An intracategorical intersectional framework for understanding ‘supportability’ in womxn’s narratives of their pregnancy
- Authors: Kalyanaraman, Yamini
- Date: 2019
- Subjects: Pregnancy -- Psychological aspects -- South Africa , Prenatal care -- South Africa , Pregnant women -- South Africa -- Psycology , Medical care -- South Africa -- Eastern Cape
- Language: English
- Type: text , Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/96647 , vital:31304
- Description: In South Africa, the current Maternal Mortality Ratio (MMR) is 135 per 100,000 live births, with a long way to go before it can achieve the Sustainable Development Goal (SDG) global target of under 70 per 100,000 live births by 2030. This research project focuses on the narratives of pregnant womxn in the Eastern Cape Province, using an intracategorical intersectional framework and Macleod’s ‘supportability’ model as a base. The study aims to locate womxn’s pregnancies within the interweaving biological, psychological, social, economic, cultural and political contexts within which they occur, while focusing specifically on the aspect of ‘supportability’. Through purposive sampling and snowballing methods, the research team recruited participants who were 18 years and older, in or past the second trimester of their pregnancy, and able to access antenatal care. Research data were produced using photo-elicitation techniques on 92 photographs and narratives from 32 interviews. An intersectional thematic analysis was used to generate themes, which highlighted different aspects that enabled or hindered pregnancy ‘supportability’. In accordance with prior research, it was revealed that womxn found emotional and tangible support the most beneficial. Findings from this study reveal the interconnectedness between a womxn’s personal (emotional, physical and cognitive) experiences of pregnancy, the micro-interactions of support (un)available from partners, family, friends, healthcare workers, workplaces and community members, and the macrostructures of socioeconomic policies, religiosity, cultural practices and healthcare systems. For example, gendered perceptions (a macro-structure) influence the instrumental support provided by partners (a micro-interaction), which impacts the womxn’s well-being (personal). Certain themes that emerged from the different narratives were: the importance of making available pregnancy-related information to the womxn; a desire for non-judgement and acceptance of their pregnancies within their community; and the need for adequate communication in microinteractions. The findings of this research also indicate that, despite the financial tensions inherent in each womxn’s life, the participants were driven by overarching hopes for their child’s future.
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- Date Issued: 2019
Governing pregnancy in South Africa: political and health debate, policy and procedures
- Authors: Du Plessis, Ulandi
- Date: 2019
- Subjects: South Africa. Department of Health (1994- ) , Maternal health services -- South Africa , Mothers -- Mortality -- South Africa , Prenatal care -- South Africa , African mothers -- Mortality -- South Africa
- Language: English
- Type: text , Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/76552 , vital:30600
- Description: South Africa democratised in 1994. However, due to the discriminatory and segregationist character of the preceding regime, vast swathes of the country’s spaces and people entered the democratic period heavily deprived of essential government services. This was the case with health care in general, including maternal health care. There were also little to no national data available on maternal deaths, especially among the black population. One of the first tasks of the new National Department of Health (NDoH) was to target the high maternal mortality rate. The NDoH made maternal deaths notifiable by law and instituted auditing and information gathering systems in the health sector; health infrastructure was expanded exponentially, and maternal health care was made free. Despite this, the last 24 years have seen the maternal mortality escalate. The latest statistics show that between 1200 and 1300 women die in the South African public health sector each year during pregnancy and the puerperium. This puts the current institutional maternal mortality rate (MMR) at around 154/100 000 live births. The international target for ‘developing’ countries was to reduce the MMR rate by three quarters by 2015, which would have meant a reduction to 38/100 000 live births. The aim of this dissertation is to examine how the democratic South African government (influenced heavily by global health thinking) has laboured to reduce that statistic. I analyse, using Foucauldian discourse analysis, all relevant health and maternal health policies, procedural documents and reports produced by and for the NDoH in the last 24 years. I draw on Foucauldian concepts, specifically those related to Foucault’s work on governmentality. In this dissertation I introduce a new perspective towards the maternal health practices implemented in South Africa, practices that have generally remained unquestioned, been perceived as self-evident, and thus often escaping critical analysis. Through an analysis of the intended operation of the public antenatal clinic (within the larger institutional system) I show how ‘development’ has come to operate as a truth regime in South Africa – facilitating the introduction of liberal governmentality (including some advanced liberal practices) into public health service provision.
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- Date Issued: 2019