HEGEMONIC AND COUNTER-HEGEMONIC POLITICS AND

POPULATION POLICY DISCOURSES IN THE CONTEXT OF

1945-1994

Submitted by Romina Guadalupe Perez Ramos

University of Copenhagen

Supervisor, Søren Rud, MA, PhD

University of Copenhagen

European Public Health Master Program

Master Thesis
(May, 2011)

1
 ACKNOWLEDGEMENT

I wish to express my profound gratitude to Professor Søren Rud PhD for his
human empathy, his capacity for interpersonal relationships and the interest he has
shown in bringing this research study to a successful conclusion. His wise and pertinent
opinions, contributions and suggestions helped me to develop my professional abilities,
strengthened my learning process and enriched the contents of the research.

I dedicate this thesis to the two most important people in my life: my daughter
Maya and my mother Roma.

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INDEX
ACKNOWLEDGEMENT ............................................................................................ 2
ABSTRACT ................................................................................................................. 4

I. PART ONE ........................................................................................................... 6

1. INTRODUCTION ........................................................................................... 6

II. PART TWO ........................................................................................................ 10

2. CONCEPTUAL THEORETICAL FRAMEWORK AND DISCOURSE
ANALYSIS METHODOLOGY .......................................................................... 10

2.1. DISCOURSE ANALYSIS TECHNIQUE ............................................ 13

2.1.1. Analytical Corpus..................................................................... 14
2.1.1.1. The primary sources .................................................. 14
2.1.1.2. Secondary Sources: ................................................... 15
2.1.2. Surface reading ....................................................................... 15
2.1.3. In-depth reading ...................................................................... 15

III. PART THREE .................................................................................................... 18

3. THE SOCIAL CONDITIONS OF PRODUCTION OF THE DISCOURSES. 18

3.1. The discourse of population control ..................................................... 18

3.1.1. ―Population growth‖ as a problem and the policy of ―Population
Control‖ as its solution. .......................................................... 23
3.1.1.1. Definition of the problem. ........................................ 23
3.1.1.2. What is the cause of the problem? ............................ 23
3.1.1.3. How can the problem be addressed and resolved? .... 24
3.1.1.4. Policy implementation: women as the object of the
policy…. .................................................................. 27
3.1.2. Partial conclusions on population control as a policy ............... 29

3.2. THE COUNTER-HEGEMONIC DISCOURSE AND ACTORS........ 30

3.2.1. The ―Gender, Human Rights and Reproductive Health Rights‖

Discourse. The violation rights as a problem and the women‘s
declaration policies as solution. .......................................................... 31
3.2.1.1. Definition of the problem ......................................... 31
3.2.1.2. What is the problem? ............................................... 31
3.2.1.3. What is the cause of the problem? ............................ 31
3.2.1.4. How can the problem be addressed and resolved? ... 32

3.2.2. Partial conclusions on the discourse of ―Gender, Human Rights

and Reproductive Health Rights‖ as an international normthat hanged
population policy ............................................................................ ..38

IV. PART FOUR ...................................................................................................... 40

4. Comparative analysis of the two discourses. .................................................. 40

3
 4.1. The Subjects/actors in the discourse. ..................................................... 40
4.2. Surface Reading ................................................................................... 40

4.2.1. Analysis of the ideological elements / semantic units in the ........

discourses and how they are articulated around antagonistic and
dichotomous hegemonic principles ..................................................... 40
4.2.2. The dichotomization of reproduction and the actors.................. 42

4.3. In-Depth Reading................................................................................. 43

4.3.1. Reproduction: its sense and meaning ........................................ 43

4.3.1.1. Reproduction and family planning programmes ......... 43

4.3.1.2. Reproduction in service provision .............................. 45
4.3.1.3. The structural poles of the discourses and how the main
Subjects/actors articulate these with the hegemonic principles ............. 48

4.4. The ideological unity of the discourses and the discursive matrix ......... 50
4.4.1. The power effects of the discourses and the interpellatory and ....
interpellated Subjects. ......................................................................... 51

4.4.1.1. The power effects of the ―population control‖ discourse51

4.4.1.2. The power effects of the ―Gender, Human Rights and
Reproductive Health‖ discourse ................................................................... 54

4.5. The historic conflict situation and the political dénouement in population
policies ........................................................................................................ 55
4.6. Partial conclusions .............................................................................. 56

V. PART FIVE ........................................................................................................ 57

5. FINAL CONCLUSIONS .............................................................................. 57

VI. PART SIX........................................................................................................... 63

6. BIBLIOGRAPHY........................................................................................ 63

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 ABSTRACT

The subject of this research study is the analysis of hegemonic and counter-
hegemonic population policy discourses (1945-1994). The study focuses on the
analysis of the discourses of ―Population Control‖ and ―Gender, Human Rights and
Reproductive Health.‖ The protagonists of these discourses are the US State and the
Global Women‘s Health and Rights Movement (GWHRM), who relate to each other
through conflict and dispute hegemony in the field of population policy. These
relationships are analysed in the process of social and political struggle, given that
discourses are viewed as a form of social existence of such struggles, in which
―unstable‖ power relations take material form through practices and apparatus to define
population policy. The spaces in which these struggles are examined are the
International Conferences on Population and Development (Bucharest 1974, Mexico
1985 and Cairo 1994), where ―population policy‖ was debated and, in 1994, defined on
the basis of ―Women‘s Voices ‘94 A Declaration on Population Policies‖. In this way,
the discourse affects reality.

The analysis of the two discourses starts and develops by examining the
historical-social conditions of their (direct) production, circulation and reception, based
on which the actors – in different historical contexts – define and recognise certain
economic, political and social problems, analyse the causes of these and propose
solutions. The problem identified by the US state is that of ―population growth‖ in
developing countries. It links this to its ―national security‖ and, consequently, to
address and resolve the problem, it defines ―population control‖ as an international
policy to be implemented by means of aggressive and cultural strategies and through
various apparatus such as the United Nations and other public and private institutions
which operated ―family planning‖ programmes aimed at ―controlling fertility‖ and/or
―women‘s lives and reproductive health.‖

The problem identified by the GWHRM is the violation of women‘s human

rights and reproductive health rights as a result of the implementation of the population
control policy and its demographic rationale. Thus, the GWRHM – which brought
together various feminist and non-feminist movements at the global level – undertook a
struggle for the recognition of these rights, articulating a counter-hegemonic discourse:
that of ―Gender, Human Rights and Reproductive Health Rights.‖ This operated as the
hegemonic principle in its constitutive interpellations that configured an alternative
population policy through ―Women‘s Voices ‘94 A Declaration on Population
Policies,‖ whose power effects dismantled the discourse of population control, caused
its organic crisis and led to the constitution of a new paradigm in the area of population
policy which was legitimated at the Cairo Conference (1994).

The study concludes with a comparative analysis of the two discourses,

revealing the differences between them with regard to the production of the sense and
meaning of their ideological elements or semantic units. One such is reproduction,
which is re-articulated with broader semantic units such as family planning
programmes and services; and these in turn with others that function in the discourses
as hegemonic principles which ultimately define the ―class/gender character‖ of

5
population policy. The study arrives at final conclusions, one of the most important
being that the determining factor of politics played a key role in the definition of
population policy and consequently the impacts it produced in the design of public
policies and in the sphere of public health.

Key words: Discourse, hegemonic, counter-hegemonic, population policies,

population control, gender, human rights, reproductive health rights, actors, Subjects,
conflict, social and political struggles, power relations, international conferences,
practices, apparatus, hegemonic principles, family planning programmes, fertility
control, sense and meaning.

6
 I. PART ONE

HEGEMONIC AND COUNTER-HEGEMONIC POLITICS AND

POPULATION POLICY DISCOURSES IN THE CONTEXT OF 1945-1994

1. INTRODUCTION

This research study will focus on the analysis of two forms of social
construction of population policies that emerged in the mid-20th century. The policies
are that of ―Population Control,‖ articulated by the US state, and that of ―Gender and
Human Rights and Reproductive Health Rights,‖ articulated by the Global Women‘s
Health and Rights Movement (GWHRM). Both policies and actors will be studied by
means of discourse theory and analysis, using the conceptual-theoretical framework
presented in PART TWO.1

Following the methodological requirements of the chosen conceptual-theoretical

framework, the time-frame identified for the study covers a process that runs from 1945
to 1994, in contexts that include the post-World War II period, the Cold War and
Globalization, when the international correlation of forces was favourable to the
hegemony of the US state in political, economic and military terms (Enciclopedia de la
Globalización, 2007)2.

In the time-frame defined, the study will track the most significant ―footprints‖
or relevant events of meaning that reveal how the policies and consequently the
discourses – as well as the theories and ideological concepts that support them – are
socially constructed and interact with reality, based on which their actors identify and
recognise certain problems, analyse their causes and propose how to solve them.

With regard to the ―population control‖ discourse, the research will examine:

First, the main theories and ideologies that gave rise to it and upon which its
discursive production is based, and which serve the US state3 as a ―conceptual-
theoretical framework‖ for interpreting and understanding the political, economic and
social reality that presents itself as problematic in the post-World War II context.

1
Cf. Infra. PART TWO. ―Conceptual-Theoretical Framework and Methodology‖.
2
Throughout this global history - between of the end of World War II and the end of the Cold War -
hegemonic nation states have consolidated and benefited from the process of globalization; such as the
United States of America, which has been instrumentalizing its power and promoting its policies. The
role played by this actor indicates that policies are fundamentally shaped by human agency, and hence
politics, around which are defined and implemented policies based on the hegemonic interest in conflict
with other actors, (Enciclopedia de la Globalización, Vol. II, 2007: 565-568) as will be developed in this
paper regarding ―population policy‖.
3
The US state does not just ―make use of‖ these theories and ideologies; these also interpellate it and
consequently constitute it as a Subject of social and political action (Cf. PART TWO); as such, it
produces the discourse of ―population control‖ and the respective population policy.

7
 Second, I will examine the analysis made by the US state of the ―problems‖
arising from a specific phenomenon in reality – the ―population explosion‖ or the fast
pace of ―population growth‖ detected in less developed countries – which it posed as a
problem (linked to its national security). I will investigate why the US state defined this
as a problem, how it analysed its causes, and the solution it proposed, which led to the
definition of ―population control‖ as an international policy and its subsequent
implementation, especially in ―poor regions of the world‖.

Third, with regard to the implementation of the policy, I will examine firstly
why women in less developed countries were constituted as the main ―object‖ of this
policy and how the policy affected their health, and secondly how the policy was
implemented and took material form at the national level through various public and
private institutions and through international organisations such as the United Nations
(UN).

Fourth, following the discourse analysis methodology, this process will be

examined by looking at the political and social struggles unleashed as a result of the
implementation of the ―population control‖ policy, given that discourses are defined as
a form of social existence of such struggles. I will therefore proceed to analyse the
power relations that are established between the actors involved in the struggle in
certain contexts and circumstances, as well as the respective spaces and settings in
which they clash. These are – or are identified in this study as – the International
Conferences on Population and Development organised by the UN. It is here that
important events took place in the production of sense and meaning, such as those that
occurred – in relation to the ―population control‖ discourse – at the Bucharest
Conference (1974) and the Cairo Conference (1994).

Fifth, I will examine how the hegemony of the dominant discourse (―population
control‖) is articulated, dismantled and rearticulated in this process, and how it enters
an ―organic crisis‖ as a result of the shift in power relations. In methodological terms,
this leads me to study the cycle of the social conditions of production of discourses and
to analyse how the ―counter-hegemonic‖ discourse is articulated and constituted in
relation and opposition to the former discourse. In my research study, the ―counter-
hegemonic‖ discourse is the ―Gender, Human Rights and Reproductive Health Rights‖
discourse produced by the GWHRM.

