiate healthcare services using theoretical perspectives in political philosophy. This is the first archival and ethnographic study of Haredi Jews in the UK and sits at the intersection of medical anthropology, social history and Jewish studies. It will allow readers to understand how reproductive care issues affect this growing minority population.

More details: Making bodies kosher: the politics of reproduction among Haredi Jews in England

Abuse in assisted reproductive technology: A systematic qualitative review and typology

Nathan Hodsona, Susan Bewley
Elsevier, May 2019

Abuse in assisted reproductive technology: A systematic qualitative review and typologyObjectives: Abuse of vulnerable patients exists in many healthcare settings and has been recognised as an inherent risk in assisted reproductive technology (ART). Systematic reviews have been used to develop typologies of abuse and ethical issues in other settings including obstetrics. The aim was to determine the full spectrum of abuse that patients can experience when using assisted reproductive technology.
Study Design: A systematic qualitative review. MEDLINE, CINAHL, and PsycINFO were searched for combinations of terms related to abuse and terms relating to ART. The last search was performed on February 12th 2018. Selection criteria were that the authors reported evidence of abuse. There were no exclusions by date, language or methodology. Papers lacking analysis of abuses in ART were excluded. For data collection and analysis, themes identified in the academic literature were coded using thematic qualitative analysis by two independent researchers. Themes were developed discursively.

More details: Abuse in assisted reproductive technology: A systematic qualitative review and typology [PDF 395.85KB]

Fertility, Health and Reproductive Politics: Re-imagining Rights in India

Maya Unnithan
Routledge, April 2019

Fertility, Health and Reproductive politicsSet in the context of the processes and practices of human reproduction and reproductive health in Northern India, this book examines the institutional exercise of power by the state, caste and kin groups.

Drawing on ethnographic research over the past eighteen years among poor Hindu and Muslim communities in Rajasthan and among development and health actors in the state, this book contributes to developing analytic perspectives on reproductive practice, agency and the body-self as particular and novel sites of a vital power and politic. Rajasthan has been among the poorest states in the country with high levels of maternal and infant mortality and morbidity. The author closely examines how social and economic inequalities are produced and sustained in discursive and on the ground contexts of family-making, how authoritative knowledge and power in the domain of childbirth is exercised across a landscape of development institutions, how maternal health becomes a category of citizenship, how health-seeking is socially and emotionally determined and political in nature, how the health sector operates as a biopolitical system, and how diverse moral claims over the fertile, infertile and reproductive body-self are asserted, contested and often realised.

More details: Fertility, Health and Reproductive Politics: Re-imagining Rights in India

Practical Justice: Principles, Practice and Social Change

Edited by Peter Aggleton, Alex Broom, Jeremy Moss
Routledge, March 2019

Practical Justice: Principles, Practice and Social ChangeThis volume engages with questions of justice and equality, and how these can be achieved in modern society. It explores how theory and research can inform policy and practice to bring about real change in people’s lives, helping readers understand and interrogate patterns and causes of inequality, while investigating how these might be remedied. Chapters outline ways in which theories of justice inform and are factored into effective actions, programmes and interventions.

The book includes an international selection of case studies. These range from global inequalities in development and health to cross-border conflict; from gender justice to disability violence; from child protection to disability-inclusive research; from illicit drug use to torture prevention; and from prison wellbeing to sexual and reproductive health and rights.

More details: Practical Justice: Principles, Practice and Social Change

Queering Knowledge: Analytics, Devices and Investments after Marilyn Strathern

Edited by Paul Boyce, EJ Gonzalez-Polledo, Silvia Posocco
Routledge, November 2018

Queering KnowledgeMarilyn Strathern’s ethnographic contributions to studies of personhood, kinship, gender relations and reproduction have achieved wide recognition in the field of anthropology. Her analytic devices, including her model of merographic connection, have had profound effects on anthropologists’ responses to the crisis of representation, especially for those who have drawn on the transformative and subversive capacities of her analytic thinking to conjure up the ethnographic present. However, to date there has been no volume that explicitly brings Strathern and queer analytics together over questions of knowledge and ontology.

This collection of original essays draws on the significance of Strathern’s work in respect of its potential for queer anthropological analysis. Utilising a range of ontological imaginings and subversions, the book explores how people might relate to queer object categories partially, merographically, or in terms of a sense of dissonance from signifier and self. The chapters examine the ways in which Strathern’s varied analytic devices facilitate the creation of alternative forms of anthropological thinking, as well as a greater understanding of how knowledge practices of queer objects, subjects and relations operate and take effect.

