Intimate Lives in the Global Bioeconomy: Reproductive Biographies of Mexican Egg Donors

Abstract

Research on cross-border reproductive care has shown how the geographical, historical, economic and political contexts in which egg donation takes place shape this transnational practice. As many women offer their oocytes due to their precarious conditions, they become seen as ‘bioavailable bodies’. The presence of these bioavailable bodies is key to the emergence of global egg donation hotspots. We argue that feminist research needs to go beyond the conceptualization of egg donors as bioavailable bodies. We suggest the analysis of ‘reproductive biographies’ as an innovative way to understand the entanglements of the global bioeconomy with intimate experiences of reproduction. We suggest advancing current feminist discussions around clinical labour by (1) studying the entanglements between the global bioeconomy, a neoliberalized healthcare system, systematic feminicide and women’s reproductive biographies, and by (2) revealing how women’s decision to donate results from gendered dependencies, obligations of care and coercive moments in egg donors’ reproductive biographies.

Keywords

bioeconomy egg donation feminicide logics of care Mexico reproductive biographies stratified reproduction

Introduction: Clinical Labour Beyond Agency and Exploitation

Sometimes I think it is because of money that I can’t be happy. When there is enough money, there is less trouble at home. I have to endure this violent situation at home. For me it wouldn’t be a problem, but I have to endure the situation for my children and for Chamaca [her dog]. I will stay with him [her partner] until my next egg donation. With the money from the donation I will buy a piece of land, and no matter what, even if I have to camp on this piece of land with Chamaca and the kids, I will leave him.

Lidia Valiños, egg provider, 24

Lidia Valiños¹ was, at the time of this conversation, a second-time egg ‘donor’² in a fertility clinic in Puebla, Mexico. She dropped out of school at the age of 13. Since then, she has worked in many different low-paying jobs to make a living and support her two children. Lidia is one of the thousands of women in different fertility hotspots around the world whose reproductive body parts have been made ‘bioavailable’ (Cohen, 2005) for the fast-growing global fertility market (Cooper and Waldby, 2014; Gunnarsson Payne, 2015). Cohen has coined the term ‘bioavailability’ to refer to the ways a body is rendered available for the disaggregation of its cells, tissues or organs that will then be reincorporated into another body in the global bioeconomy. Lidia’s body is made bioavailable by extracting oocytes from her body, which will be fertilized in vitro with someone’s sperm and then implanted into another woman’s body.

When a woman provides oocytes for other people, her bioavailability potentially exposes her to a range of possible side effects such as ovarian hyper-stimulation syndrome, abdominal pain and vomiting. The long-term risks of hormone stimulation still remain largely unknown (Pearson, 2006; Schneider, 2008). In our multiple research encounters, Lidia rarely talked about her ‘clinical labour’ (Cooper and Waldby, 2014) but preferred to talk about the dreams she hopes to realize thanks to the ‘compensation’ of US$ 800 she receives when selling her oocytes. The potentially harmful treatment of oocyte donation is legitimized by what is described by Berlant (2011: 167) as the ‘aspirational normativity of good life fantasies’: that people adhere to potentially stressful living conditions because of their desires for what is conventionally considered as a good life. For Lidia, egg ‘donation’ is not so much about ‘helping other people’ as it is about fulfilling her dream of a happy family: ‘the donation primarily helps me to realize my projects – and anyway if I don’t donate my eggs, somebody else will do it’. Recognizing her ‘disposability’ (author reference, Wright, 2006) in the vast supply of female bodies willing to make their oocytes bioavailable in Mexico’s fertility industry, she stages the donation rather as an act of self-care and care for her dependent family members. The money allows her to buy a piece of land, to build a home and to be a good mother who can provide a good life for her children and her dog. She considers egg donation as a means to more happiness for herself and her own family. The act of donation thus entails ‘an incoherent cluster of hegemonic promises about the present and future’ (Berlant, 2011: 167). In her case, egg ‘donation’ creates an exit strategy from a violent partnership, in which Lidia feels trapped due to her gendered care obligations both towards her children and her dog, her most important companion throughout her troubled adolescence. She emphasizes that without the children and the dog, she would have left her partner long ago. But as a single mother, she has to manoeuvre in a limited space of options and thus depends on the egg donation. Her (reproductive) biography, the resulting obligations of care, and her desires for a ‘good life’ (Berlant, 2011) are hence closely entangled with her clinical labour in the Mexican bioeconomy. This article suggests the analysis of reproductive biographies such as Lidia’s as an innovative way to understand the entanglements of the global bioeconomy with intimate experiences of reproduction (Mountz and Hyndman, 2006; Pratt and Rosner, 2006, 2012). We suggest advancing current feminist discussions around clinical labour in the realm of the global bioeconomy in a twofold way. First, we argue that the egg provider’s ‘clinical labour’ needs to be analysed against the backdrop of reproductive biographies to understand the entanglements between the global bioeconomy, a neoliberalized healthcare system, systematic feminicide and women’s desire for a ‘good life’ (Berlant, 2011). Second, we draw from the reproductive biographies of egg providers to argue that women’s clinical labour needs to be analysed within a relational framework of care.

