Everyday Practices in Womens Sexual and Reproductive Health, Immigrant or

Otherwise, in Catalonia

Mara E. Martnez Morant

Doctor in Cultural and Social Anthropology
Bau, Escola Superior de Disseny, Universitat de Vic
Barcelona, Spain
encarnac@cgtrabajosocial.es
mara.martinez@baued.es

Introduction
In this research, I explore the way women and their partners use, or fail to use
contraceptive methods. I seek an approach that will enable me to know the reasons
behind the rejection of contraceptives in coital sexual relations when pregnancy is not
wanted. It seems obvious that, unless contraceptives are used, the potential for
pregnancy in healthy women of reproductive age is extremely high. And women do get
pregnant.
My initial intention is to discover the technical aspects of contraceptive failures, such as
a torn condom, interaction with drugs that annul the pill's effectiveness, slipping of the
intrauterine device, improper placement of the vaginal ring, and error of calculation in
the Ogino-Knaus method. Contraceptive methods have a 95% to 99% probability of
preventing pregnancy. Nonetheless, the number of pregnancies that women say were
not planned is considerable. More than one third of such pregnancies are due to a
failure in the contraceptive method used, in a technical sense. However, according to
the conditions in which women contend that the other two thirds of unplanned
pregnancies occur, the inference is that it was carelessness during the conception,
rather than a technical failure of a contraceptive.
Unveiling what constitutes carelessness became the leading aspect of my research. In
this presentation, based on my ethnography, I show how Catalonian, Spanish and
immigrant women explain the omission of contraceptive methods and the physical and
mental outcomes this causes. Basically, I am interested in showing that the failure to
use contraceptives can hide issues related to the couple, family, religion and custom,
which are the main reasons given by the interviewees.
Access to sexual and reproductive health, where abortion is a radical contraceptive that
puts an end to an unwanted pregnancy, is a highly sensitive topic that must be
approached with caution. Therefore, selecting the female interviewees involves
explaining the project to the women who come to a social resource for abortion-related
issues and seeking their cooperation. In the case of this research, the resource was an
Association 1 that runs an aid program to finance the abortion for women who live in
Catalonia. I had the opportunity to provide my services there for several years and
attended to several thousands of women who came to the center to apply for financial
assistance.

For the purpose of maintaining anonymity, I will always refer to the social resource where I worked
attending to women who came to request social services and financial assistance to have an abortion as
the Association.

I invited potential interviewees to participate in the research in the course of the

interviews I conducted as part of my job, which is to attend to the needs of vulnerable
women from different origins who come to the Association to ask for social and
financial assistance to pay for a legally induced abortion 2 . Therefore, the study group
was women, immigrants, and either Catalan or Spaniards who were living in precarious
situations and came to the Association, where, if necessary, they were referred to
legally authorized private clinics, in the case of Catalonia, where they could have an
abortion.

Women on whom the ethnographical research was conducted

The process followed consisted of successive periods of 1 to 2 months. During these
periods I invited the potential interviewees to take part in this research and, while
transcribing the interviews, I recommenced the phase of inviting new potential
interviews to participate. I repeated the process from March 2007 to the end of
February 2008.
Despite the effort to prevent bias, a specific population was selected for the
ethnographical research, because out of all the women in Spain who have abortions,
the Association only attends to those who live in Catalonia and, of these, only to those
who have financial problems and need help to pay for a legally induced abortion.
Consequently, the data presented in this paper correspond to a specific segment of the
population and may give a perspective that does not reflect the real life situation shared
by all of the women who have an abortion.
In all, I made an ethnographical study of 112 women, whose tales describe their sexual
and reproductive health practices. The testimonies also shape the territory where
abortions are done on women whose names and places of origin are omitted to avoid
putting the chiaroscuro and ambiguity surrounding abortion at risk. Also, when I record
the interviewees' testimonies, I transcribe what they say verbatim, including their lisps,
intonation and manners of speech to preserve the emphasis and meaning they give to
their words. 3 .
With regard to the general characteristics that enable a benchmark social profile to be
identified, the 112 womens age range was 15 to 38. 70% of the women interviewed
were foreigners, whereas the remaining 30% were Spanish and Catalan. Out of the
total number, the largest group was of single women, many of whom had relationships
that lasted less than two years, during which they cohabitated. The level of
independence of nearly all of these women was subject to low-qualified jobs or they
were unemployed.

I write legally induced abortion because it fits the provisions of Spanish Organic Law 9/1985, of 5 July,
that amends Article 417 bis of the Spanish Criminal Code (referred to hereinafter as Organic Law 9/1985)
which specifies three cases in which a woman may have an abortion: 1) fetal malformation up to 22 weeks
of gestation; 2) on account of rape, after filing a report with the police and before 12 weeks of gestation; 3)
if the physical or mental health of the pregnant woman is at risk, in which case there is no time limit. It is
also worth mentioning that my research was conducted when the above-mentioned Law was still in force,
but a new abortion law was passed in Spain on 24 February 2010.

The effort to follow the interviewees expressions and manner of speech is lost in the translation into
English.

