Twenty years of democracy and the politics of reproduction in South Africa

Abstract

Reproduction is political. This article is about how young women's experiences of pregnancy and motherhood in South Africa have been affected by politics. Early childbearing has been a norm for a great part of the twentieth century, particularly among South Africa's black and coloured populations. However, it was only in the 1970s that the issue of 'teenage pregnancy' was singled out as an area of concern and one that was worthy of study. The interest in teenage pregnancy emerged at a time when young black people were increasingly becoming more vocal and militant in their opposition to apartheid. They presented a potential destabilising force in the country. In 1994, the African National Congress (ANC) took over the reigns of power as South Africa's first democratically elected government. Once in power, the ANC, under the leadership of President Nelson Mandela, made addressing and correcting past injustices a key priority, particular efforts were made to address racial and gender inequalities. The article examines health policy and legislation with regard to women's sexual and reproductive rights. The article discusses three key Acts that were introduced in the first five years of democracy which had the potential to impact on young women's sexual and reproductive health. Using ethnographic and secondary data sources, I suggest that while the Acts were significant and even groundbreaking at the time that they were introduced, today for many poor, young black women in South Africa, their impact is negligible. The article has two aims. The first aim is to show the ways in which particular ideas about young women and their sexual behaviour have resulted in the development of policies that have profoundly affected young mothers abilities to parent -positively and/or negatively. The second aim of the article is to comment on the gradual movement away from the protection of women's rights that was important in the early years of ANC rule to the increasing disregard for young women's sexual and reproductive health rights that is currently evident in the Zuma era, as well as unabashed attempts to control young women's sexuality.

Coming of age? Women’s sexual and reproductive health after twentyone years of democracy in South Africa

“…72 South African teenagers experience a high incidence of violence in their first sexual encounter. 21 Post-apartheid, advocacy has also focused on specific forms of sexual violence, such as ukuthwala -the abduction, forced marriage and rape of young girls -a distortion of a past custom for consenting eloping young adult couples. 73 Advocacy groups highlight the targeted rape of lesbian and transgender women, who do not conform to hegemonic gender norms, as a serious problem.…”

“…19,20 South African women have full legislative equality, but unequal gender power relations continue to undermine women's SRHR, particularly among teenagers and young women. 21 South African women's sexual and reproductive health status: [2004][2005][2006][2007][2008][2009][2010][2011][2012][2013][2014][2015] Contraception and pregnancy planning The contraceptive prevalence rate among South African women of reproductive age, last surveyed in 2003, is 65%. 22 However, many women begin contraception late and discontinue use, 23 with 61% of first and 46% of second pregnancies reportedly unintended.…”

“…22 Satisfaction with public sector contraceptive services is low among poor and rural women due to inadequate service availability and access. 21 Teenagers face challenges in accessing public sector contraceptive services due to judgemental attitudes from many healthcare providers for being sexually active. 20 This is despite legislation stipulating that contraception in public health care should be provided free of charge on request to any woman or girl aged 12 years and above.…”

“…32 While abortion is legal without age restrictions or caregiver consent, girls and young women reportedly find accessing unsafe abortion outside of institutional settings easier and quicker. 21 Some of the continuing barriers to safe abortion are: abortion-related stigma; delays due to opposition among providers; poor knowledge of the law and available services; shortages of trained providers; providers' conscientious objections; and no mainstreamed nursing and medical school curricula training. 33 While the law has helped to liberalise attitudes to abortion, abortion remains contested by many and † As recent national abortion rates are not currently available in South Africa, these figures are based on best estimates calculated by a biostatistician, from available information from Statistics South Africa's data base and the Health Systems Trust abortion indicators contained in its District Health Information System.…”

“…Socio-economic factors underlying teenage pregnancy include differing gendered expectations of girls' and boys' sexual and social roles. 21 With school attendance compulsory until age 15, the 2012 Integrated School Health Policy, 43 if effectively implemented, could act as an important service delivery platform for school-based SRH services. 42 The 2015 National Adolescent Sexual and Reproductive Health and Rights Framework aims to increase stakeholder coordination and information.…”