To do so, the article develops as follows: We first discuss how Cohen’s notion of the bioavailable body is relevant to the case of transnational oocyte donation, and then we detail the particular context of the Mexican fertility industry. In the section, ‘ConEGGting oocyte donation to donors’ reproductive biographies’, we spell out in three subsections (1) how the neoliberal system of health care shapes donors’ reproductive biographies, (2) why not only the intended parents but also the donors turn to the fertility industry in their search for a ‘happy’ and ‘good life’ and (3) why the act of oocyte donation needs to be understood within a wider logic of care.

The article is based on extensive ethnographic fieldwork in Puebla, Mexico City, Puerto Vallarta, Villahermosa and Cancun from 2014 to 2016 on Mexico’s increasingly transnational fertility industry (for more critical reflection about the challenges of doing ethnographic fieldwork in private fertility clinics, see Schurr and Abdo, 2016). The fieldwork consisted of participant observation in different in vitro fertilization (IVF) clinics and semi-structured interviews with 18 egg donors, 23 gestational surrogates, 19 intended parents and 24 IVF doctors and clinical staff. This article draws on interviews with 18 egg donors as well as on biographical interviews, extended discussions and participant observation in the daily lives of three egg donors from Puebla and Mexico City. Laura worked in depths with these three main informants employing the visual method of ‘photo elicitation ‘auto-driven’ interviews’ (Clark-Ibáñez, 2004). By using pictures taken by the egg donors, she analysed how the act of egg ‘donation’ relates to their reproductive lives. We coded the material in the qualitative analysis program MaxQda and analysed it inductively using Strauss and Corbin’s (1990) grounded theory.

Becoming a Bioavailable Body

Dr. Escobar, the director of a well-known fertility clinic in Mexico City, suddenly fell silent in the middle of our conversation. His gaze turned towards a group of women standing across the road in front of one of the many nightclubs in this neighborhood. I followed his gaze. The women, all of them fair-skinned mestizas, wore short skirts, high heels and makeup. Still staring towards the women, he said, “My colleagues, they just go to night clubs like this, they walk up to the girls [chicas] and recruit them as egg donors for their clinics. I am sure this is a successful strategy. Think about what they earn here and how much they would get when donating their eggs.”

What makes these chicas potential donors? Why do the doctor and his colleagues consider their bodies for egg donation in the Mexican fertility industry? And what does the selection of these particular bodies (in terms of class, race, gender, age, health and notions of beauty) tell us about the Mexican bioeconomy at large? In this section, we revisit Cohen’s (2005) concept of ‘bioavailability’ to explore how it can be and has been used to address these questions within the field of transnational assisted reproduction.

The term bioavailability is selective, as it makes some bodies more bioavailable than others based on similarity (especially in terms of immunology and phenotypical resemblance) and marginality (in terms of class, gender, caste, race, etc.). Adapting Cohen’s notion of bioavailability to the realm of the global fertility industry, Kroløkke et al. (2012: 278) argue that ‘egg donors become bioavailable bodies on the basis of similarity, frequently matching the race of the intended parents (lighter skin, for example) but demonstrating marginality on the basis of age and economic disparity.’ In terms of similarity, questions of sameness with regard to phenotypical resemblance dominate recent academic discussions on egg donors (Schurr, 2017; Gunnarsson Payne, 2015; Kroløkke, 2014; Nahman, 2006). Harrison (2013, 2016), for example, has studied the importance of skin colour and race – often disguised as ethnicity – in the online databases of egg donor agencies. ‘Sameness’ is a crucial factor related to a donor’s ‘biodesirability’ (Gunnarsson Payne, 2015): the phenotype in form of skin colour is for most recipients the main matching criteria (Daniels and Heidt-Forsyth, 2012; Karsjens, 2002; Quiroga, 2007). This ‘biodesirability’ of donors depends on hegemonic beauty ideals and the ‘global esthetics of the attractive child [as] fair-skinned’ (Kroløkke, 2014: 67). Research on oocyte bioeconomies in Europe emphasizes the postcolonial hegemony of whiteness – which especially turns women from Eastern European countries into biodesirable bodies (Bergmann, 2011; Gunnarsson Payne, 2015; Kroløkke, 2014).

