Caring for Women?: Household gender dynamics and young married women’s access to reproductive healthcare in Bihar, India

This thesis examines the marital household as a site and a set of relations that shapes young married women’s access to reproductive healthcare. I aim to develop a critical understanding of women’s care in relation to marriage and the marital household, asking if women feel cared for. The study addresses women who married as adolescents, whose reproductive health is usually studied vis-a-vis their contentious legal marital status and biological age, rather than their social position in marriage and household. The research comprises 33 in-depth interviews and 6 focus group discussions with women aged 16-28 (married between 14-19), supplemented by a participatory pilot study and extensive community engagement. The analysis is inspired by constructivist grounded theory.

The study finds that women’s conceptualisations of health are embedded in the gender dynamics and gendered relations of the household, and that women ascribe meaning to their experience of health, illness, and care to make sense of their gendered position within marriage and society. While early marriage is typically associated with poor reproductive health outcomes, in the empirical context, young married women make significant associations between the circumstances of their marriage—such as love, compulsion and honour—and their access to care. The husband’s socially-conferred authority in marriage is particularly a central force that influences women’s access to care. The husband’s authority can alternatively result in neglect, but crucially, women navigate authority by seeking care within its limits, and sometimes by challenging it. The study relatedly examines women’s decision-making practices and finds that decentering decision-making autonomy in studying women’s access to care allows us to understand women’s claims on forms of care due to them such as value for their lives, the moral responsibility of husbands to care for them, and love as wives and daughters-in-law, which capture the essence of feeling cared for.