DAY FIFTEEN: Hostile Environments of Gender and Reproduction

In this harrowing piece, Lucy Lowe reflects on the hostile environment and how it impacts pregnant asylum seekers and babies in detention centers.

Lucy Lowe

Featured image: “Yarl’s Wood Protest.” by Darren Johnson / iDJ Photography is licensed under CC BY-NC-ND 2.0.

Pregnancy and birth are complex experiences that can evoke hopes and anxieties about the past and future, and illuminate the need for care and community. For migrants, it can also mean a confronting engagement with borders and immigration controls, and regimes of surveillance and management that are defining characteristics of both pregnancy care and immigration in the UK.

In Scotland, people in the asylum system are subject to contradictory policies and political ideologies on immigration, from ‘New Scots Integration Strategies’ that claim to welcome migrants, to the UK-wide ‘hostile environment’ immigration policies that seek to make life as unbearable as possible.

The treatment of pregnant asylum seekers in the UK reveals how the control and enforcement of borders are themselves tools of violence that are frequently used but rarely recognised by the state. Increasingly restrictive access to visas or official pathways to asylum force people to pursue irregular and more dangerous journeys. Such routes put women in particular at heightened risk of violence, including sexual violence.

Taking high doses of contraceptives before their journey is one strategy that women adopt in order to prevent pregnancies occurring as a result of rape. Even if they successfully reach a country where they might seek asylum, persecution that is deemed domestic or even feminised, often fails to meet narrow legal definitions of a refugee. The ‘hostile environment’, which restricts access to basic needs and services including accommodation, healthcare, employment, and financial assistance, keeps people in a state of destitution. This state of precarity puts people at further risk of exploitation.  

Pregnancy is usually presented as an additional challenge and source of vulnerability for people in the asylum system. Their experiences of pregnancy are often complicated by health problems, including poor nutrition and mental health problems. The dispersal policy, introduced under the Immigration and Asylum Act 1999, was intended to reduce the ‘burden’ of asylum seekers in the south of England by relocating people to key sites across the UK. This forced relocation has resulted in many people experiencing repeated relocations, reducing the possibility of any meaningful sense of community or support.

Such policies can have damaging effects on the health of individuals and their children. These problems are exacerbated when people are housed in poor-quality accommodation, as they were in Glasgow in the Mother and Baby Unit, and still are, in deficient hotel accommodation, where people lack access to cooking facilities and are provided with insufficient nutrition.

This accommodation, run by the private company Mears, has been widely critiqued as unsafe and unsuitable, particularly for pregnant people and new babies. It is therefore unsurprising that asylum seekers often experience a deterioration in health during their first two to three years in the UK. The hostile environment ensures that people seeking asylum frequently encounter poverty, destitution, and insecure housing. These are key barriers to health for everyone.

The National Institute for Health and Care Excellence (NICE) has emphasised the impact of social disadvantage on maternal health and pregnancy outcomes. It classifies refugee and asylum-seeking people’s pregnancies as ‘high risk’ due to the ‘complex social factors’ they face, and recommends increased efforts to improve access and engagement with maternity services.

This ‘high risk’ categorisation involves a pathway of care led by obstetrics, rather than midwifery, and a more rigorous regime of surveillance and interventions. They frequently experience high intervention births, with notably high rates of inductions and caesarean sections.

Despite this high-intervention care, refugee and asylum-seeking women in the UK continue to be at increased risk of poor pregnancy and birth outcomes. This is part of a wider context of reproductive inequalities, where Black women are four times more likely and Asian women two times more likely to die from pregnancy related causes.

These fatal inequalities exemplify the need for a reproductive justice approach. Reproductive justice was developed as a framework for activism and analysis to conceptualize the relationship between reproductive rights, racism, classism, and other forms of oppression. While reproductive rights movements have often focused on struggles for access to contraceptives and abortion, underscored by the concept of ‘choice’, reproductive justice acknowledges both the right to have or not to have children, and the right to safely and adequately parent children.

Pregnant asylum seekers in the UK are highly restricted in their choices, from what they eat, to where they live, to where and how they give birth. The hostile environment produces and compounds these multiple oppressions among some of the most vulnerable people in our society. The political salience of borders and immigration in the UK is resulting in increasingly violent policies to prevent migrants, including people seeking asylum, entering or remaining in the country.

Borders reproduce and reinforce racialized and gendered violence by categorising people as ‘criminals’, or as unworthy of human rights, which exposes people to further violence and restricts their capacity to receive care and support.

Research on forced migrants frequently emphasises the violent state exclusion of refugees, yet reproduction presents a potential zone of inclusion, where women and their infants are rendered deserving of protection on the basis of motherhood, rather than persecution. Pregnancy and motherhood can allow refugee women to form networks of social and familial support, but the financial, physical, and emotional demands of raising children can risk further isolating marginalized women and exacerbating mental health conditions that are already more prevalent among refugees and asylum seekers.

Although healthcare is provided by the NHS and (minimal) financial support is provided by the Home Office (in the case of asylum seekers and some refused asylum seekers), a plethora of organisations exist to advise, support, and advocate for refugees and asylum seekers. In Glasgow, Amma Birth Companions provide antenatal, birth, and postnatal support for refugees and asylum seekers. Frequently referred to as the ‘Amma Family’, staff and clients frequently use kinship terminology to convey the support they provide and receive. This intimate labour, grounded in opposition to the hostile environment, provides immediate support and advocacy, but also highlights the ways in which new communities of care and solidarity can be produced through universally shared challenges of pregnancy, birth, and parenting.

Author’s Bio

Lucy Lowe is a senior lecturer in Social Anthropology at the University of Edinburgh. This post draws on her ESRC New Investigator Grant funded project Maternity, Migration, and Asylum in Scotland (MAMAS).

