Dying to Count: Post-Abortion Care and Global Reproductive Health Politics in Senegal

During the early 1990s, global health experts developed a new model of emergency obstetric care: post-abortion care or PAC. In developing countries with restrictive abortion laws and where NGOs relied on US family planning aid, PAC offered an apolitical approach to addressing the consequences of unsafe abortion. In Dying to Count, Siri Suh traces how national and global population politics collide in Senegal as health workers, health officials, and NGO workers strive to demonstrate PAC's effectiveness in the absence of rigorous statistical evidence that the intervention reduces maternal mortality. Suh argues that pragmatically assembled PAC data convey commitments to maternal mortality reduction goals while obscuring the frequency of unsafe abortion and the inadequate care women with complications are likely to receive if they manage to reach a hospital. At a moment when African women face the highest risk worldwide of death from complications related to pregnancy, birth, or abortion, Suh's ethnography of PAC in Senegal makes a critical contribution to studies of global health, population and development, African studies, and reproductive justice.
 

Table of Contents:
Illustrations 
Foreword by Lenore Manderson 
Abbreviations 
Note on Anonymity and Language 
Introduction: PAC as Reproductive Governance 
1 A "Transformative" Intervention 
2 A Troublesome Technology: The Multiple Lives of MVA in Senegal 
3 "We Wear White Coats, Not Uniforms": Abortion Surveillance in Hospitals 
4 When Abortion Does Not Count: Interpreting PAC Data 
Conclusion: Evidence, Harm Reduction, and Reproductive Justice 
Appendix A: Methodology 
Appendix B: Cases of Admitted and Suspected Induced Abortions 
Acknowledgments
Notes 
References 
Index 
                                                                                              

About the Author :
SIRI SUH is an assistant professor of sociology at Brandeis University in Waltham, Massachusetts.

Review :
"This is a magnificent book. Feminist scholar Siri Suh has written an exquisitely detailed and meticulously researched account of the introduction and use of post-abortion care in Senegal during the late 20th and early 21st century. By taking a clearheaded and compassionate look at maternal health and abortion politics in Senegal, Suh draws attention to the fact that as long as there are restrictive abortion laws women need PAC, no matter where they are living. What a superb addition to global health scholarship!"— Susan Bell, author of DES Daughters: Embodied Knowledge and the Transformation of Women's Health Politics
"Siri Suh's illuminating book Dying to Count offers a rare window into the politics of postabortion care (PAC) in Senegal, a country where induced abortion is illegal. At a time when restrictive abortion laws are on the rise in the United States and parts of Latin America, Suh's book is a meticulously crafted achievement that has important implications for scholars doing work in the Global North and South."— Joseph A. Harris, American Journal of Sociology
"[A]n impressive and detailed ethnographic exploration of post abortion care as a form of reproductive governance...Suh's critical and feminist lens infuses the book, evident not just in her incisive and reflection writing but in the methodological care that has gone into the research design and data collection."— Sociology of Health & Illness
"In this fascinating account, Siri Suh describes how tools, policies, institutions, and data come together in Senegal to make post-abortion care into 'good care.' PAC suits policy-makers' needs for targets, funders' demands for metrics, and clinicians' interests in misclassifying abortions. With devastating analytical and moral clarity, Suh shows that there's almost nothing PAC cannot do—except put women's dignity and interests first."— Claire Wendland, author of A Heart for the Work: Journeys through an African Medical School
"Dying to Count is for anyone who wishes to better understand how reproductive governance operates—via medical technology, global development policies, NGO mission statements, and moral regimes. Scholars and graduate students of science and technology, global health, population and development, and African studies will find Suh's analysis to be a valuable model for future analysis of reproductive governance across a range of social and political contexts."— Social Forces
"Dying to Count is a model of excellent academic writing...Suh's writing is clear, persuasive, and urgent: she skillfully blends different forms of empirical evidence and nuanced arguments to push the boundaries of major debates in gender and development policy." — Gender & Development
"Siri Suh's Dying to Count is a powerful exploration of the women caught by reproductive governance and surveillance in Senegal...an excellent choice for scholars of reproductive health, transnational/global sociology, and public policy."— Sociology of Race and Ethnicity
"Dying to Count represents an important addition to the literature on reproduction. Even though the primary focus of the book is on abortion care, its analyses go beyond abortion and contribute to contemporary debates on reproductive governance and justice."— Mounia El Kotni, Medical Anthropology Quarterly