Read more: Queering Knowledge

Youth, Sexuality and Sexual Citizenship

Edited by Peter Aggleton, Rob Cover, Deana Leahy, Daniel Marshall and Mary Lou Rasmussen.
Routledge, October 2018

Youth, Sexuality and Sexual CitizenshipSexual citizenship is a powerful concept associated with debates about recognition and exclusion, agency, respect and accountability. For young people in general and for gender and sexually diverse youth in particular, these debates are entangled with broader imaginings of social transitions: from ‘child’ to ‘adult’and from ‘unreasonable subject’ to one ‘who can consent’. This international and interdisciplinary collection identifies and locates struggles for recognition and inclusion in particular contexts and at particular moments in time, recognising that sexual and gender diverse young people are neither entirely vulnerable nor self-reliant. 

Focusing on the numerous domains in which debates about youth, sexuality and citizenship are enacted and contested, Youth, Sexuality and Sexual Citizenship explores young people’s experiences in diverse but linked settings: in the family, at school and in college, in employment, in social media and through engagement with health services. Bookended by reflections from Jeffrey Weeks and and Susan Talburt, the book’s empirically grounded chapters also engage with the key debates outlined in it's scholarly introduction.

This innovative book is of interest to students and scholars of gender and sexuality, health and sex education, and youth studies, from a range of disciplinary and professional backgrounds, including sociology, education, nursing, social work and youth work.

Read more:  Youth, Sexuality and Sexual Citizenship

Reproductive rebellions in Britain and the Republic of Ireland: contemporary and past abortion activism and alternative sites of care

Ben Kaastan and Sarah Crook
Feminist Encounters, September 2018

Feminist EncountersThis paper explores how feminist movements in contemporary Ireland and the Women’s Liberation Movement in Britain in the 1970s and 1980s have subverted state domination and have struggled for self-governance of the female bodies in ways that represent a continuum of responses to restrictive legislation. We address how discourses of liberatory knowledges and autonomy can give rise to ‘illegitimate’ forms of self-care as well as extra-state care (or ‘exile’) across historically-situated points in time. Moreover, we illustrate how social resistance can influence political action surrounding abortion law reform, which can be understood as an attempt to bring the ‘illegitimate’ into the realm of state control and guardianship. Our comparative approach illustrates how campaigns around reproductive rights in contemporary Ireland and in 1970s and 1980s Britain continue to share three crucial strategies: to raise consciousness and awareness; to encourage mobilisation and self-organising of care at the individual and collective levels; and to seek legislative change. Mapping the continuities in how feminist campaigns configure reproductive health and the body as a site of activism in the body politic heralds renewed feminist encounters with the medical humanities, by (re)situating women’s bodies in a historically contiguous struggle for reproductive justice.

Read more:  Reproductive rebellions in Britain and the Republic of Ireland: contemporary and past abortion activism and alternative sites of care

Irish voters repealed the eighth: Now its time to ensure access to abortion care in law and in practice

Reproductive Health MattersBen Kasstan
Reproductive Health Matters, September 2018

This commentary discusses Ireland's 25 May 2018 Referendum result to repeal the Eighth Amendment and has two key aims. Firstly, it encourages policy-makers to grasp the full potential of legislative reform by enabling and protecting women's access to abortion care within a continuum of sexual and reproductive healthcare options. Secondly, it calls for urgent clarity about access to abortion care in the interim period of legislative transition.

Read more:  Irish voters repealed the eighth: Now it's time to ensure access to abortion care in law and in practice

International Handbook on Gender and Demographic Processes

Edited by Nancy E. Riley and Jan Brunson
Spinger, May 2018

International Handbook on Gender and Demographic ProcessesThis handbook presents a comprehensive and up-to-date overview of gender in demography, addressing the many different influences of gender that arise from or influence demographic processes.  It collects in one volume the key issues and perspectives in this area, whereby demography is broadly defined. The purpose in casting a wide net is to cover the range of work being done within demography, but at the same time to open up our perspectives to neighboring fields to encourage better conversations around these issues.