With regard to the Global Women‘s Health and Rights Movement (GWHRM), I
am interested in examining:

First, the way in which this actor – in contrast to the other – arose from civil
society, bringing together various different movements (and tendencies within them) at
the global level. 4 Second, and in relation to this, I will analyse the movement‘s struggle
4
The GWHRM brought together women from the feminist movement and non-feminists, whose struggle
for recognition of their rights has taken many different forms at different moments in history. In the
developed countries, particularly the UK and the United States, women mobilized to gain access to contraceptives
and for the right to vote long before women in the developing countries, where women‘s struggle has always been
linked generically to the demand for economic and social rights and the defence of their rights as workers (in other
words, class-based rather than gender-based demands). (Schoijet, 2007)

8
for the recognition and defence of women‘s human rights and reproductive health
rights. I will therefore examine the process through which this actor defined and
recognised ―the violation of women‘s human rights and reproductive health rights‖ as a
social and political problem, and the reasons why it identified the implementation of
the ―population control‖ policy (which focused on ―reducing fertility‖ to limit
―population growth‖) as one of the causes of this problem (though not the only one)
and, consequently, took action to address and resolve the problem.

Third, as a result of the above, I will examine how the counter-hegemonic

discourse – that of ―Gender and Human Rights and Reproductive Health Rights‖ – was
articulated and constituted to interpellate the dominant one (population control). I will
also identify the political and social factors that were produced and which, based on
this counter-hegemonic discourse and the ―Women‘s ‘94 –A Declaration on population
policies‖ led to the formulation of an alternative and/or contestatory population policy.

Fourth, as in the case of the previous discourse, this process will be examined
by looking at the political and social struggles unleashed as a result of the demand for
these rights. I will therefore proceed to analyse how and in what settings the social
forces that produced this discourse came together, and at what moment the GWHRM
constituted itself as its ―organic expression‖ and as a contestatory force capable of
articulating a collective will, whose efficacy and power can be measured and examined
in terms of the paradigm shift that took place in population policy. I will therefore
analyse the process through which the counter-hegemonic discourse – and the
contestatory actor – gradually gained legitimacy, altering the power relations that are
established in certain contexts and circumstances, as well as the respective spaces and
settings in which the confrontation takes place. These are – or are identified in this
study as – the International Conferences on Human Rights held in Tehran (1968) and
Vienna (1991), the conferences held during the UN Decade for Women in Mexico
(1975 and 1984) and the Conferences on Population and Development held in
Bucharest (1974), Mexico (1985) and Cairo (1994).

The discursive cycle I will analyse with regard to ―population policy‖ comes to
an end in 1994, when the ―organic crisis‖ of the ―population control‖ discourse became
evident at the Cairo Conference. Like any crisis, this has been identified by various
researchers as the midwife of a ―new paradigm,‖ thanks to which women – who had
been consigned ―ad eternam‖ and in perpetuity to the status assigned them by global
patriarchy as the object of population policies – moved to being the subject and
beneficiaries of such policies, due to the collective action taken forward by the
GWRHM, whose struggle was closely connected to gender demands that linked
―reproduction‖ to politics and public health.

In PART FOUR I will carry out a comparative analysis of the two discourses,
focusing on a ―technical discourse analysis‖ 5 to examine the internal organisation of the
semantic utterances or ideological elements present in the discourses, and the way in
which they are articulated around the ―hegemonic principles.‖ According to the
conceptual-theoretical framework, this is what gives discourses their ―class character‖.

5
Cf. PART TWO, ―DISCOURSE ANALYSIS TECHNIQUE‖.

9
In other words, it is the ―hegemonic principle‖ that will define the ―character‖ of
population policy for a 20-year period.

The technical analysis will also enable me to identify: a) the structural poles of
the discourses, or the structure and logic of how they are organised and how they
function, based on the dichotomous relationship produced by the power relations
between the Subjects/actors, and between these and their addressees, and the historical
conditions of their social existence. On this basis, I will examine the key propositions
of the discourses, their ideological unity and discursive matrix, and the operations of
discursive practice, which refers to the utterances constructed by the addresser using
elements from the political imaginary and its links with the areas of ―knowledge‖ and
―order‖ in the discourse. With this analysis, the research comes to an end, arriving at
final conclusions in PART FIVE. The bibliography is presented in PART SIX.

Thus, I will examine population policies by analysing the ―hegemonic and

counter-hegemonic‖ discourses. To do this, I have chosen a conceptual-theoretical
framework and methodology that allows me to describe the conditions of the social
process of production, circulation and reception/power effects of discourses, and thus
considers discourse to be a specific form of social and political struggle in the domain
or register of what Ipola (1982) calls the social process of producing sense and
meaning, complemented by the technical analysis mentioned above.

Finally, it is important to mention that ―population policies‖ have been studied

by other researchers, using various different approaches and research methods. The
present research study differs from others and makes a new contribution because it
addresses the issue through Discourse Analysis, which covers a complex and relevant
academic field that basically tries to answer the question of how reality is constructed
in a particular way through the social practices of discourse and seeks to understand
what type of reality is produced and constructed by discourses in certain social
conditions of production, circulation and reception. Therefore, the study does not aim
to determine who was right in the population policies debate, but instead focuses on the
different population policy discourses and the way in which they shape reality and act
on it in various (two) ways. Thus, it is the way in which the discourse on ―population
policy‖ is conceived that helped to change social reality and, in the subject addressed
by this research, led to the paradigm shift in ―population policy.‖

To summarize this introduction: I intend to study two ways of defining the

issues related to population policy, by analysing the discourse of Population Control
and the discourse of ―Gender and Human Rights/ Health and Reproductive Rights‖.
Each of the two discourses will be addressed through the following questions: What is
the problem (addressed in the discourse)? What is the cause of the problem? How is the
problem to be addressed and solved? For whom is it a problem? Who are the advocates
of the problem defined?

10
 II. PART TWO

2. CONCEPTUAL-THEORETICAL FRAMEWORK AND DISCOURSE

ANALYSIS METHODOLOGY

Following Ipola (1982: 80), ―We will understand discourse to be a form of

social struggle in the domain or register‖ of what the author calls ―the social process of
producing sense and meaning.‖

The author thus suggests that the historical process of social and political
struggle should be thought of as the site where discursive representations are
articulated, because it is this process that constitutes the material basis of discourse.
Therefore, discourse is defined as a particular form of social struggle, while its analysis
refers to the social process of producing sense and meaning. In methodological terms,
discourse can be studied by examining: a) the social conditions of its direct production,
which are unique, singular and non-repeatable; b) the conditions in which it circulates,
and c) how it is received or its power effects (Ipola 1982: 82)6.

The analysis of […] a discourse from the angle of its direct production […] consists of
identifying the social, political and ideological determinants […] that are present in it in
the form of specific ―footprints‖ (1982: 82-83).

The analysis of direct production covers just one moment in the social
production of a discourse. It is therefore necessary to address the process of how it is
received. This alludes to its effectiveness, or the effects produced by the discourse on
certain material and social conditions.

The analysis of […] how a discourse is received consists above all of bringing to light
the ―footprints‖ that give rise to the social effects of that discourse (1982: 84).

Thus, the analysis of a discourse requires an examination of its internal

linkages, while the circulation process is the one that unites the two dimensions, since
―it is within this two-way linkage connecting the direct production of the discourse and
how it is received that the social element […] is inscribed in discursive processes‖ (:
84).

Considering that it is individuals (organised in groups, classes, social

movements and/or states, etc) who – based on certain power relations – produce,
circulate and consume discourses, in discourse analysis it is important to distinguish
between the ―interpellation and constitution‖ of individuals as subjects. Thus, the
approach builds on Althusser‘s thesis that ideology interpellates or constitutes
individuals as subjects (1986: 132), which enables the function of ideology in
discursive formations to be analysed. This is why it is necessary to distinguish
conceptually between

6
Self-identified as a neo-Marxist, Ipola adopts the methodological approach used by Karl Marx to
analyse the process of production of goods in ―Das Kapital,‖ which refers to the process of production,
circulation and consumption of goods.

11
 the ―interpellation‖ and the ―constitution‖ of individuals as subjects […]. The act of
interpellation is located in […] the discourse production process […] which takes place
under certain social (economic, political and ideological) conditions […] The effect of
constituting individuals as subjects is its exact opposite […] The discourse is received
under certain social, economic, political and ideological conditions (Ipola 1982: 113).

This differentiation leads us to think of the existence of contestatory ideologies

and discourses in subaltern sectors, the effects of which are the opposite of those of the
dominant ideology or discourse. Consequently, individuals as subjects of political
action cannot be identified with social classes, and therefore the ideological elements
do not pertain to class either; instead, they appear as disputed elements in the
discourses of the main classes (actors) who come into conflict in social struggles.
Therefore,

If these ideological elements do not express social classes, but if the classes ultimately
determine the ideology, we would have to conclude that this determination can only
result from the establishment of a principle of articulation of these ideological
elements, and that this principle is what truly confers upon them a class status (Mouffe
1980: 23).

This leads us to take up the distinction made by Laclau (1986: 186) between the
form and the content of an ideology: form should be understood as the principle that
articulates its constitutive interpellations, while content is understood as the ideological
elements (semantic units) of the discourse in question. Thus, the class (gender, ethnic
or other) identity of a discourse is provided by its form rather than by its content. For
Ipola (1986: 103), it is this articulatory principle that ensures the condensation effect
upon which the unity of a discourse rests, and which operates to constitute the unity o f
ideology and discourse. Therefore,

The measure of the hegemonic potential of a discourse is its articulatory capacity […]
to include interpellations that differ in scope and nature – some classist, others non-
classist – in a relatively structured whole. Therefore, what can effectively be defined by
class is the (hegemonic) project within which that articulation operates (Ipola: 103).

The hegemonic or articulatory principle is defined by the capacity of each

interpellatory element to play a role of condensing the others […] when each of these
interpellations operates separately as a symbol of the others, we find ourselves with a
relatively unified ideological discourse (Laclau 1986: 115).

When the articulatory principle breaks up and another takes its place, this gives
rise to a crisis of hegemony. At this point, the political-ideological setting of social
struggles is seen as a disputed space in which several discourses clash and circulate,
accompanied by a series of social practices whose aim is to develop hegemony.
Therefore, multiple discourses circulate when the hegemonic discourse enters into
crisis.

The specificity of discursive/ideological crises is expressed in the loss of hegemonic

capacity by the dominant discourse, whose ideological pulling power does not produce
the same constitutive effects as before the crisis arose […] An ideological crisis implies
that the unity of the dominant discourse falls apart, leading to changes in the
ideological arena with the entry of alternative discourses seeking to reorganise the
ideological elements based on a different interpellation (a different subject). What
12
 changes is the form (of articulation), not the content (the disputed interpellations) of
ideologies (Mayorga: 45-46).

Thus, the discursive arena is in a constant process of articulation-dismantling-

rearticulation of the ideological elements. The ideological crisis manifests itself once
the unity of the dominant ideology breaks apart with the loss of articulatory capacity
and/or discursive hegemony.

Now, this approach to discourse analysis refers to the centres or institutions of

production, circulation, inculcation and/or reception of discourses, defined by Gramsci
as the hegemonic apparatus and by Althusser as the ideological state apparatus. This
apparatus is responsible for

Producing, processing, transmitting and dictating the conditions in which ideologies are
appropriated in society (…), functioning as centres of production, (…) reception and
appropriation of discourses (Ipola 1982: 85).

