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Abortion and Culture: Socio-cultural Context of Women’s Decision-Making Power and Marginalization in Urban Bangladesh
Anika Intesar1, Md. Shahin Parvez2,[*] and Bristy Khatun3
1Institute of Bangladesh Studies, Gopalganj Science and Technology University 2Department of Sociology, First Capital University of Bangladesh, Chuadanga, Bangladesh 3Akhitara Nursing Institute, Chuadanga-7200, Bangladesh
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Keywords |
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Abstract |
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Abortion; Culture; Decision-Making; Capital; COVID-19 pandemic |
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Abortion is a highly sensitive, controversial, and taboo subject in Bangladesh. Although it is considered illegal, unsafe abortions are not uncommon. This empirical study explains how women’s abortion decision-making is negatively associated with poverty and other economic factors, patriarchy and social mechanisms, and religious norms. The study uses two qualitative methods, key informant interviews and an in-depth case study. It shows that despite women’s right to social opportunities and rights, they are largely portrayed as an inferior, subordinate, and marginalized group. With little or no economic capital of their own, women’s decision-making in the patriarchal social pattern is influenced by their male counterparts. The decision to seek reproductive therapy, whether through biomedicine or home-based traditional methods, is often made by male household heads. There are multi-layered sociocultural mechanisms in which abortion may be the only viable choice for women. If it is conceptualized merely as a biological matter, a one-dimensional analysis cannot reveal the multidimensional aspects of abortion. This study explores the magnitude of women’s decision-making power and marginalization regarding abortion. |
Introduction
The relationship between a mother and a child is credited as the blessing of the Creator. However, sometimes a mother decides to abort her unborn child. The reason should be interpreted with caution because a single perspective may lead to shadow interpretation of this sensitive, yet necessary part of reproductive health concern. Considering this analytical thinking, this study focuses on the experience of women who have gone through an abortion procedure at least once in their lifetime. In doing so, this research attempts to give voice to those who are silenced by the stereotypical socio-cultural norms in Bangladesh. From a critical medical anthropological landscape, this study shows that the decision of abortion in this country is not always optional, but rather can be forced by multi-layered socio-cultural meanings.
Abortion evokes strong moral and cultural concerns and is ranked as the third most condemned practice after homosexuality and prostitution (Ouedraogo and Juma, 2020). Around one in five pregnancies ended by abortion throughout the world (Hodes, 2016). Unsafe abortion is one of the crucial reasons for maternal mortality. About one in eight pregnancy-related deaths worldwide result from unsafe abortions (Singh, 2006) due to an unmet need for family planning and better logistical support (Singh et al., 2018). Even under proper medical surveillance, abortion is a physically and emotionally distressing and life-threatening event because it has biological, social, and mental health consequences (Dudgeon and Inhorn, 2004). Undoubtedly, women’s autonomy in making healthcare decisions is crucial for sound maternal health. In recent years, women’s decision-making autonomy for reproductive health issues in developing nations is only 55.16% (Gebeyehu et al., 2022). Therefore, a well-planned policy can address the social mechanisms of reproductive autonomy (Adair and Lozano, 2022). So, the improvement of women’s capital and decision-making power, increasing decision-making knowledge and education, ensuring gender equality and self-confidence, etc. should be prioritized (Gebeyehu et al., 2022).
In modern medical science, abortion is absolutely considered a biological matter. However, it is defined as a bio-social event in medical anthropology to examine the mechanism of biologically embedded social adversity (Frazier et al., 2018). The qualitative research strategy in medical anthropology helps to understand reproductive norms, practices, and lived experiences within cultural contexts and provide culturally appropriate interventions (Dudgeon and Inhorn, 2004). Concerning this, the present study clarifies the interrelationship between abortion and culture, by illustrating how the decision-making process of abortion is more a cultural factor than a biological one.
