Caroline H. Bledsoe

Social Dynamics of Adolescent Fertility in Sub-Saharan Africa

Adolescent fertility tends to be valued and sanctioned in the countries of sub-Saharan Africa when parents have had adequate ritual or training preparation for adulthood and the child has a recognized father. Young women and adolescents who conceive and bear children within this context are widely accepted by society; those who conceive outside of marriage however are strongly condemned by society. Over the past 2-3 decades most African countries have successfully raised their levels of education. Girls and women are increasingly privy to formal school education and training in trade apprenticeships domestic service and ritual initiation which had otherwise been denied in the past. These factors combined with declining menarche in a few areas and changing economic opportunities law and religion make it more difficult to define the exact date of entry into marriage. Many girls are taking advantage of these changing circumstances and their opportunities to obtain educations and resist early marriage and cildbearing. While defying the traditional entry into early marriage many young women do not however refrain from engaging in sexual activities. Pregnancies to unwed mothers are thereby on the rise and may constitute the most profound change observed in the social context of adolescent fertility on the continent. Once pregnant many women find themselves shut out by family planning programs and prenatal clinics which serve only married women. This paper ultimately concludes that the social context of adolescent childbearing has an effect on the outcome for mother and child which is as important as the physiological maturity of the mother.

Contingent Lives: Fertility, Time, and Aging in West Africa

Most women in the West use contraceptives in order to avoid having children. But in rural Gambia and other parts of sub-Saharan Africa, many women use contraceptives for the opposite reason - to have as many children as possible. Using ethnographic and demographic data from a three-year study in rural Gambia, Contingent Lives explains this seemingly counterintuitive fact by juxtaposing two very different understandings of the life course: one is a linear, Western model that equates aging and the ability to reproduce with the passage of time, the other a Gambian model that views aging as contingent on the cumulative physical, social, and spiritual hardships of personal history, especially obstetric trauma. Viewing each of these two models from the perspective of the other, Caroline Bledsoe produces fresh understandings of the classical anthropological subjects of reproduction, time, and aging as culturally shaped within womens conjugal lives. Her insights will be welcomed by scholars of anthropology and demography as well as by those working in public health, development studies, gerontology, and the history of medicine.

Reproductive Mishaps and Western Contraception: An African Challenge to Fertility Theory

This study compares notions of reproduction in Gambia and the West and analyzes 1992 baseline fertility survey data from the North Bank areas of rural Gambia. The sample includes 2980 women from 40 villages. The second phase was a multi-round survey in 1993 and 1994 in 8 of the original 40 villages among 270 women who had a pregnancy in the past 3 years. The Western model of fertility assumes a fixed life course and that contraception is a device for exploiting the time limits of fecundability. Gambian models of reproduction rely on a body resource framework that is based on declines in muscles strength and blood due to wearing life events. The Gambian fertility model includes more than fecundability in determining a womans ability to reproduce. Mishaps are destructive of reproductive capital. Mishaps include a heavy workload overly frequent childbearing a shortage of blood or simply being tired. Time and aging are not predictable forces that work independently of other life events. Reproduction is a potential to be realized without time limits. Fertility in the study sample was a 7.5 children/woman. Birth intervals were around 2.5 years. Contraceptive use was low and was mostly the pill and Depo-Provera. The rationale for contraception was the desire to protect the health of the children and the mother. Birth interval is regulated. Fertility behaviors change throughout the life cycle. Young women in their 30s spoke about being too old to bear another child. Older women were eager to delay childbearing. Contraceptive use was higher among women who had a miscarriage or stillbirth. A child spacing framework inadequately explained contraceptive behavior.

Constructing Natural Fertility: The Use of Western Contraceptive Technologies in Rural Gambia

In 1992 in 41 villages in the North Bank region of rural Gambia researchers interviewed 2979 15-54 year old women to examine the means by which this population maintains natural fertility birth intervals. Only 3.3% had ever had formal schooling. The total fertility rate was 7.5. Criteria the women used in their decision making process about contraception included effectiveness confidentiality speed with which fecundity returns after the practice ends and risk of long-term fertility impairment. Women practice postpartum abstinence for 5-7 months. Birth intervals were around 33 months. Just 5.4% of all married women with at least 1 child used Western contraceptive methods (i.e. oral contraceptives the condom or Depo-Provera). Most of the use of Western contraceptives (55%) occurred within 18 months postpartum especially 12-17 months the time when most womens fecundity returns. Few women used them for more than a few months however. After 30 months they stopped using all forms of preventing pregnancy (Western local and abstinence) suggesting that they do not intend to reduce fertility but to control its timing. Most contraceptors (69%) who had had sex in the last month used a Western contraceptive compared to just 33% of those who were not sexually active. Women were most likely to use any contraception once they begin to supplement breast milk with other foods and least likely once they wean the child indicating that they are planning for another pregnancy. Even though younger women of higher parity (5-6) were more likely to use any contraception than older women of even higher parity (9-10) they were more likely to use abstinence or traditional means to assure a return to fertility. Among older high-parity women Depo-Provera was the most common method surpassing traditional methods. These findings show that women actively find means to use Western methods to achieve a 2 year minimum birth interval which essentially does not change birth intervals and total fertility.

