The Reproductive Body at Work

The South African Bioeconomy of Egg Donation

Verena Namberger

• Éditeur: Routledge
• Année: 2019
• ISBN:
  9780429675881
• Édition: 1
• Sujet: Sciences sociales
• Sous-sujet: Sociologie

The transnational industry surrounding assisted reproductive technology and regenerative medicine is based on the unacknowledged labour of gamete providers, surrogates and research subjects, and benefits from low labour costs in 'enabling' sectors such as logistics and transport. This finding calls for a comprehensive analysis of how the contemporary intersection of neoliberal capitalism and the life sciences - in short, the bioeconomy - capitalises on the body and its (re)productive capacities.

The Reproductive Body at Work uptakes this challenge as it explores the relations between value production, labour and the body in one particular realm of the global bioeconomy: the South African bioeconomy of 'egg donation'. It highlights different forms and dimensions of unacknowledged or precarious human labour that are constitutive for the procurement, brokering and circulation of oocytes as valuable resources. The analysis illustrates that the respective organisation of value and labour renegotiate what 'the' (re)productive body can do, which status and roles it is ascribed, which cultural and economic values it signifies and how it is experienced and enacted within a matrix of intersectional power relations.

A theoretically profound contribution to the interdisciplinary debate on 'New materialism', The Reproductive Body at Work will appeal to students and researchers interested in fields such as gender studies, medical anthropology, cultural studies, sociology, political economy and science and technology studies.

Chapter 1

Introduction

How is value produced in the bioeconomy? Policy strategies outline a new model of biomedical production based on scientific progress, strategic investment and biological potentiality (European Commission 2012; OECD 2006; The White House 2012). They frame the bioeconomy as an “aggregate set of economic operations […] that use the latent value incumbent in biological products and processes to capture new growth and welfare benefits for citizens and nations” (OECD 2006: 1). Around the globe, policy-makers and stakeholders pin their hopes on biotechnological innovation to realise values latent in nature and the human body, and thus foster sustainable economic growth. One key area of this envisaged global bioeconomy is the life sciences and, in particular, medicinal science. Technological possibilities to extract, modify, store and recombine bodily matter, and the circulation of human tissues like blood, gametes or cell lines thus enabled, have led to new markets and regimes of accumulation. In this regard, the policy vision of the bioeconomy has already become reality. Bodily tissue, genes and biomedical knowledge are today governed by intellectual property rights, ever more new ‘bio-objects’ (Vermeulen et al. 2012)¹ acquire legal and ethical status, and the biomedical laboratory is already linked to the stock market and venture capital (in 2014 the global life sciences industry raised a total of $104.2 billion of venture capital, for instance).²

This book looks behind the glossy picture of the bioeconomy, taking a feminist perspective.³ It seeks to contribute to a thorough understanding of the modes of value production and accumulation within this self-proclaimed ‘industry of the future’. It thereby pinpoints the ubiquitous, but also apparently vague, idea of the commodification of the body at the intersection of the life sciences and capitalism. The central assumption of this endeavour is that human labour remains a key factor for bioeconomic value production, although the discourse on ‘latent biological values’ that only need to be harnessed suggests otherwise. With this reasoning, I build on scholarship that highlights new forms of “embodied labor” (Pande 2014) and “clinical labor” (Cooper & Waldby 2014) in different sectors of the bioeconomy. These authors conceptualise the provision of bodily tissues, surrogacy and participation in clinical trials as altered forms of reproductive labour – and hence as a naturalised conditio sine qua non of the political economy of the life sciences.

