Supranational Citizenship: (Im)Mobility and the Alternative Birth Movement in Mexico
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Supranational Citizenship: (Im)mobility and the Alternative Birth Movement in Mexico by Rosalynn Adeline Vega A dissertation submitted in partial satisfaction of the requirements for the degree of Joint Doctor of Philosophy with the University of California, San Francisco in Medical Anthropology in the Graduate Division of the University of California, Berkeley Committee in charge: Professor Nancy Scheper-Hughes, Co-chair Professor Charles Leslie Briggs, Co-chair Professor Charis Thompson Professor Ian Whitmarsh Spring 2016 1 ABSTRACT My research analyzes how the remaking anew of tradition—the return to“traditional” birthing arts (home birth, midwife-assisted birth, water birth, “natural” birth)—has resulted in the commodification of indigenous culture and the re-inscription of racial inequalities on the one hand, and, despite feminist rhetoric about women’s liberation from (masculine) biomedical hegemony, the reconfiguring of parent-child bonds in ways that again place the burden of correctly producing future members of society on women’s shoulders. I focus on the extremes of contemporary Mexican society—disenfranchised indigenous families and members of the global meritocracy—and in doing so, I demonstrate how citizenship retains value for some while being rendered irrelevant for others. More specifically, I argue that the privileged do not position themselves as citizens through claims to public resources; instead, they accumulate cultural capital through privatized services. Through an examination of processes of racialization and patterns of bioconsumption, I critique the broad application of the concept of citizenship, and make a case for the consideration of the bioconsumer (individuals for whom market-based consumption of medical services plays a formative role in how their identities are syncretically portrayed and perceived). The main stakes of bioconsumption are the presentation of self and accrual of cultural capital. Furthermore, I demonstrate how what is under negotiation in the alternative birth movement is the social-moral body onto which identities get mapped. Close ethnographic study reveals how the so-called “humanization” of birth and the reduction of maternal and infant mortality are distant projects that are collapsed onto one another and produce an emerging ideology of “good parenthood.” In this ideology, children represent parents’ stake in the contemporary global meritocracy. This work therefore uncovers how traditional ways of birthing are being destroyed and reinvented through racialized class privilege, which is based on a model of neoliberal consumption that simultaneously promotes “humanity” and reinforces inequality by infusing transnational movements with reified class logics and racialization. I thus consider Mexican traditional midwivery as a unique lens for examining how indigeneity becomes an object of consumption via ethnomedical piracy within a transnational racialized economy. Through 28 months of in-depth, multi-sited research across Mexico, from October 2010 to November 2013, this dissertation analyzes the physical and social mobility of some individuals, and the relative immobility of others, through the lens of humanized birth. In writing this dissertation, I aim to make the following interventions: First, I disrupt notions of citizenship-making by placing under the same lens those for whom citizenship is always just out of reach and those for whom citizenship is not a concern as their privileged access to privatized markets allows for a supra-state existence. I offer the concept of “supranationalism” as a contribution to emerging literature that rethinks states as the consolidation of territory and government, thus opening up other ways of conceptualizing polity and geography. In doing so, this dissertation challenges Foucault’s 1978 framing of biopolitics. I use the topic of birth to provide ethnographic evidence of how biopower is not only imposed by states upon citizen-subjects; but by powerful, extra-governmental, social and economic forces operating in the context of neoliberalism, thus resulting in real material consequences and shaping health outcomes. Second, I deploy the concepts of racialization (“raza” vs. whiteness, see Roberts 2012b) and power (“reproductive governance,” see Morgan and Roberts 2012) when I critique the ways in which the global alternative birth movement inadvertently appropriates and commodifies 2 indigenous culture. When “indigeneity” is invoked in the realm of so-called “humanized” birth, the object is fetishized, separated entirely from its cultural, socioeconomic, and geographical context, and repackaged for mass consumption—leading me to rethink the relationship between neoliberal citizenship and consumerism. Instead of directing attention to the body-turned- merchandise (e.g. organ trafficking and surrogacy, see Scheper-Hughes and Wacquant 2006), I use the example of midwifery in Mexico to examine racialized identities-turned-merchandise, with real effects for the bodies of women. Building upon studies that explore the political economy of the body under contemporary global capitalism, I use a transnational context to analyze the political economy of identities vis-à-vis the body. In this dissertation, I examine the disparate and unequal distribution of “traditional,” and ethnomedical forms of “natural” birth among social collectivities. Building upon Roberts and Scheper-Hughes’ work, the dissertation examines the mobility of humanized birth practitioners and participants who travel across borders to contribute to ideology and practices being produced transnationally, while comparatively immobile women are socially situated in ways that preclude their participation in medical migrations. Thus, while my ethnographic research provides detailed examples of how humanized birth is reshaped and reconstituted in sites that bear stark contrast to the social and geographic locations where the humanized birth model was originally produced, I am more concerned with how politic economic terrains are not only traversed, but are themselves transformed by medical migration. Finally, I complexify notions of feminist liberation by asking how humanized birth may be the first step within a new regime of pressures and “requirements” presented by modern-day “good parenting.” I resist viewing children only as commodities; however, I do argue that children represent parents’ stake in our contemporary meritocracy—a system that naturalizes extreme inequality by allowing us to believe in democratic structures and the idea that education and proper preparation will open doors for children to a brilliant future. Furthermore, I suggest that the pressure of meritocracy pushes back into the womb. The difference between a privatized and public childhood begins in vitro with prenatal care. In chapter one, I offer a series of interlacing ethnographic portraits that set the stage for the theoretical interventions I develop in later chapters. I introduce a network of transnational birth attendants—midwives with diverse training—in order to demonstrate how racial politics overlap with socioeconomic class to shape and constrict realms of possibility for consumption and citizenship. This chapter serves as an initial demonstration of unequal participation in the humanized birth movement and (im)mobility among midwives; thus signaling how celebration of “going back to nature,” commodification of indigenous culture, and simultaneous racialization of indigenous “others” are collapsed within the so-called humanization of birth. Chapter two points to how the humanized birth movement inadvertently commodifies indigenous culture in symbolically canabilistic ways. Members of the transnational humanized birth community seek “natural” births that reference “traditional” and “indigenous” birthing methods. However, these methods are not adopted wholesale; rather, they are reimagined by the community and reconfigured by capitalist marketing. My work builds off of Brubaker and Dillaway’s 2009 assertions that natural childbirth discourse reflects class and race biases and are based on middle-class rationalist economic ideology emphasizing control and informed consumer choice and requiring access to resources available only to privileged women. While Scheper-Hughes and Wacquant point to how the commodification of the body results in alienation of the self, in this present dissertation the commodification of others’ (imagined) “selves” can lead to violence being unleashed on their bodies. 3 Chapter three problematizes uncritical notions of liberation by asking how humanized birth may contribute to a new regime of pressures and standards for modern-day “good parenting.” Through ethnographic examples of women who struggle or “fail” to give birth naturally (see Crossley 2007), the dissertation points to how humanized birth may inadvertently represent another way the burden of correctly producing future citizens falls upon women, even as it aims to liberate women from biomedical hegemony. While biopower has often been characterized as the control of populations through “paternalistic” institutional and governmental surveillance, humanized birth practices beg the question of how “maternalistic” biopower might operate through social networks. I bring a critical medical anthropology perspective to health- related “mommy wars” circulating in popular media and analyzes how parents use birth to stake claims to moral superiority. My ethnographic research in Mexico points to how couples seek inclusion in a