Organizer: Aditya Bharadwaj, University of Edinburgh, United Kingdom Reproduction in Asia is becoming an increasingly technological event. While this may not seem extraordinary, in the new century (bio)technologies of conception and birth are transforming reproductive lives, cultural landscapes and political economies across Asia. The panel conceptualises the use of ‘technology’ in reproduction as a bio-technical assemblage as well as a discursive formation. In so doing, we empirically embed our conversations in local Asian, Inter-Asian to Global sites. The panel explores a range of technological interventions from prenatal HIV-testing and prevention of mother-to-child HIV transmission in India, to the world’s highest caesarean births in Taiwan, the transnational flow of IVF technology from France to Vietnam and it’s local assimilation, to the emerging mutation of global reproductive migrations to India in the shape of human embryonic stem cell therapies. The primary concern of this panel is to ask what it is like to reproduce in Asia today? What precise technological configurations enable and disable reproductive lives and destinies? What new forms of cultural control are emergent and how do these re-script or meld with older, more established patriarchal technologies of control? Most importantly the panel traces how technologically mediated reproduction in specific Asian sites is enmeshed in transnational flows of capital and global regimes of medical, ethical, legal, and political controls. In the final analysis we wish to produce a cross cultural analysis of Reproduction in Asia that maps the cultural contours of reproductive biology, technology and systems of control that are both localisable and yet global.
The Government of India–UNICEF program to prevent the transmission of HIV from mother-to-child by providing HIV-counseling and testing during pregnancy and anti-retroviral therapies to prevent HIV transmission has arguably become the most significant technological transformation in reproductive health care in India in the 21st century in terms of the reach and scope of the population affected and in terms of its potential to exert forms of control which are tied to class, gender, and national relations of power. Based on medical anthropological research conducted from 2003– 2008, this paper explores how counselors working in the government hospitals in India discursively negotiate the social and biological risks associated with HIV-testing as they try to encourage low-income pregnant women to undergo the test using the following strategies: 1. Circumventing the informed consent process of HIV-testing; 2. Presenting the test as a routine part of prenatal care and as akin to prenatal immunizations; and 3. Emphasizing the potential for “innocent” vs. “guilty” modes of transmission when motivating women to get tested and when getting them to convince their male partners to come in for testing. I argue that these strategies were employed because of the pressure that the counselors felt to demonstrate statistical “success” in the numbers of people who undergo HIV-testing in response to state, national, and international demands for such demographic indicators. As a result, low income women are not presented with the information necessary to make an informed choice about the use of technology in their reproductive lives.
This paper reinterprets the meaning of maternal request for Caesareans and examines the gender politics of Caesarean births in Taiwan, the country with extraordinarily high Caesarean rates. Taiwanese Caesarean rates reached 33.7% in 1995, and were reported as the highest in the world. The rates became 33.5% in 2001, the third highest in the world. In 2005, the Caesarean rate in Taiwan was 32.4%—more than twice the number the World Health Organization (WHO) defines as a normal range: 10% to 15%.
To contextually reinterpret maternal request for Caesareans, I first examine the medical discourses in Taiwanese mass media which reflects the struggle between the state and obstetric profession. When the policy attempts to promote vaginal births through health education, it is hard to do so while confronting the deeply rooted technocratic culture within the obstetric profession. These discourses not only construct the idea of a vaginal birth as an inherently risky event, but also normalize the use of Caesarean sections. These kinds of messages have been influential in women’s reactions to Caesarean sections. Second, when policy-makers and obstetricians blame women for Taiwanese high Caesarean rates, I show how the hospital birthing system itself is responsible for the high Caesarean rates. Within this context, I explore how women’s request of Caesarean sections due to their concern about “suffering twice”—attempting to deliver vaginally but ultimately having a C-section—has become a reflexive action in response to the prevalent Caesarean sections, and the dehumanizing system as well.
In Vietnam, the introduction of in vitro fertilization (IVF) during the late 1990s has led to a dramatic transformation of fertility services and the distinction between “scientific” techniques of assisted reproduction, and all others. Hospital-based IVF programs have promoted technology, medical expertise, and enumeration of successful births as means to promote services and control over the birth process. This paper draws on the short (fifteen year) history of IVF program development in Vietnam to illustrate the changing nature and interpretation of “control” over use of IVF and related technologies in the birth process. First, it explores contrasting ideas of “control” over the use of IVF, examining the transfer of IVF from France, where its use is highly regulated, to Vietnam, which at the time lacked regulation, re-scripting ideas about the bioethical use of IVF as it moved transnationally from one legal/cultural regulatory environment to another. The paper also questions how the rise of expert and technological knowledge associated with IVF reflects a rise in demand for accountability as patients seek control over unpredictable reproductive processes, as well as medical services. Second, the paper examines the elasticity of control reflected in institutional and patient innovation and adaptation used to make assisted reproduction work in a national medical complex that has contended with resource limitations and shortages. With national hospitals moving to become financially self-sufficient, decisions about how to make a program function reflect transitional ontologies between socialist leanings and new neoliberal processes at work throughout the country.
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