Paper short abstract:

This paper examines how a focus on multiple notions of ‘risk’ can illuminate the tensions of security, the state, and reproductive futures between pregnant Somali women and Kenyan medical professionals working in the Somali-dominated area of Nairobi.

Paper long abstract:

In the Somali-dominated Eastleigh estate in Nairobi, predominantly Kenyan medical professionals articulated a range of challenges in dealing with a population that was perceived as both 'risky' and 'at risk'. Fears of Islamic fundamentalism and an aggressive Somali Other were embedded in perceptions of a population constantly in flux. Perpetual flows of migrants with notoriously low rates of vaccination presented a continual risk to themselves and the host society. Somali women epitomised 'at risk' in reproduction: early and frequent pregnancies, widespread rejection of family planning, and refusal of antenatal care and many medical tests and interventions. At the same time, this Somali population, with a high demand for particular biomedical reproductive services, was a lucrative source of income for private Kenyan medical facilities. For Somali women, medical professionals presented their own risks, including exposure to the hostile Kenyan state, unnecessary medical procedures, and particularly expensive and reproductively damaging caesarean sections. Within the home, Somali women and their families - often straddled over countries and continents - negotiated desires for a particular understanding of 'safe' motherhood, with fears of the state and threatened fertility. This paper argues that interactions between pregnant, delivering, and postpartum Somali women and their medical carers highlight the ways in which trust and risk are perceived and navigated, and how these shape reproductive health decisions.