These centres and/or apparatus operate as ―sites of organisation‖ of the social

and political practices of subjects (Gluksman 1988: 90). Because of the way they
operate, they are also ―a principal site of class struggle‖ (Althusser 1974: 40), due to
the fact that because ―the State and its apparatus […] are riven by tensions and conflicts
and by unstable power relations, they are the site where political power is exercised and
produced‖ (Ipola 1982: 90). Therefore, it is necessary to identify the power structure
and the power relations which drive it (Buci Gluksman 188: 93), and also to understand
the social sphere in terms of fracture, imbalance and conflict (Ipola 1982: 92), since

The set of social relations is contradictory at all times and there is always the possibility
of a rupture in the balance of forces […] which will be expressed as an organic crisis, a
crisis of hegemony, or a crisis in the State as a whole (Buci Gluksman 1988: 97).

Therefore, hegemony is articulated/constituted through the apparatus and it is

also through the apparatus that state and society actors dispute hegemony. This is

The most openly political phase […] in which discourses/ideologies, which had
germinated beforehand, become ―partisan,‖ clash and enter into a struggle, until such
time as one of them, or a combination of them, tends to prevail, to impose itself and to
be disseminated, especially in the social arena (: 118).

This is how social and political struggles ―have a constitutive effect on the
meaning and function of discourses‖ (Ipola: 1982: 90). Therefore,

The emergence, spread and effectiveness of a certain discourse in society is intimately

bound up with the power relations and forces in which every discourse is necessarily
inscribed and which either silence or disqualify it or aim to validate it and make it
authoritative (: 91).

This is why discourse analysis must describe the power relations that are channelled
through different apparatus, in order make it clear that the conflict between discourses
does not arise ―out of the air‖; on the contrary, these are

13
 struggles in which what is at stake is the relations established by the dominant classes,
between power relations and forces that take material form in the apparatus and
discursive relations […]. These are struggles that concern the set of social processes
that produce meaning and the meanings themselves (Ipola: 1982: 92).

The analysis of discourse, understood as the social process of producing sense

and meaning, therefore implies disentangling the social conditions of production to
which it owes its existence.

Consequently, my research will be based on this theoretical and conceptual

framework and defined methodology, applying a discourse analysis technique that is
described below.

2.1. DISCOURSE ANALYSIS TECHNIQUE

The discourse analysis technique builds on the contributions made by Austin

(1992), Landi (1992), Van Dijk (1988), Lazarte (1993), Verón (1987) and Ducrot
(1984). It involves selecting an ―analytical corpus‖ and proceeding to analyse it by
means of a surface reading and an in-depth reading.

2.1.1. Analytical Corpus

The analytical corpus is made up of a set of texts, which in this study includes
both primary and secondary sources.

2.1.1.1. The primary sources

The primary sources are documents, texts and resolutions from the United
Nations, the US State Department and the GWHRM.

a) International Conference on Human Rights held in Tehran (1968).

- Tehran Declaration (1968)7.

b) WORLD CONFERENCE ON HUMAN RIGHTS held in Vienna, 14-25

June 1993 (United Nations A/CONF.157/23, 12 July 1993).
8
- VIENNA DECLARATION AND PROGRAMME OF ACTION (1993) .

c) International Conference on Population and Development held in

Bucharest, 19-30 August 1974.
- World Population Plan of Action. Bucharest, Romania (1974) 9.

d) International Conference on Population and Development held in

Mexico City, 6-14 August 1984.
- Mexico City Declaration on Population and Development. CHAPTER I, pp.
1-5.

7
Available at:http://www.notivida.org/leginternacional/Declaracion%20de%20Teheran.html
8
Available at:
http://www.unhchr.ch/huridocda/huridoca.nsf/(Symbol)/A.CONF.157.23.Sp?Opendocument
9
Pérez. G. (2000: 68-75).

14
 - Report of the International Conference on Population 1984. Mexico City
6-14 August 1984 (United Nations E/CONF.76/19)10.

e) International Conference on Population and Development held in Cairo,

5-13 September 1994.
- Programme of Action of the International Conference on Population and
Development (United Nations A/CONF.171/13, 18 October 1994)11.
f) World Conference on Women (1975), 19 June – 2 July 1975, Mexico
D.F.
g) World Conference on Women (1980) 14-30 July 1980, Copenhagen,
Denmark.
h) World Conference on Women (1985), 15 June – 26 July 1985, Nairobi,
Kenya.
i) National Security Study Memorandum 200: Implications of
Worldwide Population Growth for U.S. Security and Overseas Interests
(NSSM200) 1974.
j) ―Women‘s Voices ‗94‖ –A Declaration on Population Policies‖12.

2.1.1.2. Secondary Sources: All the texts listed in the bibliography in PART
SIX.

2.1.2. Surface reading

This reading identifies the interpellating subject – the addresser of the discourse – and
the interpellated subject – the addressees13 – and then proceeds to examine the
frequency of the semantic units that are present or produced in the texts of the corpus.
These function as pivotal indicators that can be grouped by differentiating the semantic
field in its relation of equivalence and opposition (Landi, 1992). The reading also
examines how they are linked to each other (Verón, 1987), which leads to the in-depth
reading.

2.1.3. In-depth reading

This reading involves identifying and analysing the broader semantic units, also
known as ―Meta‖ units because they articulate others around themselves and function
as symbols of the others (Verón 1987)14. It is around these units that the effectiveness

10
Available at: http://www.choike.org/documentos/conf/ICP_mexico84_report.pdf
11
Available at: http://www.un.org/popin/icpd/conference/offspa/sconf13.html
12
Available at: http//www.jstor.org/stable/2938478?seq=1
13
The addressees are: the pro-addressee, who shares the same ideas, values and objectives as the
addresser; the counter-addressee, who is the adversary or negative addressee; and the para-addressee,
who is neither a supporter nor an adversary but rather the person the addresser is trying to ―persuade‖ to
join its ranks, or the disputed third party (Verón 1987).
14
The category ―broad‖ or ―meta‖ is applied to semantic utterances and to entities (Subjects/actors). For
entities, Verón coins the term ―identity meta-collectives‖, and the GWHRM is an example of one of
these because it is an entity that is broader than ―singular identity collectives‖ (―women‖, for example)

15
of the articulation of the structural poles of political discourse operates, and through
these structural poles the ―articulating and/or hegemonic principle‖ becomes intelligible
(Lazarte, 1993).

Consequently, the in-depth reading allows us to analyse:

a) The structural poles of the discourses, or the structure and logic of how
they are organised and how they function, based on the dichotomous relationship
produced by the power relations between the Subjects/actors. On this basis, the
propositions of the discourse can be examined, leading us to analyse the binary
structure of discursive production. This is often presented in the form of a dilemma that
dichotomizes reality. This therefore needs to be ―interpreted‖ to bring to light how the
opposition is expressed, which takes us to the space of social and political
confrontation at a given moment in time. In other words, the analysis must describe the
conflict to arrive at the dichotomization (Ibid);

b) The ideological unity15 and the matrix of the discourse, also known as the
ideological or ―generative‖ matrix, because it is the basis on which various other
discourses are constructed; in other words, the same matrix produces and reproduces
discourses (Pirelli, 1985: 29-40). Analysis of it enables us to reveal a certain
ideological field; and because the discourse is linked to the ideology, the matrix makes
it possible to examine the components of it that do not vary. In other words, the matrix
can be described as the unvarying structure of the discourse. The process of social and
political struggle may or may not alter a certain matrix and/or the internal organisation
of the elements in the matrix. In both cases, ideological unity is what gives it logical
coherence (Ipola 1982);

c) The operations of discursive practice, which refers to the utterances

constructed by the addresser using elements from the political imaginary and its links
with the areas of ―knowledge‖ and ―order‖ in the discourse;16

d) The characteristics of the discourse, in order to identify its ―legal effects‖

on the basis of the utterances and their relationship with the actors. Following Ducrot
(1984: 189), one of the characteristics of political discourse is that of presenting two
―personalities‖ in its relationship with the utterance. The utterance is understood as
something that produces ―legal effects‖ and as a source of creation of rights and duties
for the interlocutors. This leads us to refer to the intersubjective relationship that is
established between the addresser and the addressee.

and ―plural identity collectives‖ (social movements identified as feminist or non-feminist). Meta-
collectives cannot be ―fragmented‖, except in very specific cases.
15
Cf. Supra Laclau (1987).
16
The relationship between the addresser (interpellating subject) and the addressee (pro-addressee and
para-addressee) is linked to the areas of knowledge and order in the discourse. The descriptive and
didactic components are articulated in the ―areas of knowledge‖ (these components are related to the
―knowledge mode‖ of the addresser, whose ―knowledge‖ is almost always outlined in a ―statement of
fact,‖ based on which the addresser formulates a ―universal truth‖), while the prescriptive and
programmatic components are articulated in the ―areas of order‖ (these components express ―the way
things should be‖ and are related to ―what can be done‖) (Verón 1987: 17-18).

16
 e) The power effects of the discourse, in order to identify how the
interpellating Subject produces its interpellations, what power effects these produce on
the interpellated subject (the addressees), and the type of relationship (inclusive and/or
oppositional) that is established with them. According to Verón (1987), this
relationship will be one of inclusion with the ―pro-addressee‖ and the ―para-addressee,‖
and one of exclusion with the ―counter-addressee‖. Thus, the interpellated subject is
defined as the first two addressees, with whom the relationship is inclusive and who
may be interpellated through identity collectives (singular or plural).

f) The in-depth reading analysis concludes by describing the ―historic conflict

situation and the political dénouement,‖ since ―understanding reality as a product of
how we articulate it is a basic feature of discourse analysis‖ (Lazarte 1993).

Thus, in PART TWO, I have set out the conceptual-theoretical framework and
its discourse analysis technique which will be developed further in PARTS THREE and
FOUR of this research study.

17
 III. PART THREE

3. THE SOCIAL CONDITIONS OF PRODUCTION OF THE

DISCOURSES

3.1. The discourse of population control

Analysis of the direct production of the ―population control‖ discourse consists

of identifying the ―footprints‖ which gave rise to it and provided its validity and
authority. To do this, I will refer to the theoretical-ideological sources upon which it
was based. These are: a) the theory and ideology of Malthus (1798); b) the theory and
ideology of eugenics formulated by Galton (1904); c) the theory of ―population
growth,‖ which drew on the arguments of the previous two and whose main exponents
were the ―neo-Malthusians‖ who organised in 1900; and d) the Demographic Transition
Theory and its inverse, developed most notably by Notestein in 1945.

a) The theory formulated by Malthus in his "Essay on the Principle of

Population as it affects the Future Improvement of Society" (1798) 17 sets out two
interlinked hypotheses. These are:

a.1) That ―the human species will grow like the sequence of numbers 1, 2, 4,
8, 16, 32, 64, 128, 256, 512 […], while the means of subsistence will do so as follows:
1, 2, 3, 4, 5, 6, 7, 8, 9, 10; etc‖ (Malthus, 1798: 60). This equation alludes to a problem
that is based in his essay on the following arguments: ―First: food is necessary to
mankind‘s existence‖; and ―Second: passion between the sexes is necessary and in
practice will maintain its current status‖; therefore, ―the population‘s ability to grow is
infinitely greater than the ability of the earth to produce food for mankind.‖ This
―implies that the difficulty of subsisting will exercise a strong and constant restrictive
pressure on the force of population growth,‖ leading to ―a waste of seed or disease and
death as well as misery and vice, in the case of human beings.‖ For Malthus, ―This
natural inequality […] is the great obstacle […] in the way of the perfectibility of
society‖ (Ibid.). To address the problem, he proposed two types of restraint: preventive
(moral restraint, including abstinence and delayed marriage) and biological (disease,
death and misery). This is illustrated in the passage entitled ―Nature‘s Banquet,‖ where
―A man born into a world which has already been appropriated, if he cannot obtain
food […] he should not in fact be where he is. In Nature‘s great banquet, there is no
place for him at the table. Nature ordains that he must leave‖ (quoted in Beltrán, Lucas
1993: 113).

a.2.) The second hypothesis, which represents a challenge to the political and
governing classes and elites, is that ―the causes of poverty are natural rather than social
in origin.‖ This naturalising of the causes of poverty gave rise to the ―naturalist

17
The theory gained political relevance and influence in the economic and social sphere of the British
empire and a Europe shaken by the French revolution of 1789. In this context, social classes were
becoming an increasingly prominent and weighty consideration in public decisions as the British empire
debated about ―social policies,‖ while in France the ideas of ―fraternity, equality and liberty‖ were
enabling arguments about the progress of ―human reason‖ to take hold. Malthus thought these ideas were
irresponsible and the Essay was his response (Pérez 1994).

