“No se Cuidan (They Don’t Take Care of Themselves)”: Reframing Reproductive Rights as Contraceptive Responsibility in Post-ICPD Mexico

Abstract

Mexico has a complicated history when it comes to contraception. Malthusian concerns about population growth have shaped national imperatives to reduce fertility by pushing contraception —especially on Mexico’s rural, poor, and indigenous. Providers have often had to comply or risk their employment. Despite signing onto the 1994 International Conference on Population and Development’s (ICPD) plan to promote reproductive choice for all, forms of contraceptive coercion still occur in Mexico. I draw on ethnographic research in a public hospital delivery ward to examine contemporary practices of contraceptive counseling. While ostensibly no longer utilizing outright force, providers continue to employ persistent pressure, urging women to choose long-term or permanent contraception by the time they leave the delivery ward. I argue that providers may view this persistence as a form of caring, as they cast women as irresponsible for what they see as their inability or refusal to “cuidarse (care for themselves).” Such refusals are framed as symptoms of national concerns, from poverty to education levels to machismo; women’s genuine desires to have more children are rarely seriously considered. I ask: how do such moral regimes of responsibilization shape women’s interactions with providers, as well as their choices, experiences, and health outcomes?