Exam Notes on Reproductive Relations PDF

**(1) Sept 3 Intro** Superbase of reproductive relations - Reproduction is a production - Donating eggs - Asking university students as they are seen as educated individuals - Shift to reproductive justice goes beyond the individual and a broader understanding of bot...

**(1) Sept 3 Intro** Superbase of reproductive relations - Reproduction is a production - Donating eggs - Asking university students as they are seen as educated individuals - Shift to reproductive justice goes beyond the individual and a broader understanding of both rights in reproduction - How many people have access to the necessary things Prehistoric veneration of the feminine divine - Superbase refers to what is the basis of a given political economy - Many different factors formulate the superbase - Parenthood wasn't understood in the same way - Split between intercourse and pregnancy - Summer solstice impact on reproduction - Growing seasons - Longest day of the year - Think they were connected to reproduction in general - We need fertility for everything to grow - Fertility and the connections to pots and containers of food - Food storage no longer relies on daily hunting - Created industry, exchange, mobilization The sociality of reproduction from ancient to feudal times - Midwives have been around since the very start - Women attending women - Not just during birth but during daily times - Cesarian section -\> C-section - Didn't understand sepsis at first - Women were associated with the body - Midwives did it all in addition to birth also helped those dying - Physicians were the more respected yet midwives were doing most of the work - Pharmacists and physicians had similar levels of power - Shifted in the 19^th^ century with physicians coming on top - Role of organized religion - Not just Christian - All three dominant religions have their role and impact on the sociality of reproduction The scientific Revolution and modern Reproductive Science - Not just about reproduction but sexual arousal - Being treated as problematic - Sexualized female body - Seen as temptation of men into something they shouldn't be doing - Leonard DaVinci's work - Perform anatomy and drawing - Was new for artists to draw from reality rather than memory - Drew from life - Wax models helped with the rotting as it was more accurate - Teaching doctors and midwives - Professionalization of medical sciences - Women taking care during the plague carried on as nuns taking care of sick patients - Rising understanding of women caring for bodies - Led to nursing being a predominantly female field Contemporary sociality of reproduction - Pelvic can be called the cradle of the world - Malnutrition leads to small pelvic with a direct correlation with being able to carry a baby to term - Pregnancy can now be seen as a vulnerability - Contemporary science was predominantly men even in the reproductive field - Out of the home and into the hospital - Pregnancy is becoming seen as vulnerable rather than string - Pathologizing of the body comes into question - Pregnancy was always hidden - Introduction of control into reproduction - Condoms existed long before medicine or herbs - 20^th^ century it started to gain attention - Gradually contraception entered the medical field - Providing medical and pharmaceutical options of contraception - Now questioning who can be pregnant/reproduce Masculinity and sexuality-reproduction - When it comes to reproduction it is always female-orientated - Hard to find what captures the men's role in reproduction - Men with an erect penis and a correlation to war - A strong figure? - Breaking the tenderness norm and changing the perception that men are unable to care for children Reproduction vs. creation - Assisted reproduction and genetic replication - Finally able to see implantation - Now able to understand how conception works visually - Still a lot we don't understand of the egg - How we are all females first and then slowly become male - Now can see what's going on inside the female body - The personification of the fetus - Introduction of fetal surgery - Heart surgery on the fetus - Can close the hole in their heart - Fetus have such an ability to heal they can be born completely healed - More and more laws are treating a fetus as a person, and a woman as less of one, as stated charging pregnant women with crimes - Replicating systems to genetically modify humans - Can control the moment of conception with technology and cut the genetic string of disease in DNA of the fetus **(2) Sept 10: early theories of reproduction** Prehistoric generation - Figurines represent previous beliefs of preproduction - Learn signs of reproduction with the cis women's body - Hard to understand what it truly means but we can try - Totem pols demonstrated the spirit that played a role in the impregnation of the women - The longest day of the year has a link between more sun and growth - Fed the animals which we relied to for food adding to the cycle of reproduction - Circle of life - Venus of Willendorf is the image of reproduction and the cycle/circle of life - Will see how that circle flattens out into an arrow of how we progress - Trajectories of life - Allows for hierarchy and how we progress as a society - Venus - Female symbol - Was associated with fertility war sex and peace - Sex is assigned to the female body as today - Shifted with the onset of writing - The view shifts to the only sex and a masculine gaze that the female figure now represents - Feminists in the 1970s adopted the symbol with a clenched fist to demonstrate the strength and power Ancient theories of generation - Aristotle's impact on the perception of reproduction - Evidence-based on what he could see - Cycles - Ejaculation - The essence of being in part to the women from the men in this purified fluid - Heat = perfection - Prepared food so that we could eat it easily - Could boil things down and essences from herbs through heat - Heat is used to create jewellery and that led to beliefs of hierarchal standing - Heat to cauterize wounds would be lifesaving - Heat was a source of purifying - Women produce less heat then men - Hence they are smaller, dumber, weaker, and live less - Male seed (perfected from semen) - Female (unperfected) semen (menses) - Aristotle did not create the significance of heat but used it - Acknowledge it as one of the first attempts of a theory of reproduction Early dualism - Heavens of light and illumination, and life-giving water - Where hopes aspire - Constatations with great stories that follow the creation for the constellation - You will become more knowing if you reach the heavens - Vs. - The dark, powerful and mysterious underworld, the basis of everyday life - Can see where they had to plug in the gendered roles - Females are the mundane creation The power of imagination and concoction - Women's reproductive fluids constantly kept inferior to that of men or obscured - women's abundant and impotent semen is unpurified (bloody) vs the precious more rare and white semen of men that act as the seed of being - The principle of the soul' the matrix - Assumes ejaculation only occurs in men - The production of fluid upon sexual excitement as touch - Females cannot purify their elements like men can - Ovaries were the female testes - We are all the same at some point as embryos - Used words such as inferior, poorer etc. in comparison to men Seed theory - The male semen contains the ability to generate the fetus in the female (the human form is not performed in the male semen, but acts like a seed in the right growing conditions - Claims only one is responsible for the being - The female can only form within itself - Like soil - Can be compared to Christian belief in the creation - From god comes the power of creation/formation imparted to the unformed material of the world \> mundus \> mundane - Female has nothing to do with the formation solely providing the basis for the seed to grow - All is contained in the origin, the origin extends to other things - Circle back to one origin With the ability to perfect comes the divine - The male as able to perfect kts semen, and to generate humans within the static female assumed not only a superior role, but one associated with godliness - The female, like nonhumans, is associated with the matter of the world; mundane (of the world), "a nurse to the seed", and not a parent - A supporting role - Not equal - Some contribution or no contribution at all - Don't get the sense of perfection and the male role in the reproduction figurines - Now seeing a relationship between reproduction and the divine The divine creator vs. women -- the earth-bound nurse - Wet nursing was a career - Hired someone to nurse their children - A mother can change her milk according to what the baby needs - Can also be a notion of race Galen's explanation of "a natural deficiency" - Although men's and women's reproductivity is thought to be similar - 16^th^ century anatomically incorrect drawings based on seed theories like Galen's which used masculine reproductivity to explain female reproductivity - Women's reproductivity is not as developed as that of men's and suffers from a "natural deficiency" - Galen defines this deficiency as a failure in women to generate heat to purify the menses - By contrast men can generate heat to purify the semen - Was the one to suggest women have female tactical (maybe testes) Contemporary anatomical sexual - While the older ones were wrong they weren't that far off - At one point we are identical The mechanisms of lack of heat - How vessels feed the right and left ovaries (called testes by Galen) explains the natural deficiency of females - One ovary is fed cleaned or purified blood from the kidneys and produces males - The warmer ovary was producing men in contrast to the colder one producing females - Getting it anatomically wrong (still) (1500) - Mixed up the arteries and the veins - Looking away at what was taking away vs. supplying - Perpetuated Galen theory - "saw the blood from the kidneys" - And the right (late 1700s) - Dispelling the myths that were created from 300 BCE - Maybe it doesn't work how it was previously believed - St. Gregory of Nyssa (335-394) argues that embryo is completed in the female by the male - St. Thomas Aquinas (1225-1274) argues that just as only god can produce from in matter, so the "active seminal power" of man's seed given form to matter provided by the women - The Judaic midrash Rabbah Genesis (1545) repeats Aristotle's theory that the make sperm acts upon the female matter (menses) to give it form Early modern reproductive theories - In the late 1600s, there is a rejection of human generation as progression from the simple and unorganized to the complex and organized - And a rejection of the mechanization of growth - It is replaced by preformation theory and the idea that growth is the unfolding from pre-existing structures: growth is in size, not complexity - By the late 1700s preformation theory was replaced by epigenesis; the embryo gradually develops from unorganized matter; embraced by Darwin who believed man's greater size meant a greater role in reproduction than the female - Can create new things