Foreign and immigrant interviewees

Amongst the flow of immigrants recorded in Catalonia in the last few years, many
young women are arriving who are or will soon be of reproductive age. Due to a
number of different factors, some of them find themselves having to face unwanted
pregnancies and abortions. Many of them are also in more a more precarious situation
than the Spanish and Catalan women because they have no job or, if they have one,
the job itself is very unstable. This circumstance indicates that their financial situation is
the main reason for seeking an abortion, and for that they need financial support from
friends, family or institutions.
The women came from several different countries, with the largest group being made
up of Latin American women (the Republic of Bolivia, the Republic of Ecuador, and the
Republic of Peru); followed by women from the Kingdom of Morocco; and lastly, from
Romania (Association, 2007:16). The study group was made up of women from
different social backgrounds and cultures. A large number of the immigrant women are
in single-parent families and their children are looked after by their maternal relatives
(only occasionally by the fathers or their paternal relatives) in the countries of origin.
These women have a primary education and, to a lesser extent, a secondary
education. Likewise, the majority have no network of contacts in Spanish society
(mother, partner, extended family, friendships, etc.) who can provide them with help
and protection if they need it. Immigrant women in general, and Latin Americans and
African women in particular, tend to have more children (compared to the currently
recorded number of children born to Spanish and Catalan women) 4 . Moreover, they
differ in the extent of their awareness of contraceptive methods and the way they
perceive abortion.
In this respect, for instance, abortion is an accessible resource to Romanian women
and it is relatively normal for them to have had more than one abortion. In contrast,
Romanian women are the ones who use the contraceptive pill and condoms the most.
Abortion is not particularly common among Latin American women, although the
number of repeated miscarriages can be quite striking 5 . Latin American women do not
use contraception much, and when they do, they mostly use the Ogino-Knaus rule,
which is not very reliable. Secondly, they use the intrauterine device (IUD), which they
refer to as the T or Copper-T. With regard to the Moroccan women, abortion is a
virtually unknown practice, as is the use of methods of contraception.
The changes experienced by immigrant women who are subject to accelerated
acculturation and neoculturation in parallel to forced integration in the country of
destination causes a metamorphosis imbued with strong emotions. Living far away
from their sons and daughters, from their partners, from their families and from their
4

In the Demographics section of the newspaper El Peridico de Catalunya, of July 4, 2008, there was a
news item stating that Catalonia had regained the fertility rate of 1984 with 1.48 children per woman. The
article reported that due to 10 consecutive years of growth, in 2007 the fertility rate (which measures the
number of children per woman of childbearing age) reached its highest level since 1984. This now means
that, at 1.48, the average number of children that women in Catalonia have is higher than even the
Spanish national average, which is a big difference to the low average recorded in 1995 (1.14). According
to the text of the article, even though Spanish women have more children, the increase in the fertility rate
is largely due to the foreign population. This is because the number of children born of immigrant women
increased by 16.4% in 2007, a figure equivalent to 18.8% of the total number of births registered in
Catalonia that year. Moroccan women had the most children, accounting for 21.6% of the total number of
births given by foreign women, according to the newspaper.
5

This level of reoccurrence made me curious as to the conditions and causes of these supposedly
spontaneous miscarriages. I found out that the miscarriages were frequently the result of acts of violence
perpetrated by the pregnant womans partner against her.

community of reference, they are extremely lonely: Im here alone, very alone,
completely alone. I have no one all of my family are over there, in my country.
Solitude is a further factor that increases the likelihood of not using contraceptives,
unwanted pregnancy and abortion:
I got pregnant and my husband is in my country aaand he doesn't know
about it he's there with my two kids because I came here to work and send
them every month and here I have no one no one at all all my family is in my
country I have no friends no one! and I felt very lonely so lonely thaaaaat I felt
really bad and I met him when I felt so lonely I met this man hes Catalan and
he seemed nice aaaand now he dumped me when I told him I was pregnant he
said it was my fault that right there I was on my own aaaandits just that I felt
so lonely and really bad () to his place he took me because he said I was
the love of his whole life and he said he loved me and I felt happy and believed
what he said and you see he got tired of me and found himself another
woman () my husband mustnt know about this [pregnancy and abortion]
so thats why I can't have it
Based on the interviews, I observed that most unwanted pregnancies and abortions
take place between a few months and the first 2 or 3 years of the womens residence in
Catalonia. Frequently, the men will abandon the woman when they find out she is
pregnant; even reunified husbands 6 , will, while blaming only the woman for the
situation. Many women assume the pregnancy as their own fault and even relieve their
partner of any blame for the situation. Usually they do not use contraception because:
its God who decides if you become pregnant or not, in my country, a man
who uses a condom is a sissy, or the doctor didnt want to put the T [IUD] in me
he said that I was too young and without a partner..
Apart from the economic instability, the loneliness and the major social and cultural
change immigrant women must experience, they must also tackle the contradiction that
having an abortion entails if religious beliefs lead them to say they are, for instance,
very believing, Im a very staunch Catholic, very devout Evangelical, or I truly
believe in God.