Conceptualizing the Culture of Abortion in Bangladesh
In the Indian subcontinent, Mahatma Gandhi was an advocate of ahimsa (non-violence) and was against abortion by declaring, “It seems to me as clear as daylight that abortion would be a crime” (Hazra, 2017). As a South-Asian developing country, Bangladesh is burdened with many obstacles and reproductive health issues owes a major proportion. As a part of reproductive health concerns, abortion is regarded as the medical termination of pregnancy during the reproductive period under 12 weeks gestation (Dempsey et al., 2021). In other words, it is the action of terminating a pregnancy by removing the fetus from a woman's uterus after conception. Generally, abortion is done with some procedures (Ouedraogo and Juma, 2020):
However, in every way termination of pregnancy is related to potential health hazards, whether it is done by the modern biomedical method or by non-medical traditional method. Though the process of abortion has severe risk factors, it is not an uncommon phenomenon in Bangladesh. The role of the state is crucial for women who seek reproductive needs (Zanini, 2021). In Bangladesh, fetus termination was not legal before the 1970s. Later, according to the Penal Code in 1860, abortion was officially prohibited except to save the mother’s life (Sultana, 2013). The contemporary legal Menstrual Regulation (MR) allows women to abort a child within 6–10 weeks from the last menstrual period, only under some logical grounds such as exacerbating the threat of death or risk of having a disabled child. In both public and non-governmental health centers, MR is performed without a pregnancy test on whom are ‘at risk of being pregnant’ (Sultana, 2013).
Around 647,000 induced abortions took place only in Bangladesh in 2010 where almost 231,400 women suffer from health-related complications due to unsafe abortion (Singh et al., 2017). Every year, nearly 8,00,000 women use different methods of abortion despite having an extremely restrictive law. It is estimated that approximately 8,000 women experience death where around 92.3% of women suffer from post-abortion bleeding and around 70% experience fever (Bhuiya & et al., 2001). But it is quite difficult to learn the accurate figure because many women perform abortion secretly at home with some locally available substances such as datura, arsenic, cotton seeds, pineapple juice, aloe latex drinks, yellow oleander seeds, etc. (Jahan et al., 2022). But the unhygienic indigenous method is not only speculative but also can cause maternal death. So, there is a desperate need for proper knowledge about MR services which can reduce the rate of unplanned pregnancy and unsafe abortion (Singh et al., 2017).
Generally, the inadequate economic capital of women, household poverty, and social stigma are fundamental barriers to seeking medical services (Dickey, 2022). Although abortion is considered a moral transgression in this region, it is not an uncommon medical experience (Hodes, 2016). Here, the word abortion is almost every time associated with religious taboo and social stigma because of the cultural notion of purity and pollution (Lockhart et al., 2022). Abortion is portrayed as a dirty or unhealthy violation of two essential epitomes of womanhood such as nurturing motherhood and sexual purity (Kumar et al., 2009). The culturally determined gender-role foster impractical expectations of a ‘motherhood mandate’ which assumes that women must inherit the ability to become a mother (Osborne et al., 2022). It is encouraged to nurture a child rather than deciding on abortion because the blood after terminating a pregnancy is viewed as polluted blood (kharap rokto). So, abortion is disproportionately represented as dangerous and shameful in the public domain (Freeman, 2022). In this country, abortion is akin to murder after the ensoulment period, when the soul enters the fetus (Hussain, 2005). Therefore, abortion stigma shapes the environment in which abortion is delivered and received and eventually affects the quality of abortion care (Sorhaindo and Lavelanet, 2022). However, sometimes the experience of abortion is less stigmatized by adding accompaniment and removing the feelings of isolation (Wollum et al., 2022). Thus, abortion can be forced by multiple socioeconomic factors. Therefore, only one dimension cannot illustrate the accurate meaning of abortion in Bangladesh.
The patriarchal social structure and cultural norms contribute to theorizing the status of women in society. The male-centric approach exists in this country, considering the son as an asset and the daughter as a liability (Hazra, 2017). According to the male-head family pattern, a home is a place of masculine dominion where men are the prime decision-makers. As women are dependent on men’s decisions, they are not usually asked whether a new child can be brought into the family or not. Also, abortion therapy-seeking behavior is manipulated by the decision of husbands. Most of the time traditional home-based methods are used by unauthorized personnel or quacks (dai) to maintain purdah norm. Also, during COVID-19 outbreak, the limited access to medical care and raising cost of medication become a crucial economic factor. So, economic support, social capital along with de-stigmatization play instrumental roles in improving the reproductive autonomy of women (Dickey, 2022).
