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 women's 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.
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Contingent Lives: Fertility, Time, and Aging in West Africa
By Fatoumatta Banja
University of Chicago PressCopyright © 2002 Fatoumatta Banja
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Kaddy Seesay, a thirty-year-old remarried divorcee, happened to fall into a sample of women interviewed every month for fifteen months, during a 1992-95 research project on contraception and birth intervals in rural Gambia. In this West African population whose people intensely desire children, Kaddy had undergone four pregnancies. Three were with her first husband. The first, a daughter who died before age three, was followed by two stillbirths. At this point Kaddy's marriage ended, very likely a consequence of her failure to produce children for her husband. Remarrying as the marginal second wife of a man already married to a younger woman with three children, Kaddy became pregnant for the fourth time and bore a son for her new husband. The monthly surveys began when her baby, still breastfeeding, was about seventeen months old. Four months later, this child died. Left in a precarious marriage with no children to support her in later life, Kaddy, still expressing a resolute desire for more children, did the last thing we might expect. She began a long course of Depo Provera injections.
This example presents three apparent anomalies. It shows high-technology Western contraceptives out ofplace: being put to use far from where they were manufactured, in a country whose uneducated rural inhabitants appear to have ideas about reproduction radically different from those in the West. It also shows contraceptive use out of time: used at a point in time and for a duration in which efforts to space children safely can hardly characterize the motive. Finally, it reveals contraceptive use in an unlikely social context, one in which a woman's future conjugal life seems to hang in the balance on the basis of her ability to produce children. It is small wonder that by the fourteenth month of the survey, Kaddy commented, "I am suffering in my marriage."
An outsider's first reaction might be to attribute Kaddy's contraceptive behavior to "noise," or data error. In a 1992 baseline survey of 2,980 women in the study area who had ever been pregnant, only 27 were found to be using Western contraception after what might best be called a reproductive "mishap." That is, their last pregnancy ended in a miscarriage, a stillbirth, or the death of a young child. This was less than 1 percent of all the women in the entire survey: scarcely worth reporting, according to most statistical conventions. Yet Kaddy's case, as startling as it may sound to the Western ear, is not unusual for women in such situations. Of the 150 women in this survey who were using any form of Western contraception, 18 percent were doing so after a reproductive mishap--nearly four times as many as the number of users in the total population (5 percent). This finding is all the more surprising since, in a population whose members value high fertility, no one in Kaddy's circumstances should be using contraceptives, at least according to the conventions by which fertility in Africa is usually analyzed. And if this were not enough, many of the women had not only had a recent reproductive mishap; they had had a history of them. Finally, whereas population studies of Africa have assumed women who use contraceptives to be those with "modern" characteristics, the wave of the fertility-reduction future, only 3 percent of the women in the 1992 survey had ever attended school (almost no one over the age of thirty-five), and all were living in poor, rural conditions where high fertility is a life goal for everyone.
These findings on contraception following a reproductive mishap, with little apparent regard for its temporal penalties for fertility, fly in the face of every demographic theory that has been advanced to explain fertility behaviors in places such as Africa. They seem to reflect efforts to reduce or "control" numbers of children under circumstances in which the economic gains of fertility vastly outweigh their costs and where a target family size can hardly have been reached. They certainly reflect circumstances that were overlooked in the project's earlier focus on child spacing as the motive for contraceptive use (Bledsoe et al. 1994): there is no child to space. Such observations make little sense in a population so desirous of children. Since these women value high fertility, such extraordinary anomalies pose significant challenges to prevailing views of reproduction and the course of physical life. It is at the extreme edges, where the logic looms so improbable, that a theory is put to its greatest test. Tiny numbers like these, as well as a whole series of anomalies that the Gambian material brings to light, have implications that have eluded not only demographers but anthropologists as well.
Durkheim long ago lent insight into the potential significance that cases such as Kaddy Seesay's represent. In Suicide (1951), he pointed out that apparent aberrations should not necessarily be regarded as separate from the rest of the population. Rather, they may be extreme manifestations of the entire shape of "normality" in a particular society, an observation that Rose (1992) develops in his discussion of the tail of the distribution in epidemiological studies. If we take seriously the cases of women using contraception after mishaps, they also are an integral part of the population in some critical way that highlights what normality is like. But what kind of normality can they be reflecting? Examining a wide array of empirical findings, I contend that, in attempting to force the course of physical life (that is, its pathway of growth and development over the life span) through filters of linear time, we have looked through distorted lenses at the dynamics of high fertility in Africa, if not those of other times and places.