The ethnographic field note about Dr. Escobar’s donor selection strategies at the beginning of this section shows that these postcolonial imaginaries of racialized beauty also shape the Mexican fertility industry. The racialized selection practices of fertility clinics result in new forms of ‘liberal eugenics’ (Braun, 2007; Rose, 2007) that are closely entangled with Mexico’s (post-) colonial history of mestizaje und blanqueamiento (Moreno Figueroa, 2010): the lighter the donor, the more desirable/demanded/valuable her oocytes are considered (Schurr, 2017).

Questions about the phenotypical sameness between the oocyte donor and intended parents are central to the fertility business and have gained much attention in scholarly debates. However, we know much less about Cohen’s second criteria: the oocyte donors’ marginality. Pfeffer writes broadly that neoliberalism not only supports the growth of the reproductive tourism industry but also creates the conditions for bioavailability by ‘exacerbating the relative disadvantage of poor and powerless women’ (Pfeffer, 2011: 634). Studies on South Asia’s surrogacy industry have shown how poverty and patriarchal societal structures create a ‘bioavailable’ population of women ready to act as surrogate labourers in developing economies (Deomampo, 2013; Pande, 2014; Rudrappa, 2015; Schurr and Fredrich, 2015; Whittaker, 2011).

While surrogate labourers’ position of marginality is at the centre of current debates on transnational reproduction (Cooper and Waldby, 2014; Parry, 2015a, 2015b; Schurr and Militz, 2018; Schurr and Perler, 2015), only a few studies deal with questions of marginality, poverty and precarity in relation to oocyte providers. Gunnarsson Payne’s (2015) and Nahman’s (2008, 2011, 2013) work on egg providers of Eastern European countries are exceptional in this regard. They argue that even though Eastern European oocyte sellers could be seen as typical victims of neoliberalism’s effects after the collapse of the Soviet Union, these women are not merely poor and passive victims who are made bioavailable by neoliberalism and a neoliberalized fertility industry. On the contrary, they portray egg sellers as active and ‘savvy participants in the neoliberal economy’ (Nahman, 2008: 67, 2016).

We take the argument that frames reproductive autonomy as part and parcel of a neoliberal logic a step further to show how women’s ‘reproductive choice’ to participate in the global fertility industry is linked to their ‘reproductive biographies’ (Perler, 2015). Understanding ‘reproductive biographies’ as women’s narrations of their reproductive life cycle and the embodied entanglements between their reproductive intimacies with their socio-economic and political environment, we focus on how their affective experiences of (unwanted) pregnancies, abortions, family planning, and sexual, physical and obstetric violence are closely entangled with their motivations to make their oocytes bioavailable. We argue that their reproductive biographies are shaped and framed by a racialized and classist postcolonial biopolitics, the neoliberalization of healthcare, the lack of a social welfare state, machismo³ and gendered obligations of care.

Focusing on the donors’ reproductive biographies, we call for the need to study the lives of reproductive labourers beyond the moment their bodies are made ‘bioavailable’ for consumption in the global fertility industry. In doing so, we aim to expand Cohen’s (2005) notion of bioavailability by understanding oocyte providers’ marginality in a broader sense – as a societal, economic and political precarious position embedded both within their own reproductive biographies and a particular cultural, political and economic context.

Mexico’s Booming Fertility Business

Now they offer IVF in every gas station. It is like the Seven Elevens [24h shops], there is an IVF center at every corner. We experience a boom of IVF clinics.

