Enriching environment
Abena Yalley
Literature, Politics and Public Administration
Abena Yalley (Postdoctoral Fellow / Department of Literature and Department of Politics and Public Administration) is a great example of how the ZUKOnnect Fellowships attract researchers from the Global South to Konstanz – who then stay there. Abena came to Konstanz as one of the first ZUKOnnect Fellows in August 2019. Just one year later, she became a Postdoctoral Fellow of the Zukunftskolleg. During her ZUKOnnect Fellowship, she established contacts with a good number of researchers at the University of Konstanz. She gradually felt comfortable with her new network of scholars and almost like a local. Right then she knew that beginning a research career at the Zukunftskolleg would mean a perfect academic environment for her. The freedom and independence presented invaluable resources and a great opportunity to be highly productive.
We talked to her about how she was able to benefit from these opportunities and resources.
You have been a Postdoctoral Fellow at the Zukunftskolleg since 2020 and you were also a ZUKOnnect Fellow in 2019 – what are your highlights from your fellowship?
I would say one of my major achievements is the position as Postdoctoral Fellow I was awarded by the Zukunftskolleg, which has enabled me to implement my current research project. In addition, my manuscripts on “Gender, masculinity and policing: The implications of police masculinized culture on policing domestic violence in Ghana and Nigeria” was published by Social Science and Humanities Open, while my paper on “Feminists across borders: Transnational feminism, knowledge production and university education in Nigeria” was also published by the International Journal of Social Sciences. I wrote these two manuscripts during my three-month stay at the Zukunftskolleg as a ZUKOnnect Fellow. In the early peak of the coronavirus pandemic, I received an invitation to join an African research consortium to map the impact of COVID-19 on research in Africa. I looked at the gendered impact of the pandemic on research in Africa. In addition, I was invited by Working Group CA18211 of the European Cooperation in Science and Technology (COST) to lead the sub-group on obstetric violence.
Since December 2021, you have also been a member of the Executive Committee – from which insights did you benefit personally?
Being on the Executive Committee is a great opportunity for me. I see it as an opportunity to contribute to the community with my own experience and background as an African scholar. I would, however, say that I’ve been schooled educative and empowering. Gaining insights and participating in administrative processes at the Zukunftskolleg, especially evaluating applications for funding and fellowships, have been so enriching. This has increased my own understanding of what reviewers look for in applications, allowing for self-reflection on my own future applications, especially to funding organizations.
I’ve also developed my own reviewing skills, being conscious now of common biases that may be present and affect a successful review.
In your research project, you are studying obstetric violence in relation to high maternal mortality and low facility-based deliveries in Ghana. Can you tell us about the magnitude of the abuse taking place in Ghana?
Obstetric violence, though a relatively new concept, is not a new experience for many women worldwide. Many women have suffered abuse during childbirth, but the sacredness of birth has often sealed their lips and prevented them from voicing their experiences. In many societies, narratives of birth experiences are considered a taboo, adding to the silence on this issue. This is similar in the Ghanaian society. The phenomenon of abuse during delivery among Ghanaian women is relatively high compared to other countries. In my research, I investigate its prevalence and dynamics in the Ghanaian context using both qualitative and quantitative research methods. In late 2021, I conducted a survey involving 2,145 women who have given birth in eight public health facilities in Ghana. My study revealed that more than two out of every three Ghanaian woman (65%) who gave birth in the public health facilities experienced at least one form of obstetric violence. Women’s experiences were not exclusive, as more than 80% of these women experienced multiple forms of abuse. The most common forms were non-confidential care (35%), where their privacy was breached by not being covered during delivery or vaginal examinations, and abandoned care (33%), where women were ignored when they needed care, with some giving birth without health workers being present. Others included physical violence (27%), which manifested itself in beatings, slapping or stitching without anaesthesia, non-dignified care (28%), where they were either shouted at, mocked or verbally abused, and detention in health facilities for their inability to pay hospital bills.
Single women were 60% more likely to be abused than married women, while women with no formal education were also more likely to experience physical abuse, thus revealing how social gender constructions of marriage and educational status shape women’s treatment during delivery. Furthermore, women with HIV/AIDS were also more likely to experience non-dignified care, while teenage mothers had a higher probability of being physically abused. All other categories, such as income, rural versus urban residence, ethnicity, religion, type of birth, gender of birth attendant, had no correlation with obstetric violence, showing that obstetric violence is highly normalized in delivery services and leading to the conclusion that all women who deliver in any of the eight public health facilities studied in Ghana are at a substantial risk of experiencing obstetric violence. My study revealed that the scale of obstetric violence against Ghanaian women is enormous and highly institutionalized, and this explains the reluctance of women to deliver in facilities.