The chapters in this handbook carefully document definition and measurement issues, and take up parts of the demographic picture and focus on how gender plays a role in outcomes.  In other cases, gender often plays a cross-cutting role in social processes; rather than having a single or easily distinguishable role, it often combines with other social institutions and even other statuses and inequalities to affect outcomes.  Thus, a key factor in this volume is how gender interacts with race/ethnicity, class, nationality, and sexuality in any demographic setting.

While each section contains chapters that are broad overviews of the current state of knowledge and behavior,  the handbook also includes chapters that focus on specific cultures or events in order to examine  how gender operates in a particular circumstance. 

Read more:  International Handbook on Gender and Demographic Processes

Transgender-inclusive sanitation: insights from South Asia

Paul Boyce, Sarah Brown, Sue Cavill, Sonalee Chaukekar, Beatrice Chisenga, Mamata Dash, Rohit K Dasgupta, Noemie De La Brosse, Pawan Dhall, Julie Fisher, Marli Gutierrez-Patterson, Oinam Hemabati, Andrés Hueso, Salma Khan, Santa Khurai, Archana Patkar, Priya Nath, Marielle Snel and Kopila Thapa
waterlinesWaterlines, April 2018

This paper provides insights from initiatives to include transgender people in sanitation programming in South Asia. Three case studies of recent actions to make sanitation inclusive for transgender people (in India and Nepal) are presented, accompanied by reflections and recommendations to guide future practice. Practitioners are recommended to: engage with transgender people as partners at all stages of an initiative; recognize that the language of gender identity is not fixed, varying across cultures and between generations; and acknowledge that transgender people are not a single homogeneous group but rather have diverse identities, histories, and priorities. The case studies aim to raise awareness of the diversity of transgender identities, exploring the needs and aspirations of transgender women, transgender men, and third gender people in South Asia.

Read more:  Transgender-inclusive sanitation: insights from South Asia

Re-situating abortion: Bio-politics, global health and rights in neo-liberal times

Special issue edited by Maya Unnithan and Silvia de Zordo
March 2018

Global Public HealthNew modes of neoliberal and rights-based reproductive governance are emerging across the world which either paradoxically foreclose access to universal health services or promote legislative reform without providing a continuum of services on the ground. These shifts present new opportunities for the expansion but also the limitation of abortion provision conceptually and ‘on-the-ground’, both in the Global North and South. The collection of papers in this special issue examine current abortion governance discourse and practice in historical, socio-political contexts to analyse the threat posed to women's sexual and reproductive health and rights globally. Focusing on abortion politics in the context of key intersectional themes of morality, law, religion and technology, the papers conceptually ‘re-situate’ the analysis of abortion with reference to a changing global landscape where new modes of consumption, rapid flows of knowledge and information, increasingly routinised recourse to reproductive technologies and related forms of bio-sociality and solidarity amongst recipients and practitioners coalesce.

Read more:  Re-situating abortion: Bio-politics, global health and rights in neoliberal times

Researching Sex and Sexualities

Researching Sex and SexualitiesEdited by Charlotte Morris, Paul Boyce, Andrea Cornwall, Hannah Frith, Laura Harvey and Yingying Huang
University of Chicago Press, February 2018

Sexuality is a complex and multifaceted domain, encompassing bodily, cultural, and subjective experiences that resist easy categorization. To claim the sexual as a viable research object therefore raises a number of important methodological questions: What is it possible to know about experiences, practices, and perceptions of sex and sexualities? What approaches might help or hinder our efforts to probe such experiences?

This collection explores the creative, personal, and contextual parameters involved in researching sexuality, cutting across disciplinary boundaries and drawing on case studies from a variety of countries and contexts. Representing a wide range of expertise, its contributors address such key areas as pornography, sex work, intersectionality, and LGBT perspectives. The contributors also share their own experiences of researching sexuality within contrasting disciplines, as well as interrogating how the sexual identities of researchers themselves can relate to, and inform, their work. The result is a unique and diverse collection that combines practical insights on field work with novel theoretical reflections.

Read more:  Researching Sex and Sexualities

B!RTH


Seven countries. Seven female playwrights. One global controversy. A world of scientific debate.