Theoretical Discussion
Theoretical analysis is crucial for this research endeavor. An anthropological explanation is viable to describe the relationship between politics and abortion, by unfolding the micro-politics of reproduction (Haaland, 2020). This anthropological study focuses on Michel Foucault’s notion of ‘bio-power’ which simply discusses the power over biological life- controlling birth and death (Thomson, 1995). He argues that bio-power is related to the practice of “make live and let die” through “an explosion of numerous and diverse techniques for achieving the subjugations of bodies and the control of populations.” (Oksala, 2013). Thus, the decision to terminate an unwanted pregnancy is not placed solely in the hand of a woman (Dudova, 2012). In Bangladesh, the idea of abortion is associated with sexual behavior and motherhood in the complex web of gender and power relations in society (Boyle, 2014). The decision of abortion can be considered as bio-power in which the husbands and in-laws’ members are the perpetrators. The women, who go through the abortion process, are muted group (Ardener, 1972) and their opinion is silenced by the structure of dominance. Some socio-economic factors such as low education level, religious values, stereotypical portrait of womanhood, lack of access to assets, etc. are responsible for their lack of decision-making power and vulnerable position in society.
Bourdieu's concept of three forms of capital is moderately relevant to this study. He argued that an individual possesses three types of symbolic capital (Neveu, 2018) such as-
In the case of abortion, the decision to terminate a pregnancy is also related to the lack of possession of three types of capital. They lack formal education, employment, and social network at the same time. Poverty limits their access to decision-making power within the household. So, women are one of the most economically vulnerable groups who lacks access to social and cultural capital.
Research Methodology
The main objective of this study is to illustrate the relationship between abortion and culture and how the decision-making process of abortion is more a cultural factor than a biological one. There are some specific objectives of this research:
This study is based on two qualitative research methods, including key informant interviewing and an in-depth case study. In addition to this, secondary data were collected from the newspaper, book, research article, and online platform. This study took 82 women of different age-group, educational qualifications, and economic status, as respondents. This study shows that despite belonging to different socioeconomic background and have different age and educational status, women are generally forced to do abortion. The following table shows the demographic profile of the participants:
Table no-1: Profile of the Respondents
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Variables |
Measuring Group |
Frequency |
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Age Group |
18-25 |
21 |
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26-35 |
39 |
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36-45 |
23 |
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46-above |
2 |
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Education |
None- SSC |
12 |
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HSC- Graduation |
52 |
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Masters or Higher |
21 |
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Occupation |
Student |
18 |
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Housewife |
30 |
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Employment |
13 |
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Temporary Job |
15 |
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Business |
9 |
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Economic Status |
Poor |
3 |
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Below avarage |
5 |
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Avarage |
32 |
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Solvent |
37 |
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Rich |
8 |
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Preferred Health care centers |
Public |
67 |
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Private |
18 |
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Total Respondents |
85 |
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Here, purposive sampling was used to find out the target population. This type of non-provability sampling is relevant for this study to find out the respondents who have best knowledge about the study topic and thus the researchers can achieve the objectives of the study. The data were collected from January 2022 to June 2024 in Mirpur, Dhaka. Five health centers in Mirpur area were selected from where the respondents were found who experienced abortion related health issues at least once in their lifetimes. Only women were selected as respondents because the actual experience of abortion is limited only to them. As abortion is related to social stigma, the identity of the respondents was kept secret, and pseudonyms were used in explaining their oral case histories. But due to the COVID-19 outbreak, respondents were not easily accessible in the early period of the study. However, this limitation was overcome in the later times. Also, data were collected by telephone conversation in order to maintain social distancing. This study is an individual project and did not receive any fund from anywhere. So, time and budget was one of the major concern during fieldwork. In short, the researchers attempt bring the best outcome for this study in every possible ways. The authors believe that this research can introduce a new academic arena for social scientists.
Result and Discussion
One of the most pathetic explanations of social hierarchy in Bangladesh is the gender-based negligence. Women experience different barriers to reproductive autonomy which permits no alternative than carrying out an abortion (Dickey, 2022). So, this study attempts to unfold the cultural meaning of the socio-economic mechanism regarding abortion.
The Decision of Abortion and Economic Factors
Bangladesh is the 8th most densely populated country with approximately 168 million people (World Population Review, 2019). This rapid population explosion, along with the scarcity of resources, causes different societal problems and reproductive health is one of the most neglected ones. It is increasingly becoming a tough job to bear and nurture multiple children while providing all the basic amenities such as food, cloth, residence, education, and medical care. Therefore, this study shows that economic reasons are a big factor in women’s decision-making process of an abortion.