18
doctrine‖ and ―biologism,‖ which were the foundations of eugenics (Collantes 2001:
4). Acceptance or non-acceptance of this ideological premise has characterised the
debate between Malthusians and Anti-Malthusians (usually Marxists), expressed in
antinatalist or natalist positions.

Malthus‘s theory gave rise to the Malthusian and Neo-Malthusian movement.

The discourse of the former centred on the economy, in terms of the balance between
population and resources, and on reducing the birth rate by means of natural methods
such as abstinence, celibacy and delayed marriage, and others linked to a moral stance
about what is ―licit‖ and what is not in the sexual and family sphere. The discourse of
the latter differed in that they sought to limit offspring by means of artificial
contraceptive methods18
.
b) Eugenics is another theoretical and ideological source of the population
control discourse because it identifies population growth as a problem. Practical ways
to control it are based on all the naturalisations of human differences and inequality that
can be explained by the theory of evolution. Eugenics proposes a qualitative,
biological, ―natural‖ improvement of the population through ―positive‖ means (to
promote reproduction by the ―fittest‖) or ―negative‖ ones (making it difficult or
impossible for the ―unfit‖ to reproduce). Thus, the ―progress‖ of human populations
cannot be achieved by knowledge and morality alone, and neither can it be limited to
the economic, political and social order. Instead, it must be produced biologically by
carefully selecting the ―quality‖ of populations to suit society, the state or the nation,
and intervening in demographic events: births and deaths (or migration). States and
governments were encouraged to adopt policies to promote this (American Bioethics
Advisory Commission 2003).

In this discourse, one of the ideological elements which helped to coin the term
eugenics in the mid-19th century is the theory of ―degeneracy,‖ which attempted to
provide a ―scientific explanation‖ for ―decadence‖ or ―hereditary decline.‖ It was
introduced by the French psychiatrist Morel (1857) who studied the ―dementias and
mental defects‖ that are signs of ―hereditary decline‖ (quoted by Soloway, 1990). The
inheritance of ―human faculties‖ and ―intellectual genius‖ studied by Francis Galton in
―Eugenics; its Definition, Scope and Aims‖ (1904)19, based on Darwin‘s principles of
natural selection, coined the term eugenics. From then on, eugenics societies
proliferated and came to function as powerful apparatus influencing the sphere of
ideology and discourse and hence social and political life (Farrall 1970, quoted in
Parking, A. 2006). They became an international movement with an influence in
several areas of the state and society after the ―First International Conference on
Eugenics‖ held in London in 1912.

Between the late 19th century and the end of the Second World War, the
eugenics discourse was able to appeal to a significant political, economic and social

18
Cf. Infra.
19
In 1904, a lecture given by Galton at the ―Sociological Society‖ led to the founding of the ―Eugenics
Education Society,‖ which started to publish ―The Eugenics Review,‖ and the Galton Laboratory was set
up. By 1907 the ―Eugenics Society‖ had branches in Birmingham, Cambridge, Manchester,
Southampton, Liverpool, Glasgow and Sydney (Australia). Cf. www.galtonintitute.org

19
elite worldwide, which acted through various state and social apparatus: public and
private institutions such as the Rockefeller and Ford foundations, institutes such as
Planned Parenthood, and international organisations such as the League of Nations and
the United Nations, established at the end of the 19th century and in the 20th century
respectively. These aimed to achieve scientific demographic objectives through policies
to ―manage‖ the world population (Adams 1990) 20. ―Eugenismo en el Mundo‖21 cites
several studies in which these objectives were pursued in various parts of the world,
including Israel, Australia, Japan, Spain, Latin America and others. In Virginia, USA,
an emblematic case of eugenics was the Lynchburg colony for ―Epileptics and the
Feebleminded,‖ which carried out the forced sterilization of 8,000 ―defective‖ children
and young people in a ―charitable‖ institution in the name of ―the biological health of
the nation,‖ since "three generations of imbeciles are enough." According to the
documentary, this ―control,‖ which formed part of ―population policy‖ and ―eugenic
sterilization laws,‖ served as a model for Nazi Germany (Bruce, E 1993).

Consequently, eugenics and its societies influenced population policies and

responded to its problems with ―treatments for physical and mental illness, the
development of new contraceptive methods, the legalisation of forced sterilization or
the use of artificial insemination‖ (Schenck, F and Parkes, A.S. 1968: 142-161, quoted
in Wat, DC 1998).

c) The third source that fed into the population control discourse by
identifying population growth as a problem are the proponents of Neo-Malthusian
thinking, who argued explicitly for the need to control population growth, thus laying
the most solid foundations for ―population control‖ (Collantes 2001: 1).

This arose in the 20th century, when ―population growth was described as an
‗explosion‘ requiring ‗contraceptives to prevent overpopulation‘,‖ upon which the
foundation of the Neo-Malthusian movement was established (Mc Laren, Angus 1997).
It was the power of the contraception discourse that inspired them to form an
association in 1900 after their first international conference, which resolved ―to
disseminate information about population growth and exact methods to limit family
size‖. The association partnered with IGOs to facilitate their cause and ―scientized‖
their agenda into a special Committee of the League of Nations. The committee
contributed to the redefinition of population growth as a potentially destructive force
(Szreter, Simon 1993).

20
Adams mentions that noted intellectuals who won Nobel prizes took up eugenics, led its societies and
founded its institutions (which today enjoy international prestige), with funding from a business elite
identified with eugenics such as the Rockefeller Foundation. Some of the most noteworthy are: a) the
winner of the 1912 Nobel prize for medicine, Alexis Carrel (1873-1944); and b) Corrado Gini (1884-
1965), known for his work “Variabilità e mutabilità‖ (1912), in which he developed his method for
measuring inequality, called after him as the ―Gini Coefficient.‖ He was awarded the Royal Prize for
Social Sciences by the ―Accademia Nazionale dei Lincei‖ in 1919. He was president of the is
essay―Societa Italiana di Genetica ed Eugénica‖ and an ideologue of Mussolini‘s population policies in h
“Las bases científicas del fascismo” (1927).
21
Cf. ―El Eugenismo en el Mundo‖ (audio, video and bibliography) In:
http://elnuevordenmundial.wordpress.com/category/eugenics/eugenismo-en-el-mundo/

20
 Tendencies within the neo-Malthusian movement include the "birth controllers"
and the ―family planners‖, with which various social, political and economic actors are
identified. Their discourse is characterised by articulating contraceptive methods
around different projects (articulatory principles). Some, such as those of ―family
planning,‖ are social in nature and refer to the exercise of individual rights, advocating
that people (especially women) should be able to decide how many children to have
and when, without renouncing sexual pleasure. Others are biologists and/or birth
controllers, and their discourse was articulated most clearly by Margaret Sanger 22.

The practices of the birth controllers and family planning advocates were
favourable to those actors (private, public, national and international) who identified
with the neo-Malthusians and eugenicists who supported each other, and only
instrumentally included and supported the pro-―family planning‖ movement and the
birth controllers. Thus, their relationships and alliances were historically based on
shared objectives (Hodgson, and Watkins, 1997)23.

The neo-Malthusian movement therefore had a significant influence in

persuading state and society actors to identify population growth as a problem. In this
sense,
―the term neo-Malthusian is applied to the international movement in favour of
controlling world population growth, driven initially by the US at the end of the
Second World War, and taken up by the United Nations shortly afterwards‖
(Collantes, p. 1, Op. Cit.)

Now we have referred to the theories and ideological sources that left their mark
or footprints on the discourse of population control, and consequently took forward
control strategies in line with their approaches, it is important to refer to the
―Demographic Transition Theory‖ and its ―inversion‖, which Hodgson (1988) calls the
US demographic ―orthodoxy,‖ as an element of meaning and a ―footprint‖ in the
population control discourse, which reveals how population growth was made visible
and recognised as a problem, and which was debated in the mid-20th century.

22
Margaret Sanger coined the term ―birth control‖ in ―The Rebel Woman‖ (1914, New York). The link
between the ―birth controllers‖ and ―eugenics‖ (Sanger 1919 "Birth control and racial betterment", Birth
Control Review, 3 (2) was made when in 1919 she joined with F. Gamble, a eugenicist who funded anti-
natalist initiatives in the US and elsewhere and ―population control‖ in less developed countries, to found
the Pathfinder Fund (1957), currently known as ―Pathfinder International‖ (Miller, J. A. (1996), "Betting
with lives. Clarence Gamble and the Pathfinder International", Population Research Institute Review,
(July/August). Sanger was one of the founders of ―Planned Parenthood Federation of America (PPFA)‖.
With the support of its eugenicist and Malthusian allies, this set up the first family planning clinic in
Brooklyn in 1916 (Hodgson and Watkins, 1997, p. 475). It contributed to the strategic design and
implementation of ―family planning programmes‖ after linking up with leaders of the ―Neo-Malthusian
League‖ in Britain and other noteworthy characters identified with eugenics such as psychologist and
sexologist Havelock Ellis, Aletta Jacobs and Dr. Johan Rutgers. By 1927 Sanger was recognised as a
leader of the neo-Malthusian movement in the USA, and was notable for organising and promoting the
first World Population Congress and, after the Congress, for helping to establish the ―International Union
for the Scientific Study of Population (IUSSP)‖.
Cf.http://www.biografiasyvidas.com/biografia/s/sanger_margaret.htm;
http://www.bookrags.com/biography/margaret-higgins-sanger/
23
They started to separate in the 1980s, with the final split taking place at the International Conference
on Population held in Cairo (1994), when the strategy was redirected towards new objectives, articulated
around the concept of ―sexual and reproductive health.‖ Cf. Infra.

21
 d) The Demographic Transition Theory attempts to explain the historical
rupture in population dynamics that is illustrated in Graph 1.

GRAPH 1. Demographic Change and World Population 1800-205024

In 1820 world population reached 1 billion and From 3 billon in 1959 to 6 billion by 1999
increased to 3 billion in 1959.

25
Source: US Census Bureau - International Data Base (IDB)

DTT argues that the pre-transitional demographics were characterised by very

high birth and death rates, and low growth. During the transition, population growth
became evident because death rates started to fall during the Industrial Revolution. In
this context, population growth ―was synonymous with prosperity and security in the
industrialized countries.‖ At the end of the 18th century, when states considered it a
good thing to have a growing population, reproductive behaviour started to change, and
this manifested itself at the start of the 20th century in declining fertility rates. Thus,
two phases can be distinguished in the transition: a) the initial phase, when death rates
decrease sharply, but birth rates are maintained at traditional levels, leading to a very
rapid increase in population; b) the final or culmination phase, in which birth rates go
down to unprecedentedly low levels, thus gradually reducing the pace of population
growth.