Re-visioning evidence: Reflections on the recent controversy around gender selective abortion in the UK

Maya Unnithan, S. Dubuc 
June 2017

Reports in the British media over the last 4 years have highlighted the schisms and contestations that have accompanied the reports of gender selective abortions amongst British Asian families. The position that sex-selection may be within the terms of the 1967 Abortion Act has particularly sparked controversy amongst abortion campaigners and politicians but equally among medical practitioners and the British Pregnancy Advisory Service who have hitherto tended to stay clear of such debates. In what ways has the controversy around gender-based abortion led to new framings of the entitlement to service provision and new ways of thinking about evidence in the context of reproductive rights? We reflect on these issues drawing on critiques of what constitutes best evidence, contested notions of reproductive rights and reproductive governance, comparative work in India and China as well as our involvement with different groups of campaigners including British South Asian NGOs. The aim of the paper is to situate the medical and legal provision of abortion services in Britain within current discursive practices around gender equality, ethnicity, reproductive autonomy, probable and plausible evidence, and policies of health reform.

Read more: Re-visioning evidence: Reflections on the recent controversy around gender selective abortion in the UK

Parenthood between Generations - Transforming Reproductive CulturesParenthood between Generations - Transforming Reproductive Cultures

Edited by Siân Pooley and Kaveri Qureshi
April 2016

Recent literature has identified modern “parenting” as an expert-led practice - one which begins with pre-pregnancy decisions, entails distinct types of intimate relationships, places intense burdens on mothers and increasingly on fathers too. Exploring within diverse historical and global contexts how men and women make - and break - relations between generations when becoming parents, this volume brings together innovative qualitative research by anthropologists, historians, and sociologists. The chapters focus tightly on inter-generational transmission and demonstrate its importance for understanding how people become parents and rear children.

Read more: Parenthood between Generations - Transforming Reproductive Cultures

Gender, Sexuality and Social Justice: What’s Law Got to Do with It?Gender, Sexuality and Social Justice: What’s Law Got to Do with It?

Kay Lalor, Elizabeth Mills, Arturo Sánchez García and Polly Haste
2016

Member Ciara O’Connel's work on 'Engendering Reproductive Rights in the Inter-American System” features in this publication.

Read more: Gender, Sexuality and Social Justice: What’s Law Got to Do with It?

Monitoring and Evaluation in Health and Social DevelopmentMonitoring and Evaluation in Health and Social Development: Interpretive and Ethnographic Perspectives

Stephen Bell and Peter Aggleton
Routeledge 2016

New approaches are needed to monitor and evaluate health and social development. Existing strategies tend to require expensive, time-consuming analytical procedures. The growing emphasis on results-based programming has resulted in evaluation being conducted in order to demonstrate accountability and success, rather than how change takes place, what works and why. The tendency to monitor and evaluate using log frames and their variants closes policy makers’ and practitioners’ eyes to the sometimes unanticipated means by which change takes place.

Read more: Monitoring and Evaluation in Health and Social Development 

After surgery: the effects of life-saving caesarean sections in Burkina Faso

Véronique Filippi,  Rasmané Ganaba, Clara Calvert, Susan F. Murray and Katerini T. Storeng

In African countries, caesarean sections are usually performed to save mothers and babies’ lives, sometimes in extremis and at considerable costs. Little is known about the health and lives of women once discharged after such surgery. The authors, including member Katerini Strong,  investigated the long-term effects of life-saving caesarean section on health, economic and social outcomes in Burkina Faso.

Read more: After surgery: the effects of life-saving caesarean sections in Burkina Faso

What Constitutes Evidence in Human Rights-Based Approaches to Health? Learning from Lived Experiences of Maternal and Sexual Reproductive Health

Maya Unnithan
Health and Human Rights Journal, Vol 17 No. 2 December 2015

Health and Human Rights JournalThe impact of human rights interventions on health outcomes is complex, multiple, and difficult to ascertain in the conventional sense of cause and effect. Existing approaches based on probable (experimental and statistical) conclusions from evidence are limited in their ability to capture the impact of rights-based transformations in health. This paper argues that a focus on plausible conclusions from evidence enables policy makers and researchers to take into account the effects of a co-occurrence of multiple factors connected with human rights, including the significant role of “context” and power. Drawing on a subject-near and interpretive (in other words, with regard to meaning) perspective that focuses on the lived experiences of human rights-based interventions, the paper suggests that policy makers and researchers are best served by evidence arrived at through plausible, observational modes of ascertaining impact. Through an examination of what human rights-based interventions mean, based on the experience of their operationalization on the ground in culturally specific maternal and reproductive health care contexts, this paper contributes to an emerging scholarship that seeks to pluralize the concept of evidence and to address the methodological challenges posed by heterogeneous forms of evidence in the context of human rights as applied to health.

