Elise Andaya, Conceiving Cuba: Reproduction, Women, and the State in the Post-Soviet Era. New Brunswick NJ: Rutgers University Press, 2014. xi + 169 pp. (Paper US$ 26.95)
“Children are the future of the Revolution” has been a rallying cry for the Cuban Revolution since its triumph in 1959. But how, in practice, has the Revolution shaped reproduction? Elise Andaya observed the daily workings of a family clinic in Central Havana for over a decade and conducted interviews with doctors, nurses, pregnant women, and mothers. Comparing this ethnographic material to official documents, and drawing on international feminist research, Andaya paints an intriguing picture of the ways Cuban women (and some men) utilize, reject, and negotiate state policy in their attempt to have children (or not), and to raise families in the midst of the ongoing economic crisis precipitated by the demise of the Soviet Union. “At stake,” she reminds us, “is not simply the reproduction of children as members of families but also the reproduction of the socialist state and its revolution” (p. 3).
Chapter 1 introduces the book’s arguments and methodology, and the history of state reproductive policy since 1959. It also explains how the economic crisis has changed the ways Cubans make decisions concerning reproduction, demonstrating that it has put a particular burden on women as reproductive bodies, parents, and workers. Chapter 2 then provides an historical overview of Cuban women in the Revolution’s first three decades.
Chapter 3 focuses on neonatal policy, stressing its aim both to enhance the health of women and babies and to improve Cuba’s standing in international tables that use neonatal births, deaths, and health as a key indicator of good governance. Cuba’s reputation as a model socialist state depends in no small part on its ability to translate healthy mothers and infants into healthy statistics. Moreover, in a country with an absolute decline in the birth rate, strong infants who will grow up to be good workers are considered crucial to the survival of the socialist state. These pressures have major consequences for the treatment of pregnant women. Observing doctor-patient relations, Andaya concludes, “Commentary on the importance of discipline as a means to optimize birth outcomes pervaded prenatal consultations” (p. 52). The result is the construction of good (“disciplined”) and bad (“undisciplined”) expectant mothers, the latter viewed as a threat not only to themselves and their babies, but to socialist society itself.
Andaya challenges this distinction. Using the concept of “moral motherhood” (p. 59), she argues that in response to the pressures on them, pregnant women make their own assessments of the risks of combining reproduction, employment, and domestic duties, acting in ways frequently at odds with definitions of good motherhood promoted by doctors, nurses, and state policy. By shining a light on the disciplinary as well as care aspects of reproductive policy, Conceiving Cuba contributes to our broader understanding of the complex workings of the much-lauded Cuban healthcare system.
Chapter 4, on abortion, provides a nuanced interpretation of Cuba’s higher-than average termination rate. It also demonstrates that the decision to abort can be a form of “moral motherhood,” given the lack of “conditions” in which to raise children. The Cuban case—where abortion is considered a public health problem rather than a moral issue—provides an interesting counterpoint to other countries with a majority Christian population. The final two chapters, on work and migration respectively, are less original than the earlier ones, because so much has been written already about these topics. Nonetheless, by focusing on reproduction, Andaya brings new insights to old questions. One example is the stories of women whose reproductive choices inside Cuba are dependent on “the strategic management of kinship ties” (p. 135) with emigrants who may be able to provide much-needed remittances.
While its conclusions overall are convincing, Conceiving Cuba is somewhat narrow in scope. Like most recent ethnographies conducted by outsiders in Cuba, it suffers from an exclusive focus on Havana. The book also misses the opportunity to pursue counterexamples that could provide insight into different histories and futures. The experiences of Cubans in same-sex relationships might shed light on alternative ways of conceiving children, and of conceptualizing relationships between gender, sexuality, and parenthood. The fleeting reference to the stigma attached to childless women could be extended to tales of women who choose not to be mothers.
Finally, the examples cited of disabled children—including one father’s disturbing view that a disabled son doesn’t count as a real offspring—and the fact that in attempting to save money the government has re-relegated care of disabled children to families, serve as a reminder that social attitudes and austerity measures in socialist Cuba have more than a little in common with those in capitalist countries. Conceiving Cuba makes good use of comparative studies of reproduction from other nations, showing some of the ways Cuba remains “exceptional,” but also drawing attention to the myriad lessons the Cuban experience has to teach the rest of the world.