Pregnant Pauses: How Urban Women Compose Connections, Health, and Modern Belonging in Postcolonial Uganda

Pregnant Pauses: How Urban Women Compose Connections, Health, and Modern Belonging in Postcolonial Uganda Anna R. Eisenstein Patterson, NY B.A., Lafayette College, 2013 M.A., University of Virginia, 2015 A Dissertation presented to the Graduate Faculty of the University of Virginia in Candidacy for the Degree of Doctor of Philosophy Department of Anthropology University of Virginia March 2020 _____________________________________________ China Scherz, Co-chair ________________________________________ Ira Bashkow, Co-chair _____________________________________________ Eve Danziger, Committee Member ____________________________________________ Ellen Contini-Morava, Committee Member ____________________________________________ Christopher C. Moore, Graduate School Representative Eisenstein 1 © Copyright by Anna R. Eisenstein All rights reserved March 2020 Eisenstein 2 “Time to us is sarcasm. A slick treacherous monster with a jaw like a furnace incinerating every moment of our lives. Shrinking therefore from facing time, we escape for shelter to things of space.” -- Abraham Joshua Heschel, The Sabbath: Its Meaning for Modern Man, prologue Eisenstein 3 Abstract This dissertation is an ethnography of pregnancy. In it, I draw on participatory photo, video, and voice recordings produced over the course of twenty-one months of fieldwork with twelve middle-class women (ages 18-28) in a fast-growing urban center in southwestern Uganda. As I consider how pregnancy figures in these women’s narratives and practices of personal and family wellbeing and progress, I argue that pregnancy in Uganda is one part of a broader process of composing a network of care around oneself and one’s (expected) children, and that this is because good health/life (amagara marungi) is understood to spring forth from good relationships. Further, since pregnancy is such a transformational period in one’s life and social relationships, I suggest that it offers a special window into the concerns surrounding kinship and relatedness in contemporary Uganda. And because women in Uganda are so closely identified with their fertility, focusing directly on pregnancy helps highlight how deeply gender contours experiences, temporalities, and trajectories of composition. In my use of the term composition, I hearken to Jane Guyer and Samuel Belinga’s (1995) efforts to discuss wealth-in-people not in terms of the typical idiom of “amassing” or “accumulating” followers, but rather, in terms of the “composition” of networks of specific individuals with complementary characteristics and offerings. I build on their insight by theorizing composition as an emergent, interactional process that unfolds in real time as social actors read and respond to one another. Far from falling back on a set of preconfigured relationships, women in urbanizing Uganda actively pursued some social bonds and closed themselves off from others through gendered forms of interactional labor, that would become key to their ability to secure health and wellbeing. Grounding my approach in linguistic anthropological perspectives on language as social action, I show how the risks and promises of Eisenstein 4 different kinds of relationships call for different forms of care, and how these forms of care influence the politics of what kind of life becomes possible, and for whom. With this argument, I participate in a medical anthropology that gets beyond the clinical gaze to instead trace relational practices of fostering life, wellbeing, and care as they lead both into and out of spaces typically cast as therapeutic. Eisenstein 5 Acknowledgements To all those in Uganda who went out of their way to receive me, to help with my research, and to make me feel welcome in so many wonderful ways, I offer my heartfelt thanks. Because many of you have allowed me to include the details of your lives in the pages that follow, although it feels cheap, I can only mention your names by pseudos here. I must first thank my extended adoptive family in Mbarara, the Atwiines: Beatrice and Issac, thank you for welcoming me into your eka, may we always continue to find ourselves “bound together in love”; Olivia, you taught me everything I needed to know about Mbarara but was afraid to ask; Emily, Sarah, and Jjajja, thank you for your friendship. I also thank the Department of Interdisciplinary Studies and the OB/GYN Department at Mbarara University of Science and Technology/Mbarara Regional Referral Hospital for hosting me; there, I owe special thanks to Samson Okello, Achen Pa’Anywar, Ruth Kaziga, and Specioza Twinamasiko for their friendship and generosity. I thank my case study participants for their enthusiasm about this project and willingness to have me around, to teach me so many things, and