Further comments on the immigrant women who represent 70% of the

interviewees
The ethnographical study includes examples of the ways in which women from different
cultures apprehend the world. Many of them take care of themselves or plan,
meaning they want to use contraceptives to prevent unwanted pregnancies. They
comment that the pace of life in Catalonia is different; they often live with their partners
after a brief relationship and they do not use contraceptives, which is why they want to
learn more about them.
Frequently they live with their partner after a relationship of only a few months because
it is preferable to feeling lonely. Normally, neither the women nor their partners use
contraceptives because their family and emotional context assumes that couples live
together out of love and the natural outcome of that love is to have children. This may

Family reunification: Under the governing law, once they have lived in Spain for 5 years or more,
immigrant women may start the application process for family reunification; that is, to arrange for their
partners and their daughters and sons to emigrate to the country (who are legally permitted to live in the
country, but not work in it). Colloquially, the term for this is reunifying someone.

be one of the reasons why the immigrant women interviewed were silent when asked
why they did not use methods of contraception.
Another feature of immigrant women is their level of dependence on their partner,
seemingly due to social and cultural teachings in their countries of origin. The same
was observed in Catalan and Spanish women but to a lesser degree. The women
seem to have a need for their partners to tell them how good they are as wives,
mothers and workers. In many of their narratives, I found that many of the men resort
to psychological and/or physical abuse that ends in conflict and aggression against
their partners, as well as temporary breakups that are sometimes final. The women
return to the men and forgive them, even when the latter have won other women and
have sexual intercourse with them, because they feel loved when the men say they
want to have a child with them and interpret this as 'a sign of love'.
The outcome of many such signs of love is a child and, sooner or later, the couple
breaks up. In most cases, the men abandon their partners and children, while the
women, after a brief period of mourning, enter into a new relationship which quickly
turns into living by that guys side, living with my husband in concubinage or
"sharing a loose relationship but Ill marry him some day. A new pregnancy follows
shortly after, based on the assumption that everyone wants a child when they love
someone, despite the briefness of the love.

Spanish and Catalan interviewees

The majority of Spanish and Catalan women interviewed came from Barcelona city and
its metropolitan area, in fewer numbers from elsewhere in Catalonia, and only a few
from other parts of Spain. Most of them come from an urban context.
Most of them had a secondary school education, although in several cases they had
not completed these studies, claiming that they did not enjoy studying, started to have
boyfriends, or had to work because their families needed money. Their low level of
schooling and limited job opportunities gave them access only to jobs in the tertiary
sector that required little qualification and were so poorly paid that they could barely
cover their needs. However, several of the women left their jobs when they become
pregnant, thus becoming dependent on their husband or partner. They were unable to
go back to the same employment situation after they had their child because they had
no one to care for the baby while they were at work, or they could not afford a nursery
or secure a state benefit for this purpose.
Therefore, with a certain frequency, these women were forced to become housewives
and to depend on the income of their husbands or partners, whose salaries tended to
only just meet the familys needs. From the interviews I detected that in quite a short
space of time the first conflicts between the couple would arise, and tensions
progressively acted upon their relationship, leading to separations and arguments, later
followed by reconciliations and further separations, in between which unwanted
pregnancies occurred.
With regard to religious practices and their influence on using contraceptives and
coming to terms with abortion, most of the women had an eclectic stance, based on the
notion of a lesser evil. That is, they decided to have an abortion when faced with the
responsibility of having a child and not being able to provide it with the necessary care.
They held the belief that God would understand their dilemma and the choice they
made.

Sexual and reproductive health in the ethnographed women

Many of the immigrant women and Spanish and Catalan women referred to the
problems and barriers they had to face to have access to reproductive and sexual
health services. These restrictions and setbacks affect immigrant women even more
so, for often they do not know how the health system works and how to use it. This is
apart from other factors, such as not understanding of the language, and what health,
illness, pregnancy, abortion and maternity may involve in different cultures.
After analyzing the data obtained, I can assert that immigrant women are undergoing
the same process most Spanish and Catalan women have been undertaking over the
past 30 years with regard to sexual and reproductive health services. This is evidenced
by the interviewees desire to take care of themselves, i.e. to use contraception and
prevent sexually transmitted infections. Moreover, these are resources that have
important deficiencies which affect not only immigrant women but all women, for public
health is a right in Spain.
Beyond doubt, the changes that have taken place in Spain in the last thirty years have
been remarkable and have made fundamental changes to the lives of Spanish women,
such as the legalization of contraceptives in 1978, the divorce law in 1981, the
legalization of abortion in three specific circumstances in 1985, womens access to a
university education and jobs (with the resulting independence this gave them), sexual
legitimation and progress in the achievement of equal rights for men and women.
Despite the presumed progress, certain issues persist, however. Some of the most
common aspects, for instance, are the scarce resources allocated for addressing the
sexual and reproductive health of men and women; overcrowding; delays of several
months in the provision of services; difficulty in acquiring contraception, whether due to
the lack of doctors prescription or due to its price; the inherent failures of methods of
contraception themselves; and the poor transfer of information by certain sectors of
medical personnel in general.
Driven by the above-mentioned circumstances, but at the same time based on
personal resources and capabilities, specific aspects must be considered, such as the
difficulties women have in using the methods of contraception correctly. Another such
aspect is the mens inhibition where contraceptive precautions are concerned, as if
they were solely the womans responsibility, and even the refusal to use a condom, as
a sign of their masculinity. Another argument is that God wishes to send a child and
you should not disrespect Him by preventing it" or that Its not the same (what they
experience cannot be compared to using a condom, and therefore they decide to pull
out). Normally, the default outcomes of these actions are unwanted pregnancies,
abortions, and sexually transmitted infections.
Whether they are Spanish or Catalans or immigrants, almost all 7 the ethnographed
women had experienced an abortion, which seems to indicate an unwanted pregnancy.
Therefore, the question as to why contraception is not used in sexual relations when
pregnancy is not intended. As mentioned above, the reasons are often unexpected
and connected with the couple, the family, religion and custom, all of which are
sufficiently entrenched to prevent precaution in coital relations, as the ethnographed
testimonies reveal.

