Conceiving Cuba: Reproduction, Women, and the State in the Post-Soviet Era

7. Conclusion

137 7 Conclusion Reproducing the Revolution This project was initially conceived as a study of the local practice of reproductive health care in Havana. As feminist scholars have long reminded us, however, reproduction is intricately enmeshed in broader cultural, social, and political-economic systems. Following the threads of women’s reproductive narratives and practices led me far beyond the medical clinic to consider how concerns about familial and household reproduction articulate with broader tensions around the stability and transformation of gendered citizens and the socialist revolution in a post-Soviet economy. This book has argued that attention to the range of social reproduction in post-Soviet Cuba casts a bright light on the gendered organization of society and the shifting relationship of the state to its citizens. As Susan Gal and Gail Kligman assert (2000, 28), debates about reproduction can be understood as coded discussions in which “the morality and desirability of political institutions is imagined, and claims for the ‘goodness’ of state forms are made.” In Cuba, state policies have explicitly intervened to shape reproductive practices (in the realm of both prenatal care and abortion) in order to achieve the desired reproductive health indices that form a central pillar in its international claims to moral modernity. More broadly, the socialist state has also attempted to shape its population and produce a new socialist citizen, by equalizing the terms for the reproduction and nurturance of children through policies targeting education, health, and other forms of social life. Yet discourses around reproduction are also a key forum through which women and men evaluate the state’s claims to nurturance and socialist progress . Reflecting Cuba’s impressive human and financial investment into reproductive health care, the women I came to know almost universally extolled the tremendous accomplishments of this aspect of the socialist experiment. At 138 CONCEIVING CUBA the same time, the ongoing reproductive difficulties reflected in Cuba’s high abortion rates, low fertility, and the struggle to bring children into appropriate “conditions” form the basis for questioning the state’s ability to nurture its citizens adequately in an often-hostile global economic environment. Tensions in household reproduction in turn shape practices of childbearing , with repercussions for the future shape of the socialist state. In 2006, after decades of below-replacement fertility, Cuba recorded its first absolute population decline, four years ahead of projections. This demographic shift has raised grave concerns among Cuban demographers and economists, and has been addressed by Raúl Castro himself in speeches to the National Assembly, Cuba’s governing body. As its population steadily ages (the current median age is over thirty-nine years, well above any other Latin American country), Cuba will face many of the social and economic challenges of so-called developed countries, only with the limited resources of an underdeveloped one. Predicting that Cuba will have to import a labor force within twenty years, a prominent Cuban demographer told me in 2004, “Those who should be working in 2025 should be being born now, and if they aren’t born, who will work?” While developed nations look to immigration, albeit not without reservations, for solutions to labor crises and low birth rates, Cuba’s embattled economy makes it a less desirable migrant destination. Moreover, as the narratives in this book underscore, Cuban women themselves are unlikely to significantly raise their fertility, given the constraints posed by limited household economies , chronic overcrowding of homes and childcare facilities, and familial pressures. At stake as well are women’s own desires to be modern female citizens , not only in the productive sphere of education and professional labor, but also in the reproductive realm, through bearing only the children for whom there are adequate “conditions.” These observations have policy implications. While social scientists tracking Cuban fertility have argued that the state must focus on improving the conditions for familial life through constructing desperately needed housing in urban areas, channeling more funding into childcare and other support services for women, and reducing the disparities between the peso and the dollar economies , the Cuban leadership has at different moments also blamed high abortion rates for population decline, linking women’s individual reproductive decision making to the future of the socialist state. Whether state policy makers attribute falling birth rates to reproductive practices or to the economy will make all the difference for the women who are considered responsible for reproducing the nation’s demographic strength. These debates are not unique to Cuba (cf. Krause 2001...