Read more: (HTML version)  and  (PDF version)

Targeting sexual health services in primary care: A systematic review of the psychosocial correlates of adverse sexual health outcomes reported in probability surveys of women of reproductive age

Natalie L. Edelmana, Richard O. de Visserc, Catherine H. Mercerd, Lucy McCabee, Jackie A. Cassell
Preventive Medicine, Dec 2015

Preventive Medicine

Women using primary care vary in need for sexually transmitted infections (STIs) testing and contraception. Psychosocial correlates of these needs may be useful for targeting services. The authors, including members Natalie Edelman and Professor Jackie Cassell, undertook a systematic review to identify psychosocial correlates of STI acquisition, unplanned pregnancy (UP), abortion and risky sexual behaviours in general population samples of women of reproductive age.

Read more: Targeting sexual health services in primary care: A systematic review of the psychosocial correlates of adverse sexual health outcomes reported in probability surveys of women of reproductive age

In dialogue with self and the world: Cape Verdean migrant pregnancy in Portugal

Elizabeth Pilar Challinor
2015

Women’s Studies International Forum

The voices of Cape Verdean migrant student mothers in Portugal are examined in the light of Archer's (2003) theory on the “inner dialogue”. The article frames the mothers as complex social actors who respond to the uncertainties surrounding unplanned pregnancy through self-reflection and dialogue with and about the world, turning the disorientation of unexpected motherhood into a meaningful project. The analysis reveals how the women's agency is located within the wider influences of kinship and gender norms and how these are already negotiated in the case of unconfirmed pregnancy.

Read more: In dialogue with self and the world: Cape Verdean migrant pregnancy in Portugal

Population Dynamics and the Sustainable Development GoalsPopulation Dynamics and the Sustainable Development Goals

July 2015

Corth members Maya Unnithan and Sajida Ally have contributed to the new report of the UK All Parliamentary Party Group on Population Dynamics and Reproductive Health report launched at the House of Lords on July 8th 2015. The report on Population Dynamics and the Sustainable Development Goals examines the interplay between population dynamics and urbanisation, climate change, migration and conflict. It will be used to guide discussion, funding and programmes of the post 2015 development agenda.

Read more: Population Dynamics and the Sustainable Development Goals [PDF 9.17MB]

International Journal of Mobile and Blended LearningMobile Game Based Learning: Can it enhance learning of marginalized peer educators?

Roy, A and Sharples, M
International Journal of Mobile and Blended Learning, 7 (1): 1-12. 2015

Read more: Mobile Game Based Learning: Can it enhance learning of marginalized peer educators?

Seventy years of sex education in Health Education Journal: a critical review

Padmini Iyer and Peter Aggleton
Health Education Journal, 74 (1). pp. 3-15. 2015

Read more: Seventy years of sex education in Health Education Journal: a critical review

Litigating Reproductive Health Rights in the Inter-American System: What Does a Winning Case Look Like?

Ciara O'Connell
Social Science Research Network, Dec 2014

Remedies and reparation measures emerging from the Inter-American System of Human Rights in reproductive health cases have consistently highlighted the need to develop, and subsequently implement, non-repetition remedies that protect, promote, and fulfill women’s reproductive health rights. Litigation outcomes that result in violations of reproductive rights are a “win” for health rights litigation, but when implementation fails, is a “win” still a win? Although there has been considerable success in litigating reproductive health rights cases, the Inter-American Commission on Human Rights and the Inter-American Court of Human Rights are not adequately equipped to follow up on cases after they have been won. Successful and sustainable implementation of reproductive health rights law requires incorporation of non-repetition remedies in the form of legislation, education, and training that seeks to remodel existing social and cultural practices that hinder women’s enjoyment of their reproductive rights. In order for a reproductive health rights case to ultimately be a “winner,” case recommendations and decisions emerging from the Commission and Court must incorporate perspectives provided by members of civil society, with the ultimate goal of developing measurable remedies that address underlying obstacles to domestic implementation.

Read more: Litigating Reproductive Health Rights in the Inter-American System: What Does a Winning Case Look Like?

