NEGOTIATING REPRODUCTION Family Size and Fertility Regulation among Shuar People of the Ecuadorian Amazon NEGOTIATING REPRODUCTION Family Size and Fertility Regulation among Shuar People of the Ecuadorian Amazon Charlotte Petersson Doctoral Dissertation in Social Anthropology School of Global Studies University of Gothenburg 2012 © Charlotte Petersson Cover Layout: Marie Mattson All photographs by the author unless otherwise noted The photo on the cover is taken in one of the Shuar centros in Morona Santiago, Ecuador Printed by Ineko, Kållered, Sweden 2012 ISBN: 978-91-628-8582-3 http://hdl.handle.net/2077/31456 To Mateo Contents Acknowledgements ................................................................................................ i A Note on Shuar Orthography ............................................................................. iii List of Acronyms .................................................................................................. v 1. Introduction ..................................................................................................... 1 Background and Rationale ................................................................................... 3 The Social Setting ................................................................................................. 6 Fertility and Well-Being ...................................................................................... 8 Multi-Sited Ethnography ..................................................................................... 11 Synopsis of Chapters .......................................................................................... 17 2. Ways of Understanding and Controlling Human Reproduction ............. 19 Demography and Fertility Transition Theories ................................................... 20 Anthropology and Human Reproduction ............................................................ 26 Summary ............................................................................................................. 36 3. The History of the Shuar Region: Integration and Sociocultural Transformation ................................................................................................. 39 History in the Tiwintza District ........................................................................... 40 Early Contacts and Conflicts ............................................................................... 44 Salesian and Evangelical Missionaries and the Ecuadorian State ....................... 46 Cultural Transformation and the Creation of New Boundaries .......................... 49 Gender Roles and Relations ................................................................................ 57 Integrated but Subordinated ................................................................................ 61 Summary ............................................................................................................. 64 4. Creating Bodies and Persons: Fertility and the Social Process of Coming into Being .......................................................................................................... 67 Shuar Cosmology and the Embodiment of Knowledge and Power .................... 68 Menstruation, Procreation and Pregnancy .......................................................... 76 Learning to Give Birth ........................................................................................ 82 Infant Care and Nurturance ................................................................................. 87 Becoming a Gendered and Adult Person ............................................................ 91 Summary ............................................................................................................. 97 5. Political Aspects of Human Reproduction: The Legal and Normative Framework in Ecuador .................................................................................... 99 Global Foundation of Population Policies and Reproductive Health ................ 100 Population Policy and Reproductive Health in Ecuador ................................... 103 Normative Fertility and Stratified Reproduction ............................................... 111 Ministry of Public Health and its Weaknesses .................................................. 116 Summary ........................................................................................................... 119 6. The Dynamics of Reproductive Relations, Values and Practices ............ 121 Kinship, Marriage and Residence ..................................................................... 122 Marital Problems and Solutions ........................................................................ 125 Cultural Values of Reproduction ..................................................................... 134 Contraceptive Techniques and Well-Being ...................................................... 139 Contesting Ideal Family Size ............................................................................ 144 Summary ........................................................................................................... 152 7. Delivering and Using Reproductive Health Care: Attitudes, Strategies and Power in the Health Units ....................................................................... 153 Health Care in Tiwintza .................................................................................... 154 Attitudes towards Large Families within the Medical Establishment ............... 159 Conceptualising and Promoting various Contraceptive Techniques ................. 162 Embodying Modernity ...................................................................................... 166 Negotiating and Controlling Differnt Bodies in a Different Context ................ 169 Going to the Health Units ................................................................................ 175 Summary ........................................................................................................... 179 8. Reproductive Change: Concluding Remarks ........................................... 181 Svensk Sammanfattning (Swedish Summary) .............................................. 191 Glossary ........................................................................................................... 197 References ........................................................................................................ 201 MAPS Map 1: The province Morona Santiago in Ecuador and the location of the canton Tiwintza ............................................................................................................... 4 Map 2: The canton of Tiwintza with its two towns and parishes, Santiago and San José de Morona, including the location of the various Shuar centros marked with dots ................................................................................................................ 7 Acknowledgements The making of this thesis has been a long journey, characterised, on the one hand, by a genuine concern about the changing circumstances of the indigenous peoples in Amazonia and, on the other hand, by the possibility of not being able to finalise the story of the people whose lives I present in this work. The question has never been when I would finish this thesis but rather if I finish it at all. There have been many changing reasons for this over the years and I am indebted to many people for being able to finish the work. During the first two years of the PhD programme I was enrolled at the Institute for International Health and Development at Queen Margaret University in Edinburgh as a self-funded, full-time student. One of the main research areas at this institute is reproductive health and development, making it a good environment for me to do my research. However, the combination of being a full-time, self-funded student and a parent can be problematic. After being enrolled for two years I was, due to financial reasons, no longer able to continue. Without funding and without the possibility to change from full-time to part-time studies I made the difficult decision to leave the PhD programme. I am, however, grateful for the support Suzanne Fustukian and Margaret Leppard gave me during my years at Queen Margaret University, in particular for their support, guidance and encouragement during the time I did fieldwork. The thanks I owe to various people for their support, encouragement and assistance during fieldwork go far beyond the words I express here. Above all else I thank the Shuar people who have contributed to the creation of this work in various ways. Special thanks to the lovely Shuar families in Kuwín for letting me stay with them, for explaining their knowledge system and worldview, and for sharing the most intimate details of their lives. I thank all the health care providers at the various health units involved in this research, who have been very patient with me, all my questions and my, sometimes annoying, engagement in the situations of various Shuar patients. I would also like to thank the Jara Tapia family in Sucúa and Reno Roman in Quito for their great hospitality, generosity and friendliness. During fieldwork I came into contact with Steven Rubenstein at the University of Liverpool. Over the years we have, on several occasions, met to discuss, share and compare the data we both obtained while doing fieldwork among Shuar people. The combination of heart, compassion, intellect and