The decline in fertility was presented as a problem, and there was an increase in
efforts and studies to identify the demographic situation, understand its causes and act
to divert it (or not) from its natural course:

Everything that, taken together, defines population policy came about […] at this time.
Because of their emphasis on the importance of fertility, they helped to create the
critical mass of statistics, researchers and resources required to develop a demographic
theory about the changes under way. One of the results was demographic transition
theory, which connected changes in fertility rates to changes in death rates based on
the information available in the most advanced countries (Pérez 1994: 105).

Thus, DTT arose because the studies indicated that fertility always
systematically declined following the fall in the death rate in the most developed
countries, in a close relationship with the industrial revolution, unleashing the transition
24
< http://www.un.org/esa/population/publications/longrange2/WorldPop2300final.pdf>
25
The Census Bureau's latest projections imply that population growth will continue into the 21st century, although
more slowly. The world population is projected to grow from 6 billion in 1999 to 9 billion by 2044, an increase of 50
percent that is expected to require 45 years. http://www.census.gov/ipc/www/idb/worldpopgraph.php.

22
process. Therefore, it could be shown that the decline in fertility was connected with
the degree of development, and this was perceived as one of the symptoms of its
success.

In contrast to this phenomenon, the studies carried out by Thompson (1929)

showed that in less developed countries the reverse process was taking place, indicating
an unprecedented ―state of potential growth‖ (with little control of births and deaths).
Consequently, these analyses of ―population growth‖ allow us to start to analyse the
definition of the problem (What is the problem? What is the cause of the problem?)
identified by the discourse of ―population control,‖ and which it sought to address and
solve by formulating a policy: that of ―Population Control.‖ It is at this point that we
can identify the discourse‘s circulation process and how it was received or its power
effects.26

3.1.1. “Population growth” as a problem and the policy of “Population

Control” as its solution.

3.1.1.1. Definition of the problem.

The international differences that showed evidence of the ―state of potential

growth‖ in the less developed countries were defined as a relevant problem for the US
government.

The present world population growth is unique. Rates of increase are much higher
than in earlier centuries, they are more widespread, and have a greater effect on
economic life, social justice, and -- quite likely -- on public order and political
stability (NATIONAL SECURITY MEMORANDUM 200. Part One: Analytical
Section, CHAPTER I - WORLD DEMOGRAPHIC TRENDS, 1974 p. 1).

―The U.S. economy will require large and increasing amounts of minerals from
abroad, especially from less developed countries. That fact gives the U.S. enhanced
interest in the political, economic, and social stability of the supplying countries.
Wherever a lessening of population pressures through reduced birth rates [slow or no
population growth p. 37-38] can increase the prospects for such stability, population
policy becomes relevant to resource supplies and to the economic interests of the
United States‖ (Ibid 200, p. 43).

The factors and causes involved in the problem were analysed by Notestein in (1945),
in the ―Office of Population Research‖ at Princeton University, as part of its role of
providing advice on US foreign policy.

3.1.1.2. What is the cause of the problem?

Notestein‘s arguments (Szreter, 1993) focused on: a) how unviable it was for
the ―poorest regions of the world‖ to follow a European-style transition. In these
regions, the reduction in the death rate cannot be explained by the slow and progressive

26
The social conditions of production of a discourse (direct production, circulation and consumption) are
linked, forming a cycle.

23
improvement in living conditions achieved with industrialisation, but by advances in
medicine and sanitation transferred from the West; b) the pace of population growth,
considered ―explosive,‖ which coexists with a low level of development of productive
forces (characterised by pre-capitalist economic structures and traditional agrarian
economies), makes their development non-viable, and generates conditions
unfavourable to capital accumulation, because capital is used up by basic social
expenditure on the new and growing younger generations; c) the ―pace of population
growth‖ and ―levels of poverty‖ lead to an explosive situation of social and political
instability (favourable to the spread of Communism), precisely in areas of US
commercial and political expansion, and if the same thing happened in the rest of the
―poor‖ regions of the world, this would create a ―national security‖ problem for the
USA. Considering all these factors, it was decided to ―reverse the terms of the DTT
and affirm that without a prior reduction in fertility, development would never manage
to take off in these countries‖ (Ibid).

Whereas all the scholars had hitherto agreed that economic development triggered the
transition and caused the ultimate reduction in fertility rates, now it was argued that the
reduction in fertility was a necessary condition for development, since rapid population
growth impeded the capital accumulation essential for industrialization (Pérez 1994).

Thus, it was by reversing the argument described as the US demographic

―orthodoxy‖ (Dodgson, 1988) that the attempt was made to deal with and later solve
the problem.

3.1.1.3. How can the problem be addressed and resolved?

Once population growth in the least developed countries (LDCs) had been
identified as ―an issue of the greatest importance‖ for political and economic reasons,
the US government advocated ―a lessening of population pressures through reduced
birth rates‖ (slow or no population growth, pp. 37-38), because ―population policy
becomes relevant‖ to the economic and political interests of the United States.
(National Security Memorandum 200, 1974 p. 43).

Based on these interests, the strategy proposed that the US should: a) obtain
international agreement and commitments from local leaders to roll out the population
policy, rearticulating in the ―population control‖ discourse some of the ideological
elements articulated in alternative discourses by opposing actors; b) play a leadership
role in family planning, and c) design development policies in aid programmes.

Development of a worldwide political and popular commitment to population

stabilization […] requires the support and commitment of key LDC leaders […] to take
the lead in advancing family planning‖ (pp. 11-12). Also, ―priority should be given in
the general aid program to selective development policies in sectors offering the
greatest promise of increased motivation for smaller family size‖ (p. 11). ―Our
assistance strategies for these countries should consider their capabilities to finance
needed population actions.‖ (Ibid. 127)

―There is […] the danger that some LDC leaders will see developed country pressures
for family planning as a form of economic or racial imperialism‖ […] ―It is vital that
the effort to develop and strengthen a commitment on the part of the LDC leaders not
be seen by them as an industrialized country policy to keep their strength down or to
24
 reserve resources for use by the "rich" countries.‖ […] ―The U.S. can help to minimize
[ideological] charges of an imperialist motivation behind its support of population
activities by repeatedly asserting that such support derives from a concern with: (a) the
right of the individual couple to determine freely and responsibly their number and
spacing of children […]; and (b) the fundamental social and economic development of
poor countries […]‖ (pp. 106, 114 and 155). ―Finally, providing integrated family
planning and health services on a broad basis would help the U.S. contend with the
ideological charge […]‖ (p. 177)

The strategy also stated that

―… the availability of contraceptive services and information is not a complete answer

to the population problem. In view of the importance of socio-economic factors in
determining desired family size, overall assistance strategy should increasingly
concentrate on selective policies which will contribute to population decline as well as
other goals‖ (p. 108), such as ―providing minimal levels of education especially for
women‖ and ―the education and indoctrination of the rising generation of children
regarding the desirability of smaller family size‖ (p. 111). ―Similarly, there have been
some controversial, but remarkably successful, experiments […] in which financial
incentives, along with other motivational devices, were used to get large numbers of
men to accept vasectomies.‖ (p. 138)

―… something more than family planning services will be needed to motivate other
couples to want smaller families‖ (p. 58). ―The great necessity is to convince the
masses of the population […] to have, on the average, only three and then only two
children.‖ ―… the obvious increased focus of attention should be to change the
attitudes of the next generation‖ (158).

Consequently, it can be concluded that ―population control‖ was a political and

foreign policy decision by the US government, which defined it as a ―population
policy‖ targeted mainly at LDCs and their people, with a gender and age bias, as it was
aimed specifically at women (without ruling out successful experiments on men),
children, young people and future generations.

So, if these were the objectives, strategy and methods of the ―population
control‖ policy, I conclude – following Foucault – that this ―population policy‖ was
also a ―tool of power‖ (1984) used to apply family planning programmes and
contraceptive methods, which were also promoted by different movements and actors
such as the ―birth controllers‖ and the ―family planning advocates,‖ who sometimes
established strategic alliances.

Thus, the ―population control‖ policy was formulated with the aim of
controlling fertility. 27 The problem would be solved by formulating and implementing
the ―population control‖ policy, which was in fact

27
From the end of the 1940s until the ‘60s, the movement acted through private US foundations which
promoted and financed research on population, reproductive physiology and new contraceptive methods.
University departments, academic institutions and exchange programmes were set up to train researchers,
technicians and administrators. Laboratories were opened to develop the most modern and effective
contraceptive methods, such as the pill. Prestigious institutions such as the Population Council and the
International Planned Parenthood Federation were established and funded, as were journals that have
become essential to the field of demography today, such as Population Index, Demography or Population

25
 The population control programme with the largest political aim ever dreamed of: to
control the world population. The central theoretical framework would be provided
by Notestein‘s DTT, and support would be sought by transferring the mission to the
United Nations itself and trying to turn it into a Programme of Action approved by the
whole world through the International Population Conferences (Perez, 1994).

This policy was implemented and put in practice by setting in motion the
―hegemonic apparatus‖ and it was Notestein himself, as President of the Population
Council and the first director of the Population Division of the United Nations, 1946–
1948, who took charge of the task.28 He had the support of private foundations that
were already operating and practising fertility control from the end of the 1940s until
1961, such as the International Planned Parenthood Federation (IPPF), Family Health
International in the US, the Voluntary Sterilization Association known as the "Human
Betterment Association of America," "Birthright", ―Negative Population Growth‖ and
others (Embid 118-124). Also involved were the big US foundations such as Ford29,
Rockefeller, Mellon and Carnegie (Caldwell, J. and Caldwell, P. 1986), the CIA
(Frances Stonor 2000) and the US Army, since population was ―a national security
issue‖. The managers and staff of these apparatus were holding public office during the
F. Kennedy administration, when population control was declared an international
policy in 196130. Thus, the federal government (starting with Kennedy, and continuing
with Johnson and Nixon) and its agencies got involved in the promotion, funding and
implementation of ―family planning‖ programmes. The World Bank started to finance
them in 1968, the year of publication of the best-seller ―The Population Bomb‖
(Ehrlich, P. 1968), which acted as the device through which the debate was introduced
to western public opinion.

and Development Review. The CIA got involved in this movement with military advisory committees
that recommended family planning assistance for third world countries, for national security reasons
(Embid, n.d) and (Frances Stonor 2000).
28
During and after Notestein‘s time in office, the Population Council (founded by Rockefeller III)
promoted censuses all over the world. These allowed the ―Population Reference Bureau‖ – also funded
by Rockefeller and working along the same lines as the Population Council since the 1950s (Embid n.d.
119) – to quantify the first results (2,500 million people in 1950, projected to grow by between 500 and
1,100 million in thirty years) and publish them in the 1954 ―Demographic Yearbook‖. That year, with the
aim of ―deepening demographic knowledge,‖ the First World Population Conference was held in Rome.
It resolved to ―encourage the establishment of regional training centres in the third world‖ (Pérez 1994).
The Second World Population Conference (Belgrade 1965) approved the creation of a trust fund for
population matters. Between 1952 and 1958 the Population Council‘s budget increased from 4.5 to 18.3
million dollars, with 8.4 million donated by the Ford Foundation, 3.4 million by the Rockefeller
Foundation, and 2.9 million by the Ellon family. By 1959 its budget had increased to 20 million dollars.
During these years it promoted the development of various hormone-based contraceptives (Embid n.d.
117).
29
The Ford Foundation collaborated with the US government from World War II until the ―neoliberal
revolution‖ promoted by the Reagan administration. It helped to implement state policies by providing
financial support to international development agencies such as the IMF, where it imposed
―professionalization and scientific social work delinked from the class struggle‖. For the CIA, the Ford
Foundation was ―the best and most plausible kind of funding cover‖ as it allowed the CIA to finance "a
seemingly unlimited variety of clandestine action programs that affected individuals, political and social
interest groups, institutions, universities, publishers and other private institutions‖ such as those involved
in ―human rights‖(Petras, J. 2001).
30
That same year, the National Council of Churches in the US approved the use of contraceptives,
reversing its historic position on the issue (Schoijet, 2007: 121).

