Fitness, fertility and femininity: Making meaning in the tying of tubes: A feminist discourse analysis of women's sterilization

Abstract

As a contraceptive technology, women’s sterilization is a medical event that is uniquely situated in relation to the dominant discursive link between women and reproduction. Intended as a contraceptive option that permanently ends a woman’s potential ability to sexually reproduce, women’s sterilization presents a significant point for exploring the discursive formation of femininity, and how the concepts thereof relate to broader questions of access, control, and regulation of sterilization and the female sterilization patient. This study uses a Foucauldian feminist theory of discourse to explore such questions in a qualitative discourse analysis of women’s sterilization, from both a historical perspective and from within contemporary medical texts. Sterilization has had a particularly tumultuous history in the provision of reproductive healthcare for women; situated within public health and welfare discourse that differentiates the “unfit” from the “fit” reproducers, women have been forcibly sterilized under classist and racist eugenic programs, while subtle yet coercive forms of sterilization abuse continue to occur as inequality of reproductive healthcare access is an ongoing issue for immigrant women, poor women, and women of colour. In light of this historical analysis, as well as the impact of feminist and bioethics discourse upon contemporary medical practice, an analysis of medical texts further explores the association of women with reproduction in the discursive form of the sterilization patient. This study argues that the sterilization patient is situated within a discourse of ideal femininity, associated with normalized forms of mothering, sexuality, and family structure. Given the historical link between the discursive “fit” reproducer, these concepts have continued implications for women’s experience of accessing sterilization as a contraceptive option.