Dr. Angeles Espinoza, reproductive endocrinologist

Mexico’s fertility business is booming. IVF is now available in all regions of the country, in large as well as midsize cities (González-Santos, 2010, 2016; Schurr and Walmsley, 2014). The history of Mexico’s fertility industry is closely linked to the state’s desire to control and limit the fertility of those populations that do not fit into Mexico’s postcolonial imaginary of a modern mestizo state. Racialized discourses about infertility treatment and family planning are hence ‘two sides of the same coin: the coin that represents control of reproduction’ (González-Santos, 2010: 67). Assisted reproductive technologies appeared in Mexico during the 1980s in the heyday of Mexico’s family planning campaigns (Braff, 2009, 2013; González-Santos, 2010, 2016). Fertility control was considered not merely as a way of achieving economic security but also of ‘reduc[ing] the population of specific ethnic or racial groups’ (Morgan and Roberts, 2009: 12). A state-mandated contraceptive program – la oferta sistemática – obliged every healthcare institution not only to inform women about family planning but also to fulfil a quota of women receiving contraception and sterilization (Gutmann, 2011: 65). Within this context, the first private IVF clinics opened their doors in the capital Mexico City and in Monterrey, one of the wealthiest cities located in the industrialized north of Mexico, in 1982 (González-Santos, 2010: 44). Towards the end of the 1990s, a second wave of clinics started to emerge outside of the metropolitan areas, thus enabling a nationwide spread of IVF treatment (González-Santos, 2016: 122). To maximize profits, private clinics started to open their doors to a foreign clientele, turning Mexico into a major destination for medical and reproductive tourism (Nunez et al., 2014). The boom of fertility clinics in Mexico after the turn of the millennium resembles the emergence of a commercial industry that resulted from the neoliberalization and privatization of the Mexican healthcare system. Mexico’s well-developed public healthcare system had been systematically eroded throughout the 1980s and 1990s by undermining its tradition of solidarity and forcing people into buying private health insurance (Fisk, 2000). The Mexican public healthcare system was not eliminated as a consequence of privatization, but its funding was diminished. As a result, it now caters only to lower-income people. The World Banks’s structural adjustment programs (Homedes and Ugalde, 2005) resulted in the privatization of healthcare and filled the lack of state support. Further, the NAFTA allowed US-managed healthcare organizations to play a key role in the privatization of Mexican healthcare.

The increasing popularity of Mexico as a global fertility destination emerged in consequence of the US-lead privatization of Mexico’s system of health care; and the fast growing national demand for assisted reproductive technologies (Rtveladze et al., 2013) resulted in a vast demand for mobile reproductive labourers willing to offer their sex cells and gestating capacities in Mexico’s fertility market (Schurr, 2019).

As the commercial sale of oocytes is prohibited through Mexico’s healthcare act, oocyte ‘donation’ is framed in altruist terms on a legal level. On a practical level, however, the US$600–1,500 of ‘compensation’ the women receive – depending on their phenotype, their educational background and the clinic in which they ‘donate’ –, turns egg donation into a commercial practice. Given that the oocyte providers we interviewed live with an average household income of US$300–500 per month, the compensation represents an important source of income for paying rent, school tuition, healthcare costs and debts.

Engaging with oocyte providers’ (reproductive) biographies and lives, the next section reveals how becoming a bioavailable body in the Mexican fertility industry is linked to the wider context of Mexico’s ‘stratified system of reproduction’ (Colen, 1995) in which the reproduction of some bodies is more desired than others.

ConnEGGting Oocyte Donation to Donors’ Reproductive Biographies

I was six or seven. […] I remember that a friend of my brother told me to come over. […] Several neighbors were there, kids my age and a little older. I remember that they took off my clothes, and they touched me and he took off his underwear and I lay down on this bed and there was a mirror where all the boys could watch me […]. I thought that it was my fault, that I cooperated and I didn’t tell anyone until the day my sister told me that a guy from her school had raped her, he gave her drugs and raped her, she was conscious but couldn’t defend herself, it was a friend of hers, and afterwards she asked him, ‘Why did you do that?’ And he told her, ‘Because I wanted to.’

Lidia Valiños, egg provider, 24

As the vignette above shows, Lidia first experienced sexual violence as a child. A violent relationship between her parents characterized Lidia’s childhood. An adolescence marked by sexual violence followed. When, at the age of 13, she discovered that her father frequently abused her sister sexually, she decided to leave her family. She then lived with other adolescents, where a peer’s father raped her.

Another of our main informants, Erica Cortez, was 16 when she was doped and then raped during a party she attended with her sister-in-law. After several visits to gynaecologists, the police sentenced the man to 18 years in prison. The sentencing of Erica’s perpetrator is a very rare case, as Mexico is known for its high level of impunity. A third donor, Eva Carrizosa, told us that the father of her children ‘once took me with violence, so I decided to leave him’. The accounts of these three women demonstrate lives marked by sexual violence. Sexual violence not only leaves a tragic personal experience, but it also reveals a systematic failure of a state well known for its impunity.