26
 According to the Population Council report (New York), in 1969 ―aggressive
strategies‖ were designed to control the population (Holdren 1977). These were also
agreed at the International Planned Parenthood Federation Congress held that same
year (Embid, 118).

The strategies were: a) massive use of a fertility control agent – sterilants mixed
with drinking water or basic foods – to maintain birth rates at a suitable level; b)
authorised payments per child, to ensure a reproduction rate of 2.2 children per couple,
or a certificate allowing people to have just one child legally; c) temporary sterilization
of all girls by means of a delayed contraceptive implant; d) obligatory sterilization of
men who had fathered three or more live children; e) obligatory abortion for all
illegitimate pregnancies; and f) ―encouragement programmes‖ such as payments for
starting to use or effectively practising contraception or for sterilization, payments for
periods of time without pregnancy or childbirth, savings bonuses for periods of twelve
months with no children born, responsibility awards for each five-year period a couple
lasts without a pregnancy or for vasectomy before the third child, and special lotteries
with tickets given to those who do not have children (Ibid. 118-119).

That same year, the trust fund became the United Nations Fund for Population
Activities (UNFPA), which was later transferred to the United Nations Development
Programme (UNDP). In 1971, 65% (US$109.5 million) of the UNFPA budget came
from the United States, 15% from other countries, 1% from the World Bank and 19.2%
from private foundations. 16% of this was contributed by the Ford and Rockefeller
Foundations (Ibid). Several developing countries received conditional aid and officially
announced that they were adopting national family planning programmes (Pérez 1994).

Consequently, political and institutional support was mobilized in all areas of

US influence around the world. The United Nations was the main apparatus that had a
global influence through the International Conferences on Population and
Development, Human Rights, and those held during the UN Decade for Women. As
well as the aggressive strategies, the policy included cultural strategies to ensure that
―people move in the direction we want for what they think are their own reasons‖
(Frances Stonor 2000). Family planning programmes were an important component of
both strategies, and the UN thus became a key driver of US foreign policy through its
Declarations, Programmes and agreed Plans of Action (Johnson 1987).

3.1.1.4. Policy implementation: women as the object of the policy.

One of the constitutive ideological elements of family planning and contraception

programmes, including voluntary and involuntary sterilization, is the relegation of
women, ―ad eternam‖ and in perpetuity, to the ―status of an object,‖ […] this is one of
the expressions of the global patriarchy that dominates the arena of public policy
formulation (Pérez, R. 1995).

In the ―family planning programmes,‖ the ―population control‖ policy found a

useful tool for exercising control and limiting fertility. It was applied most aggressively
in developing countries through ―conditional aid‖ with the support of the Population
Council. Several researchers, feminists and human rights activists called them
―eugenics and depopulation programmes‖ because they deployed strategies such as:
27
‗compulsory abortion‘ (population law) […] ―if the population crisis became
sufficiently severe to endanger the society‖ (Holdren 1977: 1280); surgical
(laparoscopy) and chemical sterilization, either voluntary or involuntary, such as
―Adding a sterilant to drinking water or staple foods‖ (Ibid., p. 1203), and other
experimental methods so that ―People who cause ‗social deterioration‘ can be
compelled to not have children‖ (p. 1281); "if the smart and responsible people limit
their families, why don‘t the stupid and irresponsible?‖ (Ibid. p. 1141).

The following examples documented by Embid (1994: 76-91) and others serve
as illustrative cases:

a) Chemical sterilization experiments involving the injection of the drug

paraformaldehyde into the uterus, which affects the endometrium, and ultimately
removing the uterus. This was applied to more than 100,000 women in 17 countries,
including the Philippines, Indonesia, India, Bangladesh, Bolivia, Brazil, Colombia,
Guatemala, the Dominican Republic, Puerto Rico, El Salvador, Panama and Peru. 31

b) Etherization by laparoscopy to obstruct the Fallopian tubes, applied initially

in indigenous communities. In Bolivia, the US NGO ―Peace Corps‖ sterilized all the
women of fertile age in the Quechua community of Kaata (Sanjinés 1969). In other
indigenous communities, between 300 and 500 women per day were being sterilized:
Bogotá (80 per day), Colombia (40,000/1967), El Salvador (30,000/1976), Guatemala,
India (837,000/1976), Peru, Mexico (1,500,000/1970s), Brazil (25,000,000/1965-
1971)32.

c) Sterilization through the tetanus vaccine containing ―hidden abortion-

inducing HCG,‖ used in the Philippines, India, Mexico and Nicaragua. 33

d) The Intra-Uterine Device (IUD) ―with the thread cut‖ was applied to
Brazilian women, who were left sterilized because the device could only be removed in
a surgical operation, and none of the women could afford to pay. 34

e) The ―Norplant Plan‖ developed by the Population Council (New York). This
is a long-lasting (5-year) contraceptive implant. It has side-effects such as blindness,
haemorrhaging, brain tumours and immunodeficiency. Having been used
experimentally on 500,000 women in Brazil, its use was extended to millions of women
in Chile, Colombia, China, Denmark, Ecuador, Egypt, Finland, India, Indonesia,
Jamaica, the Dominican Republic, Sweden, Thailand and the US.

31
Chemical sterilization was promoted by Dr. Stephen Mumford from the ―Center for population and
security research‖ and founder of the US organization ―Family Health International‖ (Embid 1994: 90).
32
In the case of Brazil, the International Monetary Fund imposed ―birth rate reduction programs‖ as an
essential condition for debt renegotiation (Embid 1994: 88).
33
The vaccination campaign promoted by the WHO had the support of the Rockefeller Foundation, the
World Bank and the Population Council. The WHO admitted that abortion-inducing HCG was present in
the vaccines, though ―in small doses,‖ as it ―came from the production process‖ (Embid, 1994: 89-90).
34
This was implemented by the "Family Welfare Association" in Brazil, a branch of the International
Planned Parenthood Federation (IPPF).

28
 f) The Enorit pill, experimented with on 1,956 women in Puerto Rico in the
1950s and ‘60s by the Puerto Rican family planning organisation ―Asociación pro
Bienestar de la Familia‖.

g) Medroxyprogesterone acetate (DMPA or Depo-Provera), a three-monthly

progesterone-based injectable contraceptive, widely used in developed countries such
as the US and on four million women in developing countries, including Ecuador, El
Salvador, Jamaica, Thailand and South Africa. It reduces bone density in certain parts
of the body and doubles the risk of breast cancer – the reason why it was banned as a
contraceptive in the United States.

Consequently, sterilization (voluntary and involuntary or forced) was applied

mainly to rural indigenous populations and to the poorest sectors of urban societies in
less developed countries such as Bangladesh, Bolivia, Brazil, Colombia, El Salvador,
Guatemala, India, Indonesia, Mexico, Peru, Puerto Rico, the Dominican Republic and
Thailand. Thus, women were forced to endure ―an assault on gender, genocide, the
crime against humanity as defined by international human rights organizations‖. ―The
consequences in terms of physical, mental and family damage to women sterilized
against their will have still not been fully assessed‖ (Reportaje de la esterilización
forzada, s/f).

It was against this policy that the contestatory movement would come together
to defend women‘s human rights and demand sexual and reproductive rights.

3.1.2. Partial conclusions on population control as a policy.

Throughout PART THREE, I have examined the process through which the
population control discourse was articulated and socially constructed, culminating in its
formulation and definition as an international policy in 1961. The study of this process
allows us to state that a population policy defined as ―the set of measures that seek to
influence the population growth rate, structures and geographical distribution‖ (Tapinos
1988: 362) is not neutral, because these measures are not ―plucked out of the air‖ but
are instead interwoven with the process of social struggle and production of meaning of
which – in this study – ―population control‖ is one of its expressions.

In this sense, the analysis undertaken allows us to state that the formulation of
the population control policy was the process through which political decisions were
taken to solve ―population growth‖ in less developed countries, which was considered
by the US state to be a problem. As we have seen, inherent in this process is ―the
meaning of the theories and ideologies that have supported and are frequently linked to
the social and political interests which its solution sought to serve‖ (Pérez, J. 1994).

Consequently, in the analysis of the discourse of a certain policy such as

―population control‖ or any other,

it is relevant to identify the Subject or actor(s) who define it, the ideology and
economic, political and social interests that work to support it, and the hegemonic
apparatus through which it achieves legitimacy and takes material form in social life.
All this leads us to situate the policy in the historical context in which it was defined

29
 and the power relations which shaped it, due to which it is vulnerable to ruptures that
usually lead to a paradigm shift in the issue in question (Pérez, R. 1993).35

Consequently, following the quotation above, we can state as a partial

conclusion that the ―population control‖ policy defined by the US state responded
essentially to its objectives of economic expansion and political domination, which are
clearly defined in Memorandum 200. Thus, it will be the articulation of these objectives
together with ―their form of implementation that differentiates this specific population
policy from others‖ (Pérez 1994). Looking at the implementation has likewise led us to
examine the apparatus and – following Foucault (1984) – to identify ―which apparatus
are to be used to take action,‖ which in turn ―leads us to examine the strategy, methods
and means.‖ Thus, the US state set in motion various ―power apparatus‖ through which
it exercised an influence to take forward its policy, which was implemented on the
basis of the correlation of forces and power relations established in the process of social
and political struggle, now more globalized, and which met with a contestatory
response from the Global Women‘s Rights and Health Movement (GWHRM). I will
conclude PART THREE by analysing the discourse of this latter Subject and actor.

3.2. THE COUNTER-HEGEMONIC DISCOURSE AND ACTORS.

There were at least three main actors36 opposed to the ―population control‖
discourse that became a policy; but in this paper, the focus is on the Global Women‘s
Health and Rights Movement (GWHRM) which is concerned with women‘s rights,
women‘s health, and women‘s lack of voice in the public and private spheres (Wendy
Harcourt 2006).

The GWHRM emerged in the 1970s. Like any other movement, it is not
homogeneous, and neither is it limited to the feminist movement. It brings together
women‘s organizations from developed and less developed countries, and therefore
links different ideological and political standpoints deriving from diverse social
realities and specific and historical social constructions of gender. It is characterised by
having denounced - with the human rights community - the abuses that were committed
by individuals dismissive of women‘s human rights. 37 Thus, based on the new unifying
principle of ―gender and human rights,‖ it defends the right to reproductive health.

35
As we will see later in PART THREE and in PART FOUR, where I will undertake a comparative
analysis of this discourse and its rival, that of ―Gender and Human Rights and Reproductive Health
Rights‖.
36
The main actors opposed to the policy were: first, the socialist block, for whom overpopulation does
not depend only on the size or density of the population, but also on the ratio of population to available
sustainable resources, and thus the way resources are used and distributed throughout the population
(John F. Besemeres 1980); second, the ―South block‖ constituted by developing world which - through
the Group of 77 - demanded a ―New Economic Order‖ NEO (Encyclopedia of Globalization 2007: 553-
555) to deal with population policy; third, the organized feminist movement concerned with women‘s
rights, women‘s health, and women‘s lack of voice in public and private spheres (Wendy Harcourt
2006).
37
Before constituting themselves as the GWHRM, different women‘s movements and groups forged
alliances with various other actors, in pursuit of the objectives that guided their actions. At the
beginning, there were alliances between a) the ―neo-Malthusian movement‖ and some feminist
movement tendencies from the developed countries known as the ―birth controllers‖ and the ―family
planning‖ movement; b) At the end of the 1960s, the alliance was made with the community of the

30
 3.2.1. The “Gender, Human Rights and Reproductive Health Rights”
Discourse. The violation rights as a problem and the women‟s declaration
policies as solution.

