Sterilization and the Ethics of Reproductive Technology: An Integral Approach
Iris Lopez participated in "Global Dimensions of ART,"
a panel discussion at The Scholar & Feminist Conference 2009,
"The Politics of Reproduction: New Technologies of Life," held on
February 28 at Barnard College in New York
City.
Listen to a podcast of
"Global Dimensions of ART."
Reproductive technologies have enabled millions of infertile couples
to have children. While assisted reproductive technologies such as in
vitro fertilization and surrogate motherhood can be beneficial, they
have also been criticized as privileging the nuclear family, being pro
natalist, and expensive, therefore inaccessible to the
poor.[1] A key
concern raised at the Scholar & Feminist Conference at Barnard College
(February 28, 2009) was that we should provide reproductive technology
to marginalized women, and the question posed was how do we go about
doing it? The implicit assumption of this question is that reproductive
technology is positive, or at least neutral, and therefore all women and
men should have equal access to it.
Prior to addressing the important question of equality through
accessibility, I believe broader questions need to be raised about what
makes the technology valuable (or harmful) to users. Reproductive
technology does not exist in a vacuum. It is used within a social
context of power relations based on the intersections of race, class,
gender, and sexual orientation.[2]
The use of reproductive technology
therefore raises ethical concerns that must be explicitly addressed.
The goals of my paper are first to challenge the technocratic ethos that
would readily apply any and all reproductive technologies to women's
lives, and second to examine the ethical implications of how
technologies are actually used in specific contexts. In whose interest
is it to use this technology in this context? Is it democratic,
ethical, non-coercive, and used for the greater good? Is it respectful
of women's desires, or is it imposed upon women in the interests of
those with more power?
My work is situated in a reproductive justice framework, exemplified
by groups such as Latina
Institute for Reproductive Health, The
Caribbean Initiative on Abortion and Contraception,
California Latinas
for Reproductive Justice, SisterSong,
DAWN and
Asian Communities for
Reproductive Justice as well as scholarly work such as Rosalind Pollack
Petchesky's cutting edge international research on reproductive
rights.[3] I seek to transcend a
binary agent/victim perspective, develop an integral interpretation that
gives voice to what women think and need, and contextualize women's
fertility experiences within a critical cultural, social, and historical
framework. I aim to make my research available to Puerto Rican women
and other communities who strive for reproductive and social justice and
to work with them in creating a better society.
In this paper I limit my discussion of the ethics of reproductive
technology to female sterilization (tubal ligation), which has been used
in Puerto Rico since the 1930s. Puerto Rican women have one of the
highest rates of sterilization of any
population/community.[4] The
explanations for the high rate of sterilization among Puerto Rican women
have traditionally been conceptualized in a binary framework. One
school of thought argues that Puerto Rican women are active agents who
make voluntary decisions, and therefore exercise reproductive
freedom.[5]
The other school advocates that Puerto Rican women are
victims of sterilization abuse.[6]
My research reformulates this
oppositional framework. I reject the notion that Puerto Rican women are
either voluntary agents or powerless victims because
neither of these poles presents an adequate picture of most Puerto Rican
women's reproductive experiences. I propose a third model, an integral
model of reproductive freedom and social justice that allows us to
situate agency, resistance, choice, and constraints in the broader
socio-political and historical framework that is based on race, class,
and ethnicity.[7]
Sterilization is the most popular method of fertility control in the
21st century.[8]
In most cases, both female sterilization (tubal
ligation) and male sterilization (vasectomy) renders an individual
incapable of having more children. As a reproductive technology,
sterilization is neither good nor bad; its ethical status depends on how
it is used. An integral analysis sheds light on how reproductive
technologies such as sterilization can be both harmful as well as
beneficial to women depending on their historical, personal, cultural,
and social conditions. For example: the sterilization policy developed
out of a legacy of colonialism, eugenics, and neo-Malthusian ideologies
that supported population control in Puerto Rico based on the idea that
only the "fit" should reproduce.[9]
However, as my research reveals, a
significant number of Puerto Rican women accepted and even actively
sought sterilization because it enabled them to control their fertility,
which they were desperate to do. This was especially true during the
early part of the 20th century when temporary methods of birth control
were not readily available to Puerto Rican women on the island.
I anchor my discussion of the ethics of sterilization in a 25-year
study that I undertook of Puerto Rican women that shows how
sterilization, originally a method of population control in Puerto Rico,
was adopted as a popular method of fertility control partially by the
women themselves. My study focuses on Puerto Rican women living in New
York, whom I term the first, second, and third generations. These are
the mothers, daughters, and granddaughters in the households I followed.
As the stories I relay below demonstrate, even poor, racialized women
who were targeted by population control strategies sometimes sought out
or welcomed sterilization, and derived benefits from it.
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