Conflicted Reproductive Governance: The Co-existence of Rights-Based Approaches and Coercion in India’s Family Planning Policies

India’s current population policy is situated between two conflicting discourses of population management, one that is governed by a demographic rationale advocating strict State regulation of fertility, and the other that is delineated by a rights-based framework that promotes individual reproductive choice and bodily autonomy. In this chapter, I show how this conflicted policy discourse becomes supportive of processes that empower the State, rather than facilitate reproductive autonomy among claimants on the ground. The chapter draws on textual analysis of policy and programme documents and discussions with health providers, users and policy makers during long-term fieldwork in the state of Rajasthan. I show that, in their role in promoting regional state directives on reproductive health policies, health workers are at once agents and subjects of State policy processes and of their community’s ideologies, preferences and practices related to childbirth and reproductive care. It is in their work and embodied practice of family planning that we most clearly evidence the implications of ‘conflicted reproductive governance’. When health workers struggle for their own remuneration and recognition, the State’s rights-based health policy objectives will remain unreachable.

Ethics experts and fetal patients: a proposal for modesty

Background Ethics consultation is recognized as an opportunity to share responsibility for difficult decisions in prenatal medicine, where moral intuitions are often unable to lead to a settled decision. It remains unclear, however, if the general standards of ethics consultation are applicable to the very particular setting of pregnancy. Main text We sought to analyze the special nature of disagreements, conflicts and value uncertainties in prenatal medicine as well as the ways in which an ethics consultation service (ECS) could possibly respond to them and illustrated our results with a case example. Ethics facilitation and conflict mediation, currently, have no broadly consented normative framework encompassing prenatal diagnosis and therapy as well as reproductive choice to draw on. Even so, they can still be helpful instruments for ethically challenging decision-making in prenatal medicine provided two additional rules are respected: For the time being, ECSs should (a) refrain from issuing content-heavy recommendations in prenatal medicine and (b) should not initiate conflict mediations that would involve the pregnant woman or couple as a conflict party. Conclusion It seems to be vital that ethics consultants as well as health care professionals acknowledge the current limitations and pitfalls of ethics consultation in prenatal medicine and together engage in the advancement of standards for this particularly complex setting.

SURROGACY – WOMEN'S RIGHT OF REPRODUCTIVE CHOICE

In the recent landmark case (PuttasamyVs Union of India)the Hon'bleSupreme Court of India dealt with two main reproductive rights, issues relating to surrogacy and reproductive freedom. The Supreme Court has held that Right to privacy is a fundamental right under Article 21 and to make her own reproductive choices of abortion within the fullment of the medical practitioners. As a result of this judgement, it will have an impact on women right of reproductive choice. In thispaperItry toexplore the validityofMedicalTerminationofPregnancyActinthe lightofSupremeCourt's judgementinPuttasamy caseandmy suggestionswithregardtowomen's rightofreproductivechoicewithreferencetosurrogacy. “The greatest good is what we do for one another” – Mother Teresa

Ethical Issues Relating to Prenatal Genetic Testing

"Introduction: Non-invasive prenatal testing (NIPT) is a rapidly developing genomic technology that is constantly widening its scope and opening up new possibilities in reproductive medicine. Ten years after NIPT has been made commercially available, it is increasingly entering routine antenatal care as either a first- or second-tier test. In England, France and Germany, for example, NIPT has been made available free-of-charge as a second-tier test to women with a higher chance of common chromosomal anomalies. The clinical implementation of NIPT carries benefits but also raises important ethical questions. Our project analyses these questions within their specific contexts in England, France and Germany. Methods: As part of a wider research project, which will involve qualitative methods, we conducted a document analysis to compare arguments about, and regulations governing NIPT in the three countries in: law and policy document; public reports; medical press; academic literature; and media. Results: Despite the similarities between the three countries to offer NIPT as a second-tier screening tool, they exhibit differences with regard to their public discourses about prenatal genomics, screening policies, the risk-thresholds they use, professional regulations and laws. These differences have an impact on the way ethical issues emerge, and questions about the meaning of health, illness and disability, the scope of public health interventions, social inclusion and exclusion as well as reproductive choice are approached in each country. "

Abortion: reproductive choice or loss of reproduction?

