Natalie Fixmer-Oraiz. "No Exception Post-Prevention." In Contemplating Maternity in the Era of Choice: Explorations into the Discourses of Reproduction. Edited by Sara Hayden and Lynn O’Brien Hallstein. Blue Ridge Summit, PA:

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  CONTEMPORARY MATERNITY IN AN ERA OF CHOICE Explorations into Discourses of Reproduction Edited by Sara Hayden and D. Lynn O’Brien Hallstein LEXINGTON BOOKSA division of ROWMAN & LITTLEFIELD PUBLISHERS, INC. Lanham • Boulder • New York • Toronto • Plymouth, UK   # $ # #%&'()*+(,,---+++ !"#!$"#"!#%&'()*+(,, +++  ./0/ --- 10.1 0-23 ./0/!" !!10.1!0 23  1 27  Amy Cappiello was twenty-four years old the night the condom broke. She sat up in a panic, thought about her job on Capitol Hill and her grad  school commitments, and cried. Then there was the fact that she and her  boyfriend had only been seeing each other for two months. It was just not  the time for her to become somebody’s mom. With her boyfriend, Cappi-ello went right to the emergency room at George Washington University Hospital. There, a doctor and nurse introduced her to the concept of emergency contraception. . . . Cappiello took [the pills]. To her relief, she didn’t become pregnant. “Not being married, making less than $30,000 a  year and going to grad school, having a baby would have been a night- mare,” Cappiello says now, a year later. “Not only was I not physically ready in terms of being able to provide a stable environment for a baby,  but emotionally I was nowhere near ready to have a baby thrust upon  me. We would have handled it, but it would have been devastating.” (Redfearn, 2002, para. 1–5) C ontraception is often coded as empowering women’s reproductive choice, and for many women, this is inarguably the case. Stories like Amy’s exemplify and bolster this collective imagining. And yet, within the broader scope of contemporary public debates concerning Emergency Contracep-tion (EC) 3  and its accessibility for American women, a focus on personal-ized accounts is exceedingly rare. Amy’s story is a narrative respite in a sea of politically contentious dispute over scientific evidence, religious beliefs,   2NO EXCEPTION POST-PREVENTION “Differential Biopolitics”   on the Morning After   1 Natalie Fixmer-Oraiz  2 27  # $ # %#&' ()*+,,---(. !"#!$"#"%#&'"()*+,, (.  /0/0 ---%1%/1 2-34 /0/0!" %1%/1!2 34  28 NATALIE FIXMER-ORAIZ and social morality. What, then, does her story reveal? She is, in many  ways, the embodiment of the contemporary (white, middle class) Ameri-can dream for women, made possible by the gains of twentieth century feminisms. Young, full of promise, pursuing higher education and a career in government, Amy is on the road to success. Hers is a narrative that as-sumes upward economic mobility and hinges on class (and, concomitantly, race) privilege. As Amy herself is clear to note, however, her circumstances bar her from responsibly bearing children (yet). She is not in a long-term relationship, makes less than $30,000 annually, and is in school. Thus, the emergency identified and addressed here is not simply a broken condom. The emergency is also the potential pregnancy under Amy’s current cir-cumstances—a clear threat to American dream-ness, white, middle class, heteromormative identity and lifestyle. The use of the term “nightmare” is both fitting in its candor and revealing in its broader cultural context. Cultural assumptions regarding birth control and women’s reproductive “choice” suture the two seamlessly together. “Choice” has become a politi-cal and colloquial referent for the unencumbered right to determine when,  whether, and with whom to have children; as such, it is invariably wed to notions of women’s individual autonomy and empowerment. And yet, imagining birth control in this way is deeply troubled. This characterization ignores the long, disquieting, and myriad histories of material practices in which contraception has been utilized to curtail, rather than enhance,  women’s reproductive autonomy in ways that fracture decisively along lines of race, class, and nationality (see, e.g., Davis, 1983; Gordon, 2007; Roberts, 1997; Solinger, 2005). In an attempt to guard against state sanctioned re-productive coercion, advocates have argued for birth control methods that place the locus of control in the hands of women themselves. EC appears to do just that—most often, the method is administered by the woman her-self and, in a significant departure from other contraceptives, is designed to be taken after   unprotected sex. And yet, a close examination of EC’s discursive figuration, of how it is imagined to shape sexuality, reproduction, social relationships and even identities, calls this facile equation into ques-tion. Using critical discourse analysis as a theoretical framework, this study explores the mediated discourses that work to craft and anchor EC within contemporary U.S. cultural imaginaries. In so doing, I ask how these dis-courses figure in challenging or reinscripting reproductive (bio)politics, and consider the implications for rhetorics of choice specifically, and issues of reproductive justice more broadly. Ultimately, I argue that the EC debates illustrate the discursive limits of choice as a means of securing a reproduc-tive justice for all women.  # $ # %#&' ()*+,,---(5 !"#!