Counseling Contraception for Malian Migrants in Paris: Global, State, and Personal Politics

Malian migrants in Paris ?gure prominently in French public discourse surrounding immigration, the role of the state in regulating population, and the perceived burden of migrants from Sub-Saharan Africa on public health and social welfare systems. Political and biomedical critiques of Malian and other African women have linked high fertility to housing shortages, polygamy, and high unemployment. This research explores how French government policies, transnational migration, and the public health system shape reproductive strategies and relations in the Malian migrant population. State pronatalism, anti-immigrant sentiment, diverse Islamic interpretations of contraception, and marital tensions over childbearing have produced both coercive and empowering strategies among midwives, hospital interpreters, social workers, and migrants. Interviews with Malians in clinical community settings as well as observations in two public hospitals in Paris suggest that women assert agency in the face of formidable constraints by choosing to use contraception. However, evidence of potentially coercive birth control interventions raises challenging questions about how (and whether) midwives and other staff disseminate information on contraception to this population.