“Es chocante,” it’s shocking, said Dr. Acosta, a pediatrician working at San Benito Youth Clinic in Petén, Guatemala. In particular, Dr. Acosta is speaking of her work with teenage mothers. As she states, these young girls find themselves in circumstances in which they must assume the role of caregiver and wife. Detailed in a recent New York Times article, Child, Bride, Mother, these overlapping realities are highlighted as are the dangers of childbirth for mothers at such a young age, both mother and child are at risk: “Young teenage girls are more likely to die due to complications in pregnancy and childbirth than women in their 20’s; their infants are more likely to be stillborn or die in the first month of life,” (UNICEF, 2014). In addition, “worldwide, more than 700 million girls who marry before they turn 18 are less likely to remain in school and more likely to experience domestic violence.”
Beyond the stark data and statistics, reading the accounts of these young girl’s lives in their own words was powerful, and grounded these figures in a context in which these mothers face challenges and obstacles to themselves and their children’s health and wellbeing. In fact some of the salient points which arose from their descriptions included feelings of being unprepared and uncertain of their children’s future.
“I went to school until the fifth grade. I was 14 when I was married. My husband is 21. It’s a girl. I want to give her everything. I want her to study” — Soyla, 15
In addition to these narratives being powerful, it is important to portray them in a balanced way, sensitive yet not exploitative.
That being said, the struggle, not limited to child marriage, which these young girls across the world face, is very poignant and certainly is a large part of the reason I have chosen to work within women’s health and reproductive rights. In thinking about what it is on a larger scale that has led me to this work, I look to Marshall Ganz and his contributions to the field of advocacy and organizing to drive change. His training series often focuses on defining your own story within a larger context or as he puts it , “the story of self, us, and now.”
As only Ganz can, he goes on to detail why this is so important, “public narrative is how we turn values into action-a discursive process by which individuals, communities, and nations construct identity, formulate choices, and motivate action. Because we use narrative to engage the “head” and the “heart,” (Ganz, 2014).
Ganz’s framework is laid out in the following sections:
The Story of Self:
My story of self begins with powerful and compassionate woman, a grandmother and mother who have worked tirelessly to drive social change, my grandmother as a lawyer and my mother whose work within international development has no doubt inspired me. This tradition of powerful women continued in my life as I attended undergrad at Smith College where I first was introduced to the language and vocabulary surrounding systemic inequity and social justice movements. It is here at Smith too where I learned all that I could of women’s health and within a larger context, public as well as international health.
In the winter of my senior year I was able to travel to Northern India and work with a group of adolescent Tibetan refugee students on matters related to their sexual and reproductive health concerns. I was surprised to find that these young women and men were asking the same sorts of questions I had heard from my own friends, and that I had wondered aloud in years past: “How could I tell if I were to become pregnant? What would I do?” These questions and anxieties, I found, are a part of a larger issue in which sexual and reproductive health matters the world over aren’t openly discussed or engaged with:
“Erratic availability, cost, laws and policies prevent unmarried adolescents in low and middle income countries from accessing contraceptives. Even when there are no legal restrictions, health workers often refuse to provide unmarried adolescents with contraceptives because they do not approve of premarital sex..” (Guardian, 2014)
It was also at this point in time that I had been planning to attend medical school. However, this experience of directly working with these students, and learning from their contraceptive concerns as well as the poor health outcomes associated with a lack of reproductive services in communities, presented me with a choice that I hadn’t fully considered previously. It is at this juncture that I found a real appreciation for working within sexual and reproductive health through a public health lens.
Today, I work with Planned Parenthood Global, the international arm of Planned Parenthood Federation of America (PPFA) and am able to contribute to greater access to quality reproductive and sexual healthcare services in our focus countries in Latin America and Africa.
The Story of Us:
At PPFA the main mission really is to provide reproductive health resources to every individual and to treat their reproductive choices with respect and dignity. The work is focused on service delivery/access, comprehensive education, as well as powerful advocacy efforts.
The Story of Now:
I was just recently asked to answer, “how often I discuss and am engaged with the work I am involved with?” My answer was everyday. In order to improve sexual and reproductive health outcomes there is still work to be done. The story of now in this context asks us to think critically of where we’d like to see women’s health outcomes in the future. In order to achieve this I would like to reflect on PPFA President, Cecile Richards’ words on advocating for reproductive rights:
“There are just three things that we have to do to build progressive power. Number one: when we organize people to be their own fiercest champions. The second is when we stand together, not alone. And, the third is when we’re bold and unapologetic about what we stand for,” (Cecile Richards, 2015).
In order to take a stand for what we believe in, we must hone our personal and collective narratives. We are after all the authors of our future and what is to come.