Researchers Examine Differing Reproductive Desires in Gambia
Basic sex education starts with the undisputed fact that it takes a man and a woman to create a baby. But what happens when the genders harbor notably different desires for children and live in a society in which there is little communication between the sexes to discuss the differences?
Allan Hill, Andelot Professor of Demography in the Department of Population and International Health, addressed these questions in "Separate Lives, Different Interests: Male and Female Reproduction in the Gambia," a paper recently published in the Bulletin of the World Health Organization. Amy Ratcliffe, a graduate student at the Harvard Center for Population and Development Studies, served as lead author.
Hill
has been overseeing a research program on the fertility and reproductive
health of people in rural Gambia for several years. In his latest research,
he has found that men wanted more than double the number of children that
women were delivering. For the men, more than 15 kids are desirable. The
number may seem high to members of Western societies, but in rural Gambia
fertility for both men and women represents more than simple family size.
Hill feels that studies such as his are necessary because they provide insight into how men and women negotiate their reproductive interests. With this understanding, he says, high fertility rates that can place women at risk could possibly be reduced and reproductive health for both genders improved in West Africa.
The people in the study live in a largely Muslim society in which males are allowed to marry up to four women at any time so long as the men can support their wives equally. Of the married men the researchers interviewed, 40 percent had more than one wife. The men achieve high fertility through polygamy or serial marriages.
When women marry, they are integrated into their husbands' lives, moving into compounds that usually include other members of the mens' families. The average age of new brides is 15 years old, whereas first-time grooms tend to be around age 25. Most of the women in the study have no formal education, but many farm their own rice fields and conduct their own economies with little male involvement. The commerce provides activity and some money, but the most accepted way in which women secure their status is by having children.
"These are for the most part uneducated women with few resources," said Hill. "Their only social standing comes from their fertility, and so by having the children that their husbands and their husbands' families want, they establish themselves in the compound."
The women tend to have about six kids during their lifetimes, spacing the births about every two years. The length of the intervals between births is important, said Hill, because a long gap tends to promote gossip about the possibility for divorce. He added that women are frequently divorced if they can't have children and often become second or third wives to other men. Infertility can lead to depression. Although rates were very low among the women, the majority of those who were depressed attributed the dysphoria to inability to bear children.
Women have been known to continue having children even after they have been warned by medical professionals to stop because they do not want to be seen as bad wives, said Hill.
"There is a lopsided pressure," said Hill. "The women are concerned about their own health and welfare while the men look at them with very different eyes."
Women who cannot conceive have a few options. They can become foster mothers to relatives' children, a common practice. Or they can train for jobs such as nurses and schoolteachers. But these goals are unrealistic for women with no schooling, said Hill.
He
suggests that the men may not appreciate the strains on the women in their
lives because both men and women are uneducated about human reproductive
biology. Although the women receive some instruction and care through
local health practitioners, men's reproductive health issues and education
have been largely ignored. Hill sees this lack of attention as a critical
hole that must be filled if the health of both genders is to be improved.
"We don't have a setting in which to reach the men," noted Hill. "They would not be caught dead in neonatal or maternity clinics. So we are trying to bring up the general issue of identifying the point of contact for men's health."
Hill is unsure if tending to the reproductive health of the men will result in lower birth rates. They are already asking about Viagra, he pointed out. But he hopes that communication between partners about family planning can ensue.
"If it is not customary to see men and women together in public situations, how can you deal with their joint health issues," asked Hill. "That is the challenge."
