Medical protocols are supposed to be scientific—evidence-based, objective. And yet those regulating the interaction between a healthcare provider and a reproductive-age woman are vastly different in each European country. Our first assumption would be that the richer countries that spend most on healthcare also have the most medical monitoring, but the reverse is closer to the truth when it comes to reproductive healthcare. For example, a recent EU report noted an inverse correlation between the number of prenatal exams and a country’s GDP, though it offers no explanation for the phenomena.
It is not only birth and pregnancy that are regulated differently across Europe, but also access to contraception and abortion. Birth-control pills are available over the counter in Spain, Portugal, Greece, The Ukraine, Russia, Turkey, the UK, Slovenia, Serbia and Romania (where not only doctors, but also social workers are able to dispense them), among other countries. The morning-after pill can likewise be bought over the counter in most EU countries, except Croatia and Hungary.
It is the latter—my native country—that is also implementing some of the EU’s strictest and most complicated policies around abortion and access to contraception: reflecting the impetus of a neoconservative backlash against permissive gender roles alongside neoliberal ideas of gendered consumption. Broadly curbing the agency of its citizens, Hungary’s strict medical protocols extend to a tight control on the discourse around reproductive rights. For example, the ‘promotion of abortion’ is illegal, meaning that rights campaigners are effectively gagged. If a pro-choice NGO or an activist group wants to avoid ‘promoting’ abortion, they must use phrases such as ‘abortion is always a very tough decision’, or state that they ‘do not encourage abortion’. In employing such rhetoric, they are also coerced into reinforcing the stigma around abortion.
elective pregnancy termination is legal in Hungary, it is not easily accessed.
A whole legal-medical institutional framework ensures that it is complicated
and/or traumatic in each instance. Regardless of how difficult the decision to
abort is for the individual, the procedure itself is made unnecessarily
onerous, violating and punitive (echoing the common stigmatisation of
child-free or non-heteronormative woman as ‘selfish’). If a woman follows the
Hungarian abortion legislation instead of buying abortion pills online or
visiting a foreign clinic/pharmacy, she must take part in two compulsory
‘counselling’ sessions at the ‘Family Welfare Office’. Only the surgical method
is allowed, and only in state-run facilities. But first, the pregnancy must be
confirmed by a doctor, usually via transvaginal ultrasound, as was similarly proposed
in the legislation which sparked the 2012 Virginia ultrasound
bill debate. (In Virginia, women would have had to view the fetal tissue
before termination as part of a mock informed consent policy,
or ‘A Woman’s Right to Know’). That bill sparked huge public outcry in the US,
with some even calling it state-mandated rape (as non-consensual penetration is
rape). Despite being a blatant example of institutional violence, the Hungarian
legislation—put into effect during the socialist era—is generally uncontested.
Today’s Hungarian medical profession is arguably as conservative and authoritarian as the rest of the country’s current ruling elite (perhaps even more so than under socialism). Concerns about women’s dignity or autonomy are rarely aired or represented. As in other European countries, the fundamentalist Christian right (mainly funded by US conservative donors) are opening so-called ‘crisis pregnancy centres’ in Budapest. These clinics rope women in through advertising free pregnancy tests and psychological counselling, but should a client be pregnant, the anti-abortion propaganda immediately kicks in. It follows roughly the same script as similar projects in other countries: manipulative questioning about personal circumstances, threats about the pseudo-medical condition ‘post-abortion syndrome’, or even (falsely) linking abortion to breast cancer and child abuse.
important conservative US actor in Hungary is the widely-criticised Komen Foundation. (Hungary’s US state
ambassador between 2001 and 2003 was none other than Nancy Brinker, the founder
of Komen and a major USA Republican Party donor.) Among other causes, Komen invests in funding the ‘Pink Ribbon’ movement and the
Mályvavirág Foundation (which is also funded by big pharma such as GlaxoSmith
Kline). The latter organisation invests mainly in raising ‘awareness’ about
cervical cancer screening, though like Komen’s, its advice does not always
accurately reflect current thinking.
Across most mainstream media, cancer screening has been promoted as an undisputed good practice, but times are starting to change. As a 2015 study in the British Medical Journal noted of a general policy shift in Germany, “policy on screening people for cancer poses a dilemma: should we aim for higher participation rates or for better informed citizens? Historically, screening policies opted for increasing participation and accordingly took measures that made people overestimate the benefits and underestimate the harms.”
the international media has recently brought greater public attention to debates
around the possible drawbacks of screening, especially breast cancer screening.
Yet these complexities have not stopped groups like Komen from nudging Hungarian women toward screening through bake-sales or pink Facebook memes (with messages such as ‘It’s for your own good’ or ‘it only takes a few minutes’). The visual marketing of both Mályvavirág and the Pink Ribbon movement is strikingly similar to Komen’s: pink in all gradients, with motifs of flowers, baking and hobby-crafts associated with traditional, domesticated femininity.
