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About a distributed decision and its allocation within couples: some insights into Costa Rican "women's decisions" to undergo sterilisation.
María Carranza
University of Cambridge
Sterilisation is the most prevalent method of contraception in the world (UN 1996:45), and it is particularly prevalent in Latin America and the Caribbean (EngenderHealth 2002:22, 25, table 2.2), where it exists almost entirely as a female practice(UN 1996:38, table 11). In Costa Rica, in spite of the existence (until 1999) of a regulation which formally restricted access to this surgery, sterilisation became a popular and "democratically" distributed practice. In 1999, 21% of women (married or cohabiting) between 15 and 44 years old were sterilised (Chen Mok et al. 2001:56, table 7), and this percentage increased to 41 among women between 40 and 44 years old (CCSS 1994:9-28, table 9.14).
This paper explores the decision to undergo sterilisation among a group of Costa Rican women of diverse socio demographic characteristics, in light of the presidential decree which liberalised access to this surgery in 1999. Drawing on information obtained from in depth interviews and participant observation, the paper challenges a straightforward (simple) understanding of what in the context of the debates that liberalised access to this surgery was referred to as the "woman's decision" to get sterilised. It explores the ways in which this decision is frequently fuelled by a mother, and agreed by a partner, in a context in which, for very particular reasons, the woman herself is perceived as the legitimate "maker" of the decision to undergo sterilisation.
The paper proposes that "instability" in partnership (real or potential) is one of the key engines of sterilisation among the women interviewed, this in a family context in which children are perceived to belong to their mothers (or not to their fathers). It shows the particular ways in which the idea that children belong to their mothers affects not only how decisions about sterilisation get made within couples, but also how sterilisation is "allocated" within couples. Finally, the paper contends that far from taking women in a new direction, the language of rights, autonomy, and even the body as women's dominion that legitimated women's access to sterilisation in 1999, have in many senses perfectly re-affirmed and re-animated prevalent Costa Rican ideas about gender, family, and reproduction.
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