out of this recombination - Different exposures can adjust your genes - The embryo is the essence Preformation theories - The entirety is encased in the sperm or the egg - All that it will be is predestined - Notion that all beings follow a line of destiny - Follows encasement - That everything extends all the way back to the moment of reproduction - Follows the idea of Russian dolls - The homunculus follows this idea as well Ovism - Brief moment (1651-1672) - Harvey -- everything comes from an egg - Quickly moved on from the idea that the egg plays a large role in reproduction - Gender discrimination carried throughout all these theories - Without an egg in sight, women's contribution remained inferior to that of men - Man's contribution is bolstered by the discovery of sperm - Even when the egg (or its likely presence) is discovered, it remains insignificant compared to the male role - Jan Swammerdam (1669) all animals come from an egg laid by a female of the same species - Renier de Graaf (1672) proves the presence of eggs by comparing the number of rabbit ovarian follicles before coitus to the number of spheres (fertilized eggs) found in the fallopian tubes afterwards - All animals come from an egg - The seed theorist, Harvey, makes this claim but maintains an inferior female role in reproduction - Neils Stenson compares reproductive tracts among egg-laying animals and live birth-giving animals and concludes that humans must have eggs - Renier de Graaf proved in rabbits that ovarian follicles are eggs Epigenesis - Karl von Baer identifies the human egg (1872) - Cell theory: germ or sex cells (egg and sperm) of a certain kind would produce adult organisms of the same kind (1839) - Darwin's theory of evolution: organisms arise and develop through the natural selection of small advantageous inheritable traits (1859) - Human reproduction is as we understand it now: the egg and sperm, as genetic equals, contribute to the formation of a combined but distinct third being Cell theory - 1665 Robert Hook sees cells under the microscope and names them as such because they look like monk's sleeping cells - 1839 Schleiden and Schwann argue that cells regenerate through division and are the basis of all organisms, including egg and sperm cells - Reproduction now happens at a very small scale, and everywhere in the body The gene - 1866 down syndrome is described as an inherited disease - At the same time Gregor Mendel identifies inherited traits in plants - 1859 George Darwin wrote The Origin of species and argues how genetic traits evolved to the benefit of the species - 1889 Hugo de Vries: "Inheritance of the specific traits in an organism comes in particles (called) (pan)genes" 20^th^ century -- genesis is genetic - Early on in the 20^th^ century chromosomes were seen to be hereditary units and necessary for embryonic development - 1913 a genetic map of the chromosome is made and sex-linked inheritance is discovered - 1930-1950 distinct contributions are identified for the cell nucleus where DNA is discovered and found responsible for cellular reproduction - 1952 the double helix structure of DNA components, G-A-C-T, is identified - 1955 each human is found to carry 46 unique chromosomes -- the distribution of chromosomes to offspring is clarified - 23 from each parent The heroic age of endocrine discovery (1929-1935) - Discovery of hormonal secretions that ripen and release the human egg and prepare the uterus for implantation - Sex hormones are discovered to be bisexual: women and men produce estrogen and testosterone - Sex hormones are linked to external sex traits and are used to "balance" sexual orientation Menstruation as - A chaotic disintegration of form - Failed reproduction - A breathless prose...describes the maturation of sperm - Remarkable cellular transformation - Amazing sheer magnitude - Streamlines The egg described - As large and passive - Nothing about their equal genetic contribution - And silence about the egg's power to allow sperm into the egg In evolution the egg came first - Eggs "incite to action" (to egg on) - Eggs provide "the energy and genetic data for embryonic development" - "eggs may also repair chromosome damage in sperm cell genes" **(3) Sept 16: Medicalization of pregnancy and birth** 1 medicalization -- sociology of medicine (1950s) - The sociology of medicine was first raised by the structural functionalist Talcott Parsons in 1951: - Medicine is a social institution - Regulates moral deviance for which the individual is not responsible - Behaviour due to madness - And for which medical diagnosis is available - Parsons was interested in gow the institution of medicine modulates social equilibrium - Including the role of physicians, the phenomena of illness, and processes of therapy Introduction to motherhood -- Heinemann - Consider this guide for women regarding their pregnancy - Published in 1950 - The last page is almost sermon-like in describing what pregnancy means to women - The larger social meaning of ideal motherhood, and the central role of the physician in bringing about the appropriate outcome - And this physician was regarded as a LESS medicalization-of-pregnancy and birth type Social context - Keep in mind the social context in which Parsons was aware - The polio epidemic was at its peak - A social movement resting cruel psychiatric treatment was underway - The plea of insanity was created - Individuals were not morally to blame for these conditions and their associated actions but carried a disease - It was the socially sanctioned institution of medicine that adjudicated over such matters and maintained social order 2 sociology of medicine (1970s) - A doctor and a physician assistant - A new role in Western medicine in the 1970s and a chance for women to advance beyond nursing in professionalized healthcare - The overall atmosphere is less formal than in the 1950s - With an inkling of respect for women's and children's rights - However the monopolization of medical knowledge and gendered division of labour remain in place The medicalization of society - According to medical sociologist Zola - The institution of medicine is one of effective social control - It is not enacted by force but due to "an insidious and often undramatic phenomenon accomplished by 'medicalizing' much of daily living Medicine and moral social power - Traditionally morality (and healing) was the responsibility of organized religion - Much of theories of medicalization distinguish medicine from this tradition - This is where many turned for determination of what is right and wrong - As well as for relied from spiritual, psychic and physical pain - Healing shrine in catholic church - The crutches in churches show that presumable someone prayed, was healed and was able to walk out based on the power of god to heal those considered worthy - Now most people turn to medical authorities for healing - And trust them for such with little question - An example of how medicine became a voice of moral authority in modern society can be found in the practice of psychiatry - Originally pathologized homosexuality only changing its diagnostic tool (the DSM) in the 1970s - Meanwhile, physicians refuse to perform abortions and provide contraceptives whether legal or not - In both cases medicine moderates morality which is the kind of thing Irving Zola criticized in 1972 - Medicine has exceeded its original mandate to heal and do no harm - The Handmaid's Tale features a dystopian near future where women are reduced to their reproductive capacity and are controlled through a fascistic regime and forced to reproduce or support those who do so according to the regime - Rape is sacrament - Contraception and abortion are crimes and are punishable by death Big pharma and the rise of a medical consumer movement - Initial concern in medicalization was not gathered but focused on the rise of a medical profession increasingly controlled by the commercial interests of a burgeoning pharmaceutical industry - Thalidomide was a drug approved in the West for treatment of morning sickness in pregnant women - It had devastating side effects on fetal formation leading to the birth of thousands of babies with missing or malformed limbs - This practice was eventually revealed as scandalous and an example of how medical knowledge and protocols were influenced by commercial interest or big pharma 2 professionalization and medicalization of pregnancy and birth - Mary Walsh, and Barbra Ehrenreich and Deidre English were among many who documented how women were removed from any authority over healing they traditionally held as modern medicine became the dominant form of healthcare - Part of European witch hunt involved targeting women healers and midwives as too influential - Even considered demonic in their control of traditional herb-based medicine and reproduction - The regulation of midwifery occurred in two phases - 1400-1400 as civic governing rose and started to replace religious authorities - Who was behind the witch craze that defined midwives as demonic - 1900-2000 as modern medical laws defined a scope for midwifery practice - Stepped, restricted and so on - Monstrous births, infertility, illness, crop failure and madness were blamed on women - Especially healers of the relative power they had in their communities - As estimated 85% of people put to death during the witch craze were women - For centuries midwives have had a lot of respect and informal authority over the treatment of the body - Including childbirth - Physicians to this point had little interest in attending to them directly - Although it is unclear exactly why religious groups went after midwives - Their profile as women with a degree of local trust and authority may have played a role - Women have been regarded as needing to be controlled and kept in place in most organized religions and responsible for unsanctioned sexual activity - In the first period of taking from midwives, men took over - The chamberlans family of male midwives used a secret weapon of forceps as a way of nudging women out of this practice - Women comprise over 75% of healthcare workers but only 34% of practicing physicians - Females are under-represented within the higher-status physician's specialties and in leadership roles throughout the healthcare sector - This paved the way for initially a male-dominated, physician authorize the practice of gynecology and obstetrics in the early modern medical profession - Irvine London, physician and historian of medicine, studies early stats on maternal mortality by who attended the birth - By race and by class - Surprisingly found that contrary to popular opinion between 193032 in England and Wales - Maternal mortality rates were higher among middle-class women giving birth in the newly established lying-in hospitals attended by physicians - Than among poor women, in both urban slums and rural areas who were attended by midwives - The culprits were a lack of proper training in physicians, sloppy hygiene procedures, and outbreaks of diseases that were in hospitals - At the same time the US has the highest maternal mortality rate in the world due to negative health outcomes - Racialization and poverty - Had almost entirely