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311426
'Nos Obligan' (They Force Us): Women's Reproductive Rights in the Peruvian Andes
Wednesday, November 19, 2014
: 8:56 AM - 9:09 AM
This paper examines maternal experiences of violence and their impacts on maternal decision-making regarding prenatal and delivery care in the rural, Peruvian Andes, where shifting traditional birth practices and the influx of biomedical ideologies are forcing rural, indigenous women to navigate competing and conflicting bodies of knowledge and varying concrete and symbolic consequences of their decisions. In light of the significantly higher rates of poverty and indigenous identity among rural versus urban populations in Peru, this paper explores the avenues through which structural violence--the systematic manner in which ethnic, gender, and socioeconomic discrimination are institutionalized--and interpersonal violence, in the clinical and familial setting, impact maternal decision-making and infringe on women’s reproductive rights. Data were collected through semi-structured interviews with mothers (n=30), healthcare providers (n=6), and social workers (n=3) and participatory action research workshops (N=7; n=69) to illuminate local maternal experiences and influential decision-making factors. Issues of ethnic and gender discrimination and financial and social coercion surfaced as substantial influences. However, women also found ways to resist and accommodate these challenges, demonstrating the intricate and on-going negotiations occurring throughout the maternal experience. The results of this research illustrate the various ways broad-level health policies manifest on the local level and impact the lived realities of Andean women. Ultimately, this paper argues for the incorporation of community voices in the implementation of local maternal health efforts to facilitate an open conversation on how to jointly improve the maternal experience and reduce barriers to accessing adequate and appropriate maternal care.
Learning Areas:
Diversity and culture
Social and behavioral sciences
Learning Objectives:
Identify important factors in rural, Andean women’s decision-making regarding prenatal care and childbirth, especially those relating to discrimination, violence, and coercion.
Explain the roles of ethnicity and socioeconomic disenfranchisement in limiting women’s bodily autonomy.
Demonstrate the local-level, unintended consequences of national maternal health policies, particularly in rural areas.
Explain the importance of community participation in local policy implementation and program development in order to establish optimal local relevance and increase the likelihood of local acceptance and sustainability.
Keyword(s): Maternal and Child Health, Community-Based Research (CBPR)
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I was the principal investigator on this research in Peru, which also served as my Master's thesis and have been a co-investigator on other research focusing on maternal health and community-based, participatory methods in the north-central Peruvian Andes. I have also previously conducted research in the US on women's birth decision-making and birth narratives.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
