Lawful Sinners: Reproductive Governance and Moral Agency Around Abortion in Mexico

The chemical geographies of misoprostol: Spatializing abortion access from the biochemical to the global

C22W38O5 is a chemical that travels. Better known as misoprostol, it was designed as a stomach ulcer drug but is now used around the world as an abortion pill due to the self-experimentation of Latin American communities who were seeking ways to end unwanted pregnancies. We develop a chemical geography approach to misoprostol that allows us to scale inward to understand the chemical properties of this medication while also being able to scale out to understand how medicinal effects are interwoven with and determined by global politics. Misoprostol as a chemical alone does not guarantee a successful abortion and instead 'scaffolding' in the form of mobility and information is required to transform misoprostol from a chemical to a safe and effective technology of abortion. First, we examine how misoprostol is moved by feminist networks in Mexico and Peru. Second, we argue that in order to be useful it is not enough just to access the pills, information on how to use them is required. These themes culminate in our contribution of 'pharmacokinetical geographies'; the micro-geography of the placement of pharmaceuticals in and on a body and its ramifications. The chemical geographies of misoprostol tell a story of power, bodily autonomy, and resistance.

Mujeres abnegadas: The influence of gender expectations on the psychiatric encounter in Mexico

Theories on the cause of mental and emotional distress contribute to illness course and treatment. The theorizing of women's experience "as problem" has been widely critiqued by feminist psychologists yet continues in clinical practice. This qualitative study reports on data collected in a psychiatric outpatient clinic in south/central Mexico on the culturally embedded causal theories of mental illness among Mexican patients, a family member or caregiver, and their psychiatrists. The author reports on the influence of gender expectations and the view of "women as problem" in Mexico. Specifically, stakeholders considered that the idea of "mujeres abnegadas" (self-sacrificing women) was the cause of illness in female patients diagnosed with depressive or anxiety-related disorders. In the face of gendered violence and abuse, Mexican women were expected to be silent and submissive, to suppress their thoughts and feelings, and to endure ("aguantar") their experiences to conform to gender-based expectations, and psychiatrists expressed little hope of alleviating women's suffering. The author discusses her findings in the context of broader sociocultural factors and globalizing forces in psychological theory and practice and provides future directions to help de-pathologize patients' distress, broaden awareness of the contextual forces that influence distress, and galvanize appropriate resources and support.

Maneuvering in Silence: Abortion Narratives and Reproductive Life Histories from the Faroe Islands

I explore what silence surrounding abortion means to women in their everyday lives and the composition of their selfhood. My analysis is based on one-year of ethnographic fieldwork consisting of 20 interviews with women from the Faroe Islands and participant observation. Building upon theoretical frameworks of belonging and subjectivity studies, I discuss women's silent maneuverings from an understanding of freedom of choice and power as complex entities and expand on the dimensions of belonging and nonbelonging. I find that women's silent maneuverings are a navigational strategy made in a quest for belonging, and propose the concept of performed belonging.

Abortion and the COVID-19 pandemic: insights for Latin America

The COVID-19 pandemic may accentuate existing problems, hindering access to legal abortion, with a consequent increase in unsafe abortions. This scenario may be even worse in low- and middle-income countries, especially in Latin America, where abortion laws are already restrictive and access to services is already hampered. Our objective was to understand how different countries, with an emphasis on Latin Americans, have dealt with legal abortion services in the context of the COVID-19. Thus, we conducted a narrative review on abortion and COVID-19. The 75 articles included, plus other relevant references, indicate that the pandemic affects sexual and reproductive health services by amplifying existing problems and restricting access to reproductive rights, such as legal abortion. This impact may be even stronger in low- and middle-income countries, especially in Latin America, where access to legal abortion is normally restricted. The revision of sources in this article underlines the urgent need to maintain legal abortion services, both from women's perspective, in support of their reproductive rights, but also from that of the international commitment to achieving the Millennium Development Goals. Thereby, Latin American countries must place reproductive rights as a priority on their agendas and adapt legislation to accommodate alternative models of abortion care. Furthermore, our results underscore the need for clear information on the functioning of sexual and reproductive health services as essential for understanding the impact of the pandemic on legal abortion and to identify the groups most affected by the changes.

‘Life Is Tight Here’

Since the civil war began in 2011, 5.5 million Syrians have fled their home country and are now living as refugees. Building upon anthropological studies of precarity, the article draws upon 14 months of person-centered ethnographic fieldwork to examine the contextual specificities of Syrian women’s protracted displacement in Jordan. By foregrounding bodily experience as described by three interlocutors during person-centered interviews, the article considers how subjectivities are reshaped under such conditions. The narratives analysed here illustrate how the precarity of displacement fosters an embodied sense of tightness, constriction and stagnation while reconfiguring temporal horizons and rendering visions of imagined futures increasingly myopic.