Leacock (1983), a Marxist feminist, argued that women are not seen to the same degree as men in the historical gender hierarchy. The origin of gender discrimination is related to economic exploitation and class stratification. In Bangladesh, the journey of women to secure equality and eliminate discrimination is almost a continual struggle for years. The traditional patriarchal power practice pushed them to subordinate status to men (Ortner, 1972). The opinions of women are hardly taken into consideration. They usually take minor decisions such as buying cheap products (vegetables, fruits, clothes, etc.), whereas men take decisions of buying valuable and expensive things (machinery, land, house, etc.). Women usually take permission from their husbands before any purchase. On the contrary, a husband may or may not inform his wife. Thus, they become a target group who are born and brought up as reliable, passive, and manipulative. With little or no income, the decision-making power is in control of the male-head member on whom women are financially dependent. Thus, gender inequality lies in the hierarchization of labor relationship between paid productive labor and unpaid reproductive work (Amelina and Lutz, 2019). The income-generating sphere is more prestigious than the nonproductive sphere of reproduction. Though women’s unpaid activities such as giving birth and raising children, taking care of husbands, cooking, etc. require voluminous time and energy, these are not viewed as real work (Al Helal et al., 2017). In a word, labor that is not paid has no economic value, and labor with no value is not paid (Amelina and Lutz, 2019). So, the systematic division of labor and lack of education hinders women to run away from and remain out of hardship. For women, the imbalance between economic desire and economic hardship is responsible for the decision of an abortion.
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Case Study: “The decision of my abortion was probably the right choice.”
Parvin migrated from the Gopalganj district and settled in a slum near the Mirpur area. She works as a temporary housemaid (chuta bua) and her husband is a rickshaw (tricycle) puller. The monthly income of her family is very insufficient to pay the house rent. Besides, her in-laws depend on their income. Further, her husband used to waste money by buying drugs. Very often she faces extreme financial crises along with starvation. So, it is very tough to manage the expenditure and survive in city life. Under this circumstance, her sudden unplanned pregnancy enhances the tension and economic pressure for bringing another life to this earth. She cannot save the necessary amount of money to bring any additional child as an economic burden in this stressful mental state. So, she decided to abort her baby despite having religious and cultural taboos. So, she argued, “family planning program advocates the idea of a nuclear family (choto paribar sukhi paribar). I do believe in their motto. The decision of my abortion was probably the right choice.” She also regrets her decision to marry which was gradually proving as a failure. |
The family planning program in Bangladesh evolved to control the reproduction and address the problems regarding population growth. Urban women are more conscious about not giving birth to so many children, rather preferring the nuclear family because paves the path to economical solvency and social beneficiaries. The government, health providers, NGOs, etc. imperatively hinges around to make reproductive health knowledge accessible to the so-called inferior, subordinate, marginalized, muted, and underserved women. Still, some women fail to achieve desired idea of contraceptives because of cultural capital such as knowledge, education, etc. and social networking.
Bangladesh is a democratic country with a capitalistic nature. Here, the social structural arrangement narrows livelihood opportunities for women and excludes them from participation in or contact with different social realms. As mentioned earlier, economic dependency is related to the social subordination of women. As they are economically inactive as wage earners, the only means of achieving social status is through marriage and motherhood (Rashid, 2006). Before marriage, they are economically dependent on their father. After marriage, husbands are the authoritative persons with economic solvency and self-confidence. On the other hand, the economic dependency of wives makes them powerless and inferior. Women have no other option but to follow their husband's decisions unwillingly. They should obtain the husband’s legal consent to pick up contraceptives (Ojanuga and Gilbert, 1992). Even if a woman yearn for having a baby, she is not able to decide when and how many children can be brought into the family. Thus, women get less chance to express their voices and contribute to familial decisions. Moreover, economic capital is like a myth which is sacrificed for the welfare of the family. So, poverty is a key enemy for the victim of forced abortion, threat, or coercion. Multiple participants of the interview have experienced enforced abortion which is performed against their will.
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Case Study: “I cannot spend them as my wish because I am still beneath my husband” Luna, a garment worker, was married off at the age of fifteen. She was forced to get married early due to her darker complexion which is negatively stigmatized in the community to which she belonged. She sadly mentioned, “my dark skin was viewed as less desirable since my childhood. I was seen as a disgrace to the family.” Soon after marriage, she understood that she was living a loveless life where her husband married her only as a nanny for his old parents. The age difference between this couple is ten years. She started to contribute to the family by making bamboo baskets. But she argues that her income is used for the welfare of the family because “Even if I earn occasionally, the money is not my own. I cannot spend them as my wish because I am still beneath my husband.” Her husband is like her guardian who mainly takes household decisions. After three months of her marriage, she got pregnant due to contraceptive failure. Though she was happy, her husband exposed mixed reactions. After doing ultrasonography, her in-laws were unsatisfied because they expected a baby boy, a rightful heir of descent identity (bongsher batti). So, she was ordered to abort the baby. Thus, the preference for a son is related to the practice of inheritance and sex-selective abortion. But she could not gather enough courage to make a single step against his decision. However, her mother took her in a nearby hospital. The doctor requested not to terminate the pregnancy because it was dangerous at that stage. After sharing this with her mother-in-law, she criticized modern doctors who merely can handle the sentiments of young patients. She rudely replied, “Are you joking? It is just a lifeless fetus, not a murder.” Also, she blamed doctors for not maintaining women’s privacy. Finally, she had an abortion at home which was beyond her choice.
