The Cancer Within: Reproduction, Cultural Transformation, and Health Care in Romania

In The Cancer Within: Reproduction, Cultural Transformation, and Health Care in Romania, Cristina A. Pop untangles the relationship between pronatalism, patriarchy, lived religion, state medical policies, morality, and women’s reproductive choices from abortion to the HPV vaccine in contemporary Romania. Pop’s ethnographic analysis of the Delcel neighborhood of Ros xiori de Vede in Romania offers a deep engagement with the complicated structural and interpersonal factors that shape women’s access to reproductive health care and the ways they understand the choices they have, the constraints on those choices, and how those choices link together both their histories of medical engagement and the futures they wish for themselves and future generations. Pop carefully considers how the context of reproductive choice and medical intervention is not unique to this neighborhood in Romania. Rather, The Cancer Within offers a framework to consider the broad and shifting structural factors that shape how patients and doctors interact, how parents and grandparents advise their children and grandchildren, and how power dynamics relating to gender complicate the deceptively simple logic that individuals will make choices based on medically accepted notions of good health. Pop, a Romanian herself, conducted fieldwork in Delcel from 2005 to 2013. In addition to interviews with women in the neighborhood, Pop conducted surveys with Romanian men (who were reticent to participate in interviews) and recounts her own experiences receiving reproductive health care and giving birth in Romania. Pop writes, ‘‘The people who populate The Cancer Within are children born to fulfill a destiny that an official state decree had already planned on their behalf’’ (p. 16). The pronatalist policies of the Romanian government shape medical care, patient choice, and the reproductive futures of any person able to give birth in Romania. Pop’s inclusion of her own experiences adds a layer of understanding to her analysis and allows the reader to experience medical care along with her. In this way, Pop’s own experience creates a bridge between the presumed world view of an educated reader with the lived experience of a community that, during the field work period, did not have a sewage system or access to running water (p. 15). Such details might shape how a reader approaches the stories Pop includes from Romanian women. By bringing together ethnography, surveys, and her own experience, Pop encourages readers to share in the full complexity of reproductive decision-making and to turn that same analytic lens to reproductive conditions in other places. The Cancer Within sets out to understand the disproportionately high rates of cervical cancer and mortality in Romania while those rates were declining in other parts of Europe (p. 1). Engaging first with epidemiological approaches to understanding these drastically high cancer rates, Pop contends that ‘‘we lack a nuanced and historically articulated picture of the reasons that single out Romania’’ (p. 4). In filling this gap, Pop argues that cervical cancer in Romania is a result of ‘‘systemic contingencies’’ in which diseases and social conditions produce inescapable forces on women’s reproductive choices. While the analysis is distinctive to the Romanian case, the consideration of 470 Reviews