DAY THREE – 37 Years of Struggle: Academics and Refugee Women Working Together to End Rape, Sexual and Gender-based Violence

Linda Bartolomei and Eileen Pittaway reflect on what has been achieved 37 years since the UN’s Nairobi Third World Conference on Women and commitments made by all governments to protect refugee women and girls from sexual abuse and violence. [Content warning: Rape, Sexual Violence]

Linda Bartolomei and Eileen Pittaway (Forced Migration Research Network, UNSW)

We have tried to tell people, but no-one will listen. They don’t want to hear. They say women will not talk about rape because we feel ashamed. Who should be ashamed? Us, or those who raped us? (El Salvadorean refugee woman 1990)

In 1985, the United Nations (UN) held the Nairobi Third World Conference on Women with the goal of achieving gender equality for women everywhere. One of the key areas of concern was refugee women and girls, named as one of the most vulnerable groups in the world with the rape and sexual abuse they face clearly identified. Commitments were made by all governments to improve the protection of refugee women and girls worldwide. Thirty-seven years on, and after almost three decades of joint research and advocacy with refugee women and girls, academics Linda Bartolomei and Eileen Pittaway reflect on what has been achieved.

While progress has been made, in 2022 the majority of refugee and other displaced women and girls continue to suffer from rape and sexual violence.

‘All my sisters, my mother, my friends – all the women have been raped. The military, they rape us. When we try to cross borders they rape us, when we go for water they rape us, when we go for food they rape us, when we go to the bathroom, they rape us. The police, they rape us. Our life is rape’.

(Rohingya refugee women 2019)

Rape occurs at all stages of the displacement journey. It is often part of persecution in homes and villages, as a strategy of conflict, in flight, at borders and in refugee sites. In 2017, a Senior United Nations High Commissioner for Refugees (UNHCR) staff member stated that 100% of the refugee women fleeing conflicts in boats had been raped and sexually abused on their journeys.

Women attempting to escape the horrors of war via smugglers are advised to carry condoms, as rape is inevitable. 

It is perpetrated by military, guards, militia, police, males from host communities and males from displaced communities, sometimes by humanitarian workers. Women are raped in front of husbands, fathers and children. The impacts are profound. Many abused women bear children of rape. Young girls die because they are too young to bear the children conceived from rape. Men are shamed because they cannot protect women and girls, and whole communities suffer collective guilt. It occurs in all aspects of their lives and cross cuts all the areas of the protection they should receive from the international community. Many displaced women are forced to sell sex to feed themselves, their children and their families. Displaced women and girls remain some of the most marginalised people in the world and this culminates in a range of human rights violations and abuses with rape, sexual and gender-based violence being the biggest barrier to gender equality (Collated findings from 33 years in the field, in Pittaway and Bartolomei, Only Rape! Human Rights and Gender Equality for Refugee Women, forthcoming 2022).

Some things have improved. Rape in conflict and refugee situations is now acknowledged and is widely reported.

Rather than being viewed as a ‘vulnerable group’ in need of saving, refugee women are being recognised as leaders in community based-protection and advocacy and the voices of the courageous refugee women and girls who are speaking out are finally being heard. They have proven time and time again that they are resilient, capable, knowledgeable and strong and can contribute sharp analysis of the risks they face, and the solutions required.

This has been demonstrated repeatedly in the Refugee Women and Girls Key to the Global Compact of Refugees Project, funded by Australia’s Department of Foreign Affairs and Trade (DFAT) and being undertaken with refugee woman, academics, NGO and UN partners in Bangladesh, Malaysia and Thailand.

Increasingly refugee women’s voices are being heard on the world stage and in important UN fora including at meetings of the UNHCR. They are now demanding a seat at the policy making table as equal players in the fight for security and justice. This has happened because of their capabilities and determination, and through the work behind the scenes of a multitude of refugee representatives who made this happen. Vibrant refugee networks, such as the Global Refugee led Network (GRN), the Asia Pacific Network of Refugees (APNOR), and Global Independent Refugee Women Leaders (GIRWL), all with strong commitments to human rights, gender transformative and inclusive age, gender, and diversity approaches, are taking the lead in advocacy and work on the ground.

But the fight for safety, justice and gender equality is far from over. Human rights activists, refugee women, and all stakeholders must continue to work together until we stop this horror for all women everywhere.

Authors’ Bio

Linda Bartolomei: Linda is a founder and co-convenor of the Forced Migration Research Network (FMRN) and the convenor of the Master of Development Studies at the University of New South Wales. Since 2002, Linda has been involved in a series of action research projects exploring the challenges associated with identifying and responding to refugee women and girls at risk in camps and urban settings. This has involved research in multiple sites across Africa, Asia and the Middle East and in Australia. Since 2017, with Eileen Pittaway, she has she worked with UNHCR Geneva and a team of refugee women conducting audits of gendered aspects of all meetings relevant to the 2018 Global Compact on Refugees (GCR) and its implementation. She is currently leading a multi-year project in four countries in the Asia- Pacific with colleague Adjunct Professor Eileen Pittaway to support the implementation and monitoring of the commitments to refugee women and girls in the GCR.

Eileen Pittaway: From 1999 to 2013, Eileen was Director of the Centre for Refugee Research, University of New South Wales, and Associate Professor in the School of Social Sciences and International Studies. The major focus of her work has been the prevention of and response to the rape, sexual abuse and gender-based violence experienced by refugee women, both overseas, and following resettlement to Australia. Over the past thirty years, she has conducted research, provided training to refugees, UN and NGO staff in refugee camps and urban settings, acted as technical advisor to a number of projects, and evaluated humanitarian and development projects in 18 different countries. In 2012, she was made a member of the Order of Australia for her work with refugees.