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This case identifies the patrilineal descent principle which is given more importance with the preference for the son and the absolute authority of men in the family. There is an economic ground behind this preference. The inheritance rule follows the Muslim family law ordinance of 1961 where the family property, titles, and obligations pass to the elder son after the death of the father. So, it is a desire of having a son as a bearer of bloodline (bonsher batti) and an heir of family property. The birth of a son is a joyful occasion for achieving the goal of inheritance (bongsho rokkha). Surprisingly, many informants mentioned that they have little idea about abortion law but have much knowledge about the property inheritance law. The preference of son is materialized by ultrasonography which can determine the sex of a child long before birth. So, reproductive technology is responsible for sex-selective abortion (Patel, 2007). Thus, the practice of abortion of a baby girl and female infanticide is related to economic ideologies. But women have little decision-making power on this abortion because the cultural right over a child is stronger for the parental descent line.
Like many other developing countries, in Bangladesh women’s ability to make decisions about their therapy-seeking behavior is dependent on economic capital of women. The household economy, over which women are dependent, prefers men to achieve proper nutrition, medical support, medicine, etc. The sons are supplied with better quality food than the daughters in Matlab, Bangladesh (Ojanuga and Gilbert, 1992). This unappopriate distribution of food and nutrition can increase maternal mortality (Ahmadi et al., 2017). Moreover, women from rich households are three times more likely to be autonomous than those from poor households (Gebeyehu et al., 2022). The economically solvent women choose clinics for abortion in terms of location, accessibility, expense, facility, privacy, safety, and legality (Heymann et al., 2022). They can afford private clinics where they can pay for the confidentiality of a safe abortion whereas poverty-stricken women cannot. The public hospitals are cheaper and more accessible for women with comparatively low economic capital. However, the lowest income group prefers to perform an abortion at their homes. They mainly depend on cheap indigenous methods by untrained personnel (village dais) in an unhygienic environment. The comparatively expensive biomedical treatment is usually the last choice for them (Begum, 2015). While a home is a more convenient and comfortable place, biomedical treatment demands high expenditure which is unable to meet (Fauveau and Blanchet, 1989). However, abortion procedures by unskilled medical service providers may cause serious physical complications, such as sepsis, heavy bleeding, abdominal pain, infertility, or even death (Singh et al., 2017). So, there is an urgent need for the improvement of MR services.Unfortunately, biomedical medical services become more expensive and less accessible during COVID-19 outbreak. However, telemedicine, including online consultation and medication, enhances access to safe abortion (Endler, 2022).
The Decision of Abortion and Social Factors
Abortion in Bangladesh is considered an inevitably destructive decision of moral values and cultural tradition (Macleod et al., 2011). Abortion is portrayed as a dirty or unhealthy violation of two essential epitomes of womanhood such as nurturing motherhood and sexual purity (Kumar et al., 2009, Koralewska and Zielińska, 2022). Abortion stigma is clearly a violation of human rights because it leads women to resort to unsafe abortions (Sorhaindo and Lavelanet, 2022). It is equivalent to murder because a human fetus is believed to has the right to live (Norris et al., 2011). Thus, stigma, a form of deviance (Goffman, 2009), takes place for both the women and their abortion providers (Haaland et al., 2020). It is a concealable stigma, unknown to others unless disclosed. Sometimes women’s social capital or networking can mitigate post-abortion syndromes such as health consequences, guilt, and shame (Kumar et al., 2009). However, the stigma surrounding abortion forces them to keep it secret and distances them from seeking social support.
