South African women still experience social prejudice around pregnancy and the reproductive decisions they make. Men, on the other hand, often escape the spotlight. Women who do not know the paternity of their children are still frowned upon. And when the fathers of their children deny paternity, they have no way of challenging the denial.
These are the findings from the sexual and reproductive health rights study conducted with the AIDS Foundation of South Africa, a non-governmental organisation supporting community-based initiatives to strengthen men and women's access to sexual and reproductive health rights.
The study underscores the need for DNA paternity tests to be made affordable and accessible in public health facilities. This is because they are a reliable way to ascertain paternity.
Denied pregnancy as a punishment
Statistics South Africa data shows that out of just more than one million infants, 50% live with a mother only and 37.8% with both parents. And of just over four million children aged one to four, 42% live with only their mothers.
In our study we sampled men and women older than 18 in three provinces in South Africa to understand the influence of culture and religion on the realisation of sexual and reproductive rights. The provinces we worked in were the Eastern Cape, KwaZulu-Natal and Mpumalanga.
Women said they felt helpless and that the justice system could not protect them because men could easily deny that the child was theirs. For many it seemed that men had the right to deny involvement in a woman's pregnancy. This, for them, was a sore point.
Similar research from the Eastern Cape showed women felt that men denied a pregnancy as a way of punishing them for falling pregnant or not using contraceptives. They recounted how men often became angry when told about a pregnancy. Some men moved away while others simply refused to cooperate. Men only took responsibility for a pregnancy when it was convenient for them.
An analysis of the research suggests that denial by men of their involvement in relationships that result in pregnancies has become normalised in some communities. It also seems clear that men evaluated relationships and if their pregnant girlfriends were not considered a main partner, they denied paternity.
The importance of confirming paternity
There are several reasons why knowing the paternity of a child is important.
The first is a family's medical history. This can give practitioners clues about medical conditions that may run in a family. In particular, it can help identify people with a higher than usual chance of common disorders. These include heart disease, high blood pressure, stroke, certain cancers and diabetes.
Medical history also can also provide information about the risk of rarer conditions, for example those caused by mutations in a single gene such as cystic fibrosis and sickle cell anaemia.
For women, having their pregnancies denied results in psychological distress, and in some cases even in suicide.
Women face additional problems such as financial stress and challenges to their standing in the community. Women can't claim private maintenance for the child unless and until the putative father agrees to take responsibility for the child. And women can lose prestige because the denial of paternity is seen to imply that they do not know who impregnated them.
How DNA paternity tests could help
If a man denies being the father of a child, the only route women can take is to insist on a DNA test. But in developing countries this is rarely an option for women.
In the developed first world countries such as the US, UK and Australia DNA testing is often used to settle disputes. In these countries access to DNA testing is more affordable and accessible. Although DNA tests are available in South Africa, they are expensive. They can range in price from R900 to R1400, which is beyond most people's means. And they can only be done through private laboratory services. In rural areas these laboratory services are limited and, in most parts, non-existent.
If DNA tests were available at primary health clinics as part of a comprehensive sexual and reproductive health service, women would be able to use this service freely and then be counselled to understand the implications of the results.
DNA paternity testing would also resolve misattributed paternity early on to avoid deferred confusion and distress for all three parties.
Mzi Nduna, Associate Professor in Psychology, University of the Witwatersrand; Deborah Lesley Ewing, Visiting Scholar, School of Human and Community Development, University of the Witwatersrand; Khanyisile Bujela, Student area of expertise unplanned pregnancy and father absence, University of the Witwatersrand; Matamela F.B. Makongoza, Student area of expertise gender based violence, University of the Witwatersrand, and Welmari Bouwer, MA in Social and Psychological research by coursework
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