Reproductive Governance, Redux

The latter half of 2018 produced some startling headlines. Forty years after imposing the one-child policy, the Chinese government encouraged citizens to have more babies by promising tax incentives, parental leave, and housing and education subsidies (Myers and Ryan 2018). The Argentine Senate rejected a bill that would have legalized abortion in the first 14 weeks of pregnancy, and a week later, a 24-year-old woman died of septic shock after a botched abortion. The United States government denied passport applications filed by children born near the Mexican border, despite the fact that those children hold state-issued birth certificates. Brett Kavanaugh, accused by three women of committing sexual assault, secured a seat on the US Supreme Court. Reproduction undoubtedly sits at the center of politics and governance.

The concept of reproductive governance directs our attention to how reproduction is mobilized and activated at particular historical moments. As Elizabeth Roberts and I defined it in 2012, reproductive governance “refers to the mechanisms through which different historical configuration of actors – such as state, religious, and international financial institutions, NGOs, and social movements – use legislative controls, economic inducements, moral injunctions, direct coercion, and ethical incitements to produce, monitor, and control reproductive behaviors and population practices” (2012:243). We were inspired by events in Latin America, where transitions to democracy and neoliberal economies were built upon a platform of respect for human rights after decades of dictatorship, and where states were in the process of privatizing public services and encouraging citizens to take individual responsibility for their health.

The seeds of reproductive governance were sown earlier, though, in the 1990s, when feminist anthropologists eagerly accepted Faye Ginsburg and Rayna Rapp’s invitation to go beyond “cultural specificity” to “conceive the new world order” (1995). We devoured Shellee Colen’s notion of “stratified reproduction,” which shows how certain groups of people are encouraged to reproduce while others are discouraged, stigmatized, deported, and punished. We eschewed the village for the nation-state, finding local manifestations of global processes in places like China, Egypt, Guatemala, India, Israel, and Mexico. Throughout the decade, feminist anthropologists began to study the gendered manifestations of international policies such as universal human rights, as exemplified by Sally Engle Merry’s analysis of human rights and gender violence (2006). Siri Suh’s article, included here, offers a contemporary iteration; even when Senegalese clinicians appear to act independently, Suh shows, they feel constrained by the international standards set by the United Nations and foreign NGOs. The theoretical tools offered by Foucault and Agamben proved useful for analyzing the mechanisms of surveillance, discipline, and states of exception that characterize reproductive regimes. Anthropologists began to investigate the production of citizenship and illegality, noting how these socio-legal distinctions constrain reproductive options (Goldade 2011; Ostrach 2017; Willen 2005).

Together with legal scholars and political scientists, we noted the trend toward judicialization, in which reproductive and sexual rights policymaking was shifting to the courts and legislatures. Elyse Singer’s article in this volume reminds us that some abortion advocates do not accept the state’s authority to bestow human rights; they have taken matters into their own hands. From the perspective of reproductive governance, however, this rationalization could appear more ominous if claimed by anti-abortion advocates. Anthropologists have become conversant in audit cultures and lawfare, defined as “diverse and intentional strategies adopted by civil society actors that seek to engage legal institutions in order to further or halt policy reform and social change” (Gloppen 2014). International treaties, declarations, legal analyses, court decisions, and concordats (see Hagopian 2006) increasingly seek to set the terms of reproductive governance. We showed how activists understand, translate, and operationalize the concept of “local moral worlds” as they negotiate international standards and protocols.

Anthropologists have so far utilized the concept of reproductive governance in two major ways. The first analyzes the emergence of new social subjects, including adoptable embryos, fetal persons, and egg-freezing millennials, as well as sperm donors and their copious spawn. The second shows how reproductive governance intersects with another feature of the zeitgeist, namely, human rights. Especially in Latin America, human rights have been a powerful catalyst both for progressive politics and for those who support the right to life (Morán Faúndes and Morgan 2018).