eradicated midwifery at the start of the 20^th^ century unlike the UK Current state of medicine and birth - Under the threat of risk, birth has come to be monitored medically in mechanical terms and by various markers of progression - Heavily controlled medically and usually in or very near a hospital - Sometimes despite modern midwives' attempts to distinguish between high-risk pregnancies that may warrant such attention and care - Normal or low-risk pregnancies that do not - It depends where you look - Many Western and northern European countries and Australia maintained a place for midwifery in the medicalization of childbirth - Adopting a stepped system from low to moderate handled by medically trained midwives to high-risk cases handled by physicians - It was 20^th^-century midwives and others interested in rolling back the effects of the medicalization of pregnancy and birth who demonstrated how highly medicalized context for birth actually increases risk - Increased C-section rates - Exposure to infection in hospital - Many hospitals and birthing centres combine domestic trappings with high-tech equipment and support nearby in managing risk associated with normal bodily function - By contrast Ena May Gaskin, a long-time proponent of midwife-assisted childbirth - Assist women at the farm - A place in the US where women go to give birth without any medical assistance - Replaces labour-as-pain with "surges" and works from the understanding of birth as normal, not risky - Hospital births increase the rate of medical interventions, including c-sections - As a major surgery can carry significant risk for both the mother and child - Current studies do suggest that high-risk pregnancies benefit from hospital-based births - Better overall health and education of women improve outcomes for the health of non-high-risk pregnant women and their newborns Racialized geo of reproductive health and childbirth - Enslaves Afro-American women were used as chattel and as experimental subjects following emancipation and as the medicalization of childbirth grew in the US during the 1800s - Reproductive politics entered the scene when slavery was abolished in the US - Between 1808 - The US stopped the importation of slaves - 1863 - When President Lincoln freed all enslaved people - Between there was a rush to increase reproductivity among enslaved women - Slave owner's interests were protected by a provision that any person norm from a slave was considered a slave - Thus all tools to promote and protect reproduction were brought to bear on these women - This almost half-century of enforced physician contact with enslaved women allowed for cruel experimentation - Helped establish medical intervention in reproduction as the norm, especially in the US - Today while middle-class white women fight for natural childbirth, Afro-American women fight for access to healthy and safe pregnancies and birth - Since the modern has also been criticized for over-treated women - Initial very high doses of hormones in early versions of the pill - High rates of hysterectomies and radical mastectomies - High rates of anti-depressant and sedative prescription - However over treatment forms a major part of middle-class white women's criticisms of the medicalization of pregnancy and birth - This online guide for women giving birth in the hospital in the US is designed to help women navigate what have become known as unnecessary procedures Colonization and reproductive healthcare - A common rationalization for colonization has been the delivery of progressive elements form the so-called developed country to one considered less - In the medicalization of child care during the height of modern civilization, this did not prove to be the case - The importation of modern medicalized pregnancy and birth often relied on medical education and infrastructure that could be provided consistently clean drinking water, shelter and nourishment - Abuse abounded - Enforced sterilization - Experimentation without consent - Substandard care without overview or repercussions - Local traditions, including traditional healing practices were often abolished and banned **(4) Sept 23: social control of reproduction** 1 Reproductive rights -- a history - The New York Times ran a special opinion report in 2019 - A women's right - Which examines how laws in the US are increasingly recognizing the fetus as a person - Women as less of one - One case of a long-abused child who quickly became drug dependent and eventually pregnant while addicted to heroin - Despite struggling to become sober, employed and raising her first child without incident - This woman falls back into addiction and overdoses while pregnant with her second child - She is arrested and the details of her case are publicized - She receives a manslaughter charge for endangering the life of her fetus - Here medicine engages with law to make the difficult problem of addiction and the complex individual but social history behind it a moral and criminal charge - The threat to fetal life from opioids - "we love to hate these women", Barry Lester, a professor of psychiatry and pediatrics at brown university "but our hatred is not accomplishing anything" Principles of social control - From intimate influence to force - Sociological and criminological theories of social control divide types between: - Informal - Involving intimate circles such as family and friends - Taken-for-granted modes of control such as tone of voice, expression - Formal types - Laws, police actions such as arrest - Many consider the informal ones more effective in bringing about social change as they affect our most tightly held sense of ourselves - This is important in the moral regulation of reproduction - Global Contraceptive Methods Use (2020) - Total women of reproductive age (15-49) using contraceptives - Permanent and long-acting methods (red/orange) - Female sterilization: 219 million (22.9%) - Male sterilization: 17 million (1.8%) - IUD (intrauterine device): 161 million (16.8%) - Implant: 25 million (2.6%) - Short-acting methods (blue) - Male condom: 208 million (21.8%) - Pill: 150 million (15.7%) - Injectable: 72 million (7.5%) - Traditional methods (purple) - Withdrawal: 53million (5.5%) - Rhythm: 33 million (3.5%) - Other methods (grey) - Other 17 million (1.8%) - Ancient roman pessary - Made of bronze it both provided a physical and chemical (anti-spermicidal) barrier at the opening of the cervix - Other pessaries were made from crocodile ding, honey and acacia gum - A known anti-spermicide still used today - IUDs were also developed early on, along with condoms and sheaths made from animal skins - Today female sterilization remains the most common form of contraception worldwide - Followed by the condom, IUD, Pill, Injectable Hormones (f), traditional methods, withdrawal, implanted hormones (f), and male sterilization - Notice that male and female sterilization are on extremes of this array - Even though male sterilization is easier to perform surgically and with less health risks - Methods are almost equally divided between permanent and long-acting and temporary Early contraceptive use - Mechanical methods and morality - Although we do not know much about the sociality surrounding the use of the earliest known contraceptives in ancient Egypt, Rome and Greece - Condoms and anti-spermicide pessaries - Mechanical means of reproduction become associated with prostitution - Carefully and legally controlled in France in the 1800s - Such as condoms and French letters, that acted as a barrier to contraception - This association of "mechanical means" of contraception to prostitution continued into the 20^th^ century and made condom procurement very difficult - Especially by women who were not prostitutes Natural methods - Before contraception was widely legalized mid-twentieth century - Many desperate women shared contraceptive information and contraceptive medicine addressing women's complaints Chemical methods - By mid 20^th^ century, contraceptive information was based on the growing scientific research into the timing of fertility in women's menstrual cycles - Hence referred to as natural - Led to the development of the pill in the 50s with essential support from a woman of means promoting family planning in the US, Canada and the UK Abortion -- from amoral to immoral to a crime - have little historical evidence of abortion practices prior to the modern period - when laws prohibited it was common - herb-based concoction and external manual manipulation of the womb were likely involved as early abortifacients and procedures - Pliny the Elder, ancient Greece, published a reference to pennyroyal used to expel a dead fetus from the uterus of Naturalis Historia - Galen also referred to the plant's ability to expel a fetus from the womb - A female ancient Greek physician, Metrodora, refers to the concoction of pennyroyal with wine to induce abortion - The use of the plant continues into the medieval period and beyond - Its use as an abortifacient is referred to by an early pharmacist and physician Abortion as part of overall reproductive care - Before modern understanding of reproduction, a woman was often not considered pregnant until she felt the fetus move - The quickening - Much like modern contraception, administration of an abortifacient was not seen as removing a fetus - But of disrupting the reproductive cycle - Much like the hormonal contraceptive pill is regarded - The term abortion now commonly carries much more moral weight than it did with the assumption that it is always a conscious act occurring externally to the body - Once criminalized, women sought access to birth control, including abortion to regularize their periods - Coded ads refer to menstrual control or regulation - They are actually abortifacients - There is something of a slide here from earlier oversight of women's reproduction including cessations of pregnancy early on - Which is not considered abortion or immoral - A list of abortifacients usually advertised as menstrual regulation and available in Canada at the turn of the 20^th^ century: - Radaways pills for female irregularities - The new French remedy therapies - Sir James Clark's female pills - Dr. Cowling's English periodic pills - English diamond bran pennyroyal pills - Davis's pennyroyal and steel pills Abortion as immoral - With many organized religions, the concept of conception was initially not fully understood - There is great variance on when and if abortion is considered morally wrong - Some Christian sects always accepted abortion in the face of a risk to the mother's life - As do some Islamic sects and branches of Judaism - However, pregnancy outside the sanctity of heterosexual marriage in all three of the major organized faiths was typically considered worthy of moral and religious condemnation Abortion as illegal - In most developed, northern and western countries, abortion laws appeared with the industrial revolution - In England the Offence Against the Person Act 1861 made a felony the act of pregnant women procuring a miscarriage - By taking substances or administrating instruments to do so - She would be imprisoned for life if found guilty - Anyone providing