Accounting for abortion: Accomplishing transnational reproductive governance through post-abortion care in Senegal

Abstract

<p class="first" id="P1">Reproductive governance operates through calculating demographic statistics that offer selective truths about reproductive events, bodies, and subjectivities. Post-abortion care, a global reproductive health intervention, represents a transnational reproductive regime that establishes motherhood as women’s primary legitimate reproductive status. Drawing on ethnographic fieldwork conducted in Senegal between 2010 and 2011, I illustrate how post-abortion care accomplishes reproductive governance in a context where abortion is prohibited altogether and the United States is the primary bilateral donor of population aid. Reproductive governance unfolds in two sites—hospital gynecological wards and the national health information system—through the mobilization and interpretation of post-abortion care data. Health workers police the boundaries of appropriate sexuality by searching women’s bodies and behavior for signs of illegal abortion. They minimize police intervention in the hospital by classifying most post-abortion care cases as miscarriage. Health authorities deploy this account of post-abortion care to align the intervention with national and global maternal health policies that valorize motherhood and reject safe abortion. Although post-abortion care offers life-saving care to women with complications of illegal abortion, it institutionalizes abortion stigma through the surveillance of women’s bodies and the masking of induced abortion within and beyond the hospital. Post-abortion care reinforces reproductive inequities by withholding safe, affordable obstetric care from women until after they have resorted to unsafe abortion. </p>