How did this change or how has it developed with regard to the global COVID-19 pandemic?
The COVID-19 pandemic has had an enormous impact on the already fragile maternal health system in Ghana, thus complicating women’s experiences. Women’s narratives reveal that the increased attention paid to COVID-19 relegated the importance placed on maternal care, leading to a lot of abandoned care in both antenatal and delivery services. Furthermore, in an attempt to curb infections, health professionals became more unresponsive to women’s requests for care during delivery and more impatient with those with special needs. Women reported more yelling and verbal abuse from care-givers, which also had an impact on their willingness to use facility-based delivery services. In many instances, this increased birth complications and maternal mortality in Ghana. The country recorded a 12.3% increase in maternal mortality, the highest number of maternal deaths since 2010. It must, however, be noted that this situation is not peculiar to COVID-19, since past pandemics, such as Ebola and Zika, recorded similar impacts on maternal health and mortality.
How did you first come into contact with your research topic?
I must say the phenomenon of obstetric violence was off my radar until 2019 when I joined the Zukunftskolleg as a ZUKOnnect Fellow. I participated in a feminist deliberation on birthing organized by Leila Abdala, a ZUKOnnect Fellow, and chaired by Professor Kirsten Mahlke from the Department of Literature, Art and Media Studies. My motivation for attending the seminar was purely my interest in feminism and to show solidarity for Leila. I was, however, moved by the discussions surrounding birth culture, patriarchy and women’s rights. As I reflected on these three concepts and their intersectionality, I remembered my own experience when giving birth in Ghana and the culture of violence. I had no idea that obstetric violence was the term for it, but I knew that I was grossly abused and humiliated. I engaged in further discussions with some of the scholars present and learnt that there was an emerging debate on obstetric violence in Latin America. I therefore did some research on the topic and also discussed it with Professor Anke Hoeffler from the Department of Politics and Public Administration, who encouraged me to conduct some empirical research on the topic with her support and mentorship. With further support from Professor Mahlke, I was able to win the Zukunftskolleg’s 2-year Postdoctoral Fellowship. I’m very happy that I was given the opportunity to implement this important research, thanks to the Zukunftskolleg’s support.
What is your research method in your project?
Exploring a feminist topic on violence demands a rigorous and a more robust methodology. I therefore used quantitative research methods to examine the extent of obstetric violence in Ghana by analyzing its prevalence, typologies and associated factors. I used a digital data collection software (Survey-To-Go) to administer questionnaires to 2,145 women who had delivered in the eight health facilities selected for the study. The women were randomly recruited in the health facilities when they took their children for immunization. In addition, qualitative interviews were conducted with 30 mothers to study women’s in-depth narratives and lived experiences, and with 30 midwives to examine their perspectives on obstetric violence and understand the causes in order to identify ways to deal with this challenge.
Your research should assist stakeholders in developing policies and frameworks. How can obstetric violence be curbed?
This is a difficult question to answer. From my study, it’s clear that the causes of obstetric violence are multifaceted and multidimensional, ranging from institutional factors, the subjugation of women in society and gender power dynamics within the health workforce, poor working conditions of midwives and nurses, the projection of women as objects of reproduction, excessive emphasis on delivery outcome than on a harmful delivery process, commercialization of maternal care, medical superiority, and ignorance of the impact of obstetric violence on women. Curbing obstetric violence therefore demands multiple approaches. It’s clear that in many ways obstetric violence is a result of patriarchal performance, hence safeguarding women’s rights and empowering them to take decisions about their bodies and the reproductive process are key. Introducing legislation to safeguard these rights and liberties is a first step. Furthermore, dealing with gender inequality in the health workforce by placing more importance on midwifery and granting women more power in the health system will inevitability reduce their stress and promote good treatment of women. There is also the need for comprehensive education in humanized birthing practices for midwives in order to promote violence-free delivery services, in addition to monitoring the conduct of care-givers and implementing punitive measures for offenders.
What were your major achievements in 2021/2022 so far?
I began my fellowship at the peak of the pandemic and, like for all other scholars, the pandemic has had a significant impact on my work. Being able to collect and analyze the empirical data for my current research project was therefore a great success for me. Within the academic year, my paper, “Martyrs of Socialization: Understanding the cause of domestic violence through the narratives of women in Ghana and Nigeria” was published by Gender and Behaviour. In addition, I also won the Visiting Scholar’s Fellowship of the Waseda Institute of Advanced Study in Tokyo and the Konstanzia Fellowship of the University of Konstanz. With an invitation from Sage Open and the South African Journal of Psychology to work as a reviewer and finally an editor, I’m very pleased to be contributing to knowledge production.
