Marketisation and Social Inequities in Reproductive Healthcare (2014-2017)

This postdoctoral project explored social relations, such as kin, gender, class and ethnic relations, in reproductive healthcare in the context of late consumer capitalism. More specifically, it studies the relatively recent changes linked to the marketisation of healthcare in the practices of care for infertility, pregnancy, childbirth and abortion. It has been noted, for example, that marketisation tends to turn passive patients into active consumers and to commodify care interventions and human tissue like gametes, foetuses and, especially, women’s bodies. Furthermore, markets for medical services have become more transnational in that people travel across state borders to access care. These issues will be addressed through analysis of how all participants in care, including professionals, patients/clients, donors, gametes, foetuses, embryos and technologies, are engaged and related in the practices of both public and private sector healthcare. Through an exploration of the engagement of participants and their relations in care, the study seeks to account for the ways in which consumer principles are realised in the care practices, and how some people seem to be granted more reproductive agency and freedom than others. The study also has theoretical and practical objectives. Theoretically, the research project aims to broaden feminist and social scientific discussions on social relations and (reproductive) agency based on the empirical study. The study will also have implications for healthcare in providing useful knowledge for professionals and policy makers. It will help to pinpoint the ways in which social and gendered inequities emerge in practice. The methodological orientation of the research is multi-sited ethnography, and the research material consists of video-recordings, observations, interviews and documentary material. The material is collected at four publicly funded maternity clinics, and at three private sector healthcare clinics that offer services for medical tourists within and beyond the national borders. The focus of the study is on the case of Finland and its service system, which combines a historical state-funded primary care system with a growing commercial care business with expanding prospects. The analysis of the material owes much to feminist studies of technoscience in material-semiotic practices and their acknowledgement of the heterogeneity, instability and fluidity of subjects and objects, of agency and of logics of power.