Cudate le dije yo Imagined Choices Models of Agency Intentional - PDF document

1 ÁCu’date!Õ le dije yoÓ Imagined Choices:
ÁCu’date!Õ le dije yoÓ Imagined Choices: Models of Agency, Intentionality, and Responsibility in Adolescent Pregnancy by Morgen Angela Chalmiers Ma

2 ster of Arts in Anthropology University
ster of Arts in Anthropology University Those who were seen by providers were frequently subjected to disrespectful and insensitive treatment (simil

3 ar to that described !!!!!!!!!!!!!!!!!!!
ar to that described !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!"!As per anthropological convention, all names used in this text are pseud

4 onyms to protect the anonymity of my int
onyms to protect the anonymity of my interlocutors.!#!Similarly, I use the generic pseudonym ÒLa Colonia,Ó translated literally as ÒThe #!Similarly, I

5 use the generic pseudonym ÒLa Colonia,Ó
use the generic pseudonym ÒLa Colonia,Ó translated literally as ÒThe Colony,Ó to refer to the community in which the research informing this thesis was

6 conducted. health The increasing anxi
conducted. health The increasing anxiety surrounding the perceived population problem created new imperatives to control population growth. fertili

7 ty rates by establishing national numeri
ty rates by establishing national numerical goals for contraceptive use. Clinics and hospitals were expected to convince a certain number of women annu

8 ally to ÒacceptÓ contraception (Gutmann
ally to ÒacceptÓ contraception (Gutmann 2007:120). This policy led to the frequent insertion of IUDs immediately post-partum, often without the patient

9 Õs knowledge or consent as well as force
Õs knowledge or consent as well as forced sterilization (Castro 2004; Gutmann 2007). As Gutmann explains, Òeach health center was assigned a goal for e

10 nlisting new birth control usersÉclinics
nlisting new birth control usersÉclinics suffered penalties, at least indirectly through loss of prestige and clout in the health system, if they consi

11 stently fell short of the federally esta
stently fell short of the federally established goals. Conversely, clinics could expect extra resources if their numbers were significantly over target

12 . What is more, the target Sample five m
. What is more, the target Sample five minute drive to La Colonia from the Otay Mesa border, I frequently noticed that almost every pedestrian I saw wa

13 s, in fact, male. Public space, at least
s, in fact, male. Public space, at least along the roadside of the highway connecting the urban centers of Tijuana and Tecate, was occupied nearly excl

14 usively by men. However, on this early N
usively by men. However, on this early November morning, a crowd of at least twenty women was gathered outside of the secundaria, arguing loudly with a

15 man whom I later learned served as the
man whom I later learned served as the schoolÕs principal. ÒComo van a salir adelante los ni–os si no les ense–an?Ó How will the children get ahead

16 [in life] if they donÕt teach them? The
[in life] if they donÕt teach them? The question was posed by the groupÕs apparent leader, who was referring to a recent controversy in the community

17 regarding three of the six teachers empl
regarding three of the six teachers employed at the townÕs middle school. The three teachers allegedly spent the majority of the school day outside of

18 the classroomÑtexting, talking on the ph
the classroomÑtexting, talking on the phone, or otherwise engaged in non-didactic activities. had triggered her intense emotional response?La impotenci

19 a,Ó Rosa replied. ÒPowerlessness. SheÕs
a,Ó Rosa replied. ÒPowerlessness. SheÕs crying out of frustration at our powerlessness.Ó Saliendo Adelante and the Ideal of Modern Mexican Womanhood

20 Throughout the focus groups and inter
Throughout the focus groups and interviews that I conducted, women used the Spanish phrase Òsalir adelanteÓ again and again to describe the hope tha

21 t their daughters advice her mother has
t their daughters advice her mother has laid out for her Òon the table.Ó While discourses among health professionals often attribute adolescent pregna

22 ncy to an impaired ability to plan ahead
ncy to an impaired ability to plan ahead and make Òresponsible choicesÓ (to use the moralizing language of policymakers) due to an underdeveloped front

23 al lobe and the resulting deficits in im
al lobe and the resulting deficits in impulse control, my interlocutors seemed to imply that getting pregnant was a calculated decision by adolescents

24 for which they must be held accountable.
for which they must be held accountable. As Eva, a mother of three, joked, Òthey plan for everythingÑthey go up into the hills, plan a time, a meeting

25 placeÑthey plan for everything except th
placeÑthey plan for everything except that [i.e. a method of contraceptionPregnancy, then, is implicitly constructed as a result of individual choices,

26 choices that, as my interlocutors were
choices that, as my interlocutors were quick to point out, come with consequences. Specifically, she defines voluntarism as Òa cultural model of pers

27 ons as free to choose their actions with
ons as free to choose their actions with a focus on the proximate actorÉrather than more distal agentsÓ (Strauss et al. 2007:812). Similar ideologies a

28 re, of course, present in neoliberal eco
re, of course, present in neoliberal economic models, specifically rational choice theory, and continue to inform interventions in the field of health

29 and development throughout the Global So
and development throughout the Global South. My interlocutors invoked voluntaristic models of reproductive decision-making not only when criticizing yo

30 ung womenÕs purported choice to become p
ung womenÕs purported choice to become pregnant but also in direct reference to their own experiences. As Paula explained to me, ÒAs a woman, one decid