This book investigates the relations between the body, value production and labour in a small area of the global merging of capitalism and the life sciences: the bioeconomy of ‘egg donation’⁴ in South Africa. This term refers to the country’s flourishing and professionalised market for human oocytes in the context of assisted reproductive technology (ART) and the associated economic structures and practices. Technologically speaking, this specific bioeconomy rests on the ability to remove oocytes from the ovaries, fertilise them in vitro (IVF), store or transport them frozen (i.e. cryopreserved),⁵ transfer them (back) into a woman’s uterus (be it the intended mother or a surrogate) or manipulate and use their reproductive capacities for research purposes. Although the notion of an egg ‘donor’ suggests otherwise, women in South Africa receive financial compensation for the provision of oocytes as valuable resources. In line with the aforementioned literature on ‘clinical/embodied labour’, I argue that the so-called donation of oocytes in exchange for financial compensation needs to be analysed and acknowledged as labour; labour that is essential to the thriving fertility industry in South Africa. Its discursive and legal framing as an altruistic donation denies the economic value of the “contribution made by the donated material itself, and the donor’s work in producing that material” (Waldby & Mitchell 2006: 75). The procurement of the material, or oocyte retrieval, comprises different steps of hormonal stimulation by daily injections and finally a surgical intervention, mostly performed by transvaginal puncture, to aspirate mature follicles from the ovaries. Depending on the protocols, the procedure takes two to four weeks; requires blood tests and ultrasound check-ups; and carries a number of short-term, and unknown long-term, risks and side effects. The procurement and brokering of donor eggs in South Africa is a paradigmatic example of the bioeconomic mode of value production, which blurs the boundaries between production and reproduction, leading to a peculiar sphere of (re)production.⁶ In addition, its institutionalised, ethically regulated and normalised functioning makes it a well-suited case study to explore the complex ways in which bodies are drawn into bioeconomic circuits of capital accumulation.

The question that this book seeks to answer is this: how does value production, the pathway from biomaterial to biovalue or biocapital, work in the South African bioeconomy of egg donation? Building on this guiding question, I further ask what does it mean for the body to be inserted into regimes of value and (re)production? The empirical foundation for answering these questions is a rich corpus of ethnographic data that I approach on the basis of feminist epistemology and through methodological perspectives taken from cultural studies. As stated earlier, my hypothesis is that the pathway from biomaterial to biovalue ultimately rests on human labour. Based on this hypothesis, I further claim that the South African bioeconomy of egg donation is doubly productive: it produces not only surplus value but also (re)productive bodies in both a discursive and material sense, and within a matrix of intersectional power relations. The structures and practices of the South African egg donation bioeconomy renegotiate what ‘the’ (re)productive body can do; which status and roles it is ascribed; which cultural and economic values it signifies; and how it is experienced and enacted at the intersection of medicine, technology and capitalism.

In line with an instrumental case study design, the aim of this book is twofold: first, the in-depth empirical analysis of the South African case contributes to scholarship on transnational markets for reproductive services and gametes. Given South Africa’s prominent position in the international fertility industry, it is intriguing that there is as yet hardly any research on its market for donor eggs. My decidedly economic perspective thus enriches the existing anthropological debate on reproductive medicine and the cultural politics of reproduction. Considering the rapid normalisation and commercialisation of fertility treatments, a focus on the political economy of reproductive technologies is long overdue. On one side is the fact that the majority of people living at the global periphery (and the poor in richer parts of the world) do not have access to infertility treatment due to financial constraints (which are added to legal restrictions). On the other side, access to ARTs is increasingly organised through the relocation of fertility-related services to less regulated markets, and in particular to socioeconomically deprived women in the Global South – phenomena which in part reiterate existing ‘global care chains’ (Ehrenreich & Hochschild 2003; Hochschild 2000) and ‘counter-geographies of globalization’ (Sassen 2000). In this regard, this study aims to fill a research gap in the empirical literature and to find ways out of the ‘feminist quandary’ (Nahman 2008: 77) in order to see both the emancipatory potential of ART and their repressive and normalising effects, to acknowledge women’s agency as well as socioeconomic inequalities and exploitative power structures, and to see both the need for feminist alliances and the pitfalls of ‘transnational feminisms’ (Gupta 2006).

