A portrait of assisted reproduction in Mexico: scientific, political and cultural interactions

Sandra González-Santos’ book offers a brilliantly assemblaged portrait of Mexico’s system of assisted reproduction and its complex entanglements with wider processes of globalization and ever-changing notions of kinship, gender, lineage, and identity. The author first offers a compelling account of the theoretical and methodological frameworks used throughout the book. Instead of focusing on assisted reproductive technology, the author offers a systems approach and explains, through the work of P. Hughes (1986, 1987), why approaching assisted reproduction through the notion of systems helps to illuminate the emergence of a socio-technical system that eventually becomes not only biologically but also socially useful. González-Santos situates the book’s contribution in a wider global context and vividly describes the intimate and profoundly complex academic enterprise of doing fieldwork. The book presents an engaged ethnography that guarantees a wide diversity of approaches and perceptions to assisted reproduction as she interviews and/or observes not only health professionals but also patients, lawyers, embryologists, marketing and policy makers and equipment distributors. The author also uses books and journals whose timing, content, and authorship are key to understand the history of assisted reproduction (AR). She looks at the cultural, political and social context of post-revolutionary Mexico to situate the conditions that allowed the appearance of AR alongside the development of the country’s healthcare system.

Part I “Origin” looks at the material and epistemic infrastructure that paved the way for the emergence of assisted reproduction during the 1920s, a process carefully explored in Chapter 2 “Interest in Sterility.” González-Santos looks at how the country’s modernizing project shaped Mexico’s healthcare system and illuminates how these processes worked as fertile ground for the creation of several medical associations, among them, The Mexican Association for the Study of Sterility (AMEE). The chapter looks into AMEE's history and the political, cultural and religious influences that shaped its membership, epistemological frameworks and views on sterility as a national problem. In Chapter 3 “Managing Reproduction,” the author traces the epistemic shifts that allowed assisted reproduction to, eventually, become acceptable. In the context of family planning campaigns and the establishment of eugenic principles and strategies, the field of reproduction was able to change its focus from infertility to reproductive biology and to embrace both halting and promoting reproduction. Throughout the book, the author illustrates the gendered hierarchies that shaped the system. Although the author indirectly mentions the issue of race in the management of reproduction, it would have been very valuable to bring more light upon the intricate history of eugenics and racism in Mexico and how that might have shaped access to reproductive technologies since their appearance.

Chapter 4 “Interest in Assisting Reproduction,” looks at a second shift that made high complexity assisted reproduction a reality; the move from thinking about population crisis to attending involuntary childlessness. González-Santos looks at the material and human resources, the institutions and human regional networks that facilitated the very first high complexity AR birth in Mexico in the 1980s. The author vividly describes the (gendered) stories of the eager physicians that were able to lobby for the national and foreign investments that would allow them to succeed in their pursuit of mastering complex techniques and procedures. Although the chapter is full of names and dates, the author is able to engage the reader. Hers is a prose that proves that rigorous academic work can also be delightful by mastering the art of storytelling.

Part II “Reproducing Assisted Reproduction,” covers the 25 years after the first successful birth in 1988, a period during which assisted reproduction became useable. It focuses on the discursive landscape that framed the sociopolitical and moral aspects of assisted reproduction technologies (ARTs). For the author, this landscape allowed ARTs to be seen, not only as technological innovations, but also as cultural novelties. In Chapter 5 “The Universe Expanding,” the author looks at the growth of assisted reproductive clinics in the country and the emergence of new international and regional networks. The author situates this expansion on a wider neoliberal project that favored the privatization of health services and vast public investment on ambitious international research agendas on genomics and the new life sciences. Chapter 6 looks at the “Discursive Landscape” and the narratives enacted in different spaces like the media, support groups, trade shows and recruiting events that worked to define assisted reproduction as a high-tech, successful, and paranatural technology but, above all, as an acceptable way of forming a family. The book closes with Chapter 7, “Contemplating a Repronational Portrait,” with a reflexive account of what the AR system has accomplished and what is expected in the years to come.

Throughout the book and at the end of each chapter, the reader finds a section on “Details of a National Portrait.” In these sections, the author offers a description and a brief analysis of the images and symbols that have framed the history of assisted reproduction in Mexico. These portraits offer a richer view of the notions on motherhood, childhood, the state and reproduction that shaped the history of ARTs in Mexico.

The book is an outstanding contribution to the field of Science and Technology Studies in Latin America as it offers an extraordinary example of how sciences and technologies are never neutral. As Sandra Harding (2011, 21) rightly notes, “sciences (and technologies) and their societies co-constitute each other. Each provides resources for the development of the other – and this can occur whether such development is politically and intellectually progressive or regressive.” The book is of great value to both postcolonial and feminist scholars with an interest on the complex relation between science and reproduction, between a global governance of health and the distinctively local hierarchies to which modernity so easily accommodates.