Like a mother-daughter relationship

Nandagiri, R., (2019). “Like a mother-daughter relationship”: Community health intermediaries’ knowledge of and attitudes to abortion in Karnataka, India. Social Science & Medicine 239, 112525. https://doi.org/10.1016/j.socscimed.2019.112525

While this article was chapter four of my PhD thesis, it was the first empirical chapter that I wrote.

The original title of this manuscript was “They know everything” after a stray remark by one of my interlocutors describing the role of lay community health intermediaries (CHIs). During one of my observational/pilot visits to a Primary Healthcare Centre, the clinic administrator told me that the best people to speak with were the Accredited Social Health Workers (ASHAs) as they were the first port of call for reproductive healthcare in most villages. I hadn’t initially intended to interview them, but after this discussion, I expanded my study population to include them. As it transpired over the course of data collection, they really did know everything.

I couldn’t fit the anecdote in my article and the title seemed a bit odd/decontextualised without it, so I ended up re-naming the paper. In my head (/my heart) this is still the “they know everything” paper.

I decided to use another direct quote in the title to try to capture the relationships and kinships that shaped peoples’ interactions and abortion care-seeking. One of the ASHA workers explained their connection with women as “like a mother-daughter relationship”, where they play a nurturing role (“mother”) but also that of a trusted confidant, one who is able to dispense advice. I think it also possibly captures other elements of a “mother-daughter relationship” - of norms-enforcement and norm-breaking, of secret keeping, and of how trust is enacted and felt. While “like a mother-daughter relationship” captures the interpersonal dynamics of abortion care, it doesn’t quite reflect the idea of “knowing” things (and what they know). I think it worked for the article, though.

Having skipped a few core readings (oops), I didn’t realise at the time that it echoed Shellee Colen’s germinal chapter ‘“Like a mother to them”: stratified reproduction and West Indian childcare workers and employers in New York’, in Ginsburg & Rapp’s still-essential-reading Conceiving the New World Order: The Global Politics of Reproduction. I plan to one day write about the echoes and reflect on where my work could/does overlap.

I agonised over this article, receiving three rounds of comments from Professor Coast, Dr Leone, and Dr Freeman. I also presented it at two conferences (inroads global gathering in 2018 and the Abortion and Reproductive Justice conference in 2018) and as a poster presentation (BSPS 2018, best student poster) before submitting it to Social Science & Medicine in March 2019. I received extensive comments from three very generous reviewers (including reviewer two!) for an R&R. My revisions were accepted with minor additional comments and the article was published in September 2019. Fortuitously, I received confirmation of acceptance the day before I submitted my thesis!

I’m still determined to use the title “they know everything” for something, though!