3.2.1.1. Definition of the problem

The universal concept of human rights set out in the Declaration of 1948 "has a
blind spot on women's human rights‖ (Steiner, H.J. et. al 2000: 158). The assertion of
these rights in the field of sexual and reproductive health followed a distinct historical
process, in the heat of social and political struggles driven by the different strands of
the feminist (and non-feminist) movement in both developed and developing countries,
which finally came together around the GWHRM. The movement worked alongside
the human rights community.

3.2.1.2. What is the problem?

The problem arose because women – the main subjects of reproductive life –
were the object and ―the main victims‖ of ―population control‖ programmes. Thus,
contraceptive methods, which are in fact a means of liberating women by separating
sexual activity from reproduction, became the instruments and devices of population
control, (Ávila, 1989: 18) with a negative effect on women‘s sexual and reproductive
health.

3.2.1.3. What is the cause of the problem?

The cause is not one-dimensional. It can be explained historically by the way in

which social gender relations have been constructed38 and the ideas on which they are
based, as expressed also in the concept of Universal Human Rights (1948) 39. The cause

Human Rights Movement; and c) in the 1970s, the alliance began to become comprehensively articulated
between different tendencies of the feminist movement from developed and less developed countries;
finally, they all came together to constitute the GWHRM.
38
With regard to the first point, and focusing only on the causes relevant to this study, it is useful to
mention that ―in the 17th century, human beings were represented by men, while women were seen as
bodily life forms half way between humans and animals. […] In the 18th century, with the clamour for
equality, liberty and fraternity (in the French revolution), women ceased to be seen as an atrophied
version of men and gained their own sex and corporeal nature‖ (Villela, W. and Arilha, M. 2003, pp. 95,
102-103). ―The newly inaugurated world of two sexes‖ did not alter the idea that ―nature had ordained
the basic differences between men and women and, based on these, the functions and roles that the two
sexes should play in society‖ (Roden n.d.: 206). The function of women was to procreate (Villela et al, p.
95), while that of men was to organise the good government and bodily economy of women, since the
development of society depended on the appropriate and efficient management of the bodily
development and reproductive capacity of women (Rohden 2003: 205-206). Consequently, the
differences imprinted by nature on the bodies of men and women located them as occupying different
social positions and functions. In this discursive formation, ―reproduction is the ultimate aim of sexual
relations‖ and ―any sexual expression that focused on pleasure rather than reproduction was rejected‖
(Villela 1992: 104). As a result of this link between sex and reproduction, the normative model was also
that of heterosexuality (Avila 2003: 466), since ―every culture, at every moment in history, constructs
symbols and signs of what is accepted and desirable in sexual terms‖ (Villela 98).
39
The adoption of the Universal Declaration of Human Rights by the UN in 1948 marked the start of
―international human rights law and the global system of human rights protection in the setting of the
United Nations‖. The holders of these rights were identified as all human beings, in general and in the

31
of the problem can therefore be identified as the failure to recognise women‘s human
rights, specifically those that relate to sexual and reproductive health (Villela, W. and
Arilha, M. 2003: 95-102), which were violated by the implementation of ―International
Family Planning Programs‖ (IFPP) (Visaria, and Chiaria 1998: 54-64).

Following an anti-natalist policy, these programs included as methods of family

size limitation: a) sterilization, b) abortion, and c) other forms of experimental
contraception. These disregarded the recognition of women's human rights, affecting
women‘s health (Ibid. 1998: 54-64) and violating their rights because these programs
were coercive, racist and even genocidal according to the GWHRM (Harcourt, W.
2006).

Therefore, according to Freedman, and Isaacs (1993: 18-30), the problem

should be addressed by breaking with neo-Malthusian ideas and moving away from the
neo-Malthusian movement, whose aim with regard to ―reproduction‖ was to limit
family size by using contraceptive methods to control population growth. Here, the
population – especially women as reproductive subjects – is seen as the object of
management rather than the subject of policies that aim to ensure their wellbeing. The
new approach focuses on ―women‘s control over their own bodies and reproductive
life,‖ once again making women the subject of a population policy whose aim is to
promote the individual‘s wellbeing (Ibid.). Here, ―family planning programs‖ and the
contraceptive methods envisaged are linked to women‘s reproductive health rights and
their right to life, ensuring them proper access to health services (CEDAW 1979). The
shift occurred once ―The demand for reproductive rights […] was expressed, based on
the link with the right to health (and) the measures that ought to be adopted to ensure
the full exercise of those rights‖ (Pintaguy 1999: 37).

3.2.1.4. How can the problem be addressed and resolved?

The problem has been tackled in three dimensions: a) seeking to deconstruct the
"theories of sexuality and reproduction" in order to build "a new approach that enables
sexual practices to be thought of as separate from reproductive practices" and include
these in the field of human rights; leading to b) a shift from the focus on 'population
control' to family planning that respects human rights and reproductive health; and c)
introducing this approach in the discussion at the International Conferences on
Population and Development, to influence decisions and action plans.

These three interlinked dimensions take us to the setting of the International

Conferences on Human Rights, held in 1968 and 1991, the International Conferences
on Population and Development held in 1974, 1984 and 1994, and the World
Conferences on Women, held in 1975 and 1984. By looking at the most important
milestones in these conferences, and what they meant, we can reach an understanding
of how the problem was addressed and resolved.

abstract. Later, as a result of the social construction of rights and social and political struggle, the
subjects of rights started to be specified in response to differences between sexes, races and age groups.
It was only in this process that the concept of women‘s human rights began to be articulated and
expressed as meaningful at the International Human Rights Conferences in Tehran (1968), Bucharest
(1974) and Cairo (1994).

32
 a) International Conference on Human Rights (Tehran-Iran 1968):
Reproductive rights as human rights.

The vindication of ―reproductive rights as human rights‖ marks a milestone at

the Tehran Conference because, according to Dixon-Mueller (1993: 3), 49 countries
voted in favour of the following resolution: ―access to family planning was indeed a
human right […] all couples had the right to freely decide the number and spacing of
their children‖ (TEHRAN DECLARATION, clause. 16 Final Act. 1968). So the Final
Act moves the ‗family planning programs‘ articulated by ‗population control‘ to
‗family planning programs‘ articulated by ‗human rights‘; and this new principle of
articulation ―privileges reproductive rights,‖ meaning ―the reproductive autonomy
exercised mainly by women‖ (Freedman, 1993: 20). This new articulation is centred
on "women's control over their own bodies, their sexuality and reproductive life" as a
fundamental human right (Ibid). The slogan ―our bodies, ourselves‖ allowed the
feminist movement to break with and distance itself from the neo-Malthusian
movement (Correa, S. and Ávila, MA, Op. Cit. p. 19).

After the Tehran conference, the feminist discourse on ―our bodies, ourselves‖
gained in strength during the 1970s, and further victories were won at the World
Population Conference held in Bucharest, Romania (1974).

b) World Population Conference (Bucharest, 1974)40: The articulation of the

GHRHM as counter-hegemonic Subject/actor.

The Conference was planned by the leaders of the neo-Malthusian movement to

be the international conference where consensus would form around their agenda
(Hodgson and Watkinns 1997: 489). The United Nations, under the direction and
leadership of the USA, was the powerful apparatus that mobilized the whole process
through the UN Economic and Social Council (Donalson, 1990). Therefore, the USA 41,
UN agencies, leaders of the neo-Malthusian movement and its demographers drew up
the ―Draft World Population Plan of Action‖ (WPPA) that ―stresses the need to limit
population growth through implementing population […] policies with direct effects on
fertility (and) embodied the convictions of those espousing the need for neo-Malthusian
population control measures‖ (Paige 2004: 63).

The Draft was altered by a counter hegemonic historic block organized by the
States of developing countries (Group of 77) 42; the socialist states43, and diverse social

40
Cf. Third World Population Conference (ECOSOC Res. 1484 (XLVIII) of 3 April 1970).
41
USA brought as much influence both at formal and informal levels to planning and preparing the
Bucharest Conference within level of expertise, manpower, financial resources, and diplomatic
persistence to approached and establishment population control. Bucharest it was an opportunity to
express what it viewed as a nearly complete consensus regarding the rapid population growth and the
advantages of countries adopting population growth reduction targets (Paige, 2004).
42
The Group of 77 was constituted by the United Nations in 1964 to provide ―a forum for the developing
world to articulate and promote its collective interest relating to the global economy‖ and ―demanded
major changes in the rules governing the global economy‖ (Encyclopedia of Globalization 2007: 553).
According to Finkle and Crane (1975: 92-97), in Bucharest the ―Declaration on the Establishment of a
New International Economic Order‖ (NIEO) and its ―Program of Action‖ (of this Group) was adopted to

33
women‘s movements articulated around the GWHRM, and NGOs. The first two, with
discourses focusing on the construction of a ―New International Economic Order‖
(NIEO), demanded socioeconomic policies that would benefit them and respect their
national sovereignty and universal human rights (UNITED NATIONS (Comp.) 1994).
The third focused on alternative discourses to population control such as family
planning programs guided by a reproductive rights and health rationale. The game
played by the Global Women‘s Health and Rights Movement (GWHRM), and the
right-to-life movement through NGOs, was significant in that the right of individuals
and couples to reproductive autonomy was affirmed at the Bucharest Conference.

So, the ―historic block‖ emerged on the international scene dismantling the
ideological elements of ―population control‖ and articulating devices such as
―development aid and family planning programs‖ linked to ―universal human rights‖
and ―national sovereignty‖. Because of the new correlation of forces, ―human rights‖ as
a new discursive principle won the debate in Bucharest.

The Draft WPPA was revised. The conference approved 44 ―family planning
programs‖ linked to ―human rights rather than population control‖ (Hodgson and
Watkins 1997: 490); with regard to sovereignty, the Plan didn‘t set any international
norm for family size or rates of population growth (Singh, 1998; 3). Countries which
consider their birth rate detrimental to their national purposes may consider setting
quantitative goals, implementing policies and programs (Paige, 2004: 67) ―to be
formulated at the national level within the context of the specific economic, social, and
cultural conditions within each country‖ (Singh, 1998: 2). So, it enshrined the right of
individual countries to determine their own population policies to suit local conditions
and without any outside interference (Boland 1995: 27-28).

Thus, the way in which the problem was addressed in Bucharest was to reaffirm
human rights as the guiding principle for family planning programs, based on a
reproductive rights and health rationale, and ―offering the media information and
education targeted to couples and individuals regarding their reproductive rights‖
(Freedman Op. Cit., 1993: 20).