Abortion is like a coin with two sides: on one side includes the mental suffering of women and on the other is physical violence. In Bangladesh where the wife-beating norm is very common (Sambisa et al., 2011), abortion frequently results in domestic violence such as physical abuse, threats, and blaming (Lee-Rife, 2010). Further, the socio-cultural meaning of certain beliefs such as black magic, evil spirit, evil eye, etc. explains as natural punishment for women who violate social norms. Moreover, the culturally illegal relationships such as premarital or extramarital affairs, incest, prostitution, etc. inflict strict punishment such as forced social isolation (ek ghore kora). However, an informant logically argued, “pregnancy through premarital relation is negatively stigmatized in society. I have seen many cases where a man does a criminal act, and it is overlooked. To the contrary, if a woman does a wrong deed, she is stigmatized by society.” This narrow treatment of women and abortion increases further complications (Osborne et al., 2022).
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Case Study: “Those women who publicly talk about their abortion are seen as shameless.”
Shetu was married to a man who was an emigrant laborer in Saudi Arabia. After several months of her first-time pregnancy, an ultrasound detects a malformed child. So, her husband decided an abortion before leaving for Saudi Arabia. Soon after that incident, many of her kin members stigmatize her abortion by saying that she suffered from the punishment (gojob) of an evil spirit. She felt lonely and distressed and involved in an extramarital relationship with a childhood friend. She accidentally conceived a baby. Then she wanted an abortion because the baby would never get any social identity. She said, “Those women who publicly talk about their abortion are seen as shameless.” Her parents abandoned her, neighbors left her in forced isolation (ek ghore kora), ever her partner refused to help her. Her husband came back quickly after knowing the disloyalty of her wife, physically assault her, set up a local tribunal meeting (shalish), and ended a divorce. Thus, her abortion was stigmatized as an immoral social act. |
In Bangladesh, the traditional stereotypical patriarchal power structure patronizes the systematic domination of men in the social hierarchy (Dudgeon and Inhorn, 2004). The domestic responsibilities of women, such as cooking, and their reproductive roles, such as childbirth, ensure an insignificant status to men (Ortner, 1972). They are subordinate to their male counterpart who is assumed as their guardians (Ahmed and Ahmmed, 2015). In this male-dominated culture, the decision-making power on major household issues lies with the male-head members who control the decision of reproductive health (Dudgeon and Inhorn, 2004). The participation of women in decision-making within the household is associated only with minor domestic spheres (Colfer et al., 2015). Even they have poor decision-making power on their own reproductive issues (Guracho et al., 2022). At the macro level, female reproductive health is influenced by male policymakers, healthcare service providers, or administrators. At the micro level, male-head members play vital roles. Therefore, the autonomy of women is restricted and very squat to women compared to their desired rights. Multiple social factors oversee this situation such as the low status of women, inadequate knowledge about contraception, lack of healthcare, patriarchy, social stigma, etc.
Besides, the decision of therapy management and the use of contraceptives barely rests on women. Likewise, in Cuba where the induced abortion rate is the highest in the world, women in this country have skepticism toward contraceptives (Bélanger and Flynn, 2009). While contraceptives can decrease unintended pregnancy (Rahman et al., 2001), the decision of contraceptive use and withdrawal depends on the agreement of men (Dudgeon and Inhorn, 2004). Thus, inadequate family planning increases the risk of unplanned pregnancy (Islam et al., 2022). On the one hand, the lack of social capital and connections hinders their access to healthcare services (Dickey, 2022). As it is associated with disgrace, shame, guilt, fear, and criminalization, and thus, women are more likely to delay seeking healthcare (Ouedraogo and Juma, 2020). On the other hand, the traditional veil (purdah) norm confined women at home and favors home-based therapy-seeking. Moreover, they think that the hospital makes a sense of alienation where they must bear impolite language and rough behavior. Moreover, many hospitals provide selective emergency services at high cost during COVID-19 pandemic. Also, social isolation and quarantine ideas hinders to seek abortion at hospitals. So, women opt for home-based treatment. Though it is notoriously difficult to count, many women try to execute an abortion at home without any medical supervision. Most of the traditional birth attendants (TBAs) are unskilled and lack formal training (Ojanuga and Gilbert, 1992). Therefore, abortion-related health hazards such as uterine sepsis increase (Hodes, 2016).
