Reproductive Health

Definition


Reproductive health is a broad framework that encompasses sexual health of men and women throughout all life stages, as well as maternal and child health, family planning, fertility, and male reproductive health.

Reproductive health within anthropology is at times amended to reflect the perspective of a particular culture or a population. Whittaker states that “Research on reproductive health within medical anthropology encompasses people’s emic perspectives on all matters related to sexuality and reproductive processes and functions.”[1] Anthropologists are also aware of and critically examine policies and practices surrounding reproductive health. This includes research on the ways in which women construct and produce their own narratives of reproductive health[2] ; women's experiences of their reproductive health (i.e., subjectivity and embodiment)[3] ; and critical analysis of the intersection of reproductive health with social and cultural constructs such as politics, class, and race[4] .

History


Today, many researchers and policy makers utilize the framework of reproductive health put forth by the World Health Organization:
“Reproductive health addresses the reproductive processes, functions and system at all stages of life. Reproductive health, therefore, implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.
Implicit in this are the right of men and women to be informed of and to have access to safe, effective, affordable and acceptable methods of fertility regulation of their choice, and the right of access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.”[5]

This framework of reproductive health is a product of the 1994 International Conference on Population and Development held in Cairo, Egypt. This conference also included a focus on reproductive rights with emphases on the rights of men and women to have the ability to “attain the highest standard of reproductive and sexual health.” Thus, while still involving family planning and maternal and child health (the traditional focus of reproductive health matters), the concept of reproductive health was publicly expanded to be more inclusive of sexual health in general as well as men’s sexual and reproductive health.[6]
Dudgeon and Inhorn argue that the shifting of this framework was in part the result of work done on sexual and reproductive rights; research and evaluations that showed the failure of programs and policies to address complex reproductive health issues; and the importance of dealing with HIV/AIDS transmission.[7]

For anthropologists researching women's health, reproductive health has often been an area of interest. Indeed, Inhorn argues that "some of the most brilliant - and best-selling - ethnographies in anthropology have come from within the domain of the anthropology of women's reproduction" (p10), citing works by Rapp, Scheper-Hughes, and Lock. These ethnographies focus on themes that have been prominent in anthropological research on reproductive health, such as maternal and child health, medicalization of pregnancy and childbirth, and women's bodies as experienced or perceived through the framework of reproductive capacity. Over time, anthropologists have expanded the focus of their research to broader areas, including fertility, sexual health, policies and rights pertaining to reproductive health, and (increasingly) men's reproductive health.[8]

Case Studies/Examples


Infertility
In studying infertility, anthropologists have researched the social, cultural, and medical burden and consequences of not being able to conceive or have a baby; the processes that women seek and endure in trying to conceive and have a child; and the role of biomedical and lay healthcare providers. While the prevalence of infertility is usually described in terms of couples, the disproportionate burden of infertility often falls on women. As Dudgeon and Inhorn point out, however, an increasing amount of research shows that the problem in conception lies in men’s biology just as much, if not more than, women’s biology. [9]

The landmark book, Quest for Conception: Gender, Infertility, and Egyptian Medical Traditions details Marcia Inhorn's ethnography of women struggling with infertility in Egypt in the 1980s.[10] At the time, in-vitro fertilization was becoming more prevalent globally, however, the procedure was not well understood in Egypt and was even considered by many to be potentially shameful. Yet some women were willing to spend all the money they could in order to undergo IVF in an attempt to have a child, since the shame of not having any children outweighed the potential shame of having a "baby of the tubes."[11]

Towghi, in studying traditional birth attendants in Pakistan, states that one of the roles of traditional midwives is assisting women who are having infertility problems.[12]

Technology in Childbirth

Robbie Davis-Floyd critically examines the use of technology childbirth in contemporary America. The impetus for this research came out of Davis-Floyd's own experience of technological intervention during the birth of her first child (an experience which resulted in a cesarean birth); she subsequently began researching technology during pregnancy and childbirth and interviewed 100 women about their experiences during pregnancy and childbirth, the culmination of which was her book Birth as an American Rite of Passage. Many other anthropologists have also researched the impact of the increasing use of technology during pregnancy and childbirth in the United States and elsewhere (see, for example, Susan Erikson and Nancy Rose Hunt).