Interlocking systems of discrimination based on sexism, racism and classism mark sexual violence in the context of Mexico (Martin and Carvajal, 2016), making poor, single and indigenous women especially vulnerable to sexual violence (Evangelista-García et al., 2016). The overall insecurity and impunity, as well as a general climate of violence, lead to one of the world’s highest rates of feminicide: the murder of women because they are women. Feminist activists in Mexico estimate that in 2012 and 2013, authorities investigated only 24% of the 3,892 feminicides. While the term ‘femicide’ refers to the act of being killed because of being a woman (Radford and Russel, 1992), we use the term feminicide to point to patterns of structural violence that lead to the killings (Bautista, 2017), arguing, that oocyte donation relies on the same system of violence that enables feminicide. We follow Lagarde (2010) in understanding feminicide as a result of historical conditions that generate social practices that allow for violent attempts against the integrity, health, liberties, and lives of girls and women. These ‘historical conditions’ in Mexico are bound up with the effects of (post-)colonialism and neoliberalism, which both create a social environment in which men are driven to hypermasculinity (Olivera, 2006). Olivera (2006) argues that feminicide has spread like a disease throughout Mexico. Our three informants’ narratives show that the Mexican fertility industry is entangled with this pathology, as it relies on ‘disposable’ (Schurr, 2017, 2018; Wright, 2006) reproductive labourers whose reproductive biographies are often inflicted with forms of systematic violence. While their motivations to donate were diverse, our informants shared similar life patterns: they all belonged to the lower-middle class, held vulnerable positions in their families and were caught in intimate relationships marked by gendered and sexualized power relations. Two of them had lived through abortions, and they all had at least one experience of sexual violence. Furthermore, the gendered ‘duty to care’ was at the core of their role as daughters, mothers and wives – as well as donors.

The common ground: A neoliberal system of healthcare

Last week, I had to take my daughter to the hospital to stich her eyebrow. When I got the bill, I thought ‘Fuck, I haven’t yet donated this month, how am I supposed to pay this bill?’

Larissa Ramirez, egg provider, 28

The practice of egg donation is closely entangled with Mexico’s highly stratified system of healthcare. Many of the 18 interviewed egg ‘donors’ stated that they had decided to sell their oocytes to pay for hospital bills of their children or other family members. Many were attracted to sign up as egg donors because the ‘donation’ offered them the possibility to receive a ‘free’ gynaecological check-up in a private clinic to which they would otherwise have no access. Due to their precarious economic situations, these ‘donors’ were bound to the public system of healthcare. Public hospitals, however, suffer from chronic disinvestment and are also epicentres of ‘obstetric violence’ (Tamés, 2014). Castro (2014) shows how machismo and sexual violence shape the medical training and everyday practices of physicians’ habitus. This habitus marked by machismo then results in systematic violence against women in Mexico’s public healthcare institutions, leading to a loss of female patients’ autonomy and causing them physical and psychological harm. Lidia Valiño’s narration about her son’s birth is exemplary for the obstetric violence women suffer in public maternity yards:

I had to wait for hours. When the labor began, I started to shake, I couldn’t control myself. Then the anesthetist told me to lie down. She was angry: “Don’t move, or we are not operating” [Lidia laughs], and I told her, “But I am not moving because I want to, [I am moving] because I can’t control myself”. And she said: “Don’t move. You’re not in school here” and they left me alone even though I was really in pain. […] They were not really unfriendly; she just lost control once. […] I am not complaining. Most people say that they [the nurses in public hospitals] are really unfriendly. They want to be treated like in the private hospitals, I mean imagine, that’s not possible. They have many more patients there [in public hospitals].

Even though Lidia experienced forms of obstetric violence, she was not upset about the way she was treated during her labour. The uneven quality of medical attention seems normal to her, it even seems strange to complain about it. Lidia considers it normal that public hospitals suffer from bad quality and do not treat patients well. Her attitude is not surprising, given that obstetric violence often implies a kind of self-incrimination whereby women blame themselves for the harassment they suffer. Lidia reproduces the dominant discourse on obstetric violence as a normal result of a lack of quality rather than a violation of human rights. Her and other egg donors’ biographical accounts offer insights into a system of healthcare in which it has become normal to experience gendered violence.

To analyse our empirical material through the social, economic and political context of Mexico means to frame egg donation as entangled in a stratified system of healthcare, feminicide and machismo, and resulting from gendered effects of the neoliberalization of Mexico’s economy. Sexual violence, machismo, the gendered effects of neoliberalism and the bioavailability of young women as egg donors are not separate entities, but they mutually shape each other.