Yet much has changed since we first wrote about reproductive governance in 2012. Now more than ever, reproduction has come to figure prominently in a global political landscape at a grand scale, in trade agreements, international human rights courts, statistical simulations, and transnational activist coalitions. Across the globe, epistemic communities working with shared ideologies develop the funding mechanisms, legal strategies, political playbooks, and media tools to advance their goals. Transnational collaborations of all sorts have been growing and intensifying. Reproductive governance is now influenced by global confluences that include elements of activism, finance, medicine, and humanitarianism. Both advocates and opponents of reproductive rights can claim victory. Sexual and reproductive rights advocates celebrated when India recently revoked its colonial-era ban on homosexuality, well after many other countries had legalized same-sex marriage and introduced liberal gender identity laws. Chile and Ireland loosened their abortion laws in 2017 and 2018, respectively, and similar struggles are underway in Brazil, Argentina, South Korea, and elsewhere. At the other end of the political spectrum, a rise in religious nationalism and right-wing populism rides on campaigns against abortion, euthanasia, marriage equality, and “gender ideology” that have been orchestrated from the Vatican during the reign of the supposedly “tolerant” Pope Francis (Kuhar and Paternote 2017).

Anthropologists are uniquely positioned to witness and connect the dots among these dizzying developments. We show how right-wing conservatives cultivate the faithful by constructing a self-avowedly “moral” political platform that promises to control gender, sexuality, and reproduction (Mujica 2007). We show how liberals struggle to find the ethical-political message that will resonate with voters to foster tolerance, diversity, equality, and justice. Clashes between these ideological extremes find expression in so many of the things we study: changing patterns of obstetric violence, child separation, deportations, femicide, racism, Targeted Regulation of Abortion Providers (TRAP) laws, violence against transgender people, and the like. Sometimes the conflicts are surreal, such as in 2017 when right-wing protesters harassed Judith Butler in Brazil, after a social media campaign branded her an evil architect of “gender ideology.”

From the perspective of reproductive governance, such ideological incitement always has an economic dimension. Neoliberal economies encourage capitalist expansion, in part, by empowering corporations and freeing capital to influence politics. The infamous 2010 Citizens United decision by the US Supreme Court, for example, allows corporations to spend freely to influence elections. As a result, “dark money” given to non-profits to influence election outcomes and anonymous “super-PACs” (political action committees) have flooded the political field. Many of them openly oppose reproductive and sexual rights because these issues are effective at mobilizing conservative voters (Stan 2013). The government consequently now over-regulates some industries (such as abortion clinics) while leaving others untouched: the US fertility industry and certain pharmaceutical applications operate virtually without government oversight or regulation. Anthropologists Cromer and Van de Wiel (2018) see “increasing consolidation of fertility, pharmaceutical and medical device companies through mergers, acquisitions and strategic alliances.”

The inconsistency of non-regulation is evident in the marketing of misoprostol. Produced by Pfizer under the name Cytotec, misoprostol is used as part of the medication abortion regimen. It is also used alone and off-label in legally restrictive settings to precipitate abortion (as seen in Elyse Singer’s article in this issue). The World Health Organization lists misoprostol as an essential medication, and one imagines that the drug must be extraordinarily profitable. Yet the manufacturer has not applied to license the drug for reproductive health “despite the abundant literature on its safe and effective use,” in part because it does not want to provoke controversy over its role in facilitating abortion (Weeks, Fiala, and Safar 2005:269). Individual women are prosecuted for using misoprostol without medical supervision, yet the conservative politicians who would lock them up never seem to criticize or question the drug’s manufacturer. The nexus of economics and politics is the next frontier in anthropological studies of reproductive governance.

Anthropologists excel at understanding how people make meaning of their experience, using our time-honored methods of sitting, watching, and listening (Pigg 2013). Yet despite our penchant for slow research, we are striving to be more agile, probing, and pragmatic. Elise Andaya and Joanna Mishtal (2017) set a good example when they called on anthropologists to document the effects of the so-called Global Gag Rule that prevents US foreign assistance from funding clinics that provide or support abortion. Similarly, Mercier and colleagues (2015) responded to the imposition of TRAP laws in North Carolina by studying the experiences of clinicians forced to submit. Documenting the effects of repressive legislation is critical, as anthropologists trace connections between reproduction and other realms. We also need new research strategies to study venture capitalists, business executives, clerics, and judges who set the parameters of reproductive governance. Increasingly, we are expanding beyond traditional themes (abortion, adoption, assisted reproductive technologies, childbirth, and contraception) to address reproductive justice, which Loretta Ross and colleagues (2017) defined as the right to have a child, the right not to have a child, and the right to parent one’s child or children in safe, healthy environments.

