Marginal matters: pregnancy loss as a social event.

Studies on fertility in Africa have known a major paradigm shift when demographic concerns about 'overpopulation' came to be replaced by new ideas about reproductive health, rights, and choices during the 1994 International Conference on Population and Development (ICPD). Whereas this shift has allowed for more recognition of losses during pregnancy which had been virtually absent in previous demographic accounts of high fertility rates, the new discourse on rights and choices turns most of its attention to induced loss. Losses that spontaneously occur remain merely bound to the medical realm. Yet this paper shows that for many women in Africa and elsewhere, spontaneous pregnancy loss is a daily life reality which is inherently related to many social affairs, i.e. life and death, illness and suffering, marriage and kinship, the body and personhood. The rather reductionist biomedical discourse prevalent in the global health arena largely ignores these themes and social complexities--thus causing a gap between health policies and daily life realities for women. Drawing on eleven months of anthropological fieldwork in Cameroon in 2004 and 2008, this article explores the way in which socio-cultural insights could contribute to a better understanding of the experiences of women coping with pregnancy loss. The notions of 'vital conjunctures' and 'social bodies' will form an alternative approach to decision-making in case of reproductive mishaps. By applying these concepts to the personal story of an informant, their relevance and contribution to an interdisciplinary discussion on the topic become clear. The author argues for an integration of anthropological expertise in international reproductive health debates and explores how interdisciplinary work could make health policies on reproductive loss less marginal than is the case at present.