$"#"%#&'"()*+,, (5  /0/0 ---%1%/1( -34 /0/0!" %1%/1(" 34  NO EXCEPTION POST-PREVENTION 29 Contrary to popular belief, emergency contraception itself is nothing new. While Plan B was approved in July of 1999, the practice of combining regular birth control pills and taking them after unprotected sex to prevent pregnancy dates back almost to the inception of hormonal birth control itself. This “off-label” 4  use of the pill began to circulate within the medical community in the mid-1960s, when a Dutch physician administered a con-centrated dose of estrogen to a thirteen-year-old victim of rape to prevent pregnancy. Over the next decade, physicians began to experiment with and prescribe this method in what they would determine to be exceptional circumstances. The first scientific study of emergency contraception was published in a medical journal by Canadian doctor A. Albert Yuzpe; the standard regimen for EC that ensued bore his name and consisted of a combination of regular birth control pills taken twelve hours apart (Johnson & Burrows, 2007). The Yuzpe regimen, however, remained relatively ob-scure, and it wasn’t until 1997 that the FDA officially sanctioned this prac-tice and solicited pill manufacturers for a new drug explicitly designed for emergency use (Johnson & Burrows). Between the years of 1997 and 2006, emergency contraceptives were approved by the FDA, but available only by prescription. For five of those nine years, while Plan B awaited approval for over-the-counter status, an increasingly contentious public debate en-sued, at its height ensnaring public health officials, advocacy organizations, medical associations, FDA commissioners and committee members, media outlets, members of Congress, the Government Accountability Office, and even the Bush Administration.These debates reside at the center of this study. Drawing from intel-lectual traditions that include critical rhetoric and discourse analysis, my interest lies primarily in what John Sloop (2000) has referred to as “the politics of doxa ” (p. 168), the myriad ways in which dominant (popular) dis-courses operate alongside one another to constrain, discipline, or otherwise function ideologically and materially. A number of sources would provide insight into an exploration of EC’s discursive figuration. To the extent that mediated accounts provide access to mainstream public voices and cultural sentiments, my focus here is on media coverage of the EC debates. To ana-lyze how choice is situated within the EC debates, I studied articles from prominent newspapers and periodicals with national circulation, published between the dates of January 1, 1997 and December 31, 2006. 5  These ten  years are particularly significant for the EC debates because 1997 marks the srcinal approval of EC for prescription sale in the U.S.; 2006 marks its final approval by the FDA to go “behind the counter” for women eigh-teen and older. While not all articles are included in the direct quotations # $ # %#&' ()*+,,---(2 !"#!$"#"%#&'"()*+,, (2  /0/0 ---%1%/1( -34 /0/0!" %1%/1(" 34  30 NATALIE FIXMER-ORAIZ provided in this study, each readily inform my analysis of these discourses and contribute to my overall argument.A critical discourse perspective explicitly invites an awareness that tech-nologies “occupy sites of struggle over meanings and power . . . [that] can both reinforce and undermine structures of inequality” (Slack & Wise, 2005, p. 2). A rich body of media studies scholarship (see, e.g., Feenberg, 1991, 2003; Hartouni, 1997; Marvin, 1988; Slack & Wise; Spigel, 2001) helps to rethink technologies along these lines, to understand them not as inevitable or predetermined forces in socio-political contexts, but rather as sites of cultural anxiety onto which codified social roles are projected and played out. In the words of Andrew Feenberg (1991), “technology is not destiny but a scene of struggle” (p. 14). I ground my approach to EC accordingly, foregrounding the complex and mutually constitutive relation-ship between culture and technology. This critical orientation provides a useful lens through which to interrogate the various economic, social, political, and historical forces that help to shape EC’s meaning, and helps to understand the kinds of institutions and/or social relationships that are perhaps (re)enforced or undermined in this process of meaning-making. In other words, rather than assume the ontological status of EC—to ask or assert how it acts on the world—I work to interrogate its epistemological function, to ask how EC is imagined to negotiate social relationships and shape cultural and political communities. Certainly, it is true that EC enables a particular physical effect on the reproductive body. That said, I argue that it also engenders another set of material effects—an expan-sion (and subsequent contraction) of discursive possibilities through which  women’s reproductive rights and choices—their experiences of sexuality, maternity, indeed of the body itself—are negotiated and constrained.This essay proceeds, then, in three sections. First, in the critical reading of these popular discourses, I explore the ways in which EC occupies highly contested and nebulous ontological ground within reproductive politics, ne-gotiating the borders and chasms between birth control and abortion. One of the fundamental questions animating public debate centers on whether this technology is a method of birth control, a form of abortion, or not quite either. This question is raised in both implicit and explicit terms, as EC is regularly posited as occupying an amorphous space  between  contraception and abortion. In this way, the defining characteristics that anchor EC’s imagining in social and political culture are unstable, unfixed, and con-tinuously open to interrogation. This instability between birth control and abortion suggests cultural anxieties regarding an excess of choice, sexuality, and reproduction in American women’s lives. Second, I argue that in re-  # $ # %#&' ()*+,,---/ !"#!$"#"%#&'"()*+,, /"  /0/0 ---%1%/1( -34 /0/0!" %1%/1(" 34
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