Abstract
Despite a lack of rigorous statistical evidence that post-abortion care reduces maternal mortality, the intervention has been implemented in over 60 countries worldwide. At a time when influential global health donors demand ever more sophisticated measures of impact and effectiveness, post-abortion care’s staying power offers important insight into contemporary politics of global reproductive governance. Drawing on ethnographic research on post-abortion care in Senegal, I show how reproductive governance is not limited to laws and policies issued by national policy makers or donor agencies, but also unfolds numerically as medical workers, health officials, and NGO personnel deploy epidemiological and demographic data to establish facts about what post-abortion care technologies accomplish in hospitals, the kinds of women who receive obstetric care in government facilities, the kinds of interventions that work in reducing maternal mortality, and the kinds of care that Senegalese women are entitled to receive. Pragmatically assembled post-abortion care 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 in government hospitals. Post-abortion care represents a critical site through which scientific knowledge about abortion reproduces inequalities of race, gender, class, and geography when it comes to who or what matters enough to count in national and global public health indicators. Although post-abortion care remains necessary in settings with restrictive abortion laws, this intervention fails to achieve reproductive justice at a time when African women face the highest risk worldwide of mortality and morbidity from complications related to pregnancy, birth, and abortion.