2. Desiring a ‘good life’: The shared quest for a happy family

I had an unwanted pregnancy, I didn’t know if I wanted to keep the child and told a friend about my hesitation. I told her my hesitation stem from the fact that I didn’t have the financial stability to provide for the child. Perhaps emotional stability; but not financial. And it was then that she told me about the clinic [and the possibility to donate].

Lidia Valiños, egg provider, 24

Pictures of mostly White, heterosexual couples with cute little babies hanging in the entrance hall of the fertility clinic welcomed Lidia on her first visit to the clinic. The families on these pictures had all one thing in common: they all looked very happy. ‘The happy family’ is the main trope on which fertility clinics build their economic success (Schurr and Militz, 2018). With the help of assisted reproductive technologies, fertility clinics promise to fulfil their patients’ biggest dream: a happy family life. In line with this argumentation, egg donors not only donate genetic material but also happiness. Research has focused so far on intended parents’ desire for a happy family and their affective struggles when hope fails (Kroløkke, 2014; Pashigian, 2002; Speier, 2016).

In fertility clinics, the pursuit of happiness through becoming a parent is constructed as ‘the ultimate argument’ used to confront possible ethical concerns (Siegl, 2018). The fertility industry’s ‘promise of happiness’ (Ahmed, 2010) stems from hegemonic imaginaries of the family as the ultimate signifier of happiness but attracts more than reproductive consumers. As Lidia’s story shows, reproductive labourers are likewise attracted to the promise of having a happier family through their intimate labour in and for the global fertility industry.

In the following, we argue that egg donors also relate to this trope of the happy family in their own quest of what Lauren Berlant (2011) calls ‘this moral-intimate-economic thing called ‘the good life’’.

In one of Lidia Valiños’ multiple encounters in the park near her house, she told Laura about the sexual affair she had had with the father of her second son, a married man:

When we were together he used to say: ‘Let’s have a baby’. […] And I asked him if he would leave his wife then. And he said yes. After that, I really tried to get pregnant. But later, I felt so stupid and I knew that I shouldn’t have done this.

Lidia and her partner’s fantasies about having a child together build on the idea of creating a family as the way to become happy. Later that same afternoon, Lidia told Laura about her second pregnancy:

I couldn’t believe it, I completely neglected the fact that I was pregnant and continued to take drugs. […] Then I had to confront myself with the fact that I was pregnant. I tried to abort, three times, but the baby survived. I then decided that I would give him away once he was born. I met a homosexual couple that wanted to adopt the baby after birth but my family couldn’t accept my decision, blaming me for how I could even think about ‘giving away someone of our blood’.

Lidia’s decision to give her son away does not cohere with the societal and cultural norms constituting happy family life in Mexico where the family circulates as a ‘social good’ (Ahmed, 2010: 41) that creates happiness and automatically leads to a good life. Lidia had already tried to abort her first son. But the attempt failed and she started looking for adoptive parents on the Internet. International couples contacted her to adopt her son on a private basis, but finally, Lidia decided to keep him because she was afraid that something bad would happen to him. Since then, she has tried to be a good mother and give her child a ‘good life’. But due to her own precarious life situation and a world that reads the family as something that makes you happy but assigns the financial responsibility to maintain the family to the individual, she constantly has the feeling that she fails to do so. She aspires to a good life, but is ‘actually stuck in what we might call survival time, the time of struggling, drowning, holding onto the ledge, treading water – the time of not-stopping’ (Berlant, 2011: 169). Lidia turns into an ‘unhappy queer’ in Ahmed’s terms when she tries to give her son away for adoption because she does not pursue the dream of becoming a family. Ahmed has coined the figure of the unhappy queer to demonstrate how people who do not adhere to social norms become necessarily unhappy ‘with the world that reads queers as unhappy’ (Ahmed, 2009: 9). While Ahmed uses the term as a critique about heteronormativity, we use the term here to emphasize how the (heteronormative) trope of the family as happy – which in Mexico is also conveyed through the Catholic church – renders those who fail to establish and maintain wealthy heterosexual families unhappy.

Lidia has affectively incorporated a classed discourse of the happy family into her own life, which becomes evident when she states that she decided to give away her son because ‘I wouldn’t be a good mother for him, because I didn’t have anything. I didn’t want anything bad for him, on the contrary’. Her fear of being a bad mother stems from a societal discourse that associates bad mothering with poverty. This discourse suggests that there is a connection between poverty, child abuse and bad mothering (Braff, 2013, 131). This depreciating discourse is also present in fertility clinics where women, desperate for their own child, frequently ask: ‘Why do the poor have them if they cannot care for them?’ (Braff, 2013: 131). When Lidia tried to place her son for adoption, she was also confronted with moral indignation and incomprehension, even from the side of the prospective parents:

You don’t have to think that just because they wanted to adopt him, they treated me well. On the contrary, they thought I was the worst thing. They could not understand why anyone would give away a baby – this is all people think about, they don’t think about the reasons that force women like me to give up their baby.

