In Mayotte, the fight against immigration affects access to healthcare for undocumented women

In August 2022, Gérard Darmanin announces that the nationality law will be modified again in Mayotte, after a first historic reform in 2018 which came fragment French nationality law by introducing, in Mayotte only, a condition of legal residence of at least one of the two parents at the time of birth for the child's future access to French nationality.

The new government proposal intends to extend the minimum duration of this legal stay from three months to one year.

This bill can be read in light of the gradual strengthening of anti-immigration rhetoric in Mayotte, as evidenced by the scores of the National Front in the 2017 presidential elections – with 42,89% in the second round contre 33,9%nationally – and those of the National Rally in the 2022 elections, with 59,1% in the second round contre 41,45% nationally.

Based on a field survey conducted in 2017 in Mayotte as part of the European project EU Border Care, it is possible to glimpse the deleterious effects of anti-immigration rhetoric on access to health services for pregnant women and their newborns.

The figure of the pregnant woman as a migratory risk

The figure of the undocumented pregnant woman is central to the debates on immigration in Mayotte. Its construction as a “migratory threat” underlies the reasoning that leads to the fragmentation of French nationality law. Media coverage of migration issues in the region has for several years contributed to reproducing the idea that Comorian women come to Mayotte in the hope that their children will be French, often read presented as obvious, without reference to field studies.

The research carried out in Mayotte as part of the project EU Border Care show why many stereotyped representations – for example that undocumented women “have just arrived” to give birth in Mayotte – are based on simplistic assumptions that qualitative interviews with the women concerned do not confirm. The analysis of the life experiences of these women reveals long-established life paths in Mayotte and pregnancies that are part of family and cultural logics.

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Reducing mobility in the region to a question of legislation regarding potential access to French nationality for children to come does not make it possible to grasp more general socio-economic considerations and above all it denies the historical and cultural links between the islands, yet decisive.

In view of the qualitative analyzes of this research, it seems unlikely that an additional reform of nationality law will significantly reduce mobility between the Comoros and Mayotte. The research carried out reveals not only a multiple causality on the side of individual motivations but also a continuous production of illegality on the side of the institutions through many barriers to regularization. Rarely mentioned, these "irregularization" policies contribute to the continued increase in the number of undocumented people on the island. Thus, contrary to the announced effects, the reform proposed by the government risks complicating access to rights for people born in Mayotte and therefore keeping some of these people and their relatives in long-term administrative insecurity. However, these exclusions produce a socio-economic marginalization that perpetuates the living conditions at the source of social tensions.

The deterioration of healthcare conditions for women wishing to access public services is a tangible consequence of this hostile political context.

The politicization of perinatal care to the detriment of patients

In Mayotte, 21 mother and child protection centers (PMI) as well as a maternity ward (with 4 annexes across the two islands) provide access to perinatal and maternity care. Since the 2011 departmentalization, the management of the PMI is the responsibility of the Departmental Council of Mayotte (and no longer of the State). In this context, these health services have become the object of politicization because they are aimed at pregnant women and are accessible to undocumented women. The stigmatization of SMIs has thus led to recurrent underfunding.

At the time of the field survey, the difficulties were particularly acute with a blockage in recruitment despite the fact that nearly half of the posts were vacant at the time. A midwife expressed her concern in the spring of 2017:

“If they don't recruit in July-August, we may only be 4 or 5 out of 20 positions. So that means that we will no longer be able to consult. The press has been notified, the Ministry of Health has been notified, the Regional Health Agency has been notified, nothing is moving, nothing. So it's a complete blockage. »

The needs also concern the equipment and materials necessary for daily care. In 2017, hygiene was impossible to maintain, as another midwife points out:

“It is completely absurd. We have nothing to wash our hands with. I bought my soap, I kept my little red thing over there, I bought my liquid soap and that's it […] But after a while, we can't manage that effort either . Because we can put ourselves in right of withdrawal, nobody does anything. »

The conditions are such that health professionals decide at the beginning of summer 2017 to call for a putting SMIs under state supervision to ensure continuity of care. Since then, the situation of PMI remains difficult and health professionals are forced to exercise their right of withdrawal regularly, this was the case for example at the PMI in Passamainty in May 2022.

Greece at the Passamainty PMI.

Women's bodies, nation and citizenship

Feminist research has highlighted how women's bodies are the object of the Nation's reproductive policies, as analyzed by British sociologist Nira Yuval Davis.

At the crossroads of restrictive migration policies and a patriarchal government of women's bodies, the stigmatization of undocumented pregnant women in Mayotte, considered a threat to the Nation, generates a continuous underfunding of perinatal, maternal and pediatric health services. .

However, the deterioration in access to healthcare in turn fuels, in a vicious circle, the image of an island plagued by uncontrolled immigration. While Gérard Darmanin justifies the new proposal for the reform of nationality law in Mayotte by the need for a fight "against the social and administrative attractiveness of the territory", it is important to emphasize that in addition to the dubious effectiveness of this type of measure, this struggle generates policies of exclusion that trample on women's rights to sexual and reproductive health.

Nina Sahraoui, Post-doctoral student in sociology, CRESPPA, CNRS, House of Human Sciences Foundation (FMSH)

This article is republished from The Conversation under Creative Commons license. Read theoriginal article.

Image credit: Shutterstock / Stefano Ember