Religion is another frontier of reproductive governance. A brief illustration comes from Costa Rica, where the reproductive and sexual rights movements were bolstered by recent decisions by the Inter-American Court of Human Rights. The IACHR ruled in 2012 that Costa Rica must allow in-vitro fertilization, and in 2018, it advised the government to permit same-sex marriage. What should have been a victory for LGBT activists backfired, however, when Catholic and evangelical opponents turned the IACHR decision into an election issue and managed to elect several evangelical legislators. Costa Rican political operatives learned that opposition to sexual and reproductive rights can mobilize voters – ensuring they will use this strategy again. Perhaps, they were inspired by what happened in the United States, where the cynical marriage of conservative religious values and Republican politics culminated in the 2016 election of Donald Trump. In June 2018, the US withdrew from the United Nations Human Rights Council. This inspired a coalition of Christian law firms and legislators (known as Project Blitz) who favor natural law over secular law and intend to “protect the free exercise of traditional Judeo-Christian religious values and beliefs in the public square” (CPCF n.d.). The connection between the rise of religious nationalism and human rights lawfare in Costa Rica and the US is more than incidental. In 2017, US Republican Senators Mike Lee and Ted Cruz wrote an op-ed insisting that the Organization of American States (OAS) and its human rights court back away from decisions supporting abortion, IVF and LGBT rights: “The OAS has also used the Inter-American Commission on Human Rights to force alien cultural practices on Latin American countries, including formal recommendations promoting abortion in countries whose legal, cultural and religious practices defend life” (Lee and Cruz 2017: para. 6, emphasis added; see also Arguedas and Morgan 2017). The imbrication of religion, conservative politics, and reproduction is not new, of course, but the lens of reproductive governance helps to illuminate and expose the links among these seemingly disparate events and strategies (Morgan n.d.). The global campaign for religious liberty serves increasingly as ethical incitement, bringing conservatives into the office while limiting access to reproductive technologies, justifying discrimination against sexual minorities, resisting euthanasia, and restricting abortion.

All politics is reproductive, as historian Laura Briggs argues (2017). Anthropologists have long shown how reproduction is politically situated even when it seems so benignly natural:

Yet all reproduction, even reproduction that appears “natural,” is assisted. Some forms of assistance are simply rendered invisible because they are taken for granted by people for whom reproduction is not an obviously political issue. If you do not have to pay money to conceive, it may not occur to you that conception can be prohibitively costly. If you do not have to transform your body to gestate, it may not occur to you that gestation is hard and risky work. If a physician has never hurt you or mocked you or ignored you or lied to you, it may not occur to you that being deemed healthy enough to have children is an ideology rather than an ontology. If you do not have to worry about the legal status of your relationship to your child, it may not occur to you that she can be taken away. If you do not fear for your safety, it may not occur to you that you need to stay alive to create life. https://bostonreview.net/gender-sexuality/merve-emre-all-reproduction-assisted

Anthropological work is essential to advocacy. In the words of law professors Alice Miller and Mindy Roseman, “Until we have more grounded answers … we are working under the effect of a kind of magical thinking, believing that all advocacy is good advocacy, that battles should be waged everywhere and norms always fought for, no matter how slight their weight, because progress is inevitable” (2011:14). Anthropologists are just beginning to untangle the ways that neoliberal economics intersect with reproductive governance. Some reproductive bodies are allowed (or not) to move across borders, while some have their children forcibly removed. Some bodies become subject to monetization and financial speculation, while others may be released from regulatory oversight. The perspective of reproductive governance encourages us to consider how religious, economic, and political ideologies intersect and find expression in an array of reproductive matters. It is a theory befitting these times.

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Lynn M. Morgan

Lynn M. Morgan is Mary E. Woolley professor of Anthropology at Mount Holyoke College and author of Icons of Life: A Cultural History of Human Embryos (University of California Press 2009) and co-editor of Fetal Subjects, Feminist Positions (University of Pennsylvania Press 1999).