The effect of child fostering on feeding practices and access to health services in rural Sierra Leone.

In Sierra Leone, where infant and child mortality rates are quite high, a large proportion of small children from 1 to 5 yr are fostered: living away from their mothers. This paper examines the relationships between fosterage and child feeding practices and childrens access to Western medical care. Ethnographic data from field studies in Sierra Leone are combined with quantitative data from Serabu Hospital, which show that fostered children are underrepresented in hospital admissions and that young fosters present more problems of malnutrition. (Fostered girls appear to be at more risk in both these categories than boys.) Unlike young fosters, however, older ones do not appear to be at more risk than children with mothers. We draw connections between these results and patterns of intra-household discrimination in food allocation and access to medical treatment for young fostered children: especially those sent to elderly rural caretakers. Finally, we examine the implications of the findings for applied issues, arguing that fostered children may slip through the cracks of maternal-child health care programs.

Transformations in Sub-Saharan African Marriage and Fertility

Among populations that value high fertility, marital practices often play important roles in regulating fertility. This article interprets ethnographic and demographic data to examine changes in contemporary African marriage. It shows that female education exacerbates inequities between de facto polygynous women who previously would have lived together, shared household resources, and acknowledged each other as cowives. These new forms of polygyny, however, hold an important key to explaining why polygyny and high fertility still proliferate. Men sustain the costs of polygyny and of high fertility in large part by marginalizing low-status women, usually those with the least education, as outside wives and their children as outside children.

Arabic literacy and secrecy among the Mende of Sierra Leone.

The social uses of Arabic literacy for concealing and manipulating knowledge among the Mende of Sierra Leone are examined. We show that those Mende who are competent in Arabic literacy use their skills much like indigenous elite used traditional secret knowledge: to gain the labour and allegiance of dependants. In contrast to the paradigm which views literacy as a mode of facilitating communication, we show that those Mende who are learned in Arabic construe the knowledge to which literacy allegedly gives access as dangerous and, therefore, secret. We contrast these patterns with the uses of English literacy and with recent changes in Arabic education itself.

The Reinterpretation and Distribution of Western Pharmaceuticals: An Example from the Mende of Sierra Leone

Western pharmaceuticals have the dubious distinction of being as popular and available around the world as Coca-Cola. In the smallest villages in many countries, one can purchase an antibiotic capsule as easily as a bottle of Coke. International alarm increases over the importation to developing countries of drugs banned in the US and Europe, including highly toxic medicines. Increasing attention is focusing on the distribution of pharmaceuticals within developing nations through the illegal activities of drug peddlers, market women, and even licensed pharmacists and medical personnel (see van der Geest 1982a, 1982b, 1984). Medicines are sold in the streets and open-air markets with no information — or wrong information — on the dosage or even on the type of illness that should be treated (e.g., Wasunna and Wasunna 1974). However, there is little research on how people have actually incorporated these pharmaceuticals into their treatment regimens — whether ‘appropriately’ or not. Moreover, we believe that even when local people do have reasonably accurate information, the ways in which they actually perceive and use Western pharmaceuticals are not always in congruence with assumptions of medical personnel and drug manufacturers about how the drugs should be used and the illnesses they should be used to treat.

The Politics of AIDS and Condoms for Stable Heterosexual Relations in Africa: Recent Evidence from the Local Print Media

Although there has been considerable attention to increasing mortality rates and economic problems in areas of Africa hardest hit by AIDS, in this paper I examine the epidemics impact on stable heterosexual relations. By identifying salient cultural themes pertaining to marriage and fertility, I examine peoples emerging responses to policy injunctions to use condoms and limit their sexual partners. I draw policy conclusions for the fate of children whose mothers die from AIDS, threats to female education in the wake of the AIDS epidemic and the likelihood of condom acceptance.

The Kpelle Negotiation of Marriage and Matrilateral Ties

Publisher Summary This chapter discusses the Kpelle negotiation of marriage and matrilateral ties. Kinship and marriage norms have a negotiated character that is shaped by their strategic use in different sociopolitical contexts. Kpelle kinship and marriage norms are analyzed as a cognitive code for construing sociopolitical relations than as jural imperatives that determine or reflect these relations. A kin relationship or a marriage transaction receives the assignation of a particular label not because of the congruence of cultural categories with objective genealogical or behavioral features but because the actors involved manage to invest it with such meaning. The key meanings in the Kpelle marriage code derive from the political idiom of the kera-mâleŋ) relationship. The management of this idiom is bound up with definitions of affinal links and cross-cousin marriages of the past that bear on rights in land, political positions, and the labor of others in the present.