Reflections on a Photovoice Approach to Exploring Connectedness and Recovery of Pregnant Women Using Substances in South African Rural Contexts

Pregnant women in low socio-economic status communities in South Africa are predisposed to adverse pregnancy outcomes due to limited access to care. As a result, they frequently engage in substance use while being pregnant. The burden of substance use in these communities reveals citizens who are disconnected from participating optimally within a democratic society. This is due to the fact that connectedness is rooted within larger social and systemic frameworks of poverty, unemployment, lack of housing, and mental disorder stigma. The resilience that the African people display in their journey to systemic inclusion is observed through a critical reflective research practice that recognizes their lived experience. The African principle of Ubuntu where connectedness, humanity, and participation require a coordinated effort and where research is conducted with communities and not in communities, is evident in this approach to research. This chapter explores the value of connectedness in the recovery journey of pregnant women in low-income rural communities. Presenting a reflection of a photovoice research exercise in collaboration with a rural-based organization working with pregnant women who use substances, the chapter illustrates how Ubuntu and Bronfenbrenner’s socio-ecological model expands on connectedness with the aim of improving quality of life. It does this by adding a social-contextual emphasis through the photovoice exercise. This exercise provided an example of research that culminated in an exhibition highlighting the stories of pregnant women in recovery. These stories will inform the development of a targeted intervention that would potentially enhance the quality of life of these women. We acknowledge the support of the South African Medical Research Council for their generous funding, which made this research possible.