the toxin or instruments or procedure the miscarriage would be guilty of the lesser charge of misdemeanor and imprisoned - Canada removed abortion from the criminal code in the 1980s - It is practical as a legal healthcare provision - With some restrictions through healthcare province by province - PEI will only provide medical abortions, not surgical ones 2 (Proper) family planning - Religious authorities and sanctioned reproduction - Long before the start of the Industrial Revolution, all dominant organized religions had restraints on human reproduction - All required recognized heterosexual unions whose main purpose was human reproduction 1900s- industrial revolution, poverty and family planning - At the start of the revolution, the dire case of poverty became a cause among wealthy and educated women - Especially in the growing cities and their slums - About this time the contraception rights movement began, led by two key women - Marie Stopes (UK) and Margaret Sanger (USA) - They established clinics, especially in poor neighbourhoods where they relied chiefly on sex education - Withdrawal and rhythm - Modern 9rubber) condoms and chemical pessaries - Plaque in Hamilton commemorates Canada's first family planning clinic in 1931 - As the drive for contraception became known, drawing it out of the realm of immoral sexual activity - The clinic provided women with information about contraception in order to meet the needs of people whose health and families suffered tremendously during the great depression - It was common at this time to equate poverty with family size - Hence the contraception - Especially among poor women was encouraged - This charitable approach laid the way for wider population control program rationales that took off later, mid-century - Good family planning, which required effective contraception, became associated with the good life Eugenics - In 1906 the Eugenics Educational Society (now the Galton Institute) was formed in Britain to further: - Eugenic teaching and understanding in the home, in the school and elsewhere" - Marie Stopes was a follower - It worked from the presumption that reproducing along 'good' and healthy gene lines would be to the benefit of society - It was used to draft the 1913 Mental Deficiency Act - Which although rejected sterilization of the feeble-minded, called for the social segregation - Between 1890 and 1920 US states passed legislation to enforce sterilization in the feeble-minded - Those with epilepsy, the intellectually disabled and the mentally ill - The laws were pitched as measures for social progress - In Canada, the Alberta sexual sterilization act (1928-72) allowed over 3000 sterilizations of "unfit" individuals of varying age and ethnicity - Including 60 Indigenous women from Saskatchewan in 2017 - A eugenic breeding test in Australia shows the racist underpinnings of the scientific discourse purportedly supporting social progress - Nazis picked up on these ideas, and their extensive programs led to the repeal of many eugenic laws after the second world war Unwed mothers and modern social control - The wedding of strict Christian belief in reproduction within a recognized holy union led to a burgeoning business in "houses" for unwed mother - Which were actually businesses like the infamous Irish Magdalene laundries, active until almost the 21^st^ century - Women were publicly shammed for evidence of unsanctioned sexual activity with men, exploited and routinely had their maternal rights completely ignored The reproductive rights movement - Some physicians did not provide abortion before it was legalized and after medicine became the authority over reproducing bodies - Roughly between the 1800s and 1970s - In the US in particular, clandestine abortions were not always performed by licensed doctors - But by those pretending to be such to desperate women willing to take the chance - This was the possibility of medically sanctioned abortions if the mother's life was considered at risk by physicians - Even this position was not universally adopted - Until very recently, Ireland protected the right to life of the fetus and the mother-to-be equally - In Pennsylvania, women who could afford it flocked there as a result, as Irish women who could also afford it, would travel to the UK for abortions until very recently - The brutal legacy of back-street abortions spurs largely white, middle-class women to coordinate in the 1970s and insist on access to safe and legal abortions in the majority of developed nations - Perhaps inspired by the civil rights movement and anti-war demonstrations in the US - Women took to the streets to demand abortion as a right - Due to the development of the pill and physicians' granted authority over its distribution - Along with an acceptance that a good modern life meant smaller family size - Contraception was quickly legalized and even accepted by most religious authorities when used in recognized unions - By and large contraception is no longer considered morally repugnant Modern theories of reproduction - Running alongside the 1960-70s social movements is an increased understanding of reproduction - All gametes were not known and their functions were more understood than before - This helped in the development of the contraceptive pill - Made surgical abortion more safe - And medical abortion is possible - In the 1960s Lennart Nilsson published his famous image of the human embryo - The first time the public had seen a human utero embryo - These images often appear at anti-abortion rallies and add fuel to fiery arguments that every pregnancy must be dignified with a birth Regulations of access to birth control: regulation of reproduction in the 2020s - In the early 1970s, before Roe v Wade, women in Chicago organized themselves as the Janes - To not only provide women with information about where to get accessible (physical and financial) and safe abortions - But dedicates that if medically unregistered male abortionists can perform them, so could they - They take matters into their own hands - Received informal medical training from sympathetic doctors - Offered 11,000 safe and affordable abortions between 1968 and 1973 - This is happening as feminist academics began their work on medicalization and gender - As other women's health groups started demanding "natural" births with midwives attending - As modern medicine became increasingly recognized as an authority on what constituted life - When and responsible for maternal health and well-being - Attention turned to the physician from religious authorities for whether contraception or abortion was warranted - Both abortion and contraception became part of healthcare in most developed countries - In some cases, requiring a panel of physicians to hear the pregnant woman's case for her abortion request and determine if it indeed threatened her well-being - Planned Parenthood, which Margaret Sanger helped establish, now houses many of the abortion clinics in the US - In 1973 the US Supreme Court found that abortion was a right of bodily liberty for women The fragility of abortion rights - In the US, social control or reproductive rights has returned to draconian legal measures especially over abortion - 2023 the federal precedent protecting abortion as a human right (Roe v Wade) was overturned - States were quick to adopt restrictions - Such as heat-beat laws - To severely restrict and forbid abortions - The results make parts of the US a dangerous place to practice medicine - Miscarriage can be n=murder - Women are not receiving life-saving treatment out of doctor's fears of criminal charges - Abortion has again become a matter of careful and clandestine activity for women seeking control over their reproductivity - In the US and Canada - Anti-abortion prosecutors can be verbally and physically violent toward pro-abortion rights activists **(5) Oct 7: Reproductive justice -- the social determinants of reproductive rights** 1 from reproductive rights to reproductive justice - Move away from formal and informal social control of individuals - To broader concerns of social justice including food and shelter, safety, education, healthcare - Historically it was a climate or moral shame surrounding pregnancy outside of conventional relationships (marriage) that put pressure on women to seek abortion - Today, as illegitimacy wanes in many societies, pressure to control reproduction, including abortion - Stems from poverty, especially racialized poverty, along with systemic barriers to creating and sustaining thriving communities - The largely white middle-class woman's suffrage movement secured such women the right to vote in the US with the passing of the 19^th^ amendment - As celebrations of the centennial of this event in 2019, how the movement did not address black women's experience in various states - Their rights to vote were cheated of their emancipation rights by local officials, and where the women were often threatened with violence when trying to register - When these women asked the suffrage activists for assistance, the activists claimed black women's voting problems were a matter of race, not gender - "while middle-class white women celebrated with ticker-tape parades, black women in the former confederacy were being defrauded by voting registrants or were driven away from registration offices under threat of violence" - This is the same lack of recognition of the transnational dimensions of Black women's experience of discrimination in the reproductive rights movements of the 1960s-70s US civil rights become militant - In the 1950s the US civil rights movement addressed structuralized discrimination began as peaceful marches of black men and women filled streets demanding: - An end to segregation in schools, on buses, at water fountains and so on - The Jim Crow laws that emerged soon after the emancipation of slaves - In the 1960s frustrations at the slow pace of improvements rose and a militant branch of the movement develops - The black panthers Anti-abortion and anti-contraception - Not only do black women find it difficult to find a place to assert their needs in a militant anti-racism - They are caught in a complex conflict of interest - The black panthers oppose black women using contraception and abortion as both are seen as black race genocide controlled by white interests - Black women want to control their family size - Consider most of the images seen of pro-reproductive rights demonstrations - There are very few black women features - Although the Janes did make access, especially to poor, Black and Hispanic women a priority, only more recently has academic work in the area acknowledged the significance of that move - As well a need to address issues such as involuntary sterilization and family-cap welfare policies in the US especially among racialized others Reproductive freedom not choice - Freedom from social discrimination - Forced sterilization - Control of welfare-dependent Hispanic and Black communities in their family planning through welfare capping by the number of children - In 1979, the US Committee for Abortion Rights and Against Sterilization Abuse (CARASA) used the term "reproductive freedom": - Freedom from