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This chapter explores processes of stratification in reproductive healthcare and considers the ways in which mechanisms of inclusion/exclusion shape reproductive opportunities and experiences. First, I consider the process of “selective inclusion” among sexual minority women. This examination questions the schisms that exist within the sexual minority population in regard to their visibility and legibility in medical, scientific, and public health discourses and constructions of reproductive health. The second process I examine is that of “exclusionary inclusion” among substance using pregnant women who have been collectively deemed “bad breeders” by medical and state authorities and whose reproduction is explicitly monitored, regulated, and criminalized. The final process I discuss is “side-stepping inclusion” which describes the healthcare and consumer decisions of women who circumvent medicalized childbirth experiences by employing the services of a midwife for their pregnancy and birth care. This chapter examines how medicalization, biomedicalization, and de-medicalization dynamically work together to expand and delimit inclusionary processes, emphasizing the spectral and interconnected quality of these processes. By exploring various processes of inclusion that shape reproductive experiences of these disparate and differentially marginalized populations, this chapter provides a conceptual and critical meditation on the ways in which “respectable reproduction” is deployed in reproductive care. In considering these processes of inclusion and the ways in which they are co-produced by medical discourses and practices, scholars may more clearly grasp some fundamental mechanisms of stratification in reproductive healthcare and knowledge production.

This essay brings structural intimacies – theorised as the meeting of social structural patterns with interpersonal lives – to the border to consider transnational LGBTQ kinships. Specifically, the paper considers ‘the border’ and its state-driven bio-regulations as a reproductive technology that produces LGBTQ, racial/ethnic and social class inequities through the consolidation of heteronormative, bio-genetic kinship institutions and ideations of family. Structural intimacies harnesses intimacy as both subject and as an analytic lens for queering reproductive sociology that insists on re-conceptualizing institutions central to our lives. Structural intimacies move our analytic gaze from how the border structures sexuality, and vice versa, to consider the border as at once a structural and an affective domain. Structural intimacies is a conceptual tool useful for cross-disciplinary inquiry into the social and structural contexts in which reproductive technologies render meaning, as well as produce families, and to illustrate the analytic necessity of storying both content and method as integral to queer/ing scholarship. Straddling the most proximal forms of daily care and labor patterning everyday intimacies with the policies and practices of the state, the concept of structural intimacies reveals moments of encounter between state institutions with the most intimate components of a person's life and identity, in this case amplified by the bio-politics of the border.

This edited collection proposes an interdisciplinary and integrated approach to the study of reproductive technologies (RTs), which reflects the fact that many people use different technologies throughout their lifecourse and resists the disciplinary siloing of research on these technologies. The ever-expanding availability of RTs, the continued roll-out of ‘family planning’ and maternity services across low- and middle-income settings and the rapid development of the fertility industry mean that it is more likely than ever that individuals, especially women and trans* people, will engage with more than one RT at some point in their life. These multiple engagements with RTs will affect users' expectations and uptake, as well as the technologies' availability, commercial success, ethical status and social meanings. We offer this book as part of a wider movement in the study of reproduction and RTs, which takes inspiration from the reproductive justice framework to address forms of exclusion, discrimination and stratification that are perpetuated in the development and application of RTs and the ways in which they are studied and theorised. Here, we introduce the project and outline the structure of the book.

The Personal Responsibility Work Opportunity and Reconciliation Act of 1996, better known as Welfare Reform, implemented, in addition to many other features, a 60-month lifetime limit for welfare receipt. Research to date primarily documents individual-level barriers, characteristics, and outcomes of those who time out. Very little scholarly work considers experiences of mothering or carework after timing out. In this chapter, I ask, what kinds of carework strategies are used by women who have met their lifetime limits to welfare? What do the ways mothers talk about these strategies tell us about the discursive forces they are resisting and/or engaging? Using in-depth interviews at two points in time with women who have timed out of welfare (n = 32 and 23), this analysis shows how mothers’ strategies and the ways they discuss them reveal covert material and symbolic resistance to key discourses – negative assumptions about welfare mothers and a culture of work enforcement – and the conditions shaping their lives (Hollander & Einwohner, 2004). Mothers use carework strategies very similar to those identified in many other studies (e.g., London, Scott, Edin, & Hunter, 2004; Morgen, Acker, & Weigt, 2010; Scott, Edin, London, & Mazelis, 2001), but they provide us with an understanding of carework in a new context. The three groups of strategies explored here – structuring employment and non-employment, protecting children, and securing resources – reveal raced, classed, and gendered labor in which women engage to care for children in circumstances marked by limited employment opportunities and limited state support. The policy implications of mothers’ strategies are also discussed.

Sterilisation in India (and globally) has a contentious and deeply politicised history. Despite this troubling legacy, India continues to rely on female sterilisation as the main form of contraception and family planning. Abortion, which has been legal under broad grounds since 1971, intersects with sterilisation at different points over women's reproductive lifecourse. Drawing on three case studies exploring women's abortion trajectories in Karnataka, India (2017), this chapter examines sterilisation as a reproductive technology (RT) in women's abortion narratives. These include experiences of failed sterilisation necessitating abortion, as well as narratives around pre- and post-abortion counselling with sterilisation conditionalities. Women report healthcare workers shaming or scolding them for not being sterilised after their last pregnancy – demonstrating the prominence of sterilisation as an enforced social norm using ‘health’ frames. Using reproductive justice (RJ) as a lens, I analyse how sterilisation interacts with abortion and the narratives of shame and stigma that surround the two technologies and make visible the ways in which it results in the denial and restriction of women's reproductive freedoms.

The burgeoning practice of peer-to-peer breastmilk sharing in the United States conflicts with public health concerns about the safety of the milk. In-depth interviews with 58 breastmilk sharers highlight the ways in which these respondents counter widespread risk narratives. These caregivers deploy existing social values such as self-reliance, good citizenship, and “crunchy,” or natural, mothering to validate their milk-sharing practices. However, because of stratified reproduction, in which society encourages White motherhood while it disparages motherhood among poor women and women of color, these discourses are more accessible to milk sharers who are White and from middle-class. Black and Latinx milk donors and recipients offer additional rationale for milk sharing that includes reclaiming their legacies as worthy mothers and elevating milk sharing to justice work. In rejecting and reframing risk, all of these milk sharers work toward flattening the good mother/bad mother binary.

Here we provide a short reflection on the persistent themes from the volume and relate it to wider reproductive studies.