Birth controlled

Selective reproduction and neoliberal eugenics in South Africa and India

Amrita Pande

• Publisher: Manchester University Press
• Year: 2022
• Print ISBN:
  9781526160546
• eBook ISBN:
  9781526160539
• Topic: Social Sciences
• Subtopic: Gynecology, Obstetrics & Midwifery
• Index: Social Sciences

Birth controlled analyses the world of selective reproduction – the politics of who gets to legitimately reproduce the future – through a cross-cultural analysis of three modes of 'controlling' birth: contraception, reproductive violence and repro-genetic technologies. It argues that as fertility rates decline worldwide, the fervour to control fertility, and fertile bodies, does not dissipate; what evolves is the preferred mode of control. Although new technologies like those that assist conception or allow genetic selection may appear to be an antithesis of other violent versions of population control, this book demonstrates that both are part of the same continuum. All population control policies target and vilify women (Black women in particular), and coerce them into subjecting their bodies to state and medical surveillance; Birth controlled argues that assisted reproductive technologies and repro-genetic technologies employ a similar and stratified burden of blame and responsibility based on gender, race, class and caste.

To empirically and historically ground the analysis, the book includes contributions from two postcolonial nations, South Africa and India, examining interactions between the history of colonialism and the economics of neoliberal markets and their influence on the technologies and politics of selective reproduction.

The book provides a critical, interdisciplinary and cutting-edge dialogue around the interconnected issues that shape reproductive politics in an ostensibly 'post-population control' era. The contributions draw on a breadth of disciplines ranging from gender studies, sociology, medical anthropology, politics and science and technology studies to theology, public health and epidemiology, facilitating an interdisciplinary dialogue around the interconnected modes of controlling birth and practices of neo-eugenics.

Part I
Birth projects

1
Birth projects, selective reproduction and neoliberal eugenics

Amrita Pande

See Taj Mahal by the moonlight while your embryo grows in a petri-dish. (A reproductive travel website, India, 2006)

The young doctor doesn't remember the first time he slapped someone in the [public] labour room [in Kolkata, India]. Everyone slaps patients, all his MBBS classmates did, and the postgraduate students do, too. It is almost a rite of passage. ‘There was one guy, he was so shy. He never lost his cool. The day he slapped his first patient, that was an event. We made him treat us to biryani,’ he chuckles. (Chattopadhyay, 2015)

South Africa, for a variety of reasons, especially its stratified health care and racial composition of the population, has emerged as a node for global egg provision in the Global South. (Pande and Moll, 2018)

[In South Africa] The routine administration of injectable contraceptives immediately following childbirth has resulted in them being referred to facetiously as the fourth stage of labor. (de Gruchy and Baldwin, 2005)

Social scientists have convincingly demonstrated that population control and related matters have never been restricted to biomedical interventions or patient–doctor relationships. They have always been deeply political. In his seminal work, Fatal Misconception, Mathew Connelly surmises that the global campaign for population control, although not a conspiracy theory, is a neo-colonial attempt to control the world, ‘a transnational network of population experts taking over where the empires left off (2008: 11). What are these neo-colonial projects that attempt to control the world? What shape do these projects take in an era where population control has become a taboo phrase in policy making? This chapter draws on the concept of birth projects to demonstrate that as fertility rates decline worldwide, the fervour to control birthing bodies, especially of low-income and Black women in the global south, does not dissipate. The twentieth-century top-down population control projects, embedded in state propaganda and policies, were easily identifiable because of their starkness and brutality. What we have today are birth projects that are diffuse and couched in the frame of individual choice, which absolve the state of its responsibility. These neo-eugenic birth projects are based on a subtle form of eugenics that depoliticises issues and justifies systemic inequalities by couching them in the frame of choice. The following sections compare the history and presence of population control policies in South Africa and India to two other modes of delimiting the fertility of a certain demography – that of obstetric violence and to emerging repro-genetic technologies.

I argue that forced contraceptive, limiting (legal) access to contraceptive, exposing women to violence during pregnancy and birthing, and the inherent stratifications of new repro-genetic technologies, although seemingly contrasting, belong to the same neo-eugenic continuum.

