Rubeena Slamat about her PhD research: “Maternal and reproductive-health stigma of women in a rural Punjabi-Pakistani community"

Maternal health is a crucial aspect of life that researchers have extensively studied, especially in developing countries. While issues like maternal mortality, birth control, and other related topics have received significant attention, there has been less focus on understanding the stigma surrounding failed reproductive outcomes in places like rural Pakistan. Within my dissertation, I worked on this line of research. So, this study aims to fill this gap by investigating how such stigma affects women in these communities.

One contribution of my study is that ‘child’ is an important or essential part of a woman’s life. Motherhood is mandatory, so what happens with women who cannot achieve motherhood status or bypass the cultural rules after achieving motherhood, such as opting for induced abortion? My study explores how stigma in daily life is created through language and what the experiences of these women are. For this purpose, I approached various theoretical frameworks such as ‘Stigma as a discrediting attribute’ (Goffman, 1963), ‘The process of stigmatisation’ (Link & Phelan, 2001) and ‘Frontstage/backstage theory [stigma management]’ (Goffman, 1959). The focus was on how stigma is created in daily life and how women navigate it, as well as what strategies they use for destigmatisation.

My thesis is based on two research questions: 1) How is stigma socially constructed? 2) How does stigma impact the lives of women who bear it, and what do these women do to navigate it?

‘Stigma’ means that an individual possesses a trait or condition considered abnormal within that culture. This stigma, as described by Goffman and others, affects the daily lives of those who experience it, often leading to social exclusion and limiting their opportunities. Moreover, stigma operates within power dynamics, with marginalised individuals bearing the brunt of its consequences. However, the study also suggests that stigma can be mitigated through strategies such as concealing the stigmatising attribute.

This dissertation explores how various forms of reproductive failures, like childlessness, miscarriage, stillbirth, and induced abortion, are stigmatised in society. It highlights that women who experience these events are often blamed for them. The level and duration of stigma vary: some face quick and severe consequences, like being isolated due to a folk illness called ‘athra’, while others experience a gradual buildup of stigma, such as in the case of childlessness. Women who undergo induced abortion face lifelong stigma, leading them to keep it secret even within their inner circles.

The study also shows that social norms, authority patterns and the societal emphasis on childbirth (pronatalism) influence the stigma surrounding reproductive failures. Additionally, the availability and use of healthcare services, including traditional and biomedical options, impact how stigma is perceived. Despite the assumption that limited biomedical resources contribute to reproductive failures and subsequent stigma, the research reveals that community members often rely on healthcare options aligned with their cultural beliefs, like spiritual healing, which also shape the stigma surrounding reproductive failures.

My study also suggests that ‘religion’ is not a cause of stigmatisation for these women, as it has been described in previous studies. There are some cultural institutions that play a role in the social construction of stigma for women who bear reproductive health issues.

Supervisor: Prof. dr. Piet Bracke
Co-supervisor: dr. Melissa Ceuterick