Childbirth Interventions: Technology's Impact on... by birthologie


Related Terms/Pages


Biomedicine
Critical Medical Anthropology
Embodiment
Life History Theory
Robbie Davis-Floyd
Infant Mortality

Online Resources


Division of Reproductive Health, Centers for Disease Control and Prevention
http://www.cdc.gov/reproductivehealth/DRH/

Birthologie.com


Further Reading


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Unhealthy Health Policy: A Critical Anthropological Examination (2004). Arachu Castro and Merrill Singer, eds. Altamira Press: New York.

Erikson, Susan
2006 Risks, Costs and Effects of Homebirth Midwifery Legislation in Colorado. In Mainstreaming Midwifery: The Politics of Change. Robbie Davis-Floyd and Christina Johnson-Levitin, eds. Routledge: New York.

Erikson, Susan
2007 Fetal Views: Histories and Habits of Prenatal Technology in Germany. Journal of Medical Humanities. 28:187–212.

Sellen, Daniel
2007 Infant and young child feeding practices: evolution, recent cross cultural variation and contemporary public health challenges. Annual Review of Nutrition 27:123-147.


References


Dudgeon, Matthew and Marcia Inhorn
2004 Men’s Influences on women’s reproductive health: medical anthropological perspectives. Social Science and Medicine 59:1379-1395.

Towghi, Fouzieyha
2004 Shifting Policies toward Traditional Midwives: Implications for Reproductive Health Care in Pakistan in Unhealthy Health Policy, Arachu Castro and Merrill Singer, eds. Altamira Press: New York.

Whittaker, Andrea
2004 Reproductive Health. In Encyclopedia of Medical Anthropology: Health and Illness in the World’s Cultures, C. Ember and M. Ember, eds. Kluwer Academic/Plenum Publishers: New York.

World Health Organization
2011 Reproductive Health. http://www.who.int/topics/reproductive_health/en/.
  1. ^ Whittaker, Andrea
    2004 Reproductive Health. In Encyclopedia of Medical Anthropology: Health and Illness in the World’s Cultures, C. Ember and M. Ember, eds. Kluwer Academic/Plenum Publishers: New York.
  2. ^ Inhorn, Marcia
    2007 Introduction. Defining Women's Health: A Dozen Messages from More than 150 Ethnographies. In Reproductive Disruptions, M. Inhorn, ed. Berghahn Books: Great Britain.
  3. ^ Davis-Floyd, Robbie
    1992 Birth as an American Rite of Passage. University of California Press: Berkeley.
  4. ^ Ginsburg, Faye and Rayna Rapp
    1991 The Politics of Reproduction. Annual Review of Anthropology 20:311-343.
  5. ^ World Health Organization
    2011 Reproductive Health. http://www.who.int/topics/reproductive_health/en/.
  6. ^ World Health Organization
    2011 Reproductive Health. http://www.who.int/topics/reproductive_health/en/.
  7. ^ Dudgeon, Matthew and Marcia Inhorn 2004 Men’s Influences on women’s reproductive health: medical anthropological perspectives. Social Science and Medicine 59:1379-1395.
  8. ^ Inhorn, Marcia
    2007 Introduction. Defining Women's Health: A Dozen Messages from More than 150 Ethnographies. In Reproductive Disruptions, M. Inhorn, ed. Berghahn Books: Great Britain.
  9. ^ Dudgeon, Matthew and Marcia Inhorn
    2004 Men’s Influences on women’s reproductive health: medical anthropological perspectives. Social Science and Medicine 59:1379-1395.
  10. ^ Inhorn, Marcia
    1994 Quest for Conception: Gender, Infertility, and Egyptian Medical Traditions. University of Pennsylvania Press: Philadelphia.
  11. ^ Inhorn, Marcia
    2010 "Quest for Conception: Gender, Infertility, and Egyptian Medical Traditions.” Reprinted in A Reader in Medical Anthropology: Theoretical Trajectories, Emergent Realities, eds. Byron J. Good, Michael M. J. Fischer, Sarah S. Willen, and Mary-Jo DelVecchio Good, p319-326. Wiley-Blackwell: New York.
  12. ^ Towghi, Fouzieyha
    2004 Shifting Policies toward Traditional Midwives: Implications for Reproductive Health Care in Pakistan in Unhealthy Health Policy, Arachu Castro and Merrill Singer, eds. Altamira Press: New York.