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But for Imanandi, who is pregnant and displaced in war-torn Sri Lanka, the danger and uncertainty all around obscures the hope that new life brings. She is overwhelmed with worry for the child who is due any day: How will I protect my baby from danger? How will we survive when water and food is so limited? Will we have to flee again? Will we ever be able to go home? Over the years, the war has killed over 70, and injured and displaced hundreds of thousands more. Yet to the rest of the world, Imanandi and her family and those like her are a forgotten people in a forgotten conflict. In recent months, the Sri Lankan government has regained control of many rebel-dominated areas. The intensity of the fighting has displaced dozens of communities and people are now arriving into towns where they are placed into temporary shelters. In February, 32, internally displaced people arrived in Vavuniya district, including an estimated — women who were in different stages of pregnancy.
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In Sri Lanka, motherhood within marriage is highly valued. Sex out of wedlock is socially unacceptable and can create serious public health problems such as illegal abortions, suicide and infanticide, and single motherhood as a result of premarital sex is considered shameful.

The way unmarried women facing single motherhood reflect on and make use of their agency in their social environments characterised by limited social and financial support has consequences for the health and well-being of both themselves and their children. The aim of this study was to explore and describe how unmarried women facing single motherhood in Sri Lanka handle their situation. This qualitative study comprised semi-structured interviews with 28 unmarried pregnant women or single mothers.

The data were analysed by qualitative content analysis and the results related to the conceptual framework of social navigation. The women facing single motherhood expressed awareness of having trespassed norms of sexuality through self-blame, victimhood and obedience, and by considering or attempting suicide.

They demonstrated willingness to take responsibility for becoming pregnant before marriage by giving the child up for adoption, bringing up the child themselves, claiming a father for their child, refraining from marriage in the future, permanently leave their home environment, and taking up employment. Throughout the interviews, the women expressed fear of shame, and striving for familial and societal acceptance and financial survival. A social environment highly condemning of unmarried motherhood hindered these women from making strategic choices on how to handle their situation.

However, to achieve acceptance and survival, the women tactically navigated norms of femininity, strong family dependence, a limited work market, and different sources of support. Single motherhood is an increasing global phenomenon [ 1 ]. In many countries, single mothers risk discrimination, poverty, and lack of support [ 1 - 3 ]. Female education, autonomy, and marital age is relatively high in Sri Lanka [ 11 , 12 ] compared to other South Asian countries, and health outcomes for women and children are good [ 13 ].

Subversion from sexual norms may result in social ridicule, reprimand and exclusion from both family and society. Even so, premarital sex appears to be increasing [ 19 ]. Measurements of trends and distribution across socioeconomic groups in this field are difficult in absence of statistics and population based studies. However, researchers in the field points out circumstances that are likely to contribute to increased prevalence of premarital sex in Sri Lanka.

The disputed, yet internationally recognised concept of sexual and reproductive health and rights SRHR includes the right to reproductive decision-making and information, the means to exercise choice regarding own sexuality and reproduction, freedom from gender discrimination, and freedom from sexual violence and coercion [ 21 ]. Consequently, sexually active unmarried women in Sri Lanka are vulnerable to SRHR risks, including unwanted premarital pregnancies and unsafe and illegal abortions [ 25 , 26 ].

Generally in Sri Lanka, motherhood is crucial to female identity, and women are perceived as natural reproducers, nurturers, mothers and wives [ 13 , 32 , 33 ]. Around one-fifth of the households in the country are headed by women [ 34 ]. The majority of these women are widowed, many of whom are war widows, divorced, or separated, and have in most cases, conceived their children within marriage [ 33 ].

Thus, while motherhood within marriage is highly valued, single motherhood as a result of premarital sex is considered shameful [ 5 , 17 , 36 ].

The stigmatised nature of unmarried motherhood renders official registration and measurement of the phenomena non-existent or unreliable. Facing single motherhood within this particular complex social environment, where social norms strongly condemning pre-marital sex and motherhood and virtually no social and financial security and support system other than the family, can be extremely challenging. How women actualise their agency within this particular social environment can provide important clues about their ability to pursue their goals and access to resources.

Thus, disentangling how women understand and tackle their situation when facing single motherhood could give useful insights into the health risks, and health promotion, for these women and their children. This study was designed with the aim of exploring and describing how unmarried women facing single motherhood in Sri Lanka handle their situation.

More specifically, their perceived possibilities, difficulties, and support in their present and future life were investigated. To ensure sample variation, participants were recruited at different sites: in the districts of Colombo, Gampaha, and Kaluthara, urban and semi-urban areas in the Western Province; and in Kurunegala, semi-urban and rural areas in the North Western Province.

Potential participants were identified by public health midwives and nurses in district antenatal clinics and public hospitals, thus reflecting recruitment from the lower levels of the socio-economic strata. Thirty-three women were approached and informed about the purpose and procedures of the study and of the measures taken to ensure confidentiality, and that participation was voluntary.

Four women declined participation, and one interview was omitted due to its short length and minimal content. Thus, the study sample consisted of 28 women. Nine women had been unemployed when they discovered they were pregnant, and the majority of employed women had been working in factories or as housemaids when they discovered they were pregnant.

Twenty women reported they had become pregnant after consensual sex, and eight after rape. Of the 16 women still pregnant, 9 planned to give their child up for adoption, 6 planned to keep the child, and one was undecided.

Sri Lankan medical graduates and social scientist students, fluent in both spoken and written English and trained in qualitative data collection, organised the recruitment and conducted the interviews in Sinhala or Tamil.