31 es how many children youÕll have because
es how many children youÕll have because men just wash their hands and leave. Marianismo, often described as Òthe opposite face of On a larger scale,

32 the example of teenage pregnancy reveal
the example of teenage pregnancy reveals significant limitations of rational actor theory as a tool for analyzing reproductive and health-related beha

33 vior (Luker 1997). Such theories remain
vior (Luker 1997). Such theories remain analytically alluring in part due to their elegant reductionism. The intricate and opposing forces that motivat

34 e human behavior are disentangled and di
e human behavior are disentangled and distilled down to their most basic form as represented in economic models of the marketplace. Orientati sex educa

35 tion continues to be emphasized as a sol
tion continues to be emphasized as a solution to unwanted pregnancies, such educational initiatives fail to disrupt the social hierarchies that continu

36 e to structure gendered power relations
e to structure gendered power relations of race, class, and indigeneity (Gutmann 2007). Under these conditions of structural violence (Farmer 2004), e

37 ducation alone can do little to address
ducation alone can do little to address intersecting and compounding in complex, messy ways that defy definitive interpretation. On one level, struc

38 tural inequalities and patriarchal socia
tural inequalities and patriarchal social norms render adolescent girls more vulnerable to what are referred to in the public health literature as Òunw

39 antedÓ or ÒunintentionalÓ pregnancies. A
antedÓ or ÒunintentionalÓ pregnancies. As Luker (1997) points out, the social norms that define respectable sexual behavior for a woman require her to

40 display relative sexual inexperience, wh
display relative sexual inexperience, which may be demonstrated by a lack of preparation for a sexual encounter. These values are internalized long bef

41 ore sexual activity begins. Nice girls,
ore sexual activity begins. Nice girls, after all, donÕt carry condoms. The cultural ideals of modesty, deference to male pleasure, and s, my interloc

42 utors emphasized the difficulty of obtai
utors emphasized the difficulty of obtaining care at health centers. Women must make appointments in advance or spend all day waiting at the clinic wit

43 h no guarantee of being seen by a provid
h no guarantee of being seen by a provider. Very few families in La Colonia own cars, which makes it inconvenient to reach the nearest health center, a

44 thirty minute walk from La Colonia. The
thirty minute walk from La Colonia. The clinicÕs hours prevent women who must attend school or work from being able to unintended dichotomy masks oth

45 er inequalities. As she states, the conc
er inequalities. As she states, the concept of Òreproductive intentionality privileges individuals for whom particular reproductive choices are 1958)

46 makes between the self and self-represen
makes between the self and self-representation (Ewing 1990).Like EwingÕs informant Shamim, might CarminaÕs representations of her past actions and moti

47 vations shift depending on the context?
vations shift depending on the context? My own uncertainty in interpreting CarminaÕs description of her ef ideologies that are primarily neoliberal rat

48 her than religious. Adolescent pregnancy
her than religious. Adolescent pregnancy prevention programs both rely on and reinforce this neoliberal moral climate in which the Rational Actor is pr

49 ivileged as an ideal to be aspired towar
ivileged as an ideal to be aspired towards. Despite such aspirations, the life narratives of pregnant adolescents themselves continue to reveal the way

50 s in which theories of human behavior th
s in which theories of human behavior that treat emotion, experience, and relations between persons as variables, albeit complex o ÀHa sufrido de algun

51 a enfermedad transmitida sexualmente? ÀC
a enfermedad transmitida sexualmente? ÀCu‡ndo? ÀQuŽ hizo para tratarla? ÀCree que las infecciones transmitidas sexualmente son comunes aqu’? ÀCuales

52 las razones por las que una muchacha de
las razones por las que una muchacha de 13 a 15 a–os tendr’a relaciones? ÀUsted piensa que las muchachas de esta edad tienen la habilidad de decirle

53 ÒnoÓ a un chico? Embarazo de Adolescen
ÒnoÓ a un chico? Embarazo de Adolescentes ÀLe parece que el embarazo de a comunidad. Es que les parece un fen—meno nuevo aqu’ en la comunidad? Cuand

54 o empez—? Siempre algunas muchachas de e
o empez—? Siempre algunas muchachas de ese edad han salido embarazadas o es que ha aumentado ese fen—meno? Si ha ÀPor quŽ quisiera una adolescente tene

55 r un hijo? ÀLa mayor’a de embarazos adol
r un hijo? ÀLa mayor’a de embarazos adolescentes son intencionales o por accidente? ÀComo son los actitudes de los mŽdicos y las enfermeras hacia las

56 adolescentes que van al centro de salud
adolescentes que van al centro de salud para citas prenatales o para obtener anticonceptivos? ÀCu‡l ser’a la edad ideal para una mujer tener hijos?

57 (ÀCuantos a–os ten’an ustedes?) ÀCu‡nd
(ÀCuantos a–os ten’an ustedes?) ÀCu‡ndo es que una mujer sea lista para tener un hijo? ÀEs solamente una Davis- Farmer, Paul, Philippe Bourgois,

58 Nancy ScheperHughes, et al. 2004 An An
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60 2000 Feminist Participatory Action Res
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ress. Kleinman, Arthur, Leon Eisenberg, and Byron Good 1978 Culture, Illness, and Care: Clinical Lessons from Anthropologic and Cross-Cultural Resear

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63 hinyere, and Alicia D. Bonaparte 2015 B
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