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The Politics of Reproduction in the MENA—Birth, Midwifery, Illegal Mothers, and Abandoned Children

Panel II-6, 2023 Annual Meeting

On Thursday, November 2 at 5:30 pm

Panel Description
This interdisciplinary panel engages the agency of women and children at the margins of reproductive politics in the MENA--biomedical, colonial, national, and juridical. Through the stories of these mothers, midwives, women, and children in Iran, Morocco, Egypt, and Tunisia, we trace how individuals have confronted colonial and national structures to create their own identities, pursue freedoms and autonomy, and build families. These histories also make visible the insidious frameworks that expand control over women’s reproductive bodies by claiming nature, the public good, morality, law, and science. By exposing the nexus of law, biomedicine, and state through women’s voices, we consider how women’s self-determination may be recovered. The politics of reproduction have been studied largely as the state biopolitical control of natalism, sexuality, and childrearing to promote a healthy national population for work, wealth, and military power. Those who fall outside its laws can be criminalized or deprived of citizenship rights altogether, especially children born to unmarried parents. Reproductive politics take on yet more violent forms among colonized and enslaved populations, and the race-based and eugenic logics have persisted quietly in WHO and Rockefeller Foundation population policies after the end of empire. Yet women have also reclaimed agency as mothers, midwives, and advocates of “reproductive rights” (birth control, abortion) and access to gynecological and obstetrical medical care. Through these women’s stories of non-biomedical midwives, illegal mothers, abandoned children, and colonized birth, we consider challenges and solutions to restoring women’s agency over their bodies and reproductive lives.
  • This exploration of midwifery, obstetrics, and birth in colonial and postcolonial Morocco centers the “traditional” Moroccan midwife (qabla) in her many dimensions—legal-medical expert, mediator between medical systems, female elder, pharmacologist, and healer in a community of practice. French obstetrics for Moroccan women came first through the efforts of French women doctors in the 1920s, who sometimes incorporated qablat. The French colonial state, on the other hand, objected the qabla as an Islamic sorceress and sought to replace her with a French-trained native biomedical birth attendant, the muwallida (“she who births”), in Protection Maternel et Infantile of the late 1940s. How Moroccan mothers negotiated among frameworks, how they utilized new biomedical therapeutics and health professionals, how French and Moroccan women interacted in healthcare, and how Moroccan midwives survived from colonial to postcolonial health is a social history from below. This history is a corrective to narratives that present the WHO, the IMF, and the Rockefeller Foundation as “the history of global health.” This history also provides insights for maternal and infant health in Morocco today, as Moroccan biomedical midwives demand equitable working conditions and mothers and families struggle for woman-centered maternal and infant health care. As a community-based, non-biomedical practitioner at the margins of official Moroccan healthcare, the qabla has yet much to teach about women’s health. This paper draws upon research in French colonial archives in Rabat (BNF) and Nantes (Affaires Etrangères), medical monographs, journal articles, and reports by French physicians and anthropologists, Arabic medical manuscripts in Morocco, a current review of the published medical literature, and interviews with midwives, women, and men in two clinics of Fez, Morocco.
  • Many scholars have looked at gendered legal discrimination in the Middle East and North African (MENA) countries, but few have taken an intersectional approach focused on marital status to examine its impact on women’s rights. Morocco and Tunisia largely represent opposite ends of the spectrum in terms of gendered legal discrimination in MENA countries. Although Morocco’s 2003/2018 Penal Code and 2004 Family Law reforms improved women’s rights relatively, women who fall outside of the legal marital framework –single women, single mothers, divorcees, widows– and their children continue to face numerous obstacles to equal treatment before the law. The discrimination begins with the denial of unmarried women basic sexual and reproductive health (SRH) rights, including SRH education and services, such as access to contraception, emergency contraception, and abortion. In contrast, Tunisia is an exemplar both in the MENA region and beyond in terms of women and men’s access to SRH rights, which include SRH education programs