Some of the interviewees decided not to abort and went ahead with the pregnancy.

Reasons teenagers give for not using contraception

The desire to become pregnant, omissions of contraceptives that may end in
pregnancy and abortion as an alternative to contraceptives appear in a different light
when teenagers are involved. Their narratives evolve around accidental pregnancies
caused by inadequate use or omission of contraceptives in relationships that are not
going anywhere, as they express it. When asked why they do not use contraceptives,
most of the young people replied:
he always used a condom well thats what he said and I believed him, you
know?actually, he did use it quite a lot but I was really surprised because
before coming well he took it off and came outside of me, you know? and I
thought that it all went away when he pulled out to come and that nothing would
happen () [She is asked why she did not take contraceptives] To tell
you why, Id have to lie or make it up I cant say why I didnt use
anythingwell, we didnt, because it takes two, right?.
for me its the first time this has happened to me [referring to her pregnancy]
and I dont have a clue about what happened because its the first time I ever
did it and he didnt come inside he came outside and I just dont know what
happened () I dont see how I got pregnant because a friend told me that
at first you cant get pregnant because since its the first time well, it's
okayyou get pregnant when youve been doing it for a whilewhen you do it
a lot of times and all that, you know what I mean?
Some of the reasons teenagers give for not using contraception in their sexual relations
can be quite surprising:
I dont take pills [contraceptive pills] because he doesnt want me to and I love
him so much well I dont take them because he says that if I do its because I want
to be with someone elsethat Im going to get laid by someone elseand he tells
me not to take them and its because hes jealous because he loves mebecause
hes a good personand thenyes, he got scarednow he did!he tells me to
take them once this [the abortion] is done with so it wont happen again and I will
because now hes got the idea
he loves me a lot he takes care of me better care than my mother, even!
he pays attention to everything he knows when I have my period and which
are the risky days to do it [to have sexual relations] and he pulls out in
timewell, almost always! because sometimes he can't and so I'm going to
take the pill [post-coital pill] () he doesnt want me to take pills
[contraceptive pills] or the ring [the vaginal ring] like his sister because he says
that if I use it or take pills its because I dont trust him when he gets mad at
me he tells me dont you dare take them [contraceptives] because hes sure its
because I want to do it with someone else () he wants them to get rid of
it [to have an abortion] more than anything because he doesn't want any
problems he says he doesn't want children and that's why he tells me to get rid
of it and that he'll be more careful after that"
Many teenagers find abortion easier to deal with than adult women do because they do
not have plans for a steady relationship and they think the time has not come for them
to have children, given their family and economic situation. Teenage girls normally
have boyfriends in their same age group, with whom they establish relationships that
last between 2 months and 2-3 years. Teenage girls tell their partners about their
pregnancies, although sometimes they do not, because they are anxious not to involve

them in a process they believe to be theirs only or because they do not view their
relationship as stable.

Methods of contraconception and womens reproaches

The emergence of methods of contraconception meant an entirely new world for
women. Hritier points out that contraceptives were a tremendous revolution because,
for the first time in history, men needed womens consent to procreate. The
anthropologist asserts that men accepted the development and widespread use of
contraceptives because they did not realize what they would do (Hritier, Diario
La Nacin, 2007).
It is a wonderfully emancipative instrument (Hritier, Diario La Nacin, 2007), for it
touches upon the exact moment in which female dominance takes place. Hritier
rotundly proclaims, I believe that, even today, women do not realize the full scope of
contraception (Diario La Nacin, 2007). The issue Hritier appears to address is how
women still do not see themselves as subjects and remain ensconced in the notion of
being objects, an ambiguity apprehended in the course of History. Perhaps that is why
so many women still do not employ methods of contraception in their coital relations.
The sum of issues could give rise to reluctance to and rejection of abortion, as opposed
to the virtues of maternity.
With the exception of male contraceptives and vasectomies, most methods of
contraception target women. It is the women who must choose a contraceptive and
assume responsibility for continued use to prevent unwanted pregnancies and sexually
transmitted infections. Each method of contraception has a series of side effects that affect
womens health to a certain extent. It is no wonder, then, that in their testimonies, the
women complained about the symptoms caused by contraceptives, which made them stop
taking the pill or using an intrauterine device, vaginal ring and so on. Many health
professionals did not give much importance to womens grievances but the side effects
they experienced are a recurrent theme in the interviewees narratives and reflect their
discomfort.
Many of the women interviewed reported that they stopped taking hormone
contraceptives because they made them gain weight, suffer headaches and become
unusually moody. Varicose veins and frequent vomiting and dizzy spells were other
unwelcome symptoms. The women explained that they did not want to stop taking the
pill but they made appointments with their gynecologists to switch to another method of
contraception. However, the delay in getting an appointment (4 to 6 months) forced
them to desist, forget about it, or get pregnant in the interim. Evidently, they could have
chosen another method of contraception, but they and their partners had grown
accustomed to relatively reliable methods and discarded any others, either through lack
of foresight or mere omission.
Many of the women were annoyed because drugstores refused to sell them
contraceptives over the counter, alleging that they had to go in for a checkup and get a
prescription for the right kind of contraceptive. When the women went through the steps
and finally saw a doctor, they were dispatched in a couple of minutes and prescribed a
battery of tests that took weeks before they could see a specialist. Occasionally, they
were prescribed contraceptives with no examination at all, which meant it would have
been better to be sold the contraceptives over the counter without having to go through
the entire time-consuming process, said the interviewees.