In South Africa, abortion is publicly condemned to regulate reproduction on the one hand. On the other hand, it is privately sanctioned for individual health benefits (Hodes, 2016). In Bangladesh, abortion culture also reveals a similar paradox. Here, the therapy management group, a set of individuals who are helps the sufferer, helps women to terminate pregnancy secretly to avoid stigma. Women always depend on their husbands who are taken for granted as guardians. Despite living in a ‘medical pluralistic’ country where multiple therapeutic traditions exist in the same cultural setting (Begum, 2015), women are hardly allowed to ask for better treatment. They are a ‘muted group’ (Ardener, 2005) which is seen as ideal womanhood (meyeloker shovab).. Several informants of this study claimed that cultural tradition puts women’s needs in the lowest priority and distanced them from decision-making ability. What is more, peripheral women are less exposed to media and have 1.8 times less autonomy than urban women (Gebeyehu et al., 2022). So, the countrywide scenario is very similar.
The lack of knowledge on contraceptives due to early marriage is another problem. In Bangladesh, the average mean age of the first marriage of slum women is only 16.54 years (Akter and Rahman, 2009). The early age of marriage hampers decision-making rights regarding contraceptive use (Akter, 2020). Nevertheless, many young women are at risk of health hazards for unintended pregnancy and repeat abortion more than once. Also, the incorrect use and failure of contraceptives led to the decision of postponing childbearing (Sultana, 2013). Also, husbands’ rejection of using condom often ends in induced abortion (Bairagi and Rahman, 1996). Again, the legally restrictive law increases the demography of abortion (Levandowski et al., 2012). So, more access to abortion can reduce unsafe abortion (Sedgh et al., 2007).
In Bangladesh, the rising number of ‘female headship’ households is vibrantly evident (Khan et al., 2018). These women are a particularly vulnerable group who are divorced, separated, or abandoned by their male partners (Ahmed and Ahmmed, 2015). It is common in Bangladesh that some men tend to hide their past marital history, relocate, remarry again, and leave their previous wives after becoming pregnant. It throws women into social insecurity as single mothers, economic hardship, and mental hazards. Furthermore, a child’s identity in this country is determined by the biological father and patrilineal descent lineage. So, neither the mother nor the baby can achieve any social value. Moreover, women sometimes try to prevent possible implantation because daughters are discouraged to raise in the patriarchal society (Abrejo et al., 2009). More than half of the respondents mention that there are some practical reasons behind the preference for sons such as the need for male agricultural labor, heir of family name and property, taking care of old parents, avoiding dowry, etc. So, female selective abortion (FSA) is not unknown idea in this country. In fear of these factors, women cannot but justify their choice of an involuntary abortion.
However, community-level discussions need to focus on the reduction of stigma (Levandowski et al., 2012). Over and above, raising mass awareness, increasing accessibility of family planning services, and training on MR methods must be strengthened (Ahmed et al., 1999). Because the benefit of safe abortion can contribute to the public health sector (Hodes, 2016). In Bangladesh, many social activists such as the Naripokkho organization believe that women’s reproductive rights must not be jeopardized for the sake of traditional orthodoxy, rather they advocate the idea of ‘my body, my decision.’
The Decision of Abortion and Religious factors
Religion is a major component of culture (Corrigan and Hudson, 2018). However, different religious groups in Bangladesh portray abortion differently, but with negative attitudes. Here, legal abortion faces opposition to religiosity (Osborne et al., 2022)., This study tried to find out the religious beliefs and mechanisms that influence women to take the decision abortion with related case study.
In Bangladesh, religion is a very sensitive issue, which is termed dharma, meaning uphold (Devine et al., 2019). Sometimes it is a more serious matter than the economy. Most of the population of this country is Muslim (around 87%), and the remaining 13% of people are Hindu, Christian, Buddhist, and others (Devine et al., 2019). The religious taboo and different the belief, ritual, and prohibition of different religion regarding abortion influences the decision of abortion. The state plays an ambiguous role with respect to women and religion (White, 2010). According to Islamic Sharia Law, embryonic development is very crucial. The fetus gets a living soul after four months (120 days) of gestation and abortion after that timeframe is impermissible and prohibited (Hussain, 2005). However, under extreme circumstances such as physical danger, rape, fetal impairment, etc. it can be permitted (Hessini, 2007). For Muslim women, it is forbidden (haram) and a great sin (paap) to abort a baby which ensures suffering after death or the afterlife (porokal). So, Muslim midwives randomly refuse to provide abortion services on moral or religious grounds (Fekadu et al., 2022). Again, many Muslim respondents argue that Surah Al-Isra (verse- 31) warns not to abort children for the fear of food and poverty. Moreover, there are many religious fatāwa (Hessini, 2007) regarding the use of contraception, a process of birth control with the help of a device, medicine, or surgery.
