Confronting the Biomedical Sphere

Abstract

This chapter examines the quality of care for women seeking reproductive health services at health clinics in Niamey, Niger. Whether it is to pursue treatment for infertility, give birth, or obtain contraception, issues ranging from miscommunication to medical violence arise that are rooted in the asymmetrical power relationship between providers and clients. Crucial decisions regarding a woman’s body are often made without her prior consent under the guise of an emergency. Surgical procedures such as tuboplasties and hysterectomies are sometimes carried out without the patient’s agreement or understanding. Despite widespread rumors about their harmful effects, some women go to clinics to obtain contraception. But once there, women are met with long waiting times and inconsiderate staff. Interviewees report being treated rudely by nurses and midwives if they are not their friends or of equal or higher social status. Women say they feel tense, dehumanized, intimidated, and disrespected in their interactions with health professionals. Health clinic staff talk about particular women—notably, those with less formal education and income—as being “bad patients.” While medical facilities ought to provide the best fertility management options for women, systemic problems within those spaces make it hard for women to use them.