Another aspect criticized by the women was the cost of contraceptive pills, male
condoms, the intrauterine device (IUD) and subcutaneous implants. The latter two
devices are worth the extra cost if one considers the years of contraceptive protection
they afford, but in the opinion of most of the interviewees, condoms and the pill should
be sold for a symbolic price or be free of cost, and be readily available to women and
men of any age. The interviewees held similar views with regard to postcoital
contraceptives, which they felt should be available to women over the counter 8 .
Grievances with regard to abortion as a radical method of contraception appeared in
the narratives closely connected to each womans particular circumstance, that is, to
each womans perception of the process and her personal resources. The difficulty
involved in finding information on where to go for an abortion and how to apply for
financial assistance, if necessary, was mentioned. So was mistreatment on the part of
certain health care professionals when they expressed a desire to abort, the kind of
attention they received at the hospitals (respect, anonymity, waiting time, personalized
or mechanical care, unpleasant incidents with the staff, post-abortion complications,
etc.), and the anxiety with which they endured the process were some of the factors
most frequently mentioned by the interviewees.

Reckless conception or wrong contraception?

As mentioned above, the reliability of widely-used contraceptive techniques such as the
pill, condoms and intrauterine devices, while not totally safe, still provide around 99%
assurance that pregnancy will be prevented. Nonetheless, the women still reported a
considerable number of unwanted pregnancies. In the interviews, I found that more
than one third of the unwanted pregnancies were due to failures in the method of
contraception used, in a technical sense.
I infer from this that a reliable number of unwanted pregnancies would be due to torn
condoms, interactions with drugs prescribed to combat pathologies that diminished or
annulled the effects of the oral contraceptive, slipping or inadequate insertion of the
intrauterine device (IUD), incorrect placement of the vaginal ring, detachment of the
transdermal patch, a miscalculation of the fertile days, and so on. In view of the
conditions in which the women contended that the other two thirds of unplanned
pregnancies occurred, I infer that it is due to carelessness during the conception
connected with unsuspected reasons that emerged during the interviews.
no I didnt use anything and he didnt eitherwhy? I dont really know Im
not in the habit Ive never used any method and thats why I didnt think Id get
pregnant () Im really feeling sensitive these days and I cry all the
time I think I wanted to [get pregnant]I know thats crazy but Ive been
thinking about it because even I can't understand it I mean why I didnt use
some kind of method
In the scenarios described so far, it cannot be said that the women (and their partners)
had taken every precaution to prevent a pregnancy, because if they had, it would not
have occurred. Even so, they did not forget to take precautions deliberately, with the
intention of getting pregnant. These are ambivalent situations in which an omission
8

At the time of this research, a doctors prescription was required in Spain. Getting a prescription involved
making an appointment to see a doctor, who gave her information on the potential side effects and what to
do if they occurred, and a prescription for free oral contraceptives. Appointments for post-coital pills,
however, were handled at the Primary Health Care Centres emergency service, where they were given
immediately, kept confidential and were not entered in the woman's medical record.

leads to pregnancy and abortion is the remedy to a precaution that was not taken. In
other words, the desire to get pregnant overrides the method of contraception which
would have been advisable. Abortion annuls the negligence with regard to
contraception and the possibility of pregnancy, if any, is interrupted.
Omission was the reason for resorting to abortion most frequently cited. It fell within the
category of the accidental, the result of fortuitous circumstances connected to
unintentional mechanical failures in the contraceptives used. A precarious and unstable
situation that ruled out the intention of living together as a couple was among reasons
the women gave for being unable to continue with the pregnancy. Moral considerations
also came into play, as though the new being would be deprived of living a full life
under such circumstances:
well we met around three months ago, more or less, and after two years
without a partner or relations or anything well I got pregnant the very first time
because I was careless I don't take the pill or anything and he well he didn't
havehe pulled out but something must have stayed in but I just cant
understand it ()I cant have a child now because we dont even know
each other its not the right time and because I have a girl age 7 and he has two
kids of 9 and 13 who are with him so it's impossible to have a child in the
situation the two of us are in ()besides with no future to give the kid that's
bornno way! it's very hard for me but I have no choice"

