Haunting Images: A Cultural Account of Selective Reproduction in Vietnam by Tine Gammeltoft (review)

In this finely written ethnography, Tine Gammeltoft dives deep into the socio-moral factors guiding women's decisions to terminate their (desired) pregnancies in urban Vietnam. Haunting Images: A Cultural Account of Selective Reproduction in Vietnam follows 30 women in the multiple locations in which these decisions come to be: the 3D scanning room of Hanoi's Obstetric and Gynecologic Hospital where they are told that a fetal anomaly is detected, the antenatal care room where they are advised to terminate their pregnancy, and, finally, women's homes where their families and in-laws gather to narrate their own decision-making process. Gammeltoft reveals how, in each of these sites, the decisions are deeply entwined with mutual moral obligations and understandings of suffering.

Haunting Images is based on three years of fieldwork and a decade of work in Vietnam. It relies on ethnographic methods of participant observation and interviews, combined with mass media analysis. Gammeltoft's ethnography is rooted in a collaboration with several Vietnamese researchers. The author's transparent writing discloses methodological and ethical questions as Vietnamese women ask members of the interdisciplinary team for advice on their pregnancies. The ethical reflections that follow, and the open discussion of the ethnographer's uneasiness or disagreement at times, are an important contribution to the field of social science methodology.

Over the book's seven chapters, Gammeltoft disentangles the many networks in which pregnant patients are embedded and which lead them to terminate their pregnancies–sometimes in the second or third trimester. The research highlights how abortions are never women's decisions alone. Contrasting with the situation in Europe and the United States, where medical professionals present information for women and their partners to make informed decisions, the author shows how in Vietnam these same professionals are expected to guide their patients toward the right, or moral, choice. Women's choices are then positioned within webs of sociality and morality that include listening to medical advice and becoming full members of local and national communities by giving birth to non-disabled children. Daily interactions between patients, medical staff, families, and the researchers are haunted by images of Agent Orange children, widely shared on television programs, and memories of severely disabled children of neighbours, family members, or friends, who "[spend their] entire life lying in one place" (p. 171). Developing a framework for an anthropology of belonging, the author shows how undergoing an abortion is not a rejection of the disabled fetus, but a commitment to one form of belonging over another in a context shaped by local moral worlds, national history, and broader geopolitical forces. Gammeltoft's anthropology of belonging interweaves doctors' moral dilemmas as counsellors of their patients with pregnant women's narratives, providing readers with a humane understanding of their often painful decisions.

Vietnam's liberal abortion policy is reminiscent of other post-socialist contexts, like Cuba (Andaya 2014). In these two countries, the focus on family planning and on building a healthy citizen body was part of the revolution's goal. By providing strong historical background, Gammeltoft bridges women's intimate decisions with the state project of building a healthy modern nation. When women comply with medical advice, they become modern citizens and show their commitment to the state. Scenes at Hanoi's Obstetric and Gynecologic Hospital vividly portray the daily work of medical practitioners in overcrowded and underfunded hospitals. They embody the state beyond its bureaucratic characteristic, illustrating how it is an "open and affective structure of mutual belonging" (p. 102).

When a fetal anomaly is detected, parents and their families recurrently ask "why?" as they struggle to find answers and scrutinise their environment, their family's history during the "American war," their collective fate, and their individual behaviours during pregnancy. Their crafted answers to the question "why?" rarely include an association with the spectre of Agent Orange, which, if admitted, might haunt the rest of their reproductive lives. A family's refusal to be associated with the potential...