to indulge me in so many ways. Pamela, I will always be grateful and glad that you put your cell phone number into my phone when you sold it to me on my very first day in Mbarara! Who could have anticipated all that would follow? Lillian, your warmth helped soften my hardest moments in Mbarara; oyine obuntu buzima. Abigail, you have allowed me the precious gift of sharing in the most sensitive parts of your salvation story; I hope you will find I have honored it here. My research assistants, Justus Kananura, Jonah Ndyomugyenyi, and Ronald Nkamwesiga, provided vital support with research and Runyankole, as well as many kindnesses. Daniel Mwesigye, my boda-boda driver, safely transported me into and out of every corner of Mbarara, rain or shine, and kept me laughing all Eisenstein 6 the way. Dixon Nuwagaba, Cranimer Siimamukama, and Kenneth Ainamatsiko, you are gifts to my life. Timo, you were my home away from home. I am grateful for the intellectual training I received in the Department of Anthropology at the University of Virginia, both through coursework and close mentorship from my committee members, Ira Bashkow, China Scherz, Eve Danziger, and Ellen Contini-Morava. Each of you have intimately shaped my ways of thinking and knowing about ethnography, theory, and life. Ira, thank you for so generously sharing your approach to culture as interactional patterns and patterning; as you well know, this has been the foundation on which I have endeavored to build, ever since learning of it through your courses and through our many coffees, conversations, and walks through Grounds. China, I count it a special blessing to have crossed paths with you in Charlottesville, to have learned about the anthropology of care from you and your writings, and to have been able to follow in your footsteps to Uganda. Eve, you, and the semiotic theories you have taught me, have been a source of stability for me throughout; thank you. Ellen, from you I learned my love of proverbs and of discourse analysis, both evident throughout this dissertation. Also at UVA, I thank Jim Igoe for teaching his critical perspectives on African ethnography during that challenging, but rewarding, seminar in 2016. I recognize Christopher Moore for the good name he has built for the University of Virginia in Mbarara; Chris, thank you for allowing me to come in on your coattails and for being willing to share your relationships with me. More thanks go to Joel Robbins for a powerful conversation that greatly enriched chapter three, as well as the editors and anonymous reviewers of Cultural Anthropology for feedback that further benefitted that chapter. I thank the Reed College Department of Anthropology for providing an institutional base for me in Portland and for allowing me to participate in department life while I was writing up; my interpretations of the ethnographic material presented Eisenstein 7 in chapters six and seven have taken shape in relation to your generous input. Thanks too to Tyler Zoanni for convening AAA panels that provided spaces for me to begin developing my arguments on temporality and touch. I also continue to thank Andrea Smith for consistently being a mentor and model of collegiality and meaningful scholarship from my earliest days in anthropology to the present. The financial costs associated with this project were underwritten by the National Science Foundation, Philanthropic Educational Organization, and the University of Virginia’s Department of Anthropology, African Urbanisms Humanities Lab, Center for Global Health, and Center for Global Inquiry and Innovation. I thank these organizations for investing in my work. Completing this project would not have been possible without the help of family and friends, far and near. I thank my parents, Jill and Bruce, and my sister, Becca, for unflagging support. I thank Michelle Morgenstern, Ida Hoequist, Arsalan Khan, and Roberto Armengol for being the best colleagues and friends one could ever hope to have. I thank Greg Earle, Kimberly and Christina Hunt, Phil Brewer, and Stefan Serrianni for your continuing compassions, over what has surely been a long journey. Eisenstein 8 Table of Contents ABSTRACT ......................................................................................................................................................... 4 ACKNOWLEDGEMENTS ................................................................................................................................. 6 TABLE OF CONTENTS ..................................................................................................................................... 9 CHAPTER 1: INTRODUCTION .......................................................................................................................12 WELLBEING,

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