Feminist Perspective on the Broadening Concept of Reproductive Health

A major shift in the perspective and methods of promoting womens reproductive health and population programs has occurred in the last 30 years.

From a narrow and conventional concept of fertility regulation and maternal health, reproductive health has now broadened to encompass all aspects of sexuality and reproductive health needs throughout the life cycles of women and men.

This means going beyond the numbers beyond fertility and population growth rates, and dealing with womens health concerns beyond pregnancy, childbirth, the post-partum period, and lactation.

Reproductive health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and all its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide when, and how often to do so(ICPD Programme of Action 199645)

This broadened concept of reproductive health recognizes the importance of fundamental conditions that affect womens sexual development, health, and childbearing. These include their economic, social, cultural, and educational environments.

Helping women to decide whether to bear or not to bear children requires a deeper understanding of their status, their needs, their resources and their realities. As DAWN (Development Alternatives with Women for a New Era), a group of feminists put it
Women know that childbearing is a social, not purely personal phenomenon

Womens bodies, however, must
not be treated as pawns in struggles among states, religions, male heads of households and private corporations, and unless womens needs and interests are taken into account, family planning programs are unlikely to succeed.

A women-centered reproductive health approach is sensitive to womens needs.It should encompass a womans total sense of well-being. It goes beyond health care delivery systems and fertility regulation and involves an upgrading of womens overall status. Three basic principles underlie women-centered approaches to reproductive health (Freedman and Isaac 1993). First is trust in women and in their capability to make decisions about reproduction based on access to adequate information and appropriate service then the sensitivity to and understanding of womens reproductive experience. This moves away from view of health as a biomedical phenomenon and focuses attention on the provider-patient relationship and lastly is to connect the various levels of interventioncommunity, country, and internationalin planning and implementing health programs.

A reproductive health approach places womens reproductive choice at the center of their reproductive autonomy. From a feminist perspective, Correa and Petchesky (1994) define reproductive and sexual rights in terms of power and resources ie., the power to make informed decisions about ones own fertility, childbearing, childrearing, gynecological health, and sexual activity and resources to carry out such decisions safely and effectively.

It has taken some time for reproductive rights to be recognized as human rights in the Universal Declaration of Human Rights. When the first declaration was adopted in 1948 by the United Nations General Assembly, no mention was made of reproductive rights. It was only in 1968 or 20 years later, in Teheran Conference, when a provision was made regarding parents basic human rights to decide freely and responsibly on the number and spacing of children and a right to adequate education and information in this respect.

A Feminist Social Science Research
A brief review of the epistemological debates in social science research will help contextualize the feminist advocacy for an alternative paradigm that addresses womens concerns.

At least two paradigms with fundamentally different assumptions about social reality have competed in social science research namely logical positivism, as the dominant one, and the phenomenological and hermeneutic perspective.  Logical positivism is associated with empirical-analytical inquiry that uses quantitative and experimental methods to test hypotheses deduced from theories. Phenomenological inquiry uses qualitative and naturalistic approaches to inductively and holistically understand human experience in context-specific settings.

Feminist research has closer affinity with the phenomenological methods of inquiry. Toby Jayaratne and Abigail Stewart (in Fonow and Cook eds. 199181-106) summarize the reasons for the support and advocacy of qualitative method by feminist researchers

Running through much of this enthusiasm for qualitative methods has been an understanding that many aspects of womens experience have not yet been articulated or conceptualized within social scienceQualitative methods permit women to express their experience fully and their own terms.. offer more  human, less mechanical relationship between researcher and researched

In addition, the feminist perspective finds close links with thw critical social approach that directs attention to oppressive and inequitable social systems. Critical sociologists emphasize the need to pinpoint and locate social problems and issues of which ordinary men and women are not yet aware.

Like other critics of the positivist position, critical social researchers for examining social structures and processes that maintain them. It is concerned with revealing underlying social relations and showing how structural and ideological forms bear on them. Apart from showing what is happening at the societal level, it is also concerned with taking political action to eliminate these structures that are oppressive.

It is this component of transformative action that participatory research deems most important. Knowledge productionwhether technical, interpretative or criticalis insufficient, unless that knowledge is put to use for emancipatory purposes by people themselves.


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