As a member of Muslim majority society, women emphasize the Islamic norms and practices. They must maintain privacy (purdah) by wearing the veil (Hussain, 2010). They should be submissive and pacifist to the contrary of men who are dominative, vocal, and powerful. So, the decision of women’s reproductive health rests on dominant male members because it is a matter of shame for women. In the name of maintaining family privacy, women are bound to choose the home-based indigenous abortion methods, mainly done by untrained personnel or the village "dais" under unhygienic conditions. Hospital care is the last resort for them after considerable suffering. Also, the ‘purdah’ culture restricts women’s knowledge about reproduction and is against the concept of ‘bring women out’ (White, 2010).
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Case Study: “I will die in pain but never go to a male doctor”
Smrity, a 35-year-old informant, is a homemaker. She was the second wife of his husband to whom she had two stepsons. Her husband was nearly 15 years older than her and was diagnosed as a diabetic patient. She mentioned that the sharp age difference between spouses is very common in her community. With little educational qualification and a lack of economic capital, she was confined at home after getting married and had little opportunity to take any decisions regarding household matters. She accepted every decision of her husband because there was a common saying in this country that the heaven of a wife is under the feet of her husband. Though she was a pious Muslim woman, her husband decided to abort their first baby. At first, she was suspicious of his intention. She doubted that she was only married to take care of his sick husband. But she could not establish her opinion due to hesitation and shame. Her abortion was done at a private clinic near Mirpur. She did not resist because she was more comfortable with her female doctor. She said, “I will die in pain but never go to a male doctor.” So, the purdah norm plays a very crucial role regarding abortion. |
Among the religious group, the unrecognized sexual relationship and unwanted pregnancy is socially immoral act. In this case, women who perform a secret abortion on the illegal ground, ask for repentance (taubah) and perform a shower for purification (paak goshol). Sometimes, they used amulets (tabij), drink holy water (pani pora), read sacred texts from the holy book (dua), etc. They believe that these can protect them from health complications, the pain of bleeding, anxiety, stigma, and even from unnatural death.
Abortion is viewed as a violation of religious ethics and women has fear of community condemnation (Cockrill et al., 2013).According to the Christians respondents, the Roman Catholic Church realizes that abortion goes against their belief. For them, humans are only custodians, not the owners of their lives (Hazra, 2017). Also, according to the Hindu informants, abortion is not permitted by Hindu Vedas. Classical Hindu philosophy considers abortion as a sin (bad karma). In Rig Veda Samhita, the fetus was ordered to protect by Lord Vishnu (Hazra, 2017). Moreover, only a son has the right to perform the last rite (puja) of his parents. Therefore, killing a male embryo who could have been a Brahmin is considered a serious crime.
Conclusion
In Bangladesh, abortion is portrayed as morally reprehensible and regarded as one of the most heinous actions. Although almost all respondents of this study encourage to value and nurture children, they may nonetheless be unwanted under certain conditions. This comprehensive study demonstrates different cultural factors which work as a mechanism behind the decision to abortion of women. This research indicates that abortion and culture are both interrelated. While cultural factors can influence the decision of abortion, abortion may also shape some cultural phenomena. It shows that Bourdieu’s idea on different capital plays vital roles in the decision making process of abortion. Thus, women’s economic, social, and cultural capital can deliberately influence abortion related incidents. Moreover, poverty, status of women in the patriarchal society, role of therapy management group, lack of women’s reproductive health right, domestic violence, stigma, religious views on abortion and contraceptives, etc. shapes women’s choice of an abortion. After formulating these thought-provoking ideas, this study concludes that there is no way to consider abortion as an entirely biological matter, rather it has more cultural implications.
This study offers more in-depth research which needs to be done on some other issues such as sex-biased abortion, women’s empowerment in reducing abortion rate, gender discrimination in reproductive healthcare, suicide and homicide due to illegitimate pregnancy, etc. The results of this study can contribute to such analyses and can fill the research gap by understanding various perspectives on abortion.
Ethical Consideration
This research is only meant for academic investigation. As abortion is a confidential matter, the identity of the respondents is kept secret, and pseudonyms are used in this study. Further, this work ensures proper permission before every interview session. Also, this study was conducted in accordance with regional ethical guidelines.
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Corresponding Author. E-mail: shahin.bsmrstu.soc18@gmail.com
DOI: doi.org/10.64172/ssr.2025.i3.12