in the public high schools, a broad selection of contraception and emergency contraception available regardless of marital status, and first trimester abortions upon demand and free at state hospitals. This disparity in Moroccan women’s treatment drives its high levels of unwanted pregnancies, unsafe abortions, and maternal mortality rates, especially among unmarried women. Additionally, the study demonstrates how the Moroccan law holds single mothers –but not fathers– accountable for their “illegitimate” children’s maintenance and welfare, since marriage, not biological paternity, determines a child’s name, maintenance, and inheritance rights. In contrast, Tunisia with the 1998 Patronymic Law granted children born outside of marriage the same rights and protections as “legitimate” children, including the right to a name, maintenance, and inheritance rights. This comparative case study analysis includes a broad examination of Morocco and Tunisia’s current legal codes, recent reforms, and pertinent Supreme Court (Court of Cassation) rulings as well as each countries UN human rights convention commitments and numerous national and sub-national studies. I also conducted 200+ in-depth interviews with Moroccan and Tunisian women’s civil society activists, lawyers, judges, parliamentarians, and government officials, and focus groups with single mothers, between 2013 and 2019. The analysis offers unique insights into the way Moroccan laws marginalize and exclude women –but not men– who fall outside the marital framework and how Tunisia has remedied many of these gendered issues.
  • In colonial and semi-colonial Egypt, most childbirths occurred at home with dayas or hakimas (midwives) in attendance, with most deliveries proceeding normally. But occasionally a pregnancy went wrong, terribly wrong, either before, during, or after childbirth. Complications included miscarriages, ectopic pregnancies, placenta previa, ruptured or prolapsed or retroflexed uteruses, puerperal sepsis, and fistulas. The list of what could and did go wrong at different moments was long and included mental health illnesses. Looking at the problems of pregnant, parturient, and post-partum women in the first half of the twentieth century opens a window onto the experiences of childbirth in Egypt before the dramatic shift to hospital-based medicalized childbirths later in the century and helps in retrieving forgotten or suppressed birth stories. Due to pain and shame, these stories were often silenced yet remained etched on women’s bodies, embodying the practices and politics of maternal health. This paper draws on memoirs; medical journal articles and books by Egyptian doctors, most notably Dr. Naguib Mahfouz; and Mahfouz’s Gynecological and Obstetrical Museum. It uses visual, oral, and literary sources to recover women’s voices and memories of their unborn fetuses and newborn infants.
  • In 1968 a devastating earthquake rocked Khorasan province. Some sources estimated the immediate loss of life as between 8,000-12,000. The disaster disrupted life in predictable ways: homes were demolished and people’s livelihood destroyed. Families fell apart, and children were left abandoned by an unforgiving calamity. A moving photograph from these difficult days captures the sheer devastation of this seismic event, as well as its emotional toll on the earthquake’s youngest victims: its children. The heart-rending image of an unnamed boy, tearful and seemingly abandoned amidst a pile of rubble, begs the question: What happened to children and orphans when disasters hit? The earthquake likely injured and mutilated many who survived but lost the ability to use their bodies in full. Despite its scope, seismic activity was not new to this region of Iran and its borderlands. However, we know little about the impact of such devastation on afflicted families and individuals. This essay explores two complicated but related subjects: the role of children in Iran’s modern history and its connection to discourses about disability and social welfare policies and services. It argues that disasters such as the 1968 earthquake in Khorasan made it difficult, if not impossible, to contemplate the hygienic discourses that tended to focus the conversation about healthcare on prevention of disease, disability and “wholeness.” Calamities, in fact, threw these discourses and vulnerable institutions into chaos. As the response to this disaster showed, local and national authorities struggled to provide the necessary services to ensure the survival of badly affected residents of Khorasan province. Years after the disaster, what became of the abandoned and neglected young victims of this disaster? While acknowledging the challenges of locating first-hand survivor accounts, this essay will attempt to fill in some of these silences by piecing together existing historical sources.