Culture, Health & Sexuality - special issue on the relationship between rights and justice

Culture, Health and SexualityMaya Unnithan & Stacy Leigh Pigg,  including articles by Kalpana Ram, Paul Boyce, Lynn Morgan among others.

Vol 16, issue 9-10, Oct-Nov 2014

Special Issue: Themed Symposium: Sexual and reproductive health rights and justice -- tracking the relationship

Read more: Culture, Health & Sexuality

Challenges in ‘Translating’ Human Rights: Perceptions and Practices of Civil Society Actors in Western India

Maya Unnithan and Carolyn Heitmeyer
Development and Change, Volume 45, Issue 6, pages 1361–1384, November 2014

Development and ChangeRights-based approaches have become prevalent in development rhetoric and programmes in countries such as India, yet little is known about their impact on development practice on the ground. There is limited understanding of how rights work is carried out in India, a country that has a long history of indigenous rights discourse and a strong tradition of civil society activism on rights issues. In this article, we examine the multiple ways in which members of civil society organizations (CSOs) working on rights issues in the state of Rajasthan understand and operationalize rights in their development programmes. As a result of diverse ‘translations’ of rights, local development actors are required to bridge the gaps between the rhetoric of policy and the reality of access to healthcare on the ground. This article illustrates that drawing on community-near traditions of activism and mobilization, such ‘translation work’ is most effective when it responds to local exigencies and needs in ways that the universal language of human rights and state development discourse leave unmet and unacknowledged. In the process, civil society actors use rights-based development frameworks instrumentally as well as normatively to deepen community awareness and participation on the one hand, and to fix the state in its role as duty bearer of health rights, on the other hand. In their engagement with rights, CSO members work to reinforce but also challenge neoliberal modes of health governance.

Read more: Development and Change

The Cultural Politics of Reproduction: Migration, Health and Family Making

The Cultural Politics of Reproduction: Migration, Health and Family Making.Edited by Maya Unnithan-Kumar and Sunil K. Khanna.  Includes chapters by Kaveri Qureshi, Elizabeth Challinor *, Sajida Ally, Laura Griffith, Catherine Locke, Mirabelle Fernandes, Rachel Olson, Maya Unnithan, Sunil Khanna.
Oxford: Berghahn. November, 2014.

*Elizabeth Challinor’s chapter:  "To Be or not to be? Cape Verdean Student Mothers in Portugal"

Charting the experiences of internally or externally migrant communities, this book examines social transformation through the dynamic relationship between movement, reproduction and health. The chapters examine how healthcare experiences of migrants are not only embedded in their own unique health worldviews, but also influenced by the history, policy and politics of the wider state systems. The research among migrant communities provides an understanding of how ideas of reproduction and ‘cultures of health’ travel; how healing, birth and care practices become a result of movement; and how health-related perceptions and reproductive experiences can define migrant belonging and identity.

Link to publisher: The Cultural Politics of Reproduction: Migration, Health and Family Making

MATER SEMPER INCERTUS EST: WHO'S YOUR MUMMY?

Rita D'alton-Harrison
Medical Law Review, Summer 2014

In English law, the legal term for father has been given a broad definition but the definition of mother remains rooted in biology with the Roman law principle mater semper certa est (the mother is always certain) remaining the norm. However, motherhood may be acquired through giving birth to a child, by donation of gametes or by caring and nurturing a child so that the identity of the mother is no longer certain particularly in the case of surrogacy arrangements. While the law in the UK may automatically recognise the parental status of a commissioning father in a traditional surrogacy arrangement, the parental status of the commissioning mother is not automatically recognised in either a traditional or a gestational surrogacy arrangement. Thus the maxim mater est quam gestation demonstrat (meaning the mother is demonstrated by gestation) is also not approached consistently in the legal interpretation of parentage or motherhood in surrogacy as against other assisted reproduction methods. This raises questions about the extent to which motherhood should be affected by the method of reproduction and whether the sociological and philosophical concept of motherhood should, in the case of surrogacy, give rise to a new principle of ‘mater semper incertus est’ (the mother is uncertain). This article will argue that the time has come to move away from a legal definition of ‘mother’ that is based on biology to one that recognises the different forms of motherhood.