structured racialization that targets women and their reproductivity - Involuntary sterilization of marginal populations has run throughout more than a century of: - North American among Puerto Rican women (l'operacion) - Afro women (the Mississippi appendectomy) - "mental defectives" (by state and provincially sanctioned eugenic laws) - Indigenous populations (Innuit women in Canada) - US introduces welfare cap policies in some states - Families needing welfare cannot claim the benefits if they have more children than the cap allows - Not only are they seen as ineffective in addressing poverty, but they function as a form of genocide given the heavy rate of use of welfare by racialized populations Clinical tip - Recognize that many First Nations women, families and communities have had significantly negative experiences with child protection and social services personnel - That can have a profound effect on their interaction with the healthcare system - There is currently a move by Indigenous advocates and activists to address more sensitive medical care in Indigenous communities - Not sending people on long trips outside from treatment including routine births - Or accommodating Indigenous culture in non-indigenous healthcare centers - For Afro-American and Black Canadian women, Indigenous women and other vulnerable women, reproductive rights are often tied up with the right to safe and sustainable communities - Where poverty doesn't undermine your ability to have and provide for your children in many ways - Black Lives Matter points to police violence associated with being black, including the shooting of unarmed young black youth A recent women's rights demonstration - At the same women's rights demonstration in Washington DC Jan 21^st,^ 2017 around the time of trumps inauguration - We see a similar racial split to the reproductive rights movement at the time of the legalization of abortion - White women focus on sexism, equality and the right to choose - Individualized rights - Women of colour focus on systematic issues such as gun violence and mother - This schism explains why black women and Indigenous women do not feature in reproductive rights campaigns - In the 1960s, black women, like middle-class white women, wanted and needed access to safe, effective and affordable contraception and abortion - But for different reasons - Black women had to control family size due to severe financial and security pressures on them their families and their communities - Black women did not feel welcome or included in white women's rights campaigns - Black women's complex and systemic issues were not understood, nor were black women granted authority in such groups and movements - For black women racial concerns, often a matter of life and death, trumped reproductive ones 2 global population control - Global population started post WWII and is premised on the main concepts - The world has limited carrying capacity which is threatened especially by non-developed populations that have the largest birth rates worldwide - Development is understood as social stability = economic prosperity and consumption Currently targeted populations whose reproduction is controlled globally - Ongoing population control measures include - Women who are addicted in the US and elsewhere and face court challenges to their fitness to parent who are sterilized or whose contraception is enforced or coerced - Trans people who must be sterilized to acquire gender-affirming surgery and endocrine support, and government documents acknowledging their chosen gender - LGBTQ2S+ people who live in countries that prohibit or limit their access to reproductive technologies allow them to form families Reproductive justice - Not all reproductive rights protect all people - Reproductive justice does not look the same everywhere **(6) Oct 21: reproduction and sexuality** 1 unhinged reproduction from sexuality - The early 1900s: Family planning - Mid 1900s: The pill - 1960s: the sexual revolution Social control of reproduction and sex hormones - Sanger - Working in a family planning clinic - Meets Catherin McCormick - The second woman to graduate from MIT who has money by marrying into the family owning international harvester - Both establish family planning in the US - Planned Parenthood is the national association formed from this work that still functions today offering women access to safe and effective contraception and abortion - 1951 Sanger meets Gregory Pincus - A brash researcher in reproductive physiology who discovered that progesterone could block ovulation - John Rock - Harvard-trained infertility specialist and devout Catholic - Worked with hormones to help women conceive - Administrated progesterone to temporarily suspend ovulation in the hope of a jumpstart afterwards - Sanger and McCormick hire Pincus, Rock and Min-Chueh Chang to develop a contraceptive pill - Chang and Pincus also helped develop in vitro fertilization or IVF - Pincus - A scientist who relied on Rock, a medical doctor, to research and test on Puerto Rican women due to the anti-contraception climate in the US - Rock - A devout catholic argued with the catholic church that suspension of ovulation was akin to the rhythm method and should be accepted as "natural" and medically sanctioned - Not like condoms that were associated with prostitution - It almost was accepted by the catholic church - But the Vatican eventually disproved the technique - Despite this, almost 50% of American Catholics in 1960 were practicing some form of birth control May 1960- FDA approved the pill - The prescribed pill to be taken by people who are not sick - 1961: 400,00 women were using the pill - 1962: over 1.2 million - 1965: over 3 million - 2019: over 151 million worldwide - Freer access to heterosexual men and worry-free sex for women - Many in positions of power didn't like the scene and blamed the pill and women's liberation of increased promiscuity - Not on men... - In fact the requirements for the changes in sexuality of the 1960s were well in place before the pill came along - Women's emancipation, a rising consumer culture that favoured families with fewer children, a burgeoning economy - And the pill did not produce the kind of free-wheeling and sexualized women Women's expanded participation in the Canadian labour force - 1950-2013 - Figures mirrored in most developing countries during this period - Access to safe, effective AND socially accepted contraception, including the pill, played a role 2 unhinging kinship - The 1960s was a decade of various social revolutions that at times interlaces and supported each other under an umbrella of human rights concerns - Not as widespread as the other 1960s social movements, the Stonewall riot in NYC brought attention to at that time gay male rights - Gay men were chiefly patrons of the Stonewall Inn bar in NYC which was unlicensed - Without clean water and bathrooms and run by the local mafia - Police would regularly raid but usually with notice - One night they gave no notice of the raid and treated the patrons like animals, shaming and arresting them for their sexuality - A riot ensued giving rise the gay pride and homosexuality taking to the streets Legislation (male) homosexuality - 1533: England makes male-to-male sexuality a crime punishable by death - Repealed in 1861 - 1885: England names sex between men as "gross indecency" - 1921: the UK recognizes lesbian homosexuality and also bans it as gross indecency - 2014: UK recognizes same-sex marriage - Many countries now recognize same-sex marriage - However even in places where gay rights are protected by law, serious harassment and violence, including death continue - 2016 a gunman entered a known gay bar in Orlando killed 49 people and injured many more - In many countries, same-sex sexual acts are illegal and in some places punishable by death Recreating the nuclear family - Assisted reproductive technology for LGBT families - Although LGBTQ2S+ people continue to be harassed, discriminated against and persecuted - Even where their rights are protected by law - There has been a move to assert their reproductive rights - Initially, this was handled discreetly through sham heterosexual marriages with the risk of being discovered and losing parental rights on indecency charges - Once gay marriage started being recognized in law, adoption could be used to secure parental rights from same-sex couples - And now many fertility clinics allow access to reproductive technologies to create their families - Or not? - The kinds of strategies the LGBTQ2S+ communities have had to adapt to create kinship raise the question about the need for a two-parent, or two-generational family - By unlinking kinship from physical ties, the door opens to variations of relations that mix physiology - And claimed kinship made possible by new reproductive technologies considered widely now as both legal and moral - Surrogate mothers - Birth mothers - Contracting parents - Donor eggs, Sperm and embryos - However given the political obstacles in recognizing the right to do kinship outside of normal parameters, queer kinship mist also transform kinship itself - By its very looks, as well as by different family structures - In mid-October the Italian government banned all international surrogacy - When citizens go outside the country to secure a surrogate birth of a child that may be genetically related to at least one of the contracting parents to be - Those who disobey the law face up to two years jail time and almost CDN\$1.5 million in fines 3 capitalizing on kinship and sexuality - The global contraceptive pill market size was valued at USD 13.11 billion in 2018 and is projected to reach USD 29.04 billion by 2032 - One of the success factors in making contraceptives socially acceptable was to sell it as medicine - Enter the pharmaceutical industry - The same science of hormones used to create the pill can also suspend menstruation entirely - Which is now being marketed as both a health benefit and a lifestyle preference - Seasonable is a relatively new packaging of a contraceptive hormone that suspends ovulation for 3 months at a time - Producing 4 periods a year - Like the seasons -- as nature, or natural - This introduced convenience as a reason for taking hormones to cease menstruation and naturalizes the a-reproductive, heterosexually-available women - It also allows women to more fully participate in public-sphere work, where having a period would be an issue - Law, medicine and astrophysics, and in traditionally male manual labour such as deep-sea welding, construction and so on Medicalizing male sexual aging - Another medicalization of a lifestyle issue - This one associated with aging is the creation of "penile dysfunction" which has been corrected with nitric oxide medication - Viagra - Created by Pfizer, who held the patent until 2020 - It too was effectively marketed as a lifestyle enhancement as well as a medical disorder Menopause medication - The global market for hormone replacement therapy was USD 21.8 billion in 2022 - Estimated to surpass USD 40 billion by 2032 - Menopause is now undergoing the same process of medicalization and treatment to address quasi-medical, quasi-lifestyle