In sub-Saharan Africa, women often experience difficulty accessing essential reproductive health services such as contraception or treatment for sexual violence. This often leads to unwanted pregnancies, unsafe abortions, or infanticide, which is the intentional killing or fatal neglect of an infant under one year of age. It can also be referred to as “neonaticide”, particularly when the pregnancy is concealed and the newborn killed within 24 hours of birth.
Infanticide is a complex social fact and public health in Senegalwhere it represents one of the five main causes of detention of women in prisons, namely 19% of incarceration cases.
While the subject highlights the extreme economic and social vulnerability of women and girls, it also reveals how the absence of reproductive justice affects women’s reproductive choices. This leads to dramatic consequences such as maternal deaths due to unsafe abortions or infanticide.
The justice reproductive is a feminist concept that focuses on the gendered power dynamics and political complexities that shape people’s lives and experiences of reproduction. This concept, first developed in the United States, shows how socially, politically, and economically marginalized women experience various forms of reproductive oppression, such as limitation of access to contraception, abortion, and obstetric violence. As the American academic and activist explains Loretta Ross de Sistersongreproductive justice analyzes how the ability of each woman to decide her reproductive destiny depends on the conditions of her community.
The concept has gained ground in Africa thanks to movements seeking to improve access to sexual and reproductive health and rights (SRHR) servicessuch as safe abortion care.
A qualitative study carried out by theAfrican Population and Health Research Center (APHRC) et Ibis Reproductive Health in 2021 with 19 women accused of infanticide in Senegal shows how a continuum of reproductive injustice creates the conditions leading to infanticide.
Unplanned pregnancies
Our study highlighted the fragility of social ties, precarious employment, transactional sex relationships and sexual violence as factors contributing to the vulnerability of women and girls to unplanned pregnancies. The study also showed the culture of silence and blame surrounding sexual violence, leading women not to report rape for fear of shame and retaliation. This culture of silence is aggravated by a lack of awareness of the health services offered to victims of sexual violence in health structures.
Other research shows that in Senegal, prosecuting a rapist often requires physical evidencedifficult to obtain due to pressure to silence survivors and the costs of a medical certificate. Lack of access to contraception by adolescents and women also increases vulnerability to unplanned pregnancies, particularly for young people and single people.
A key player explains that adolescents and young women, who are supposed to avoid pregnancies, are denied the information and services necessary to do so because of the taboo and stigma surrounding their sexuality.
Stigmatization of extramarital pregnancies
Once adolescents and women became pregnant, they faced another form of reproductive injustice, including patriarchal norms that stigmatize pregnancies outside of marriage. Most women did not reveal their pregnancy to anyone. They hid it for fear of social stigma and sanctions that result from a premarital or extramarital pregnancy.
In the rare cases where a woman wanted the pregnancy, the partner’s refusal made her socially “dangerous” and, therefore, unwanted. Some adolescents and women, who did not want their pregnancy, considered abortion to avoid stigma and social exclusion, but they were unable to access it due to another form of reproductive injustice: legal restrictions on abortion in Senegal.
Impacts of legal restrictions
Regardless of the country in the world, when a pregnancy is unwanted or unacceptable, abortion is often considered as a possible solution, whether the normative framework is restrictive or not. Women and girls accused of infanticide in Senegal said they wanted to have an abortion but were unable to do so due to very severe legal sanctions and the strong social and religious disapproval of abortion. Abortion is illegal and allowed only when the pregnancy endangers the life of the mother. Participants described extreme difficulty finding information about providers or safe methods of abortion.
The few women who discussed abortion with their partners, family or caregivers were threatened with violence or denunciation, leaving them with no medical or legal option to safely end their pregnancies. Consequently, they had to carry it out by hiding it, facing pain, guilt and depression. In almost all cases, they gave birth alone, in fear and exposed to the risk of complications.
The experience of imprisonment
In most cases, infanticide would have resulted from an attempt to silence the newborn’s cries to avoid detection. Other women have reported cases of unwitnessed stillbirth or death resulting from what appears to be an episode of depression or extreme distress after delivery. This is likely a result of the emotional burden of carrying and giving birth to an unwanted pregnancy.
The women were publicly arrested, either by a contingent of police sent to their homes or handcuffed at the health facilities where they were receiving treatment. The experience of imprisonment – especially spending several years in preventive detention – is difficult to endure. The women interviewed in this study explain having been abandoned by their family, and suffering from depression and stigma.
As for the five women who left the prison, they describe the persistence of isolation, shame and depression. Some have not been able to return to their original neighborhood for fear of persistent hostility in those around them. They thus remain confined to their homes, cut off from the social ties that define daily life.
What to remember
Patriarchal norms cast shame on adolescent girls and women who have extramarital sex. They limit access to or use of contraception, sexual violence that goes unreported, socio-economic precariousness and the stigmatization of extramarital pregnancies. They also create the conditions for unplanned pregnancies and the need to get rid of the pregnancy.
Deprived of the right to abortion by legal restrictions, these women come, out of desperation, to infanticide as an inevitable option to escape social exclusion and maintain the networks necessary for their survival. And when we say “necessary for their survival”, that is not an exaggeration. In the family and social structure of many communities in Senegal, a woman excluded from her family due to an unwanted pregnancy loses all economic and social support. However, infanticide aggravates this exclusion, making it go from “deviant” to “criminal” with all the sanctions that implies.
While changing social norms is a long-term effort that can span generations, changing policies to achieve reproductive justice requires only political will.
Advocacy is more than necessary to align sexual and reproductive health policies in Senegal with international texts, such as the Maputo protocol . This will increase access to contraceptives and safe abortion services, especially in cases of sexual violence.
At the community level, social interventions are needed to change attitudes toward extramarital pregnancies and sexual violence and expand access to contraceptive information. These efforts can help reduce unwanted pregnancies and the stigma associated with premarital pregnancies and prevent cases of infanticide.
Ultimately, these interventions would make it possible to protect vulnerable Senegalese adolescents and women from the triangle of fire : die from an unsafe abortion, be arrested and imprisoned for clandestine abortion or infanticide, or be disabled for life due to complications related to an unsafe abortion.