Interventive Care: Uncertainty, Distributed Agency, and Cesarean Section in a Zika Virus Epidemic

Beginning in 2015, Brazil witnessed the births of thousands of children with neurological abnormalities linked to the Zika virus. Drawing on ethnographic fieldwork conducted between 2016 and 2018 with parents of children with congenital Zika syndrome in Salvador da Bahia, this article attends to how one of Brazil's most overused obstetric technologies-cesarean section-was mobilized to mitigate the uncertainties of Zika's reproductive consequences. I argue that during the epidemic, C-section constituted a form of what I call interventive care, in which others interceded on behalf of pregnant women to secure surgical delivery. In dialogue with scholarship problematizing autonomy in reproductive decision making, I show how my Bahian interlocutors understood such intercessions, and the C-sections themselves, as forms of appropriate, concerned care. I suggest, furthermore, that interventive care highlights the ways in which reproductive decisions are distributed among people rather than autonomous, particularly in contexts of heightened uncertainty.

Abortion exile: navigating Mexico's fractured abortion landscape

This paper develops the concept of 'abortion exile' to understand the situation of women who are forced to travel for abortion services because the procedure is outlawed, stigmatized, unaffordable or otherwise inaccessible in their place of residence. A number of legislative, economic, and moral mechanisms conspire to deny women abortion rights at home such that they must journey within and across national borders in pursuit of needed abortion care. While anthropologists have examined the movement of women and men in search of fertility care that is unavailable at home, attention to the situation of women forced to relocate to terminate an untenable pregnancy is surprisingly scarce. Taking Mexico's fractured abortion landscape as an ethnographic starting place, this paper examines the experiences of women made to venture to the capital for legal abortion services because the procedure is criminalised and difficult to access elsewhere in the country. The concept of 'abortion exile' can helpfully explain the forced movement, political status and subjective experiences of women in different world regions where abortion rights are limited, absent, or under threat, and for whom reproductive citizenship remains elusive.

Twelve years after abortion decriminalization in Mexico City: Can we still remain an island of liberties?

Latin America hosts the most restrictive abortion legislation globally. In 2007, Mexico, the second largest Catholic country in the world, decriminalized elective abortion within the first twelve weeks of pregnancy in the capital: Mexico City (also known as Federal District of Mexico). Following the reform, the Mexico City Ministry of Health (MX-MOH) implemented safe and legal services. Free services are provided to Mexico City residents and a sliding fee of up to $100 is applied to women from other Mexican states. Conscientious objection (CO) was addressed and included in service provision guidelines. Since 2007, 18 of 32 states amended their penal codes to restrict abortion. The road toward increasing access to abortion services at the MX-MOH included a shift from dilation and curettage (D&C) to medical abortion (MA), first with the misoprostol-alone regimen, followed by the combined mifepristone-misoprostol regimen. Manual vacuum aspiration is offered to out-of-state-women or to those beyond the gestational age where MA is less effective. Contraceptive uptake among abortion seekers is high (up to 95% of them prefer a free method of their choice). The Legal Interruption of Pregnancy program at the MX-MOH continues to provide effective, safe, reliable, and free services. However, women from indigenous groups residing in rural areas, those with low schooling, and adolescents with an unintended pregnancy who live in rural, urban, peri-urban districts, and at the state level are underserved despite being legally eligible to receive abortion services. Therefore, information and services for the disadvantaged groups need to be strengthened.

[Difficulties accessing abortion in legal termination contexts: high school students' narratives in a rural community in Mexico]

In this article, we analyze beliefs and practices among young high school students who seek out or consider the possibility of terminating a pregnancy. We selected students from a public school located in a rural, peasant community in México City, México. This is a constructivist ethnographic study based on in-depth interviews with 15 sexually-active women aged between 18 and 24 years. The interviews were recorded with participants' authorization and informed consent. Results indicate that social stigmas persist which affect the dignity of women who have chosen to have an abortion. However, Catholic ideologies do not seem persuasive for participants who chose to carry the unwanted pregnancy to term. In any case, the absence of confidentiality in the clinics may lead young women to opt for clandestine spaces or for self-medication, usually based on natural medicine or abortive pills. Significantly, participants acknowledged that they did not use condoms and that they occasionally use oral contraceptives. The public health system in the community does not always guarantee confidentiality for legal terminations, for this reason participants do not consider it the first option for having an abortion. On the other hand, sexual education projects are indispensable for enabling young women to avoid unwanted pregnancies and to freely exercise their sexual and reproductive rights. Additionally, actions are needed for sensitizing and training education workers.