concerns **(7) Oct 28: New reproductive technologies (NRTs)** Scientific and social development related to NRTs - 1890s: Walter Heape experiments with transferring rabbit embryos - 1920s: Cow semen successfully frozen and transported - 1930s: hybrid breading sought for the meat industry and cancer experimentation/experimentation in donor/recipient hormone testing - 1944: superovulation (in cows) developed for the meat industry - Although the first "test-tube baby" was born in 1978, there was a lot going on almost a hundred years before - There are three main areas of development for the meat industry - Developments in animal husbandry or domestic animal breeding to serve the meat and dairy industries - The development of a medical specialty in assisted conception - Developments in genetics including human genetics from exploration to engineering - Running along all three areas are capitalist intersects in finding new deficiencies and new markets - 1900 - Contraception as social progress is introduced in the UK, Canada and US - 1950s - 99% of American births take place in hospitals - 1960s - Effective and widely available contraceptives (the pill) present with limited access to abortion - Population control programs as developed take off - Decriminalization of homosexuality begins - Keep in mind what was going on in terms of reproductive rights during this time - The normalization of family planning - The medicalization of pregnancy and birth - Accessible safe and effective means of controlling birth The externalization of contraception -- in vitro fertilization (IVF) in humans - IVF is the externalization of contraception from the female body - Ripe eggs and sperm must be retrieved and combined in a Petrie dish in a lab - Nourished to allow cell division a few days, inserted in a uterus that is prepared to allow implantation - This development caps millennia of speculation, scientific and religious, of what happens at the moment of conception - It is also a moment that illustrates a confluence of several scientists' explorations - Anatomy of far more reproductive components that never identified before in terms of both form and function, especially in the female - Ovarian influence in egg maturation and ovulation, fallopian tube transport and impact on conception, egg layers allowing sperm entry, uterine implantation and the formation of the placenta - Sperm mobility and count, sperm pathology NRTs and the meat & dairy industry - 1890 - Walter Heape successfully transfers a rabbit embryo from one rabbit to another - But cannot bring the embryo to term leaving both embryo and gestational rabbit dead - By the 1930s Russian livestock breeders are successfully inseminating cattle with sperm - Significantly reduces breeders' costs of bringing fully grown animals together to breed - Followed quickly by developments in gathering, freezing and storing sperm and generating a global market for such - By 1951 with the synchronization of hormones, embryo transfer of a cell succeeds in Paris - A Texan rancher attempted 750 bovine embryo transfers in 1949 IVF - Thanks to several developments drawn from the meat and dairy industries IVF in humans was developed - Understanding of hormones that mature and release eggs and prepare the uterus for implantation - Pincus, Rock and Menkin who had all worked on developing the pill - Created the "fertility drug" claimed to hyperovulate women - This was used since the 1900s as one of the few fertility medicines of the time without completely understanding how it worked - Collecting sperm and eggs and preparing them for conception outside the body - Sperm collection is relatively straightforward and requires no medical intervention besides a precursory visual inspection under a microscope, freezing and storage - Egg collection is much more involved and now requires hormone protocols and surgery - Storage of early-developing embryos - Preparing the woman's body hormonally to accept the embryos after a few days of development outside the body IVF and medicine - By the 1970s, experiments with IVF moved from the animal-based food industry to medical research - Robert Edwards, an early genetic researcher - Widely recognized as the first to succeed at applying IVF in humans - Resulting in the first test-tube baby - Louise Joy Brown (born 1978) - In 1951 Edwards was a part of the Cambridge research group using embryo transfer in mice to explore genetics - By teaming up with the obstetrician/gynecologist, Patrick Steptoe, he was able to access human ova to make the transition to IVF possible - Other teams working on the same about the same time included - Carl Wood (ob/gyn) at Monash University in Australia - Georgeanna and Howards Jones (ob/gyns) at University of Virginia's medical school where Edwards spent some time researching the difficult-to-get human eggs IVF Inc. - Once IVF succeeded, the practice was quickly adopted into largely private, medical practice in three key areas of its development - The UK (Bourne Hall established by Edwards and Steptoe) - Australia's Monash University clinic run by Carl Wood - At the US's first IVF clinic at Univ. Virginia run by the two doctors Jones's - Rarely and not for a long time was this kind of highly experimental and largely unsuccessful procedure - 0-5% take-home baby rate was common - Adopted by public health systems nor by private medical firms in the US - Leaving the high costs to be borne by potential parents-to-be - Today the take-home baby rate hovers around 25% and remains a private cost in many places - Or partial private cost - The cost of required and expensive hormones are often paid by the patient - Still competition among clinics caused concern over reporting measures where chemical pregnancies were counted as a success in practice that has very high miscarriages and implant failure rates Number games - Indications - Success rates - Hyperovulation - Embryo transfers - Hormone protocols - Ultrasound-guided egg retrieval - Initially IVF was indicated medically only for women with blocked or missing fallopian tubes - This does not constitute many patients among the infertile - 33% due to male factor - 33% due to all female factors - 33% unknown - About 5% of the population - By expanding the indications to include male infertility (ICSI- which inserts a single sperm into an egg ex utero) and unexplained infertility (where it could be hyperovulation that makes the difference), the market increases to 60% of all infertile people - Success rates can be manipulated by what type of pregnancy is counted, hiding the take-home baby rate, and only counting attempts in women under 40 - Natural cycle IVF was quickly replaced by hyperovulation so that multiple embryos could be implanted - Increasing chances of pregnancy occurring - Initially embryo transfers were not capped at a low amount followed by selective reduction when multiple pregnancies occurred - Up to ten embryos at a time were allowed at some clinics - Move from simple hyperovulation to complete suspension of female reproductive hormonal function allows doctors to add back the necessary hormones to time ovulation at the clinics convenience - Ultrasound-guided egg retrieval allowed move from an operation to a clinical setting - US first used in ob/gyn by Steptoe - Obvious from the start of IVF is the potention for GE in both non-human mammals and a bit later on, in humans - Public concern over test-tube babies and the prospect of research on human embryos had to be quelled by assurances that these embryos are just a bunch of cells with no ability to feel - Spare embryos, pre-embryos and the primitive streak are terms used in the 1980s to do this New access to human eggs - As soon as the conceptus was outside the body, it became the focus of interest of especially geneticists, who could now research entire human genomes - Genetic engineering was also developing at the time of IVF initiation in humans, again starting in animal husbandry and then transferring over to human research - To promote GE in humans many promises were made - To eradicate genetic-based disease before implantation - Destroying affected embryos - To advance our knowledge of genetic-based human development to treat diseases in adult humans - Diabetes, MS, Parkinson's - To apply genetic knowledge to improve food production - Animal and plant - 1953 - The double helix of DNA discovered - 1970s - Twinning sheep - Chimeras - One animal containing cells from more than one genotype of set of chromosomes - Sex early cow embryos - 1979 - Birth of Louise joy brown (1978) - Steptoe and Edwards presiding - Test-tube babies - 1980s - Sheep, goat, bovine chimeras (cross-species) - Sexing of human embryos - Genetic probes for some human diseases - 2003 - The entire human genome mapped - Interest in applying what was being learned genetically and in the meat and dairy industries is promised as great medical advance in humans - The mapping of an entire human genome gave a huge push to GE in humans - There has been to date a great hesitation in engineering sex cells - Sperm, egg and embryos for implantation - Presently there is only GE in somatic cells - The rest of the cells that do not reproduce the genetic engineering - Except for one case in China - The same holds true for human cloning and human/non-human recombination's - Both have been achieved in sheep, goats, cows - Currently and thanks to the CRISPR Cas9 technology in the 2010s, genetic splicing and managed recombination of genes is much simpler and cheaper than before - Cures for certain forms of blindness and Parkinson's are currently being explored using this technique of somatic-cell GE - Somatic cells are not reproductive cells or germ cells Cloning by twinning - The 1970s the twinning of various animals in the meat and dairy industry - To allow for the spread of desirable genetic traits found in females more efficiently was done with sperm before - Cloning by in vitro nuclear ovum transfer (IVONT) - Steen Wiladsen (1984) - Working for the British Agricultural Research Council - Clones a mammal for the first time using undifferentiated or stem cells from early sheep embryos - Enucleated ovum and an electric shock - But it is "cloning blind" or from unexpressed and unknown genetic traits - Ian Wilmut et all in Scotland (1996) - Use differentiated cells from an adult ewe (with genetic traits) - Enucleates ovum and an electric shock - "biochemical trickery" was used to undifferentiated the cells before cloning The creation of human embryonic stem cells - Advances in genetic science transformed from breeding allow for the retrieval of pluripotent human embryonic cells to create desired stem cell lines - Embryonic cells that are undifferentiated and can become anything **(8) Nov 4: regulation of NRTs** Models of regulation - The UK - 1978: the birth of Louise Brown - 1982: Committee of Inquiry into Human Fertilization and Embryology/Mary Warnock presiding philosopher of mortality, Oxford - 1984: Warnock report - 1987: legislative framework - 1990: Human Fertilization and Embryology Act/ HFE authority - 1998: Human Rights Act - 2009: HFE act amended to allow same-sex and unmarried couples to be recognized as legal parents - Once human conception