In this book I examine two disparate views of female reproductive capacity and aging. After describing a view that I call "linear," based on a countdown to menopause and senescence, I re-describe these phenomena according to what I call a "contingency" view. In this latter vision, the pace and character of the decline of reproductive capacity are outcomes of the cumulative physical tolls that women experience, tolls that age them or wear them out. Reproductive capacity is measured not by an abstract, universal, and naturalized time line of physical decline but by individuated experiences of cumulative wearing, traumatic events. The process of decline is seen as a function of the actions one takes and the social resources one can muster to mitigate the effects of injurious events. Thus, in attempting to avoid the wearing effects of multiple traumatic pregnancies that would attenuate her future capacity to reproduce, Kaddy Seesay, like many other women in her predicament, sought out Depo Provera not to limit her fertility but to regain her strength. But the differences between the two overall descriptions of life are immense. Perhaps most striking are the descriptions of senescence. In the first depiction, the pace and character of aging are chronological inevitabilities; in the second, they are products of social action.
The possibility that an apparently exotic set of facts is a more comprehensive account of the body's workings than the science we typically utilize in our writings and envision in our lives is a provocative one. What most interests me about these sets of observations, however, is how such apparently straightforward biological phenomena as reproduction and aging can be perceived in such utterly different ways. What soon becomes clear is that different phenomena can be deceptively commensurate. They may be overlapping and intertranslatable. But they are not necessarily identical. In fact, the more similar two perspectives appear to be, and the more they share vocabularies, the greater our chances of falling into traps of commensurability. Shrouded by layers of naturalized common sense, the multiple perceptual frames from which our science springs can follow the same track for quite a long way without our noticing how different they actually are. In the case of reproduction and aging, I believe, the vision of chronological "time in the body," on the basis of which we typically analyze fertility and aging, is deceptively commensurate with bodily temporalities that are more contingent in nature. As a result, scientists who study the course of physical life persuade themselves that they can assimilate information to a certain framework. Yet when the empirical baselines of time, place, and circumstance shift rapidly, views of "normality" change, and the conditions that shaped the original conclusions are quickly lost to view. We all entertain both the contingency and the linear models. We interweave their elements in different blends and in different contexts. I sketch below some of the tensions between universalisms and local specificities raised by this phenomenon of the disappearing baseline. The Gambian view, however, brings to the center what Western academic practice sets at the margin. It asks what the world looks like when contingency, and not linear time, is the cornerstone of physical experience.
The data for the book come largely from the 1992-95 project on contraception and birth intervals in rural Gambia. However, the book draws also on my prior field research in Liberia and Sierra Leone and from some brief field and library research on American and European counterpoints to the African findings.
Structuring the Problem
The possibility that high fertility is a social achievement rather than an accident of nature has indisputable appeal for sociocultural anthropology. I document some of the anthropological riches the subject brings to light. Contraception, on the other hand, has hardly drawn the interest in anthropology that it has for demography, a field for which the rate of reproduction in a population is the point of analytical departure. Yet the latter half of the twentieth century saw a dramatic escalation in the use of what are commonly called "modern" contraceptives throughout the developing world. Women in Latin America, Asia, Africa, and the Middle East are now using contraceptives in numbers that our discipline would hardly have predicted even two decades ago. But although increasing proportions of the world's women are turning to these contraceptives, little anthropological attention has been devoted to how people may be configuring them to their reproductive and social lives.
Findings on contraception in rural Gambia provide a powerful discovery heuristic. Contraceptive use is a social activity in that it bespeaks relations with sexual partners and with a wider world of co-wives, in-laws, patrons, and ancestors. It also opens a window onto classical anthropological questions of time, aging, reproduction, and the body. In pointing to facets of their lives they seek to adjust, users are revealing by their contraceptive actions physical phenomena that our routinized perceptions miss. My interest in contraceptives thus lies not in their effects on fertility levels of the overall population, the central issue in population studies. What interests me instead is why they are used. In rural Gambia, the principal reasons fall into two related categories. One is a woman's effort to manage reproductive life in ways that will secure her position in a social world dominated by her in-laws ("affines," in anthropology terminology). The other is her effort to bear all the children that God might give her by adjusting the timing and circumstances of her pregnancies. To any scholar attuned to the transformations in meaning in the global flows of ideas and technologies, it should not be surprising to hear that contraceptives are not always used in the way that the distributors intended. But the fact that they might be used for precisely the opposite reason is paradoxical, to say the least.