Available at:  Oxford Journals

Reproductive ageing and conflicting clocks: King Midas’ touchReproductive ageing and conflicting clocks: King Midas’ touch

Irenee Daly and Susan Bewley
Article in Reproductive Biomedicine Online, September 2013

The population attempting pregnancy and having babies is ageing. Gynaecological and obstetric complications worsen with age. Maternity services are struggling. Increasing rates of infertility and complications are not matched by the marvels in the laboratory. This paper argues that assisted reproduction treatment has had a damaging social impact. Despite its public acclaim, it helps few and fails many more. The assisted reproduction industry could take a new and revolutionary direction towards empowering men to experience pregnancy, producing babies from artificial gametes, with a final goal being the liberation of both women and men from the burdens and dangers of pregnancy through the development of artificial wombs.

Read more: Reproductive ageing and conflicting clocks: King Midas’ touch

Thinking through Surrogacy Legislation in India: Reflections on Relational Consent and the Rights of Infertile Women

Maya Unithan
in Journal of Legal Anthropology (2013) Vol. 1. No.3:287-313

Thinking through Surrogacy Legislation in IndiaAs its main focus the article is concerned with explaining the proposed Indian Assisted Reproductive Technologies (ART) Bill 2010 (2008), and in particular discusses some of its limitations using a relational conception of consent and autonomy. It is argued that two major limitations arise from, firstly, the way the Bill attempts to introduce ‘universal’ notions of informed consent into a cultural context of socially determined decisionmaking, resulting in the failure to safeguard the welfare of Indian surrogates. A second limitation is that the proposed law entitles only some poor women (surrogates) in India to realise access to quality medical healthcare services compared to others (poor, infertile women). Given the significant class and gender based inequalities which frame reproductive healthcare service delivery in the country, legally guaranteed access to health services for surrogates becomes a privilege where the rights of some individuals and couples to reproduce and exercise procreative agency is valued and not others. The article argues that the Bill must give due consideration to the complex, relational and highly stratified contexts in which women undertake childbearing in India to understand why legally comprehensive consent procedures can co-exist with violations of personhood in practice. Without such consideration the article suggests that injustice toward infertile women can become part of the same legal process wherein overcoming infertility is recognised as a right.

On reproductive justice: ‘domestic violence’, rights and the law in India

culture-health-sexuality

Sumi Madhoka, Maya Unnithan & Carolyn Heitmeyer
In Culture, Health & Sexuality: An International Journal for Research, Intervention and Care

In this paper we draw attention to the difficulty of accessing reproductive rights in the absence of effective state and legal guarantees for gender equity and citizenship, and argue that if reproductive rights are to be meaningful interventions on the ground, they must be reframed in terms of reproductive justice. Drawing on multi-sited ethnographic fieldwork conducted in Rajasthan, Northwest India, we track two dynamic legal aid interventions on reproductive health rights in India, concerned with domestic violence and maternal mortality respectively, that have sought to fill this existing gap between ineffective state policies and the rhetoric on reproductive rights. Through an analysis of these interventions, we propose that requirements of reproductive justice cannot be met through discrete or private, albeit creative legal initiatives, pursued by individuals or civil society organisations but must involve comprehensive policies as well as strategies and alliances between state, non-state, transnational organisations and progressive political groups.

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Sexually Transmitted InfectionsSexually Transmitted Infections

Sexually Transmitted Infections is the world's longest running international journal on sexual health. It aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV. The journal publishes original research, descriptive epidemiology, evidence-based reviews and comment on the clinical, public health, translational, sociological and laboratory aspects of sexual health from around the world. We also publish educational articles, letters and other material of interest to readers, along with podcasts and other online material. STI is an official journal of the British Association of Sexual Health and HIV and the Australasian Chapter of Sexual Health Medicine.

Women’s and Children’s Health: Evidence of Impact of Human RightsWomen and Children’s Health: Evidence of Impact of Human Rights

Women and Children’s Health: Evidence of Impact of Human Rights is a monograph produced by WHO in 2013 (in which Maya Unnithan was a co-author) and launched at the World Health Assembly in May by lead author, Dr FLavia Bustreo, Assistant Director General, Family, Women’s and Children’s Health, WHO.

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The Health of Women and Girls in Urban Areas with a Focus on Kenya and South Africa: A Review

Hawkins, K., MacGregor, H. and Oronje, R.
Evidence Report 42
Publisher IDS

The Health of Women and Girls in Urban Areas with a Focus on Kenya and South AfricaThis thematic review focuses on a range of health challenges faced in particular by women and girls living in low-income urban settlements in expanding cities in Kenya and South Africa.