was successfully externalized (1978) several matters of regulation came into play - The legal status of the embryo - Oversight of medical practice and protocols in IVF - Oversight of genetic research on human embryos - Implications for abortion - Implication for kinship as a result of gamete and embryo donation Key principles - Reproduction as a human right - Seeking medical treatment for infertility is protected as a right - Not any right to reproduce - Fertility treatment is limited to "stable, heterosexual couples" - The good of the child is dominant - An externalized conceptus is "out of its element" and at risk of wanton and monstrous manipulation - Selling and trafficking of embryos is intolerable - Tracking of genetic parents is important to avoid inbreeding and allow access to medical information - Physicians are the gatekeepers for access - Can decide who is allowed to access on moral, social and criminal grounds - Reproduction in terms of medical attention is protected as a human right - Not the social condition of producing a family - Throughout the creation of the legislative framework, the Warnock committee limits access to all reproductive technologies included in the framework (including AI and Abortion) to stable, heterosexual couples - This was overturned in the 2009 amendments to the HFE Act following the 1998 Human Rights Act - Same-sex and unmarried couples are recognized as legal parents Legal protection of the embryo - HFE act includes access to abortion confirming the previous provision and extending the upper limit - 14-day limit to embryo research - Prohibition of creating embryos for research - Prohibition of implanting researched embryos - Prohibition of admixed embryos - Human and non-human - Prohibition of commercialization of embryos and gametes - Laura Weir calls this moment when "the threshold of the living subject" shifts from the perinatal to conception - Which could threaten abortion provisions - The HFEA includes abortion, confirming previous legislated access based on the medical authorization according to negative medical and social implications affecting the woman if she continues with the pregnancy - The upper limit for abortions is extended to 24 weeks - Then the age of embryo viability - One of the world's longest windows for a legal abortion - Embryo research is allowed but only up to 14 days following conception - Relied on terms such as pre-embryo, primitive streak, and spare embryo to distinguish research embryos from ones used for procreation - Any commercialization of human embryos and gametes is prohibited - The HFEA manages to contextualize and distinguish between embryos - It does not adopt the position that conceptus is a person Australia and Canada - Both countries are federations with a central parliament and lower state or provincial governments which are responsible for healthcare - Matters of criminality are under federal jurisdiction - Therefore, legislation of NRTs is split between two levels of government depending on jurisdiction Australia - By 1995 it established a state authority to license and monitor medical practitioners involved with IVF - Between 2010 and 2018 all states had approved access through petitions to same-sex couples and allowed LGBTQ adoption rights - Abortion is available on request to a medical professional for up to 22 weeks with the need for two physician's approval after then - 1982: state of Victoria, committee to consider the social, ethical and legal issues arising from IVF - 1984: Victoria infertility (medical procedures) act - 1995: Infertility Treatment Act - 2010-2018: all states extended access by petition to same-sex couples Key principles - No commercial exploitation of those using NRTs nor of children born from them - Commercial surrogacy and gamete donation are banned - Open access to genetic information for those using NRTs - Maintain the health and well-being of those accessing NRTs - No discrimination in access to NRTs - Physician-authorized access to NRTs - Government oversight of embryo research - Like the UK, Victoria initially limited access to married heterosexual couples and tracked genetic links to be provided to parents and children - Removed state by state throughout the 2010s - Although initially banned in some states, embryo research is now allowed but controlled along similar lines as with the UK - Access to LGBTQ2S+ folks remains problematic in Australia due to physician authorization - Initially, some argued that members of this community were not medically infertile but socially infertile Canada - Canada is later than the UK and Australia to establish legislation - Its very lengthy report was one of a few that immediately allowed access to single women - 1275 pages with 293 recommendations - This opened the way for LGBTQ+ people to access - Also unique in that it recognized that the experience of reproduction for people with ovaries and uteri are different from those with testes and a penis - 1989: Canadian Royal Commission on NRTs - 1993: proceeded with care report - 1995: interim moratorium on cloning, implantation of researched embryos and admixed embryo - 2004: Assisted Human Reproduction Act - 2012: amendments after Quebec SC challenge Key principles - Individual autonomy - Management of social identity and kinship - Equity - Access to NRTs by single women allowed - Respect for human life and dignity - As embryos and gametes - Protection of the vulnerable - Embryos - Non-commercialization of reproduction - Gametes, embryos and gestation - No admixed embryos, no implantation of researched embryos, no cloning - Unlike the UK, there is no provision for abortion in the AHRA - It continues to be offered province by province as part of healthcare - In Canada, a person is not legally recognized until birth - The commercialization of surrogacy, gamete and embryo donation are prohibited Worldwide - As the first site of IVF and where it was commonly practiced initially, much of Europe has legalized IVF and in 2017: - Nordic countries (among top 6 users) - Belgium (second highest rate of use) - Eastern European countries (lowest rate of use) - 2020 no. of legal NRT centres - India (1500) - Japan (574) - USA (450) - China (400) - Russia (200) - Brazil (200) - Australis (100) - UK (83) - Canada (33) - Typically provisions for IVF and embryo research follow those established by the UK - However local provisions can differ according to norms, religious values and so on - In Italy egg donation and surrogacy are forbidden - Many countries restrict access to LGBTQ+ people - 10/22 European countries allow access to single women with seven allowing access to lesbians - Also finances restrict access and have now generated a healthy industry in reproductive tourism Reproductive flows - The higher the public funding of NRTs the greater the demand - The greater the demand, the more the restrictions to access - The greater access is restricted, the more people will travel elsewhere - Berg Brigham et al (2013) findings of a study of NRT access in the context of public and private (insurance) funding assistance - Egg freezing has taken a lot longer to master than sperm and embryo freezing and storage - As a result the management of eggs medically, scientifically and socially enters a different regulatory context than especially embryos - There is more acceptance in the storage of eggs, and techniques have improved to replicate using eggs - Effectively regenerating more research material - Mitochondrial DNA donation has also been approved in the UK and Canada - Allowing for three genetic patterns Preimplantation genetic screening - PGS (preimplantation genetic screening) - Screens embryos to ensure that 23 pairs of chromosomes are present and there is no aneuploidy - 22 autosomes and the sex chromosomes X and Y - PGD (preimplantation genetic diagnosis) - Diagnoses embryos for known genetic disorders that both the patient and partner are carriers of - Sickle cells, cystic fibrosis, SMA1, Tay Sachs, Fragile X, etc. - PGS functions like amino and CYS to screen out genetic anomalies in an embryo - But in this case BEFORE implantation - PGD is a practice testing of embryos before implantation for known diseases like sickle cell and cystic fibrosis - Largely this is considered a medical advantage and is allowed through physician authorization with similar provisions against GE procedures - Cloning, implanting a researched embryo, admixing DNA The business of it all - NRTS - Since its inception IVF service prices - 1986 one cycle costs \$6000 - 2003 cost \$12,400 - 3 attempts in Canada today is at least \$50,000 - Prices did not DROP as is usual in high-tech development and eventual large-scale distribution - IVF equated to luxury consumption - Genetic engineering (GE) - CRISPR Cas9 makes GE much simpler and cheaper - Used to develop COVID vaccines - Worth at least USD 45 billion - Pfizer, Moderna, Johnson&Johnson and Astra Zeneca - Medical treatment and physical enhancements are both possible through GE - An important practicable distinction between 'therapy' and 'enhancement' may need to be drawn and effectively implemented in future regulations - Although a distinct line between two may be more difficult to draw **(9) Nov 11: reproductive right in the face of NRTs** Initial criticisms of NRTs in terms of reproductive rights 1. Feminists 2. Religious 3. LGBTQ2S+ Feminist criticism - FINRRAGE -- feminist international network of resistance to reproductive and genetic engineering - Long-active hormones and implants (developed out of IVF) seen as a new opportunity of population control - Procedures are experimental and focused on women - Exposure to hormones, risk of operations for egg retrieval - Extends male-preferred sex-selection from early pregnancy to preimplantation stage - NRTs are tightly engaged with GE - Economic and agricultural risks associated with GE (food security) - 1985 -- established by an international group of feminists - Scientists (medicine, biology especially genetics) - Activists (from earlier reproductive rights and gay rights movements and a growing green movement, especially in Germany) A new face of population control - Hormones used in IVF are simultaneously employed to control contraception in ways that make it difficult or impossible for women to control - Implemented vials of slow-release progestin - Injections of slow-release progestin - 4% of women still on the method today State-mandated/coerced sterilization - These types of contraception have been used as part of court rulings - Women have been convicted of maternal neglect, drug addiction, and so on - Are seen as an extension of coerced and state-mandated sterilization Experimentation and health risks - Medical risks associated with early forms of the contraceptive pills discovered are recognized in the same hormones used in IVF - Higher rates of heart problems and cancer rates with high dosage formats - Along with the risk of CID transferred via IVF when relying on human-derived hormones - Feminists extended earlier criticisms of the medicalization of reproduction in women (i.e., thalidomide) with advents in pharmaceutical and surgical interventions resulting from IVF - FINRRAGE members immediately saw a