Relationship between violence against women, pregnancy and abortion

Lori Heise (1998:265) provides a conceptual model to determine the connection
between violence against women, pregnancy, abortion and the consequences of all
these at three levels: the individual level, the interpersonal level and the community
level. The individual level includes factors that increase a womans risk of being subject
to violence or of a person committing violence. At the interpersonal level, Heise adds
factors that affect personal relationships with partners or the family. At the community
level, she factors in an individuals immediate environment: the wider community with
certain rules and local beliefs, social networks, and the institutions that provide
services. Thus, the community level encompasses cultural values and beliefs that
have an impact on the other two levels.
The aspects that can affect and produce a connection between violence, pregnancy
and abortion are differentiated according to the social, community, interpersonal and
individual level (Heise, 1998: 284). The social level comprises tolerance of violence,
ideas regarding honor, violation as an instrument, rigid gender codes and restricted
access to abortion. Culture codes involving male dominance and mens sexual right
over women expressly relate violence, pregnancy and abortion. In relation to the social
level pointed out by Heise, the interviews conducted in this research revealed cases in
which the women reported having been sexually forced by their partners.
At the interpersonal level described by Heise ranks male dominance of his partner,
marital conflict with the acceptance or tolerance of violence as a way of solving
problems and the prohibition of using contraceptives. Many women fear their partners
or suffer violence from them, and they often say that it is difficult, if not impossible, to
mention contraceptives to them. Moreover, the women may fear abuse or actually be
the victims of abuse if they use contraceptives without their partners' consent:

10

he always told me he was careful and that he did it outside that it ended up
outsideand that's why he didn't let me use the T or take pillsand I was so
afraid that I didnt dare say anythingto say no to him
I think that's actually what he wanted to tie me to him to have me dependent
on his will because he didn't want me to take anything he said that way I
wouldn't harm my healthI think he only wanted to get my pregnant to tie me to
him so I wouldnt go offthats why I want to have an abortion without him
knowing maybe Ill tell him later but now Ill think of something I dont know that I
aborted all of a sudden or something like that"
he discovered that I took pills [the pill] and threw them out the window into
the street telling me not to take them ever again and he has such a bad temper
he was so angry he hit me he hurt me a lot and when they heard my screams
they called the police and took him away I don't know where they've got him
locked up () he always told me I would have to accept all the children
God gave me thats why I couldnt plan [take contraceptives]"
Im going to ask him Ill tell my husband because he knows about that
[contraception] I dont know I never used anything only my days [Ogino-Knaus
method]Ill ask him about what you told me this morning [she was offered the
placement of an intrauterine device at the Association] may I come back [to the
Association] and tell you if he says yes?
you are different here because in my country women cant go to the doctor
alone or anything because their husband always has to go with them because if
they go alone they dont get care and thats why my husbandI tell him about
everything and he decided for them to place the T the IUD [intrauterine device]
after they do it[an abortion].
These narratives make it clear that men often prefer to leave the burden of
contraception to their partners because, paradoxically, it is the men who decide
whether or not the women should use contraceptives. As many interviewees reported,
a womans independent decision on whether or not to use contraceptives is viewed by
many men as an attempt to escape their control or as proof that their woman is
unfaithful to them or planning to be in the future.
Women who have to conceal their methods of contraception for fear of their partner's
violence do not use contraceptives properly or do not have the courage to use an
intrauterine device (IUD). Women immigrants report that their partners forced them to
stop using contraceptives before setting out on their migration journey:
before I came here he made me take out the T [intrauterine device] because
he said that since I wasnt going to have relations here because he stayed there
and I went to the doctor to have it taken outand thats why I dont want the T
because he doesnt know about my pregnancy and I cant let them place it in
me because my husband would notice and I cant tell him anythinghe doesnt
know what Im going to do because it was here that I have a new relationshipI
felt so lonely hereaaaand then, how could I explain the T to him?
he calmed down then because before I came here I had the T [intrauterine
device] taken out because he didnt want me to come with the T and why are
you going there with the T if I'm staying here and you're leaving to work? he
always said that until I had it taken out and then he calmed down

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Many women reveal that defying their partners can cause threats, blows and abandon.
To avoid such situations they obey their partners and do not use or stop using
contraceptives. As a result, they cannot prevent unwanted pregnancies. In other cases,
the womens partners may force them to use ineffective methods, and then refuse to
follow the methods guidelines:
I count my days but he doesnt care its when he wants and thats that! and
of course hes so manly! he doesnt want to use a condom because he says it
wasnt made for him but he always wants sex, sex and more sex!and I
don'tand its because I can't because Im always so tired with all the work and
the housework and my three children and everything!maybe you could tell
him talk with him and explain to him so hed understand me, you know?
because I've just run out of words with him its no use he doesnt listen and
maybe he'd listen to you"

