When Doctors Don't Tie: Hierarchical Medicalization, Reproduction, and Sterilization in Brazil

Abstract

Drawing on ethnographic fieldwork among black women, medical personnel, and activists in Brazil, this article highlights the implications of hierarchical medicalization. I show that the prioritization of particular forms of medicalized contraception for women located differentially in society enables different relations, political positions, and mobility. Denial of a tubal ligation in favor of modern reversible contraceptives, in a context of inequitable distribution, can perpetuate social stratification. This work contributes to literature exploring the complexity of medicalization and its relationship with society via reproduction.

Scars from a Previous Epidemic among White and Black Women: Social Proximity to Zika and Fertility Intentions During the Covid-19 Pandemic

“…That white women react by intending to postpone suggests that white women might perceive the public health crisis as a temporary barrier to childbearing, whereas non-white women might view it as a more permanent barrier. Fertility already takes place in highly contentious and uncertain circumstances among non-white women-unintended fertility is high among non-white women, who also face serious barriers to contraception 34 , and institutional discrimination 28 including regarding reproductive health 35 . In a context of back-to-back novel infectious disease outbreaks, non-white women might perceive the combined weight of these barriers as leaving them with little option but to intend to forgo future childbearing.…”

Vidas precárias: tecnologias de governo e modos de gestão da fecundidade de mulheres “vulneráveis”

“…Como o acesso a métodos contraceptivos se constitui um direito das mulheres, toda a complexidade que subjaz a essa oferta e o modo (violento) como ela é apresentada pode estar sendo subvalorizado pelas instâncias de controle social do SUS e por movimentos sociais organizados. 22 As significativas dificuldades para acesso às laqueaduras tubárias no SUS, permeadas pelo racismo institucional e por interesses médicos corporativos, fartamente documentadas em estudos etnográficos realizados no país (Carvalho, 2017;Corossacz, 2009;Dalsgaard, 2006;Edu, 2018Edu, , 2019Faya-Robles, 2015), podem estar funcionando como um caminho que vem sendo pavimentado para a entrada maciça, em larga escala, dos métodos LARC no Brasil, atendendo, assim, a interesses empresariais, de corporações médicas, de gestores públicos e, não menos importante, de produção de conhecimentos científicos, por meio de potenciais participantes de estudos clínicos oriundas do SUS.…”

Race and Biomedicine Beyond the Lab: 21st Century Mobilisations of Genetics—Introduction to the Special Issue

“…Eugenic beliefs were articulated in official state-sanctioned practice in many countries well into the twenty-first century and continue in what many would call neo‐eugenic forms (Hoffman 2017 ; Tausig et al 2003 ). New epigenetic research does not evade this, but can reinscribe old categories of race, and even as it documents the impact of a racist environment, problematically locate responsibility in the bodies of racialised women (Saldaña-Tejeda 2018 ; Valdez 2018 ) in ways that are continuous with medicine’s role in racist medicalisation through both imposition of treatment and denial of care (Edu 2018 ; Roberts 1997 ). Race is often poorly defined in biomedical research, yet implicitly relies upon this kind of reification (Lee 2009 ).…”