where pregnancies were terminated—whose decision it was to opt for an abortion.
Grace and Akwasi: What happened to Grace’s ‘unmet need’?
Grace is a 48 year-old assistant head cook in one of the student halls of residence and her husband Akwasi is a 55 year-old laboratory technician. Grace has one daughter and a son by a previous partner and together the couple have three daughters and a son. Akwasi typifies the type of behaviour regarding reproductive decision-making that is conjured up by the literature on the ‘male role’ and male dominance in childbearing behaviour. Akwasi feels he came to the marriage disadvantaged. Of Grace he says, “she has the upper hand” as he puts it, because Grace already had two children from a previous relationship. Indeed, at the time Grace got married to Akwasi she did not really want any more children—neither to prove her fertility, nor to experience the so-called resource-related or emotional benefits of having children. In this sense we might argue that her last four children (with Akwasi) were all ‘unwanted’; however, during the survey both Grace and Akwasi say that at the time of Grace’s last pregnancy the child was wanted ‘then’. Hence, Grace’s ‘unmet need’ is not exposed. It is only during the interview that Grace laments about the repeated pregnancies she has had to go through to satisfy Akwasi’s fertility aspirations. Akwasi’s responses, of course, are consistent for both the survey and the interview, especially since the last child was the son he had so long desired.
According to Grace, when her third child with Akwasi turned out to be a third girl he was unhappy, and she became very worried. Although she insisted to Akwasi that it is “God who gives children”, and Akwasi acknowledged that “girls can do all that boys do” Grace still felt concerned and wanted to ‘give’ Akwasi a boy. When the third girl was born Akwasi refused to go to the hospital to see mother and child until he had to bring them home. After the birth of her fifth child, and third child (daughter) with Akwasi, Grace started using contraceptives, but Akwasi wanted Grace to have yet another child. She told him that if he insisted on having another child he would have to get another woman to have it with since she did not “need any more children”. Further, she explained to me that all her pregnancies and deliveries had been difficult ones and her doctor had advised her not to have any more children. However, Grace did become pregnant a fourth time in her marriage. Initially Akwasi did not say much, but after some months he began to speculate, or wish aloud, that it would be a boy, and told Grace that if she had another girl she would definitely have to have another baby subsequently. Several years after the birth of this child Grace is still affected by the telling of the story, and sighs, “by God’s grace I had a boy”.
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This story points to an important issue in the designation of reproductive outcome categories, i. e. the shortcoming of the so-called ‘agreement’ category. Grace and Akwasi’s story shows that this category does not necessarily really reflect agreement, rather that one partner (in this case the husband) coerces, convinces
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Whose ‘Unmet Need’ Dis/Agreement about Childbearing among Ghanaian Couples
or suggests a reproductive outcome for the other to follow. Further, the failure of the survey instrument to capture the process that led to the child’s birth masks Grace’s ‘unmet need’, not for contraception, but to be able to effect her reproductive preferences. A couple may ‘agree’ to have (or as in Nana and Nortey’s case, to not have) a child, not because both want the same thing, but both ‘agree’ that what the man wants holds; here an examination of gender power relations is crucial.