A History of Family Planning in Twentieth-Century Peru by Raúl Necochea López (review)

A History of Family Planning in Twentieth-Century Peru examines the “wide cast of actors and organizations” (p. 2) that have weighed in on questions of fertility regulation in Peru since the late nineteenth century. The book consists of six chapters, each of which proceeds from the perspective of one or more of these actors, including doctors, eugenicists, feminists, individual women and men, proponents of contraceptive initiatives, local and international government agents, and the Catholic Church. Necochea highlights the complex and layered nature of the conflicts that occurred over fertility regulation across these years. Both local and international in scope, these conflicts brought to light the “huge” stakes of family planning in Peru, comprising issues of national economic and political progress, “the future of gender relations, [and] individual autonomy” (p. 2). As elsewhere in Latin America, the tenor of debates about population regulation in Peru shifted in response to a range of evolving factors, from ideas about race, ethnicity, and appropriate parenthood to broader geopolitical and economic concerns. In other respects, Peru differed from its Latin American counterparts. While sharing economic, political, and sociocultural features with its neighbors, Peru’s relatively robust economic position and high rates of maternal death over the period make it an interesting comparative case.

Necochea builds upon some understandings of demographic transition theory (which seeks to explain the transition from the large families characteristic of “traditional” societies to a smaller, more “modern,” family structure) while challenging others. Necochea questions the primacy of the United States in the development of family planning initiatives in Latin America, demonstrating that local actors and systems of understanding (such as lay knowledge of contraceptive and abortifacient plants) and influences outside of the United States (such as French puericulture) were more central to the history of fertility regulation in Peru. While U.S. agencies participated in fertility control efforts in Peru, these had to “negotiate their interests” (p. 5) with those of local women, men, and government and religious officials in order to implement family planning programs. As U.S. agents sought to control the “demographic danger” (p. 9) posed by 1960s Latin Americans, “sex, racial, geographic, and class distinctions” shaped local “determination[s] of what populations suffered from an ‘unmet need for contraception’” (p. 85). In chapters examining fertility regulation in the second half of the twentieth century, Necochea pushes beyond the well-documented relationship between reproduction and politics during the nation-making era, revealing how “population size became a strategic factor during the Cold War” (p. 8). In so doing, Necochea contributes to understanding the “style of intervention that has characterized U.S.-Latin American relations from the late 1940s on” (p. 10), rather than simply the local development of birth control initiatives.

Other contributions of Necochea’s text are its substantive treatment of abortion and its inclusion of men. While abortion in Peru was both stigmatized and illegal, Necochea demonstrates that sympathetic medical personnel and inefficient legal systems limited policing of women and medical providers in connection with the procedure. The chapter also pushes beyond explanations of reproductive decision making as spurred only, or even primarily, by financial considerations. Necochea’s consistent treatment of men throughout the book frankly breaks new ground and should encourage scholars to give would-be fathers a closer look. As Necochea notes, “Defining and defending a proper male role was as cherished a goal of eugenicists as was shaping a proper female role. Men and the management of their emotions such as fear and disgust [in response to the threat of venereal disease] have been important and neglected aspects of the history of Latin American fertility control” (p. 29).

Necochea’s book contributes to the histories of Latin America, medicine, and sexuality and reproduction. Of particular interest to scholars should be Necochea’s revelation of the centrality of individuals, their relationships, and the emotions implicated in these...