Conclusion
An integral model of reproductive freedom challenges and expands common thinking about reproductive technology. Sterilization is neither good nor bad; its outcome depends on how it is used. For example, the integral model of reproductive freedom and social justice shows that although most Puerto Rican women make decisions and are not victims of sterilization abuse in the classic sense, this does not mean that they are or were not oppressed, or that they are exercising full reproductive freedom. High rates of sterilization are driven by the marginalized and impoverished social conditions of Puerto Ricans on the island and in the United States. The circular migration of Puerto Ricans to and from the United States, the unofficial population policy that promoted sterilization, and the impoverished social conditions in both places reflect their dependent position in a transnational global economy based on colonialism and inequality.1 Yet an integral model of reproductive freedom and social justice shows that even though poor women are targets of population control they do not follow population policy blindly; most women exercise a certain degree of agency.
Undoubtedly, sterilization was unethically implemented in Puerto Rico as a form of population control to ameliorate a problem that was created not by overpopulation but by Puerto Rico’s dependence on the United States.2 However, an examination of the personal, cultural, and social realms shows how Puerto Rican women themselves use sterilization to cope with poverty, lack of access to quality health care, and experiences with sexism, and to negotiate their own reproduction. An integral analysis elucidates how the State’s goal to lower the rate of population growth intersected with Puerto Rican women’s needs to control their fertility, thus increasing the rate of sterilization among Puerto Rican women on the island and in the United States.
In summary, Puerto Rican women make reproductive decisions; however, choosing between sterilization and continuing to have children under adverse conditions, or getting sterilized as a last resort after having more children than they desire, does not constitute full reproductive freedom. What’s more, although all women’s reproductive choices are constrained, poor women’s reproductive freedom is even more limited because of their poverty and lack of access to quality health care, which limits their knowledge about contraceptives and reinforces their misinformation about the permanent nature of tubal ligation. My study shows that low-income Puerto Rican women do not have complete access to the full range of birth control methods on the market today and available to other women. This reproductive disparity is an ethical issue.
An integral model of reproductive freedom and social justice also builds in a notion of optimal reproductive freedom as an ethical goal. Reproductive freedom consists of the personal/gender consciousness and political capability to decide if, when, how, and with whom a person may want to have children, free of coercion or violence. It also entails having social conditions that enable an individual to have children, for example having: viable birth control options, quality health care, prenatal care, and childcare, the right to a legal abortion, and a support system that allows women and men to raise children in a healthy environment.
As long as sterilization continues to be used as population control in the Third World, justified by representations of Puerto Rican and other poor racialized women in the U.S. as burdens on the State, and as long as these women do not have access to adequate living conditions and access to quality health care services, Puerto Rican women and other poor, marginalized women will not exercise true reproductive freedom. But this breach of freedom cannot be ethically answered by painting Puerto Rican or other women as mere victims or dupes of racist, classist, sexist, and colonialist policies. Solidarity and change requires that we see—and help others to see—how women have resisted, too, and have found some space to exert their own will as they make their way and build their families under oppressive circumstances.
Podcast
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Global Dimensions of ART – Podcast Description
Iris Lopez introduces and moderates this panel discussion on “Global Dimensions” of ART practices which features speakers Dana-Ain Davis, Laura Briggs and Claudia Castañeda. Increased demand for assisted reproductive technology (ART) and transnational adoption has been propelled by a number of factors, including the development of new technologies and changes in familial form – such as childrearing in second or third marriages; lesbian, gay, and transgendered families; and delays in childbearing and subsequent difficulties in conception – that make ART helpful. Other relevant factors include environmental changes that have negatively affected fertility levels, new levels of transnational migration and interaction that have fueled awareness of babies available for and in need of adoption, and concerns about genetic diseases and disabilities. Effectively, the various imperatives and the desires, both cultural and personal, that the use of ART fosters and responds to, have created a “baby business” that is largely unregulated and that raises a number of important social and ethical questions. Do these new technologies place women and children at risk? How should we respond ethically to the ability of these technologies to test for genetic illnesses? And how can we ensure that marginalized individuals, for example, people with disabilities, women of color, and low-income women, have equal access to these new technologies and adoption practices? And, similarly, how do we ensure that transnational surrogacy and adoption practices are not exploitative? These questions and many others on the global social, economic and political repercussions of these new forms of reproduction were the focus of this year’s Scholar and Feminist Conference, “The Politics of Reproduction: New Technologies of Life,” which took place on February 28, 2009 at Barnard College.