Connection between violence, pregnancy and abortion from an individual's

perspective
Let us return to Heises conceptual model and the aspects that can associate violence,
pregnancy and abortion at the level of the individual, which is where childhood abuse
and abuse by family or partners occurs. That is, rape and incest, unprotected sex,
contagion of sexually transmitted diseases and economic dependence. Here there is a
direct connection between unwanted pregnancy and not using contraceptives.
At the individual level, a strong connection between religious beliefs and the use of
contraceptives and resorting to abortion was detected during the interviews. A number
of women asserted that they were "profoundly religious (Catholics, Muslims and
Evangelists, in this research). They expressed intense anguish when they stated their
decision to interrupt their pregnancies and the contradiction they had to face, contain
and integrate. In a similar vein, the women had to counterbalance the strong family
principles they had integrated through socialization and interpreted as whats done in
my family, what my mother (or any other authoritative female family member) says or
what our father taught us with having an abortion, which symbolized breaking the
rules and customs.
Certain studies substantiate with evidence that childhood abuse is the tendency of
female victims to participate in risk-taking behavior that affects the use of
contraceptives (De Bruyn, 2003:11). I observed in some testimonies that pregnancy is
a factor that triggers a partners physical and psychological violence in the form of
punishing the woman for getting pregnant.
It is essential for abortion-related research to examine violence as well. In the literature
and studies consulted (Senanayake and Potts, 1995; Center for Reproductive Rights,
2007; United Nations Development Fund for Women, 2007; International Planned
Parenthood Federation, 2006), which were conducted in countries where abortion is
legal and there are few restrictions regarding the reasons for aborting, the responses
described are unspecific, such as unexpected pregnancy, problems with the intimate
partner and family problems. The reasons could also be more specific, such as
financial or health problems, the failure or non-use of contraceptives and so on, but
they do not mention violence. Apparently, there is a tendency to exclude such a
delicate topic as violence, even in the questions on miscarriages, where abuse and
rape can be the cause of the pregnancy and violence the action that puts an end to it,
as several narratives collected in the course of our research shows.

12

Considering that the majority of acts of violence against women is gender based, an
approach that can pinpoint and reveal the standards connected to femininity and
masculinity is essential. Armed with this knowledge, it will be easier to access and treat
community factors, such as the social and cultural tolerance that allows women to
remain in a situation of violence and keeps them isolated. In this sense, the situation is
very clearly illustrated in the interviews conducted at the Association, where many
women from Arab countries, Pakistan, India, Bangladesh and African countries, after
years of living in Catalonia, still speak their native languages only. This means that the
only way they can be treated, or carry out any activity in the public domain is to be
represented by their husbands and partners, who accompany them at all times. Not
knowing the language is not correlated to violence, but it does create a situation in
which it is easier for violence, if any, to develop inadvertently.
Interpersonal factors also emerge in the interviews, revealing that cultural standards for
the role and status of women and men foster the belief that men are entitled to control
and punish their wives. This situation is evident at the Association, when the interviews
are conducted with women who need the intermediation of their husband or partner
owing to the language barrier. It is always the men who carry the women's identity and
health documents. It is the men who provide the data regarding menstruation,
fecundity, fertility, contraception and so on, without consulting their female partners,
and the men who explain that she did not take the necessary precautions and that is
why she is pregnant. Normally they scold the women if they do not remember
something they are asked, and they decide whether or not the women should use a
method of contraception.
Moreover, the husbands or partners explain that it is they who provide the economic
resources to support the women and their children, if any, while the women are shut
away in their homes with no relationships with others, not even with neighbors and
people in their immediate surroundings. This means they do not learn Catalan or
Spanish, because they are dull and ignorant, the men say. Frequently, the women are
illiterate or have not completed primary education. Even if they have reached the level
of higher education, their situation of dependence and isolation is not visibly different,
at least it is not apparent in the examination conducted during the interviews. At the
request of specialist who attends to them at the Association, the husbands and
partners translate the information for the women, but how they translate it and how
much the women understand is not known.

By way of conclusion
Contraceptives became a widespread practice that converted planning for children into
a reality. It is not until contraception became safer and available to most Western
women in the 1960s, however, that womens sexuality became effectively separated
from maternity. Maternity, women's lot for thousands of years, became a matter of
choice. The desire for motherhood, which is a characteristic of fecundated women
conducive to acceptance of all their pregnancies, was transformed into a planned
intention, a project. Therefore, unwanted pregnancies are perceived as a failure or
become unintended actions.
An evident contradiction underlies many unexpected pregnancies, consisting in the
intention to avoid pregnancy and not taking adequate measures to prevent it. Such
actions are not as casual as they may seem at first because how can one think that
nothing will happen just this once if contraceptives are not used? In fact, there are
elements in the narratives that deflect conscious intention, remitting to an unresolved
conflict between practicing non-procreative sexuality and an unconscious desire to be

13

fecundated. Although the fecundation is consciously rejected, it is not fully rejected,