connection between the medical applications in IVF and broader applications of genetic research and engineering - Industrially-controlled food security - Genetic modifications of plants to respond only to proprietary pesticides and herbicides - Ownership of seeds (plant regeneration) through genetic modification - Bio-warfare based on genetic profiles Differing feminist views - Feminists associated with FINRRAGE early on spoke against surrogacy as an exploitation of women - Whereas others like Michelle Stanworth in 1987 argued that women had the right to financially benefit from their bodies in surrogacy contracts Religious reactions to NRTs 1. Christianity - The catholic church was among the first organized religions to report a position on NRTs - Chiefly IVF to start - In 1987 it released its instruction to its church and although it initially saw IVF used among married couples with no donated gametes as mirroring God\'s intent for procreation - Came down against it s men (sic) playing god or going to far in the provision of birth - Today the Vatican has also denounced surrogacy, any gamete and embryo donation and transgender affirming interventions - The church views conception as the start of human life to be treated with dignity - It also states that science cannot make its own rules and should adhere to the morals and teachings of the church - Other Christians sects allow for IVF and donated gametes, with the most progressive also allowing for surrogacy and gamete and embryo donations - Including among members of LGBTQ2S+ communities 2. Judaism and NRTs - As with Christianity, there is a prime directive in Judaism for procreation among people in the faiths recognized unions to - Go forth and multiply - This directive has become stronger following the persecution and massacre of Jews around the second world war - Israel has the most NRT clinics per capita worldwide - Surrogacy and gamete and embryo donation may be allowed by various sects but maternal conversion to Judaism is usually required 3. Islam - 2 main sect - Sunni (85%) and Shi\'ite Muslims (Iran, Iraq, Lebanon, Bahrain, Syria & Saudi Arabia) - Islam is not only a faith but also a judicial component in Muslim communities - 1980s - Muslims largely accepted IVF - In 1990 split between the sects with Shi\'ites taking a more flexible position towards NRTs - Finding ways to allow surrogacy and egg donation - The husband briefly marries the donor or surrogate until the child is born and then he divorces her - Sperm donation is not allowed as this constitutes infidelity which can be punished by death LGBTQ2S+ communities - Reproductive rights for non-heterosexuals began with the fight for sexual identity - In North America, this roughly came along as one of the quieter revolutions in the 1960s - Stonewall riots, the birth of pride - By the 2010s most Western democracies recognize same-sex marriages - Initially most regulations prevented same-sex and singles from accessing NRTs - Except in Canada where single women were allowed access from the start - With the advent of human rights legislation in many Western democracies, as same-sex unions were recognized, reproductive rights quickly followed Trans families have a harder battle - Rights of sexual identity recognition and access to NRTs is a relatively new battle - They are tied up with each other as some countries who recognize people's right to affirm their sexual identity are required to at the cost of their reproductivity - And require proof of gender-affirming surgery - All of this before assigning key identity documents such as birth certificates and passports - Often this surgery means sterilization - Belgium, Czech Republic, Finland, the Netherlands, Turkey and Sweden require the person requesting formal affirmation of their chosen sexual identity undergo sterilization - It is often hard for trans people to access NRTs today - Clinics which are usually private limit such access - Also many trans people have an aversion to seeking medical assistance given fairly widespread discrimination against them **(10) Nov 18: reproductive justice: reproductive health, NRTs and GE** Differences in reproductive choice - Access - The US case of abortion - By the end of the 1960s most developed countries legislated access to safe and effective contraception - However the pill was not cheap - About this time, many countries decriminalized abortion but leaving in its place requirements for women to plead their case in front of panels of physicians to access - Safe, surgical abortion that chiefly took place in large hospitals and cities - At the same time that critiques NRTs arose (1980) - A substantial backlash to abortion rights began - The US provides the case for how vulnerable such rights are - Demonstrates increasing division between those who can access them and those who cannot Access in Canada - 1969 - Limited access to abortion allowed under medical authorization - 1970 - A caravan of the Vancouver Women\'s Caucus crosses Canada demanding abortion on demand - Not pleading in front of physicians - 1982 - The Federal Charter of Rights and Freedoms enacted - Canadas constitution - 1988 - The SC Morgentaler decision decriminalized abortion on the basis that it violates the charter - 1995 - Federal and provincial court rulings force NS and NB to provide private abortion clinics - More liberalized access - Abortion availability across the country remains spotty - 2006-2015 - Continued attempts to pass anti-abortion legislation - 2015 - Mifepristone approved by health Canada for medical abortions - 2017 - Mifegymiso available in Canada - 2016-2020 - Access improved in PEI, NFLD & Lab, Que, Ont, Alb & NS - Including prohibiting anti-abortion demos near clinics Access in the US - 1973 - SC decision, Roe v. wade states abortion is a women\'s right according to S14 of the Constitution - Privacy and liberty of the person - 2000 - Mifepristone approved by the FDA for medical abortions - 1970s-2020 - Many states pass TRAP laws (targeted regulation of abortion providers) or otherwise create hostile environments for abortion provision - Roe v wade means they cannot entirely prevent them but court challenges and enforced clinical provisions make it difficult for women to access - 2021 - After the death of SC justice ruth Ginsberg (an abortion advocate) - Her replacement by Trump with pro-life, justice Amy Coney Barrett, roe v wade comes under threat - 2021-2022 - States (Texas, Oklahoma, Montana, Arizona, s. Carolina, Kentucky) reduce abortion access - Cut funds to clinics - Limit abortion to 6 weeks - Heartbeat bills - Prepare ban in anticipation of the overturning of Roe v Wade - 2022 - The SC overturn roe v wade June 24th - Dobbs v Jackson women\'s health organization - 2022 - - Since the overturn of roe v wade, 144 states have enacted near-total abortion bans - 4 have banned it after 6 weeks, 28 states have protected it - This leaves a very uneven distribution which contributes to reproductive injustice - The US followed a very different legal path than Canada in terms of abortion rights and makes this particular right very uneven in its distribution - Leaving the most marginalized women without access - Wealthy women will always be able to access the health service - Despite states\' gains in protecting abortion, many fear that the FDA will be forced to ban it - Seriously affecting women\'s access in an already uneven distribution of reproductive rights in the US IVF and Dobbs v JWHO - The future of in vitro fertilization in the US is uncertain after the SC overturned Roe v Wade in 2022 - State laws - States can now decide when life begins - Could impact IVF - For example some states have personhood laws that grant legal right to embryos, such could outlaw IVF - Anti-abortion bills - National anti-abortion bills, like the life at Conception Act, could outlaw IVF - State silence - Some states, like Texas, have banned abortion but are silent on IVF - Political landscape - The political landscape in your state could impact access to IVF - Doctors both those who provide abortions and those who provide NRTs are very nervous about their practice - Even when an abortion is required to save the life of the mother or to improve the prospect of an IVF cycle resulting in a live birth Double standards -- how NRTs become a reproductive justice issue - Population control - 1950s India becomes first target of first worlds countries' population plans - Development is tried to lowering especially impoverished populations - 1975 state of emergency in India - 6.2 million men living in poverty are sterilized - 2,000 die from botched surgeries - 2014 BBC reports that India has internalized pop control from within and from without - PM Modi cracks down on \"reckless population explosion\" many non-impoverished Indians agree - One adverted birth raises GDP one hundred times more than production investments - During the second half of the 20th century when the world was being carved up by the World Band and others into economic-based statuses of development - Reproduction was quickly recognized as key - Standing on the success of early family planning advocates (Sanger and Stopes) - Global financing saw control of populations key to economic progress - Already wealthy nations needed to keep a steady growth - While underdeveloped and developing countries had to cut back on theirs - This concern was then transferred to environmental concerns and early anti-population proponents blamed underdeveloped countries for environmental degradation - Deforestation for fuel - Water pollution by human waste and so on - When in reality it is the industrialized nations that were harming to environment far more The phantasma of the girl - Today population control programs have become internalized (as with India) and transferred from aid in return for lower birth rates - What Michelle Murphy calls the phantasma of the girl - This girl is typically obviously from a developing country and draws sympathy for her impoverished plight - Enhanced by prejudicial assumptions about her level of education and her ability to choose how she lives - It is this poster child for education, that almost always centres on reproductive information and access to healthcare - Including contraception that drives much of development today - It is the salvation of this girl, through her family planning, that will improve the lot of her people and drag them into developed status - Murphy notes that "populations" that need to be controlled tend to be coloured people - While those deserving individual rights, including reproductive choice, tend to be white people - This racially intersectional "rights" and "choice" is what is meant in the reproductive justice approach to reproduction Intra-national reproductive injustice - population control US - 1970 - US passes the Family Planning Services & Population Research Act - For contraceptive programmes & voluntary sterilization - 1975 - LA-based medical residents sued for performing tubal ligations on Mexican-American women without proper consent - 1995 - Pres. Clinton reforms the welfare act so that larger families lose access to welfare - 2017 - Pres Trump calls for the institutionalization of teen mothers to