The intimate state: female sterilisation, reproductive agency and operable bodies in rural North India

Abstract

Female sterilisation or tubal ligation remains the most promoted and prevalent method of contraception in India today, especially among the rural and urban poor. This thesis provides an ethnographic account of poor women’s experiences of the sterilisation procedure in order to investigate the intricate relationship between the state, biomedicine and poor women in rural North India. The thesis draws on 18 months of ethnographic fieldwork in a mixed-caste village in Southern Rajasthan. Besides engaging with women in their daily lives in the village, participant observation was also carried out in regularly organised sterilisation camps, which were run by Marie Stopes India in two nearby towns. The thesis aims to explore how women experience the female sterilisation procedure, how this procedure relates to concerns beyond the sterilisation camp and how various forms and sources of authority influence reproductive decisions. The female sterilisation procedure encapsulates not only people’s engagements and negotiations with the power, practices and discourses of the state, but also with other forms of authority, such as biomedicine, and intersecting structures of gender, caste and class. The thesis approaches the main research theme – the relationship between the state, biomedicine and poor women in rural North India – by examining various relationships and power struggles within these domains as much as between them. The chapters focussing on the history of family planning in India, on local articulations of the state in the village and on local health workers who are an integral part of “motivating” women for the female sterilisation procedure reflect an effort to problematise “the state” and to investigate how local embodiments and discourses of the state contribute to women’s decisions to stop childbearing by undergoing the tubal ligation procedure. The ethnography of a sterilisation camp provides a look into processes of biomedical examinations conducted in the camp before the procedure, and shows how biomedical tools of knowing, seeing and acting are negotiated and contested by various biomedical personnel, bureaucrats, as well as by women seeking the procedure. In such a way, I problematise the category of “biomedicine” and highlight its contested nature. Finally, chapters on reproductive agency and operable bodies examine how women themselves make sense of tubal ligation, how they negotiate conditions under which to undergo the procedure, and how female sterilisation becomes a site to negotiate one’s social status. An ethnographic investigation of the state, biomedicine and poor women as categories which are not homogenous but rather are constituted through multiple internal and external contestations allows a deeper and more complex understanding of how increasing medicalisation of women’s lives in rural North India is experienced in various different ways. Furthermore, acknowledging the multiplicity of agendas, discourses and experiences within the categories of “the state”, “biomedicine” and “poor women” provides an insight into how power is contested and articulated on multiple levels and by multiple actors, resulting in theoretical contributions to the existing theories on power, governmentality and biopolitics.