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Although research on reproductive technologies such as IVF and egg freezing has traditionally been rather separated from the work on contraceptives and abortion, analysing reproductive and nonreproductive technologies together, as this volume proposes, can provide the basis for a broader contemporary politics of reproductive control. This chapter analyses this politics of integrating reproductive and nonreproductive technologies by focusing specifically on IVF-based fertility (preservation) treatments and (medical) abortion. More specifically, it explores both technologies' interrelated research trajectories and the financial and platformised dimensions of their clinical implementation. With a dual focus on egg freezing and medical abortion, this project seeks to explore how processes of platformisation and financialisation shape the clinical and commercial infrastructures that govern twenty-first-century reproduction. The chapter's broadened analytic scope that incorporates both reproductive and nonreproductive technologies highlights how a contemporary biopolitics of reproductive control may be expressed through these technologies' interrelated regulatory practices, shared politicised reference points (e.g. the embryo), opposite investment practices and mutually reinforcing social effects.

To explore the politics of gender, health, medicine, and citizenship in high-income countries, medical sociologists have focused primarily on the practice of legal abortion. In middle- and low-income countries with restrictive abortion laws, however, medical sociologists must examine what happens when women have already experienced spontaneous or induced abortion. Post-abortion care (PAC), a global reproductive health intervention that treats complications of abortion and has been implemented in nearly 50 countries worldwide, offers important theoretical insights into transnational politics of abortion and reproduction in countries with restrictive abortion laws. In this chapter, I draw on my ethnography of Senegal’s PAC program to examine the professional, clinical, and technological politics and practices of obstetric care for abortions that have already occurred. I use the sociological concepts of professional boundary work and boundary objects to demonstrate how Senegalese health professionals have established the political and clinical legitimacy of PAC. I demonstrate the professional precariousness of practicing PAC for physicians, midwives, and nurses. I show how the dual capacity of PAC technologies to terminate pregnancy and treat abortion complications has limited their circulation within the health system, thereby reducing quality of care. Given the contradictory and complex global landscape of twenty-first-century abortion governance, in which pharmaceutical forms of abortion such as Misoprostol are increasingly available in developing countries, and as abortion restrictions are increasingly enforced across the developed world, PAC offers important theoretical opportunities to advance medical sociology research on abortion politics and practices in the global North and South.

The European Society of Human Reproduction and Embryology (ESHRE) defines the act of travelling abroad to undergo reproductive medical treatments, including assisted reproduction technology (ART) treatments as cross-border reproductive care. The experiences of patients seeking affordable reproductive care abroad have been widely studied in the last decades (Bergman, 2011a, 2011b; Blyth, 2010; Bracewell-Milnes et al., 2016; Culley et al., 2011; Guerzoni, 2017; Hudson, 2017, 2020; Hudson & Culley, 2011; Kroløkke, 2014a, 2014b; Rodino, Goedeke, & Nowoweiski, 2014; Salama et al., 2018; Shenfield et al., 2010; Van Hoof, Pennings, & De Sutter, 2016; Whittaker, Inhorn, & Shenfield, 2019; Zanini, 2011). However, French women and couples pursuing ART treatments abroad have received little scholarly attention until now. In this chapter, we aim to address this gap in the literature with the results from an ethnographic study conducted with French women and couples who seek ART treatments in Barcelona (Spain) using data from participant observation and in-depth interviews. We begin by discussing the European reproscape, introducing French and Spanish ART legislation, to explain why a large number of citizens are excluded from the French system of reproductive governance and why they choose Spain as their destination. Then, we will discuss the obstacles faced during the reproductive journey, and the impacts of this journey on the embodiment of the treatments are explored, in order to show how French women and couples handle the physical, emotional and cultural displacements that their reproductive project entails.

The politics of intimate relationships structure innovation for sexual and reproductive health technologies. In this chapter I present three case studies that explore how national political concerns surrounding maternal intentions and the race of sexual women shape the production of sexual and reproductive health technologies. The products I examine are: GONAL-F, a subcutaneous injection of follitropin alpha for ovulation induction; Evra, a transdermal patch containing norelgestromin (NGM) and ethinyl estradiol (EE) for hormonal contraception; and zidovudine (ZDV) for HIV therapy, including the prevention of mother-to-child transmission. Together, these case studies illustrate how the politics of intimate relationships, which are deeply engrained in societies, structure clinical innovation, through conditions of inclusion, exclusion and anticipation.

Communities are critical sites for studying the politics of inequality within neoliberal capitalism. We illustrate this by providing regional case studies of the enactments and outcomes of three types of neoliberal policies in the United States: (1) cutbacks in family planning policies, (2) municipal underbounding and failures to provide public infrastructure within unincorporated communities, and (3) “tough on crime” policies leading to mass incarceration. Building on insights from intersectional feminist theory and using evidence from in-depth interviews from three Southwestern communities, we argue that neoliberal capitalism is compounding intersecting inequalities affecting women of color. In particular, we claim that neoliberal policies at the local and state levels are compromising the reproductive autonomy and public health of women of color and creating new challenges for their family care work.

Here we provide a short reflection on the persistent theme of choice in reproductive studies which allows us to draw out further insights from each of the chapters.

Sterilization is endorsed as a method of family planning by international governmental organizations; abortion is not. Focusing on policy development for these two issues in a single country, Peru, we ask how power and inequality operate under conditions of global consensus or dissensus. The case of sterilization unfolded the way many previous research studies would predict, with Peruvian state actions corresponding to a global diffusion process. We find that global consensus provided cover for top-down actions that violated the human rights of indigenous women in the country, who were predominantly poor, non-Spanish speakers, and residents of the mountainous, sparsely populated parts of the country. With respect to abortion in Peru, in the absence of global consensus, the state resisted calls for change, advocacy networks have worked at cross-purposes, and a powerful local actor, the Catholic Church, has effectively blocked liberalization efforts. As with sterilization, however, marginalized indigenous women and their interests were rendered invisible.