Lidia’s story shows how difficult it has been for her to pursue the happy family life the fertility clinics promote. For her, as for many of the interviewed donors, financial remuneration for selling her oocytes presents a possibility to come a step closer to the dream of a happy family life and the pursuit of ‘the good life’. Berlant writes about how people remain attached to ‘good life’ fantasies, even though these potentially threaten their well-being. This ‘relation of attachment to compromised conditions of possibility whose realization is discovered either to be impossible, sheer fantasy, or too possible, and toxic’ (Berlant, 2011: 24) is an attachment of ‘cruel optimism’. Lidia’s biography showcases cruel optimism in different ways: her involvement in a potential harmful medical procedure such as egg donation as a mean to have a ‘good life’ can be described as a ‘condition of maintaining an attachment to a significantly problematic object’ (Berlant, 2011: 24). Her fantasy of having a baby is a proxy for having a ‘stable and happy family life’. The fact that – in her own view – she fails to adhere to social norms and cultural expectations of motherhood can be further described as ‘an enabling object that is also disabling’ (Berlant, 2011: 25). The vision of this normative happiness brings with it a series of conditions (such as in her case the necessity to donate) and hinders her from seeing her actual life as it is as potentially happy.

3. Reframing clinical labour: Egg donation within a logic of care

While the clinic personnel we interviewed were convinced that women donate because ‘they are empathic with the women that cannot have children’ and ‘donate in most cases out of altruism’ (Linda Reyes, IVF clinic psychologist), the interviewed donors all agreed that they donate to support their children, families, fellow citizens – and in the case of Lidia, even their animals:

With the money from egg donation I will buy a piece of land […on which] I can build a house and grow vegetables. [In the long run] I will buy another piece of land to open a shelter for animals […] I will create jobs and pursue another dream: to help other families and to ensure that Mexico is better off […] and that my kids have a home.

Most of the egg ‘donors’ we met in Mexico did care about the recipients’ happiness, but they cared – understandably – more for their own family members: they wanted to give them a stable life and make them happy. Their motivation to donate stemmed from their manifold gendered obligations of care. The egg donors we have met often decided to donate because of their own quest for a good life. They cared about their kids, their dog or even their country. Hence, egg donors’ decision to donate is not an autonomous choice but rather grows out of a gendered desire (and obligation) to care for their family members, animals or their nation state. Molas and Bestard (2017) showed that, in Spain, the economic remuneration is the main motivation for women to donate their oocytes. Nevertheless, they emphasize that solidarity and altruism are important factors that help donors to legitimize and make sense of their donation. We argue that solidarity is indeed an important feature of the donation, but that the notion of solidarity needs to be expanded towards the donors’ own families. The constant justification of selling their oocytes as an act of solidarity with family, animals or even nation states shows how the participation of women like Lidia in the fertility industry is framed within a logic of care. In such a logic of care, interdependencies with family members motivate the donation. But it is important to underline that this logic of care is determined, shaped and enforced through machismo and a climate of gendered and sexual violence which forces women not only into sexual intercourses but also into their roles as mothers and donors. The story of Rosa, an egg donor from Cancùn, exemplifies this connection when she talks about the relations between her divorce, the donation and the moral degrading of her mother:

So the relationship with my husband wasn’t good, so I decided to split up against the will of my parents, because they are very traditional in the sense of ‘you have married in church now you have to stay with your husband’ (…) I was really a disappointment for them (…) [after the rupture, Rosa started donating] so my mother knew about the donation and she told me ‘What do you think, you are donating? And your kids?’ And I asked her: ‘Ay mama, will YOU give me all this money?’ She didn’t really have another option but to accept it’.

Further, as the case of Lidia shows, abortion and adoption are often not considered acceptable solutions for unintended and teenage pregnancies. The cultural patterns of machismo along with an absent social welfare state result in a logic of care in which women are the main and often only caretakers for their children. This becomes evident in Lucia’s comment about the fathers of her children:

They are from different fathers and they don’t give a shit, they don’t give money. (…) Nothing, nothing, nothing, zero, totally zero. The father of one of my daughters, he disappeared, and now after three years (…) he wants to see her but he doesn’t want to give money.