Demonstrating that high fertility is a social achievement and that contraceptives are seen as devices toward this end should be intrinsically interesting to anthropologists as cases of agency superseding what otherwise would appear to be uncontrolled biology or (alternatively) local cultural meanings superseding those of international population programs. Yet there is a more compelling reason why these themes should engage sociocultural anthropology. This reason has to do with the character of physical experience. This field has long had an ambivalent relation to universalizing models, especially those that seek to privilege biology over culture and social life. Margaret Mead's Coming of Age in Samoa (1928) argued strongly for the priority of environment in conditioning behavior and the mind, a position underscored by her mentor Franz Boas in his preface to the book and one that intensified in the latter half of the twentieth century. Even Meyer Fortes, who sometimes rubbed shoulders with demographers (for example, 1978), argued that although anthropology's sweep was broad, its limits with respect to biological questions were clear: "We must leave to physiology, genetics and demography the exact study of these determinants" (1958, 1; see also Sahlins 1976). In the wake of such reservations, the science of human biology has ebbed as a domain drawing central analytical interest in most of sociocultural anthropology.
Yet if we are to attempt a reclamation project, how should we proceed? Should we accept a "core driver" theory that privileges genes and biological forces as the underlying determinants of social life? In my view, we have all received basic genetic instructions to be human. Beyond this, there is so much room for tinkering that arguing for any hard-wired genetic contributions to social life would be misleading. What intrigues me instead is the tinkering itself: how we seek to make the biological social. Reproduction and the workings of the body are vital nexes around which social relationships are built. They are the objects of maneuver, exchange, valuation, construal--even play. Facts such as these make a strong case for designating human biology as legitimate, if not compelling, subject matter for sociocultural anthropology.
If I am to argue that the course of physical life offers pivotal subject matter to sociocultural anthropology, how should I structure this case? I would argue first that there are deep cracks in the core of contemporary Western knowledge that shape how all of us, whether we write from the universalizing sciences or from their humanistic critiques, collectively believe in certain naturalisms in the body. I would then point to a very different, even counterintuitive, interpretive frame in which physical life appears to operate: one in which social practice bears on physicality in ways that even the most resolute culturalists among us have not imagined. Such a possibility looms large in our handlings of facts concerning time and aging--specifically, the tendency to map aging onto the passage of time. This tendency has become deeply embedded in our early twenty-first-century middle class habitus, the taken-for-granted shroud of culture that guides our most minute perceptions and behaviors and in which social necessity is made to appear natural. The equation of age with aging (or senescence) shapes the way we write about the world. Yet it is so deeply embedded that, as Pierre Bourdieu (who most developed the notion of habitus) would predict, it is largely invisible to us.
Contemporary social science and humanities scholarship has shown convincingly that society symbolically inscribes bodies or tinkers with body form (for example, gaining or losing weight, building muscles, piercing, scarring, or tattooing the body). The Gambian findings, however, bring to light management efforts of an entirely different order. They reflect attempts to guide the physical trajectory of aging over the adult life course. What should most beckon to anthropology is the possibility that aging, like high fertility, is socially constituted to a degree that we have not apprehended. The possibilities that the process of physical aging is not tied to age, that time is not determinant of childbearing ability, and that aging is under social control in ways that we have not considered are highly counterintuitive to the academic common sense from which most of us write.
To address these issues the book takes two classical anthropological tacks. First, it lays out the logic of high fertility in a society very different from our own. Second, it deconstructs the concepts by which contemporary Western thought has conventionally viewed this logic. It does so to the point that the locally meaningful categories of experience, rather than scientific convention, increasingly dictate the analysis. Beyond this point, sociocultural anthropology has tended to hesitate, holding the exotic and the familiar firmly apart. This book takes an additional step. It takes findings that converge sharply around a certain set of facts that is very different from the one we usually employ. It recycles these findings back through Western science's own universalizing filters, to see how they stand up.
Excerpted from Contingent Lives: Fertility, Time, and Aging in West Africa by Fatoumatta Banja Copyright © 2002 by Fatoumatta Banja. Excerpted by permission.
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Table of ContentsForeword
Anthony T. Carter
2. Reproductive Tolls and Temporalities in Studies of Reproduction
3. Setting, Data, and Methods
4. Managing the Birth Interval: Child Spacing
5. Disjunctures and Anomalies: Deconstructing Child Spacing
6. Realizing a Reproductive Endowment in a Contingent Body
7. Time-Neutral Reproduction, Time-Neutral Aging
8. Reaping the Rewards of Reproduction: Morality, Retirement, and Repletion
9. Discovering Our Habitus: Contingency and Linearity in Western Obstetric Observations
10. Rethinking Fertility, Time, and Aging