This literature review of articles devoted to the problem of abortion and pre-abortion counseling has been carried out. The legal features of the development of the right to abortion at the request of a woman are outlined. The main stages in the development of the concept of perinatal psychology and pre-abortion counseling are described. The procedure for conducting pre-abortion counseling in the Russian Federation has been studied. The effectiveness of the existing algorithm was assessed and the prospects for further research aimed at studying and improving the effectiveness of pre-abortion counseling were outlined.

Reproductive and Maternal Health in Anthropology

In anthropology, the subject of maternal health is diffused within the broader areas of the anthropology of reproduction, fertility, and reproductive health. As a topic it is constituted by work at the intersections of anthropology, public health, feminist studies (covering topics on reproductive choice and autonomy, for instance), and development studies (with its focus on the issues of maternal and infant mortality). The citations presented here are grouped into six topic categories as linked to maternal health, each with further subtopics, on childbirth and maternal/reproductive health, fertility and infertility in maternal health, reproductive technologies and maternal health, family planning and maternal health, abortion, and maternal-health policy and human rights. The topics have been selected on the basis of historical work in these areas and in terms of new directions presented by more-recent work. Wherever possible, indigenous anthropological expertise stemming from local authors in the topic areas has been included.

CHILDBIRTH POSTPONEMENT AND AGE-RELATED INFERTILITY IN SERBIA

Childbirth postponement has been a widely discussed topic since the 1990s, and was pushed to the top of the demographic agenda with the emergence of the Second Demographic Transition (SDT) paradigm. Mechanisms of childbirth postponement mostly explained by economists or sociologists were understood as rational-based decisions of individuals (or couples) trying to cope with the requirements of modern society. These mechanisms explained by income and consumption rationale (Becker, Modigliani), or by liberal and postmodern values (Van de Kaa, Lestheage), barely mention the physiological limitations of the individual choice. These limitations given by the human species reproductive span, with no exception, affect everyone trying to make an optimal reproductive choice. There are two main effects of fertility postponement on births and fertility rates. The first effect arises when couples postpone childbearing to a later age during a certain period and fewer births take place than in the absence of such postponement – the ‘tempo effect’. The second is a negative effect of fertility postponement on completed fertility and increased childlessness attributable to the age-related increase in infertility. This second negative effect in particular is our field of interest. The decline in cohort fertility due to postponement has been mostly studied using data on age at first birth and subsequent fertility, as well as models of fecundity, pregnancy loss and time to conception by age, which we will try to apply to the period data. Using period data, we will try to quantify the potential number of births that would occur in the absence of childbirth postponement in Serbia during the past two decades.

The Inadequacy of “Choice”

This chapter examines the limitations of feminist discussions about disability and reproduction. Feminism and disability rights often hold different places in reproductive justice discussions. Feminism often oversimplifies the idea of reproductive choice, focusing on individual women and endorsing cultural stereotypes of disability. As a counterpoint to the scholarly literature of these issues, Alison Piepmeier interviewed twenty-nine parents of children with Down syndrome, asking them about their pregnancy, prenatal testing, and their families. The responses of these parents illustrate how families need more support than just individual rights to raise a child with a disability. Although reproductive decisions may rest on an individual woman, she must also consider community support and health services in her decision to raise a child, particularly one with a disability.

Prioritising Or Postponing?” Thematic Analysis Of Reproductive And Motherhood Choices Among Educated Indian Married Women

This paper attempts to understand and explains the intersection of reproductive and motherhood choices among educated working and non-working married women in India. The choices women pick in realm of sociological, cultural and religious controls have been largely silenced in literature. This phenomenological study looks into lives of 20 married educated Indian women and their reproductive and motherhood choices. With the help of semi-structured questionnaire, 20 women, predominantly educated middle class women, have been interviewed. A thematic analysis using a grounded approach has been used to analyse the qualitative data obtained from these 20 women. Two dominant themes emerged in the systematic qualitative review. Among educated working women, voices of career goals, self-accomplishments, and career promotions were the major theme manifested while exercising their reproduction choice. On the other hand, theme emerged among educated non-working mothers were enhancement in social influence, stability and social pressure. Study revealed the stress and social tensions embedded in exercising reproductive choice con-joined with family influences, economic priorities, career and biological clock urge. The study further describes how increase in technological advancements and modernism has not affected largely sphere of women reproductive choices and changed social perception of motherhood; rather complicated dilemmas for her.