Life and Abortion: The Post-Biopolitics of Reproductive Health in Ulaanbaatar, Mongolia Mari Valdur Doctoral thesis, to be presented for public examination with the permission of the Faculty of Social Sciences of the University of Helsinki in Hall 1, Metsätalo, Unioninkatu 40 and via Zoom online on 18th November 2020 at 12 o’clock. Helsinki 2020 Academic dissertation Doctoral programme in Social Sciences, University of Helsinki The Faculty of Social Sciences uses the Urkund system (plagiarism recognition) to examine all doctoral dissertations. Opponent: Prof. Rebecca Empson, UCL Custos: Prof. Sarah Green, University of Helsinki Pre-examiners: Prof. Susan Gal, University of Chicago Prof. David Sneath, University of Cambridge Supervisors: Prof. Sarah Green, University of Helsinki Dr Toomas Gross, University of Helsinki Research Series in Anthropology, Volume 32 University of Helsinki, Finland Distributed by Unigrafia https://unigrafia.fi/en/ [email protected] ISBN 978-951-51-6802-3 (paperback) ISBN 978-951-51-6803-0 (PDF) Unigrafia 2020 Abstract This thesis is an ethnographic study of how various insecurities and vulnerabilities are produced and maintained, such as the health risks of informal abortion in a context where abortion is legal. Throughout this thesis I suggest that the answer to this question has to do with particular and gendered forms of governance rather than individual experiences of the general stigmatisation of abortion. I first unfold this by taking up the concept of biopolitics and its prevalence in the anthropology of reproduction: in studying reproductive technologies, the subdiscipline has been shifting towards harvesting temporal and discursive ruptures, which is often paired with the framework of biopolitics. While biopolitics remains bound to the life of an individual, and through this to the governance of imagined wholes like populations, this study shows that when it comes to abortion and reproductive health in Ulaanbaatar, there are a number of competing conceptualisations of life at work, several of which surpass the individual lifespan. Therefore, the thesis provides a different perspective of governance as dependent on the time and place in which it occurs. I study six relevant and overlapping spaces in Ulaanbaatar: the nation state and macropolitics; religion, medicine and kinship; care and motherhood; sexuality and knowledge; biomedicine; and the medication market. Gender appears at the core of these forms of governance: for instance, through the establishment of biomedicine as a predominantly feminine sector, and reproductive healthcare as synonymous with women’s healthcare. Moving beyond ‘public’ and ‘private’, and ‘formal’ and ‘informal’, I propose that ‘doctor’ in the Mongolian reproductive healthcare system can be viewed as usufruct, as a type of temporary ownership: the credentials are provided by the state, but these can be used to seek profits and practice beyond what a doctor’s work involves on paper. Meanwhile, the informal abortion medication market reveals that the prevalence of informal abortion is shaped by a range of socioeconomic and healthcare system specific considerations. In this context, the seeking of trustworthy iv information and services draws on people as infrastructure rather than any ‘formal’ structures. This thesis is post-biopolitical in the sense that it recognises the core relevance of ethnography, gender and the need for more nuanced approaches to governance as directly and indirectly linked to reproductive health. v Table of Contents Abstract ................................................................................................. iv Acknowledgements ............................................................................. viii Translation and Transliteration .......................................................... xi Chapter 1. Introduction ........................................................................ 1 Reproductive healthcare and biopolitics .............................................. 3 Position and subjectivity in and out of the field ................................... 9 Mongolia: Broader context of the study ............................................. 12 Outline and contribution ..................................................................... 16 Chapter 2. ‘Abortion’: A Brief Political History in Mongolia ......... 21 Introduction ........................................................................................ 21 Population development ..................................................................... 27 Capitalism ........................................................................................... 38 Legislation .......................................................................................... 42 Rights and freedom ............................................................................ 50 Conclusion .......................................................................................... 56 Chapter 3. ‘Life’ in the Bone Marrow: Traditional Medicine and Kinship .................................................................................................. 59 Introduction ........................................................................................ 59 Legitimacy of Mongolian traditional medicine .................................. 62 Conception and the composition of a human ..................................... 66 Mutuality of the child and the mother ................................................ 69 Motherhood and reproductive challenges .......................................... 72 Transmissions of Mongol-ness ........................................................... 86 Conclusion .......................................................................................... 92 Chapter 4. The Practical Matters: Motherhood in the City ............ 95 Introduction ........................................................................................ 95 Liminal student years in the city ........................................................ 97 Plots of womanhood ......................................................................... 104 Spaces of care and their lack ............................................................ 106 Motherhoods of secondary care ....................................................... 111 Conclusion ........................................................................................ 121 vi Chapter 5. Contraceptive Knowledge: Making Sexuality for YouTube ............................................................................................. 124 The beginning ................................................................................... 124 The video-making process ................................................................ 126 Failures without the state .................................................................. 128 Gendered qualities ............................................................................ 137 Intimate contraceptive knowledges .................................................. 145 Conclusion ........................................................................................ 151 Chapter 6. The Gynaecologist: Usufructuary Gains and Losses in Healthcare .......................................................................................... 156 Introduction ...................................................................................... 156 Job position as usufruct .................................................................... 157 The usus ............................................................................................ 160 Shortcomings of ‘privatisation’ ........................................................ 165 The fructus ........................................................................................ 171 Conclusion ........................................................................................ 181 Chapter 7. ‘A Little More than a Period’ at the Market: Infrastructures of Informality .......................................................... 184 Introduction ...................................................................................... 184 Dying of informality, dying without sociality? ................................ 186 Infrastructures of informality ........................................................... 189 Conclusion ........................................................................................ 207 Chapter 8. Conclusion ....................................................................... 210 References ........................................................................................... 217 vii Acknowledgements I would like to thank all of my friends and acquaintances in Mongolia who took the time and trust to share their experiences, lives and reflections with me. You are at the heart of this work and it would have not been possible without you, nor would it have been as enjoyable. Thank you, Prof. Sarah Green and Dr Toomas Gross, for your hugely insightful, generous and well-balanced supervision, and the time you have invested in me and the project. I am thankful to Nasantogtokh bagsh and Tserenchimeg bagsh from Sodon Chimee language school for teaching me Mongolian all these years. I am indebted to the Lhagvasuren family, Ariuna, Zoloo, your kind parents and siblings, for your patience with me and for caring for me. I am grateful to all of my friends in Mongolia: Javzandulam Batsaikhan, Amgaa,