Second, this case study simultaneously incites, facilitates and substantiates a theoretical interest in the ‘body at work’ in the bioeconomy. With this book, I aim to contribute to existing work on naturalised labour in the bioeconomy by inviting the body to take centre stage. I regard the bioeconomic era as a new chapter in the history of the body in capitalism. The impetus for this research interest is the finding that the ‘body at work’ – or the body as a (re)productive body in capitalism – has been left at the margins of interdisciplinary research on the bioeconomy as well as in feminist body studies (see Section 1.2). In other words, “[t]he bridge between bodies and labor [has] remained a relatively unexplored territory”, as Amrita Pande (2014: 105) aptly points out. The notion of “bodies at work” (Wolkowitz 2006) evokes associations of hard physical labour; of blue-collar workers with heavy tools; of curved backs on Fordist assembly lines; or, nowadays, of new lifestyle diseases inflicted by office work. The capitalist exploitation of bodily capacities, and even the integration of reproductive processes into modes of production, is nothing new (one just has to recall that in colonial times slave women were exploited by being forced to generate surplus value through labour, prostitution and reproduction). However, relations between the body and labour in the bioeconomy are markedly different from those of earlier phases and other economic spheres, and challenge existing sociocultural ideas and analytical categories that are held dear in (feminist) Marxist theory. This book approaches the research gap on the body/labour nexus in the bioeconomy through a diffractive reading of Marxist theory, Marxist/materialist feminism⁷ and feminist body theories on the foundations of science and technology studies (STS).

Let me illustrate the overarching theoretical research interest of this project with a thought experiment based on Charlie Chaplin’s classic film Modern Times (1936). Commenting on the humiliating effects of industrialised factory production on the (male) worker’s body, the film portrays the main character as bound to the assembly line, his body reflexively repeating mechanised motions dictated by the rhythm of the machines. He even remains other-directed by the forces of production during his lunch-break, when he is fed by a machine. What would Chaplin’s mechanised body look like today, in the age of experimental life sciences and bioeconomies? How would it be disciplined as both a working and a consuming body? Would it embody the factory, or would it be the tools? Would it still be male⁸ or have a gender at all? Would it be a Black⁹ or a white body, or would race not matter anymore? What kinds of routinisation, standardisation and power relations would it be subjected to? What forms of resistance would be imaginable? How would one display the effects of its insertion into the life-science industry, its enclosure in laboratories around the globe? Although this analogy has its limits, it serves as a metaphorical signpost for the theoretical trajectory of this thesis. It highlights the core topics this project intends to explore: relations between body and labour, human and technology/machine, and production and reproduction. The remaining parts of this introduction will first sketch out the theoretical strands of literature in which this book is embedded and my particular contribution to the debate; second, it will give an overview of empirical research on egg donation; third, it will present the case study, methodological framework and methods, and finally give a brief outline of the book.

Marx, biotechnology and the life sciences: rewriting biocapital?

The intersection of biotechnology, medicine and capitalism has become a thriving field of research within social and cultural studies of science. Scholarship seeks to theorise the economic value of the body, or ‘life itself’,¹⁰ at the intersection of biological science and profit-oriented enterprise, coining terms like biovalue (Waldby & Mitchell 2006), biocapital (Rose 2007; Sunder Rajan 2006), bioeconomy (Birch & Tyfield 2012; Lettow 2012a), the ‘biotech mode of production’ (Thompson 2005) or ‘life as surplus’ (Cooper 2008). It seems like a collective attempt at “(re)writing volume 1 of (bio)Capital” (Franklin & Lock 2003: 13), as Sarah Franklin and Margaret Lock depicted the future of anthropological studies of the biosciences at the beginning of the new millennium. The field shares a critical attitude towards policy initiatives promoting the bioeconomy as a scenario to reconcile economic growth with sustainability and a better life for everyone. Another point of convergence of this scholarly work is that it goes beyond mere ethical debates. Most authors take a critical stance towards the juridical and techno-deterministic perspective of bioethics as an institutionalised field of expert knowledge. STS approaches challenge the bioethical conceptualisation of technological development as an autarkic realm, the social and ethical implications of which can only be assessed in retrospect. Another point of critique is that bioethics makes universal claims whilst remaining based on particular interests and values (Sunder Rajan 2006: 65). Consequently, bioeconomy literature has turned bioethical debates and regulations into an object of study and reveals the functional role of bioethics for processes of economisation: for example, in the sense that bioethics “‘taint[s]’ the petri dish and […] public opinion becomes, in a sense, part of the culture medium for creating new life forms” (Franklin 2003: 99). Additionally, bioethics is c...

Table des matières

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Table of Contents
• List of figure
• List of abbreviations
• Foreword
• Acknowledgements
• 1 Introduction
• 2 Valuable eggs and lively capital in South Africa
• 3 Deconstructing nature’s ‘latent value’: Labour in egg donation
• 4 Bodies made in South Africa
• 5 Body formation in Bioeconomic Times
• 6 Conclusion
• Index