The lack of effort of the Mexican state to make absent fathers pay child support or provide social benefits to single mothers, and the increasing privatization of healthcare and education, forces single mothers with few employment opportunities to look for venues of income. Selling oocytes seems an effective and simple response to the multiple demands resulting from this gendered logic of care: the very act of donating oocytes is not time-consuming, payment follows suit, and with no formal system of control in place, ‘donations’ can occur whenever (extra) income is needed. Lidia’s, Rosa’s and Lucia’s donations can be understood as a mode ‘to maintain, continue and repair ‘our world’ so that we can live in it as well as possible’ (Fisher and Tronto, 1990: 40). Within such a logic of care, care is not a transaction, but ‘an interactive, open-ended process’ (Mol, 2008: 23), which can ‘entail good and bad practices at the same time’ (Mol et al., 2010: 12). The ambivalence of the act of donation with regard to its potential to be able to care for others becomes clear in another interview quote from Rosa:

Every time before they put me to sleep with an anesthesia before they extract my eggs, I ask myself: “What happens to my own children, if I don’t wake up from the anesthesia anymore? Who will take care of them?”

Building on Mol’s logic of care, we aim to take a critical stance against viewing care as something positive per se. Rather, we call for the need to investigate how practices of care are saturated with power relations. In the context of Mexico, these power relations become visible in gendered obligations of care resulting from machismo and the patriarchal state which do not protect women’s rights and lives. Following recent debates on care as ‘produced inter-subjectively, in relation, and through practice’(Raghuram, 2016: 515), we suggest to expand current analysis of clinical labour through the lens of care. In a nutshell, we argue that to analyse the logics of care that motivate the donation helps to foreground the multiple dependencies, multi-scalar power relations and gendered obligations of care that characterize the oocyte providers’ reproductive biographies.

From Bioavailable Bodies to Logics of Care

In the transnational fertility industry, the egg donor can be considered a chimera. As a woman typically belonging to the lower-middle class, she has manifold experiences of the malfunctioning and sometimes even violent public system of healthcare. As a reproductive labourer, however, she participates in a private healthcare system that is normally restricted to the wealthier and White(r) upper (middle) classes. As an egg donor, she is creating happy families, but in her own reproductive life, she is struggling with a classist and heterosexual norm of a happy family life that is linked to wealth and Western notions of agency and self-determination. In a society that considers the family as a happy object and an affective norm, egg donors’ reproductive choices to abort, to give up their babies for adoption or to be low-income mothers are morally condemned. Paradoxically, reproductive consumers’ way into happiness depends on harvesting the reproductive body parts of so-called unhappy queers (Ahmed, 2009). The women portrayed in this article share the reproductive consumers’ desires for a happy family and a good life, but their life circumstances refuse them the same happy family life of which the intended parents dream.

In this article, we have called for the need to analyse the act of oocyte harvesting beyond the moment in which it is made bioavailable. We have argued that it is necessary to analyse the ways in which the act of donation is entangled with women’s intimate biographies as well as with the wider cultural, political and economic context in which it takes place. We suggest framing the women’s decision to sell their oocytes within a logic of care to show how the act of donation results from multiple dependencies, gendered obligations of care and coercive moments in egg donors’ reproductive biographies. Considering transnational egg donation within a logic of care that relies on structural violence forces us to question the ethical foundations of the global bioeconomy of the Mexican fertility industry. Multiple donations particularly might have a long-term effect on the women’s future lives. Who will ‘care’ for the oocyte donors years after their donation? What are the responsibilities of fertility clinics, experts in the field of reproductive medicine, reproductive consumers and the family members of oocyte vendors? And what are the responsibilities of the wider public, of academics and researchers? These are questions that need to be discussed and researched – embedding the donors’ lives in their reproductive biographies and disentangling the entanglements between the intimate act of donation with national and global politics of reproduction.

Footnotes

Acknowledgements

First of all, the authors would like to thank the egg donors and the staff at the fertility clinics in Mexico who shared their intimate experiences with them. The authors would like to thank Professor Sabine Strasser who has co-supervised the MA thesis on which this article is based. They also thank Luis Velasco-Pufleau, Anna Molas and their colleagues at the University of St. Gallen and University of Bern who gave them feedback on earlier drafts of this article, and finally they thank three anonymous reviewers for their generous, encouraging and thoughtful feedback.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported generously by the Swiss National Foundation through a doc.ch grant and the ‘The Branco Weiss Fellowship – Society in Science’.

ORCID iD

Carolin Schurr

Notes

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