The review has been compiled as part of a larger body of work being conducted by the Institute of Development Studies (IDS) and its partners on gender and international development and financed by the UK Department for International Development (DFID).

The review was preceded by a literature search (using keywords to reflect the thematic focus) of key databases of published literature, as well as a search for grey literature and documents describing interventions aimed at addressing these health challenges. An online discussion hosted by IDS gave a further indication of current debates and assisted in the identification of interventions.

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Sexual and Reproductive Health Rights of Women Living with HIV in South Africa

Muller, A. and MacGregor, H.
IDS Evidence Report 3
Publisher IDS

Sexual and Reproductive Health Rights of Women Living with HIV in South AfricaSouth Africa's constitutional and legal framework reflects the country's commitment to women's Sexual and Reproductive Health and Rights (SRHR) in line with international commitments. Nevertheless, women's rights are still abused and overlooked.

Numerous policies detail the provision of services around sexual and gender-based violence, fertility, maternal, perinatal and newborn health, sexually transmitted infections (including HIV), and cancers of the reproductive system.

However, these policies exist in a social climate of extreme inequality, with high rates of poverty and unemployment. Despite almost equal representation of women in government and other high-profile areas, women in South Africa experience unprecedented rates of sexual and gender-based violence, and women's autonomy is all too often compromised by poverty, limited access to education, limited access to health care, and ongoing gender inequality that is bolstered by patriarchal norms.

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Fatness and the Maternal Body: Women's Experiences of Corporeality and the Shaping of Social Policy

Fatness and the Maternal BodyMaya Unnithan-Kumar and Soraya Tremayne (eds)
Berghahn, 2011

Obesity is a rising global health problem. On the one hand, a clearly defined medical condition, it is at the same time a corporeal state embedded in the social and cultural perception of fatness and body shape and size. Focusing specifically on the maternal body, contributors to the volume examine how the language and notions of obesity connect with, or stand apart from, wider societal values and moralities to do with the body, fatness, reproduction, and what is considered “natural.” A focus on fatness in the context of human reproduction and motherhood offers instructive insights into the global circulation and authority of biomedical facts on fatness (as "risky" anti-fit, for example). As with other social and cultural studies critical of health policy discourse, this volume challenges the spontaneous connection being made in scientific and popular understanding between fatness and ill health.

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Sexual behaviour

Medecine, May 2010

Recognition of sexual behaviours and needs is essential for all doctors in diagnosis, care after major illness, and humane management of social needs. The majority of adults are heterosexually active from adolescence into old age, while a minority of individuals have homosexual relationships throughout their lives, or during shorter periods. Among adults aged 16–44 years, a third of men and a fifth of women report a new partnership in the past year, and this proportion is higher among younger adults and men who have sex with men (MSM). Anal intercourse is practised by a significant minority of heterosexuals, as well as among MSM for whom it is a major route of HIV transmission. A small minority of individuals have large numbers of partners (a ‘core group’), and contribute disproportionately to the transmission of STIs and HIV. Behavioural interventions to reduce sexual risk among MSM can be effective, as in other groups, but attention to wider social determinants is also important in controlling STI and HIV transmission.

Read more: Sexual behaviour

Who Are ‘Informal Health Providers’ and What Do They Do? Perspectives from Medical Anthropology

Who Are ‘Informal Health Providers’ and What Do They Do?Cross, J. and MacGregor, H.
IDS Working Paper 334
Publisher IDS

This paper explores gaps and limitations in the conceptualisation, methodology and policy implications of debates about informal health care providers by examining a cross section of empirical studies.

Drawing on a tradition of critical medical anthropology, we argue that existing debates hinge on a particular understanding of what constitutes appropriate knowledge and on particular expectations of how economic actors in the medical marketplace will behave.

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Reproductive Agency, Medicine and the State: Cultural Transformations in Childbearing

Reproductive Agency, Medicine and the StateMaya Unnithan-Kumar (ed.)
Berghahn, 2005

Recent years have seen many changes in human reproduction resulting from state and medical interventions in childbearing processes. Based on empirical work in a variety of societies and countries, this volume considers the relationship between reproductive processes (of fertility, pregnancy, childbirth and the postpartum period) on the one hand and attitudes, medical technologies and state health policies in diverse cultural contexts on the other.

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Banner image: credited to Unnithan Res-062-23-1609