The topics covered in the interviews included life situation before pregnancy, realising the pregnancy, difficulties and possibilities in present and future life, and support from partner, family, and society.

All interviews were audio-recorded and transcribed into text. The same research assistant who conducted the interview translated the text from Sinhala or Tamil into English. Another research assistant checked the audio recording against the text.

To obtain the complex and rich descriptions of the participants diverse views, qualitative content analysis [ 41 ] was chosen as the analytical method. Qualitative content analysis aims at grasping the manifest and latent messages in the texts, a process that involves multiple readings of the text and identifying meaning units or sequences of importance for the study aim.

The meaning units were condensed and further shortened into codes, which were finally grouped into categories and sub-categories based on similarities in the manifest content. The interviews were held in privacy to ensure confidentiality.

Before giving their informed oral consent, participants were provided oral and written information about the procedure of data collection, confidentiality, and voluntary participation, including their right to withdraw from the study at any time. Permission to recruit participants was obtained from the heads of the hospitals and the Medical Officers of Health in each district. The women are presented with pseudonyms in order to safeguard their confidentiality.

The women became pregnant before marriage and within a social environment characterised by strong family dependency, poverty, limited employment opportunities, the idea of a mother as self-sacrificing, and social norms condemning premarital sex. Their relationships with the man who fathered their children were complicated, in most cases over and seldom supportive. The women had not used contraceptives or attempted to prevent the pregnancy in other ways, and reported this to be due to being unable to foresee the sexual act, being raped, having limited sexual knowledge, assuming the partner would take responsibility, hoping the pregnancy would lead to marriage, or not considering the possibility of becoming pregnant.

Some women had tried to abort the pregnancy through traditional methods, but without success. The reasons presented by the women who had not tried to terminate the pregnancy were delay in realising the pregnancy, perceiving abortion a sin, wanting to become a mother, seeing the child as a product of love, expecting to marry their ex-partner, or hoping the birth of the child would bring the partner back.

The fear of shame due to having trespassed social norms of sexuality on becoming pregnant before marriage dominated the interviews. In order to avoid exclusion from family and society and to ensure their financial and social survival, the women attempted to seclude their pregnant conditions for their social environments. When unable to do so, the women tried to reduce the shame and minimise the reactions of families and society by expressing awareness of having trespassed important social norms through demonstrating self-blame, victimhood and obedience, and by considering or attempting suicide.

The women tried to hide their pregnant conditions from neighbours, employers, ex-partners, and relatives, including their own parents, due to fear of social ridicule, reprimand and exclusion from their families.

However, the difficulty in concealing the pregnancy from their closest family members and the need for support meant the majority informed at least one person, often their own mother. Participant: Nobody knows, only my family knows this. When informing others about their pregnancy, the women encountered different reactions; some were supported and emotionally soothed, whereas, others were scolded, threatened and punished. In the hope of reducing the risk of rejection and condemnation, the women demonstrated self-blame, regret and guilt when facing their family members, employers, friends, or FBO or health staff, irrespective of having consented to sex or not.

The women blamed themselves for having agreed to sex or exposing themselves to rape, and demonstrated remorse when scolded by family members:. They [the family] scolded me very severely. I kept my mouth shut. Because I did the wrong thing. The women portrayed themselves as victims of dishonest and calculating men as part of demonstrating awareness of having trespassed sexual norms. In doing so, the women acted in accordance with a social environment where women are depicted as submissive, trustful and helpless in relation to men and sexually active unmarried women are regarded as both promiscuous and immoral.

The women described themselves as morally upright women who had been abandoned by a dishonest man after being persuaded to have sex, as association with promiscuity meant risk of being excluded from kin and society:. He worked in a bus. I went to Colombo on that bus. Then we had an affair. I asked him to marry me. Then he took me somewhere far away and we married. Signed the documents. After that, I came home. That very day his relatives came to my house and told my mother that he was a married man and to ask me to stop the affair.

They had found one of my letters. Then he told me that he was a father of three. Some women considered and attempted suicide out of fear of shame related to having become pregnant prior to marriage. Suicide was perceived as a means of escape from their shameful conditions, and communicating suicide was a way of expressing awareness of the gravity of the situation and attaining support.

While the majority of women who had considered suicide re-evaluated the situation and discarded suicide as a solution, one woman had attempted suicide by drinking pesticides:. Participant: You know I realised only after developing this pain that I had become pregnant. How women reflected on what to do after the baby was born depended on the reactions they received within their social environments, their personal capacity, and on the time allowed for reflection. The women all demonstrated willingness to take responsibility for becoming pregnant before marriage, although in different ways.

In doing so, the women hoped to be accepted by their family and society, and ensure their financial and social survival. One way of taking responsibility for having become pregnant prior to marriage was to have the child adopted. Adoption was often encouraged by family members, employers, friends, and health and FBO staff and a degree of coercion was involved:. But everybody asked me not to keep him with me and they threaten to kill me. They do not want me to come to the village with the child… Anyway, I cannot stay here alone. Dayani, 19 years.

If the pregnancy was not publicly known, having the child adopted enabled the woman to return to her community with her reputation intact; thus, the woman remain marriageable, and was something that was regarded as the best option for both the woman and her family. Moreover, having the child adopted enabled the child to grow up in a two-parent family instead of growing up with a stigmatised, unmarried mother. Without support to keep their child in their social environment, adoption was considered the only realistic option:.

It is difficult to take care of my child. Most people advise me to give the child up for adoption. Madam [employer] also told me so, and she told me that she will help with the adoption. She is helping me… she came here and gave me some clothes, and money too.



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