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Motherhood and Choice in the Age of HIV/AIDS: Policy, Politics, and Experience

By Mai Schwartz

Abstract

The majority of women living with HIV in the United States are of childbearing age, and many choose to have children. While biomedical advances have reduced the risk of mother-to-child transmission of the virus to near zero, women continue to face stigma from negative public opinion, and debates about public health measures – such as prenatal testing - have centered on protecting vulnerable fetuses from irresponsible women. That the terms of the public debate remained consistent while biomedical understanding of perinatal transmission was transformed highlights the extent to which these are actually contests over the meaning and legitimacy of reproduction and motherhood at large, particularly who can legitimately reproduce and under what circumstances. Debates about the rights, responsibilities, and choices of 'women living with HIV' that do not explicitly address the specificities of their being poor and of color make it possible to use HIV as a rationale for repressive strategies that are neither new nor unique to it, legitimizing the state's role in regulating reproduction by linking it to public health interests. More coercive and intrusive interventions into women's reproductive lives in the name of HIV prevention are politically palatable because they primarily affect women who are already marginalized, whose reproductive capacity is undervalued and whose rights and ability to exercise reproductive choice is already under attack. It is therefore imperative to analyze how HIVIAIDS entered into a history of state intervention into the reproductive lives of poor women, women of color, and disabled women; a history of sterilization abuses, coerced contraception, and eugenics that echoed in the public health response to mother-to-child transmission of HIV. In this thesis, I trace a history of the HIVIAIDS epidemic in the United States as it relates to women, paying particular attention to the responses of the scientific establishment, medical institutions, and legislative and administrative bodies of the state to the biological, cultural, social, and political phenomena of HIV infection in women. I analyze how gender has structured\ud the public health response, erasing women as patients while targeting them as vectors of infection to children and male partners, and locate these developments in the context of concurrent shifts toward neoliberal forms of governance. I focus particularly on the tension between the transfer of responsibility for health from the state onto individual subjects and attempts by the state to retain control over defining legitimate circumstances for reproduction, paying special attention to analyzing and critiquing how morality-based claims are made in these areas. Through data from interviews conducted with women living with HIV in Philadelphia, I explore how women understand, describe, and place themselves relative to the hegemonic discourses surrounding the meaning of motherhood, while challenging the ways in which the narrow norms they define exclude them

Year: 2010
OAI identifier: oai:triceratops.brynmawr.edu:10066/5622
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