An Assessment of Romani Women’s Autonomy and Timing of Pregnancy in Serbia and Macedonia

Abstract

Background Roma are Europe's largest minority population. Serbia and Macedonia have the greatest proportion of Roma outside of the European Union. Our objective was to examine women's agency and how it related to desired timing of pregnancy among Romani women in Macedonia and Serbia. Methods We surveyed 410 Romani women who had given birth in the last 2 years between November 2012-February 2013 in Serbia and Macedonia using purposeful snowball sampling. Log-Poisson models were used to examine the association between women's inclusion in healthcare decision- making and desired timing of pregnancy. Results Romani women in Macedonia and Serbia were excluded from the labor market, with over 80% being unemployed, approximately 30% had no schooling, and 17% were not included in healthcare decisions. Romani women who were sole decision-makers in relation to their health were 1.4 times more likely to desire the timing of their most recent pregnancy [RRR = 1.4, CI (1.1, 1.8)]. Conclusions Romani women who have great involvement in their own healthcare decisions were more likely to desire the timing of their current pregnancy. Women's inclusion in such important decisions is important and empowerment programs that address gender inequity are needed in Romani communities, particularly for control of timing of pregnancy.

Engaging hard-to-reach populations in research on health in pregnancy: the value of Boal’s simultaneous dramaturgy

“…Engaging with minority groups on healthcare issues is important if the full range of human capabilities are to flourish (Nussbaum, 2011). One such minority group is Roma people who live worldwide and are Europe's largest and the most marginalized ethnic minority (Stojanovski, Janevic, Kasapinov, Stamenkovic, & Jankovic, 2017). According to the European Commission in 2010, it has been estimated that there are between 10 and 15 million Roma people across Europe.…”

RoMoMatteR: Empowering Roma Girls’ Mattering through Reproductive Justice

“…Roma Girls Motherhood (RGM) is deeply embedded in a tangle of multiple discriminations and used by certain sectors of European society to validate the stereotyping and rejection of Roma [ 1 , 2 , 3 , 4 , 5 ]. Research in this area consistently affirms that RGM is one of the factors that impoverishes the life of girls, increases the risks of suffering physical and mental health problems, makes them vulnerable to intimate partner violence, and prevents them from remaining in the educational system and successfully inserting themselves into the labor market [ 6 , 7 , 8 ].…”

“…In fact, many studies have shown that child motherhood is often associated with emotional stability, purpose, and responsibility as well as a strong sense of belonging to a cultural community [ 7 , 18 , 19 ]. This is especially explanatory in impoverished Roma communities where girls happily assume motherhood in return for acquiring mattering despite the hard limitations entailed in their lives and without questioning why their parents and close relatives promote it despite knowing the limitations this poses in their lives [ 2 , 4 , 20 , 21 ].…”

“…This cultural control also entails sexual control that forces Roma girls to submit their bodies—and the decisions about them—to the pressures, demands, and expectations of general population/others in issues like virginity, marriage, or maternity. These discriminatory and oppressive mechanisms smother any opportunity for self-determination, undermining the pillars on which Roma girls construct their gender identity, build their families, choose their partners, and decide on motherhood [ 2 , 4 ].…”

International comparison of reproductive health seeking behaviour in Roma population

“…In the previously published literature from this area, the authors have highlighted that empowering Roma women to be involved in their health care leads to their stronger independence regarding the decision of pregnancy timing (2). Therefore, guided primary care can help Roma women being more aware of their reproductive health options.…”