Abstract
Almost all global maternal deaths occur in sub-Saharan Africa. In addition to promoting facility-based births, global health experts have encouraged harm reduction interventions and medications such as the post-abortion care (PAC) model and misoprostol to reduce maternal mortality related to abortion complications and postpartum hemorrhage (PPH). Misoprostol can be administered by non-physicians, or by women themselves, in managing abortion complications and PPH and in terminating pregnancies. Drawing on ethnographic research in Burkina Faso and Senegal, I explore how models and discourses of harm reduction and self care are transforming clinical, professional, and technological landscapes of reproductive health in West Africa. While these approaches have increased access to life-saving care for some, they have also exacerbated reproductive health inequalities and constrained mid level providers’ capacity to provide care. In this talk, I call attention to the role of aid donors, NGOs, and pharmaceutical companies in the global governance of reproductive health, and reflect on possibilities for reproductive justice.