Screenshot from the Mályvavirág (Strawberry Mousse) Blog Facebook page. Hungarian popular media discourse is too authoritarian and too intertwined with big pharma to give space to the complexity of screening issues. There is a marked discrepancy between popular media narratives and both scientific discourse and strategic debates. Screening is instead presented not as a decision about risk management, but within a moralistic framework as the ‘responsible’ thing to do. It remains taboo to acknowledge the risks involved and the inadequacy of the technology (and all of this for a cancer which is comparatively uncommon in Hungary, accounting for around one per cent of all cancer deaths.) One could reasonably argue, as have some medical professionals themselves, that non-participation in these programmes is a rational choice, and yet it is near universally accepted that this screening is indeed a good, mature, responsible thing to do. It is a non-choice, because not engaging with such technologies would violate accepted meanings and the social norms imbued in them.
Irrespective of the doubtless life-saving potential of screening tests, its uncritical, passive-aggressive promotion in Hungary further establishes the normativity of the medicalisation of the healthy female body. Women who do not wish to participate are denigrated as ‘uneducated’ or ‘childish’. Alongside, other kinds of dubious and downright dangerous services and products (among them, vaginal rejuvenation and aesthetic laser) are marketed to the public, framed as a question of morality and good taste—as if engaging with the right kind of healthcare consumption, affirms one’s membership of a higher social strata.
As highlighted in these examples, the medicalisation of the healthy female body has become ubiquitous, rendering the routine violation of reproductive rights almost invisible in wider public discourse. This means that women have to be prepared to accept intrusion. They must not only think of their bodies as needing constant surveillance and intervention (arising from misogynist notions of biological inferiority), but their feminine selves must also be cultivated through care—namely enhanced investment in self-improvement.
In contemporary Hungary, the female subject in the media and popular culture is often presented as the 'igényes nő': a loosely adapted Hungarian version of the ‘responsible woman’. She is a managerial, self-governing, ‘sophisticated’ and neoliberal subject clad in increasingly globalised visual and formal codes. This subject position has clear social and class connotations. But just as different countries have different class structures, the term ‘neoliberal’ should be used with caution when applied to Hungary. The governing right-wing Fidesz party might adapt policies which are part of an economic toolkit deemed neoliberal, but broadly speaking, the Hungarian market is still very much dependent on and subordinated to the state. It is no wonder then that the women visible in the media who fit the ’igényes nő’ criteria are often connected to men embedded in the state apparatus, instead of strictly following the neoliberal individualist model of social self-advancement through individual means.The other feminine ideal in media discourse is the ‘női principium’: an essentialist model popularized by neoconservatives who, denying the socially-constructed nature of gender, project traits like ‘nurturing’ or ‘caring’ as inherently feminine. Within both prototypes, women are expected to conceal their own reproductive labour.
The demands on an igényes nő are a supposedly independent but neurotic regimen for body and mind that privileges constant self-regulation and an endless consumption of services and products. She is often more than a mere consumer, with self-management turning into self-branding and then brand-building. One example of the marketing directed at this type of woman is Hungary’s ‘Strawberry Mousse’ blog run by MSD Pharma. The company’s flagship products include a hormonal contraceptive device, and Gardasil, the common vaccination against the Human Papillomavirus (HPV). In the tone of a bubbly girlfriend, the blog devotes its airtime to HPV and the benefits of hormonal contraception alongside fashion, colourful recipes and neurotic lifestyle tips (of course involving more consumption).
The női princípium by contrast manifests mainly through political communication, rather than advertising, projecting women as inherently nurturing and submissive. Reproductive labour is therefore not labour, but the ‘natural order of things.’ This ideology has undeniable demographic implications: instead of implementing labour market policies which privilege the inclusion of women in the workforce (such as remote or part-time work), female bodies are instrumentalized to reproduce the labour force.
Beyond the governing Fidesz, political communication on this theme still operates within the nation-state rhetorical framework: it is the duty of women to protect national integrity and ‘the borders’ of the country. Indeed, when the Parliament debated the proposal to discuss the ratification of the Istanbul convention, Duro Dora, one of the token women in the far-right party, Jobbik (who has a sticker on her laptop bearing the text ‘the nation lives in its wombs’) claimed in her speech that the Convention was inadequate in preventing domestic violence as most domestic violence is committed against the unborn in the form of abortion. Biopolitics is full of irrationalities and paradoxes globally, and Hungary is no exception.
Far-right politician Duro Dora with the sticker 'the nation lives in its wombs'. Credit: Magyar Narancs.
What I describe here is not how Hungarian women live per se. Different political and social actors of course establish their own media discourses concerning what a woman should do and who she should be. Yet both the above subject positions have the same effect: they erase the potential for women to name reproductive labour as reproductive labour, and both enable technological interventions and state surveillance to be interpreted as ‘self-care’.
Just as media does not exist in a bubble and visual representations both depend on and produce social inclusions and exclusions, technology also embodies and perpetuates social norms—media, bodies, selves are always in a complex entanglement. Both strategies of control and strategies of resistance must therefore work with this new notion of the self as fundamentally mediated.