Population control in India and South Africa

India has been declared the ‘first’ in many aspects of the global campaign for population control. It attracted the first sustained efforts by British and American birth control activists to establish clinics abroad. It invited the first United Nations advisory missions in demography and family planning. It hosted the funding conference of the International Planned Parenthood Federation, and together with Bangladesh and Sri Lanka, the Indian subcontinent was the testing grounds for new contraceptive techniques as well as the recipient for an outpouring of international assistance around the same. The population ‘problem’ of India had become a colonial focus as early as the nineteenth century, in effect, before any real data existed to establish population growth (Rao, 2004a). This colonial anxiety had enthusiastic support from the Indian elite. The National Planning Commission (NPC), established by the Indian National Congress, framed birth control as a way to keep the reproductive machinery ‘fresh and vitalized’ for a healthy nation, as well as to advocate for an explicitly eugenic programme that ensured a physically and mentally healthy race (NPC 1948, quoted in Rao, 2004b: 20). As expected, the burden of this imagined healthy state fell on the shoulders of Indian women. The Indian woman was the primary target of nationalist reformist agendas such as the population control campaigns, partly because ‘archaic’ practices like sati, child marriage and polygamy had been used by British colonisers to legitimise their civilising mission. But ‘modernity’ needed to be defined cautiously. The modern Indian woman had to be distinguished, not only from the archaic woman but also from the westernised, ‘individualistic’ woman. This is what Nilanjana Chatterjee and Nancy E. Riley (2001: 819) call the ‘nationalist leadership's selective appropriation of modernity’. For instance, nationalist reformers and activists supported the use of contraception for improving maternal and child health and not as a means to greater female autonomy. Autonomy was seen as a ‘distinctly Western notion and therefore not necessarily desirable’ (Chatterjee and Riley, 2001: 821).

This continues to be the underlying philosophy of the government's agenda, which frames its anti-natalist policy as ‘family welfare planning’. Such framing avoids the association of contraceptive use with so-called western notions of sexual freedom and autonomy and at the same time reaffirms the state's initiative in upholding the ‘traditional’ institution of the family (Pande, 2014). Post-independence, India became the first country to have an official population control programme. Unlike China, the democratic state of India had to maintain its liberal stance, but these liberal principles have been constantly eroded by numerical targets, financial (dis)incentives, and sometimes aggressive promotion of sterilisation (Ram, 2001). In general, the sterilisation programme was implemented with coercion and, not surprisingly, the illiterate, economically disadvantaged, Dalits and members of other disadvantaged castes, and Muslims were the primary targets (Karkal, 1998).

While the population control policies had caste, religious and ethnic underpinnings in India, in South Africa the conversation around population control is deeply embedded in racial politics and apartheid policies. But, much as the chequered history of contraception in India does not start and end with the British impetus, the history of birth control in South Africa starts before the National Party's (NP – Afrikaner ethnic nationalist party that designed and implemented the apartheid state) preoccupation with apartheid and population control. An emphasis on selective reproduction, by race and class, can be observed as early as the 1930s, and during the time of the Great Depression. The starkness of these programmes of (selective) birth control allows comparisons between birth control and other instances of reproductive violence. In the 1930s, a eugenic take on population control influenced one set of policy makers to take policy measures of a surprising, racialised nature – targeting the population of low-income whites in urban areas in order to prevent a ‘national decline of the entire white race’ (Klausen, 2004). Although such eugenicists (for instance, the Race Welfare Society) were responsible for the first birth control clinics, they were not as successful as the ‘maternalists’, mostly middle-class and elite anglophone white women troubled by the high mortality rates related to botched abortions amongst low-income white women, but also the threat this posed to ‘white prestige’ in South Africa (Stoler, 2002). Though the concerns of the two differed, they were, in effect, together in the campaign for white supremacy and a modern white nation. The campaign to increase access to birth control was to prevent poverty amongst white people, with little regard for the poverty simultaneously being imposed on Black South Africans.

With the NP and the apartheid state, there was a shift in population control policies, with the singular focus of limiting the population of Black South Africans. The fertility of Black South Africans was una...

Table of contents

• Cover
• Half-title page
• Series page
• Title page
• Copyright page
• Dedication
• Contents
• Notes on contributors
• Foreword
• Editor's acknowledgement
• Prologue
• Introduction
• Part I Birth projects
• Part II Birth violated
• Part III Birth assisted
• Index