and therefore it can take place unexpectedly.
Sometimes it could be said that the way to make the desire for motherhood come true
is to transgress a method of contraception. This is what seems to emerge from the
explanations given by certain interviewees when asked why they did not use
contraceptives. Many of them could not give a good reason for not using
contraceptives to prevent pregnancy. On the other hand, the women who mentioned a
failure or omission that caused pregnancy seemed ready to admit a symbolic or
psychological motivation when they studied their situation in the course of the
interviews and became aware of their unconscious desire for motherhood. It seemed
incomprehensible to them how little control they had over themselves in such an
important matter in which their partner is practically absent and excused because most
of the women are convinced that the pregnancy is their fault, failure, responsibility or
mistake.
The scenario they create also seems intended to prove that they are able to breed,
expressed as I thought I couldn't have children because I didn't get pregnant" by
women who had taken precautions for a long time with effective contraception but were
anguished by a presumed loss of fertility. Likewise, it may be a way of gaining control
over their partners, a radical way of breaking their isolation or of proving they are still
able to have children despite their age. In any case, fecundity appears in connection
with sexuality, from which it is not completely removed. To this we must add the fact
that no method of contraception is one hundred percent safe, and therefore the threat
of unwanted pregnancy overshadows all heterosexual womens coital sexual relations.
Thus, an unwanted pregnancy may be beyond all attempts at planning and control, in
which case the only remedy is abortion.
In many cases, poverty and a precariousness place women in a situation of extreme
vulnerability in which physical and sexual violence seem to be the norm. Economic
penury accelerates the deployment of male violence against women, alcoholism and
abandonment by their partners or leads some women to resort to sexual work. Male
violence against women is a recurrent situation for women immigrants because gender
norms in Latin American, African and Asian societies dictate that men must decide on
matters related to fertility, family and women themselves, the interviewees reported.
Therefore, the men have the authority to decide whether or not their women can use
contraceptives. This male prerogative to decide is also found in many of the cases
reported by Spanish and Catalonian interviewees.
In my opinion, it is essential to state that when women, whether they are immigrants,
Spanish or Catalonian, are physically and/or psychologically mistreated by their
partners, family, society or employers, they tend to face situations that make it difficult
to use contraceptives. Consequently, their right to choose whether or not they wish to
have children voluntarily and without being coerced is violated. Likewise, many women
who seek an abortion or want to use emergency contraception report that they
encounter institutional violence. This may be because they were denied their
entitlement to abort, they were not given the post-coital pill, they were not attended by
the sexual health and reproduction services, or they were not given adequate
information when they expressed their desire to end the pregnancy, among other
possible situations. To summarize, in general, they reported some of the aspects
related to violence in connection with the omission of contraception, pregnancy and
abortion that contravene womens rights and their freedom to decide whether or not to
procreate.

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References
DE BRUYN, M. (2003) La violencia, el embarazo y el aborto. Cuestiones de derechos
de la mujer y de salud pblica. Un estudio de los datos mundiales y recomendaciones
para la accin. Carolina del Norte: Ipas.
HEISE, L.L. (1998) Violence against Women: an integrated, ecological model.
Violence against Women, 4:262-290.
INTERNATIONAL PLANNED PARENTHOOD FEDERATION
Legislation in Europe. Brussels: IPPF European Network.

(2004)

Abortion

SENANAYAKE, I.P.; POTTS, M. (1995) An Atlas of Contraception. London: Informa

Healthcare.

Additional References
BADINTER, E. (2003) Maintenant, cest la femme qui dcide. LHistoire, 277 :56-59.
BOLTANSKI, L. (2004) La condition ftale. Une sociologie de lengendrement et de
lavortement. Paris : Gallimard.
DELGADO, M. (2001) Las pautas anticonceptivas de las espaolas a fines del siglo
XX. Aula Mdica, 1:77-80.
DEVEREUX, G. (1960) A Study of Abortion in Primitive Societies. London: Thomas
Yoseloff Ltd.
INSTITUTO DE LA MUJER (1996) Declaracin de Beijing y Plataforma para la Accin.
IV Conferencia Mundial sobre las Mujeres (Beijing, 1995). Madrid: Ministerio de
Asuntos Sociales. Instituto de la Mujer. Paragraphs 94, 95, 96, 97, 216, 223.
MARTIN, E. (2001) The Woman in the Body. A Cultural Analysis of Reproduction.
Boston: Beacon Press.
RICH, A. (1996) Nacemos de mujer. La maternidad como experiencia e institucin.
Madrid: Ctedra.
ROBERTS, H. (1981) Male Hegemony in Family Planning. En ROBERTS, H. (ed.)
Women, Health and Reproduction. London: Routledge.
TULUD CRUZ, G. (2006) Faith on the Edge: Religion and Women in the Context of
Migration. Feminist Theology, 15 (1): 9-25.

Further Bibliographic Resources

Legal Framework
Spanish Organic Act 9/1985, of 5 July, that amends Article 417 bis of the Spanish Civil
Code. [Online]. BOE (Spanish Official State Gazette) No. 166 page 22041
published on July 12th 1985. Website: www.boe.es [Consulted, 20.07.08].

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Press
Diario El Peridico de Catalunya (2008) Catalunya recupera la fecunditat del 1984
amb 1,48 fills per dona. El Peridico de Catalunya, Friday, July 4th. Demography
Section.
Diario La Nacin (2007) El predominio de los hombres no tiene ningn fundamento.
[Online] Interview eith Franoise Hritier, on May 9th.
Website: www.lanacion.com.ar/cultura

Electronic resources
ASOCIACIN. Programa datenci a la maternitat a risc. Memoria 2006. [Online].
[Consulted, 20.09.08]
CENTER FOR REPRODUCTIVE RIGHTS. Leyes sobre el aborto en el mundo. Hoja
informativa, mayo 2007. [Online]. Website: www.reproderechos.org [Consulted,
14.02.08]
FONDO DE DESARROLLO DE LAS NACIONES UNIDAS PARA LA MUJER
(UNIFEM) (2007) Ni una ms! El derecho a vivir una vida libre de violencia en
Latinoamrica y el Caribe. [Online]. Website: www.unifem.org.mx/cms/index.php
[Consulted, 21.01.08].

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