After Bucharest, the ―population control‖ discourse began to fall apart. Now that
the social and political process had delegitimized it, it entered a crisis from which it would
never recover. The US government changed its strategy once it recognized ―that population
policy is a human concern intimately related to the dignity of the individual and the
objective of the United States is to work closely with others, rather than seek to impose

rectify an unequal and unjust distribution in global wealth, to restructure existing debt repayments and
engage in debt forgiveness, to make technology transfers to the Global South, and to seriously address a
host of others issues championed by the developing world.
43
The Socialist states acted with them as an ant imperialist block against the USA identified as the main
political adversary and so leadership of the West vs. East block in the context of the Cold War interested
in realizing by consensus its ―foreign policy objective‖ (population control) and the resulting strategy
called by them ―Global Population Strategy‖. For the ideology of the communist international
―population growth‖ has solution if the resources of the society are been distributed socially, such as
socialistic system (Besemeres, 1980).
44
The World Population Plan of Action, was adopted by consensus of the 137 countries represented at
the United Nations World Population Conference at Bucharest, August 1974. http://www.population-
security.org/27-APP1.html#Cover

34
our views on others‖ (NATIONAL SECURITY COUNCIL, WASHINGTON, D.C.
20506)45.

With the shift in strategy and the legitimation of the counter-hegemonic

discourse, ―population control‖ ceased to circulate as a hegemonic discourse. It was
displaced and disqualified by the UN itself when it declared 1975-1985 as ―the UN
Decade for Women‖ and organized global conferences 46 to design new and improved
policies to address population problems, based on the new ideological elements put in
place in Bucharest.

c) The first Women‟s Conference - Mexico 1975.

A year after Bucharest, the First World Conference on Women, held in Mexico
in 1975, included two significant elements in its Declaration: a) ―equal rights,
opportunities and responsibilities for women and men,‖ thought of as the ―reallocation
of the functions and roles traditionally assigned to each sex‖ by ―deconstructing and
reconstructing what it means to be a man or a woman‖ (Murube, n.d. 2); and b) the
right to reproductive autonomy, adopting the right to reproductive choice and the
notion of bodily integrity and control47.

The powerful effects of this discourse became evident when in 1979 the UN
adopted the Convention on the Elimination of All Forms of Discrimination against
Women (CEDAW)48, which was based on the "double duty to eliminate discrimination
and ensure equality" (Piovesan, 2003: 207).

d) International Meeting on Women and Health - Amsterdam 1984

The demand for reproductive rights was discussed in Amsterdam at a meeting

convened by the ―International Campaign on Abortion, Sterilization, and
Contraception‖ (ICASC), which was later re-named as ―Women‘s Global Network for
Reproductive Rights‖ (WGNRR) following pressure from Southern women‘s activists
to express their ―health and rights agenda‖ (Correa, and Reichmann 1994: 61).

45
In this discourse, the enunciation ―work with the others‖ doesn‘ t mean that they are no longer
―population controllers‖. To work closely with others, means to take the opportunity to promote their
own new agenda toward the new principle of the human right, and the USA did, taking advantage from
the US feminist and their notion of rights (linked at the liberal ideology) in the sense that ―White House‖
want to link also the policy with ―neoliberal economic policies‖ to curb population growth in the
developing world. So, rearticulating as ―populations controllers‖ their demographic rationale and their
neoliberal economic policies with the new principle, they have agreed ―gave to women another option in
fertility reduction‖ (Paige 2004: 90). So the strategy shift has been successfully from 1975 to 1984,
during the ―UN Decade for Women‖.
46
Three women‘s conferences were held: Mexico (1975); Copenhagen (1980) and Nairobi (1985).
47
Mexico Declaration, states that: Equal rights, opportunities and responsibilities will be achieved
through "reallocation of traditional roles and functions allocated to each sex", means "through the
deconstruction and new construction of what is men and women" (Murube, s/f/).
48
Article 16 declares that member states are obliged to adopt all necessary measures to eliminate
discrimination against women in all matters related to marriage and family relations. In particular, they
must ensure – based on equality between men and women – that women have the same rights to decide
freely and responsibly how many children they wish to have and when, as well as having access to the
information, education and means that will enable them to exercise those rights.

35
 Here there was a consensus to understand "women's health" rights as linked to
an agenda for women's reproductive self-determination (CORRÊA, S. and ÁVILA,
M.B. Op. Cit, p. 20). The debate focused on the deconstruction of motherhood as a duty
to fight for the right to abortion and contraception in developed countries (Correa,
1999: 14). This considers reproductive choice as a universal human right (Freedman,
and Isaacs 1993), through which states can be required to adopt preventive and
remedial measures to protect women's reproductive health, giving them the
opportunity to exercise their reproductive self-determination (Cook 1993).

e) International Conference on Population and Development– Mexico 1984.

Building on the gains achieved by the GWHRM, this Conference introduced the
duty of governments to make universal access to family planning programs effective.
At the Nairobi Conference (1985), this was linked with the ethical critique of the
demographic approach to population control programs, advocating alternatives against
the dominant norm and rearticulating a new norm of human rights. The human rights
community and the GWHRM worked toward this objective at the UN World
Conference on Human Rights (Vienna 1993).

It can therefore be stated that a new approach to the problem was taking shape
based on the new meanings that emerged in the late 1980s and early 1990s, when
women in diverse countries took up the human rights framework and began developing
the analytical and political tools that together constitute the ideas and practices of
women‘s rights (Bunch and Frost 2000: 2).

f) Second World Conference on Human Rights - Vienna 1993.

In the Second World Conference on Human Rights, Vienna (1993)49, the issue
of sexuality, which had been absent from the discourse on international human rights
(Petchesky, n.d 2), was included in paragraphs 18 and 38 of the Declaration and
Programme of Action, which proposed to "eliminate gender-based violence and all
forms of abuse and sexual exploitation," including the trafficking of women,
―systematic rape, sexual slavery, and forced pregnancy‖.

In December of the same year, the UN adopted the Declaration on the

Elimination of Violence against Women, condemning, in paragraph 2, the various
forms of physical, sexual and psychological violence suffered by women, claiming that
such rights and principles are embodied in international human rights treaties. It should
be noted that this declaration was the basis for the Convention on the Prevention,
Punishment and Eradication of Violence against Women, adopted by the Organization
of American States in 1994, whose content is legally binding for the countries that
ratified it.

So, after the Conference (1991), reproductive rights (and health) emerged as a
human right, gaining international attention. The global network and actors influencing

49
In Vienna, the States agreed to consider any violation of women‘s specific rights as a violation of
human rights. The Conference was a major shift in human rights theory, because it established that
human rights can be enjoyed both in public and private; and therefore, can be violated in both areas.
There it was determined that human rights are universal, interdependent and indivisible.

36
each other have recognized that woman‘s rights are universal, inalienable, and
indivisible. Consequently:

The reproductive right‟ became globalized by framing it as an international human

rights norm […] The abuses of women‟s human rights in coercitive population control
programs were deemed unjust and intolerable […] the acceptance of reproductive
right and health by the United nations, donor agencies, foundations, and states would
help ensure a more just, tolerable, and human rights oriented world women. The
framing of reproductive rights as an internationally recognized human rights also
gave human working within their governments, public agencies, and even other
individual who prevented women from exercising their reproductive autonomy (Paige
2004: 114).

Therefore, the framing of reproductive rights as international human rights was

instrumental in moving global population policy away from population control to
reproductive rights and health, and ―the discourse of population control was replaced
by the language, norms, and policy prescriptions consistent with reproductive rights
and health‖ (Paige 2004: 114).

Thus, the norms supporting population control were further undermined, and
women ceased to be treated as targets and acceptors of family planning programs
guided by the ideology that emerged at the beginning of global history. After Vienna,
women have the right to control their reproductive capabilities or have a right to make
voluntary and informed choices about their reproductive and sexual health. In the
material social processes of globalization, women have articulated and constituted an
alternative oppositional ideology that challenged the norm of ―population control‖ and
constructed one that changed the paradigm on population policies. The latter has its
main expression in the ―Women‘s Declaration on Population Policies‖ (Women‘s
Voices ‗94‖ A Declaration on Population Policies, 1993: 637-640), legitimized at the
United Nations International Conference on Population and Development (ICPD) that
was held from 5-13 September 1994 in Cairo, Egypt.

This process is what led to progress on the agenda of the International

Conference on Population and Development held in Cairo (1994) where "reproductive
rights" were enshrined. According to paragraph 7.3 of the Programme of Action
adopted in Cairo50.

reproductive rights rest on the recognition of the basic right of all couples and
individuals to decide freely and responsibly the number, spacing and timing of their
children and to have the information and means to do so, and the right to attain the
highest standard of sexual and reproductive health. It also includes the right of all to
make decisions concerning reproduction free of discrimination, coercion and violence
as expressed in human rights documents.

Thus, "women, the main victims of population control programs, went from
object to subject of population and development programs,‖ when it was resolved that
the issue of population should be addressed from the perspective of reproductive rights
and their recognition. It was thus explicitly defined that population policies should be
guided by human rights. The relationship between population and development clearly
50
Text paragraphs 7.2 to 7.4.

37
accelerated the legal recognition of reproductive rights, as human rights, "born in [...]
conditions characterized by the struggle in defence of new freedoms against old
powers" (BOBBIO 1992: 5).

So, in conclusion, it can be said that the issue was partially resolved at the Cairo
Conference, because:

i) The policy of "population control‖ was delegitimized and reproductive rights

legitimized as an international norm that changed the politics and global population
policy;
ii) It established a program where the new paradigm for family planning
programs:

 Envisioned the practice of family planning as voluntary and free of

demographic targets (Hardee et al 1999: 53),
 The focus and objective were moved from fertility reduction to the needs of
individual women, ensuring conditions that encourage voluntary and
informed choice about their reproductive and sexual health (Forman and
Ghosh 2000: 2),
 Replaced the regulatory approach, backed by the biomedical model, which
saw increases in contraceptive prevalence as the best solution to rapid
population growth, with a humanistic agenda centered on people, their
health and rights (Piage 2004: 135 Op. Cit.); and finally

iii) Effected an ―ethical and moral‖ reform when it stated that the use of
coercion, incentives/disincentives, targets, quotas, or any inducement used to affect
fertility, does not constitute appropriate behaviour by states, agencies, or any other
actor involved in international population policy. Thus, it stated that governments ought
not to pursue an antinatalist or pronatalist agenda in their support of family planning
programs (Paige 2004: 160).

Consequently, it is possible to affirm that the problem was solved by the

paradigm shift. The following paragraph summarizes and expresses the resolution:

Discursive and normative change has occurred at Cairo […] represented

transformations in the ideology of the field […] is an unusual policy document. […]
intended to establish norms guiding international population policy for the next twenty
years […] the phrase ―population problem‖ is totally absent from the „Program of
Action‟ (and) put away at the rationale undergirding population control ( Hodgson and
Watkins 1997: 469).

3.2.2. Partial conclusions on the discourse of “Gender, Human Rights and

Reproductive Health Rights” as an international norm that changed population
policy.

Throughout PART THREE, I have examined the process through which the
―Gender, Human Rights and Reproductive Health Rights‖ discourse was articulated
and socially constructed, culminating in a ―fundamental shift in the design, structure
and implementation of population policies, to the empowerment and well-being of all
women‖ (―Women‘s Voices 94‖, A Declaration on Population Policies, 1993: 637).
38
 My study of this process allows me to state that the formulation of this policy:
a) was interwoven with the process of social struggle and production of meaning, in
which the meaning of ―reproductive health and reproductive rights‖ stands out as one
of the expressions cut across by ethical principles that change the orientation of
population policy. Heading the list of these principles is the one stating that ―Women
must be subjects, not objects, of any development policy, and especially of population
policies‖ (Ibid. In: ―Fundamental ethical principles‖, 1993: 638); and b) was articulated
from civil society, once the violation of women‘s human rights and reproductive health
rights was recognised as a social problem after the Tehran conference (1968), and
consequently action started to be taken through a process of collective action that
defined and articulated – over the years between 1968 and 1994 – the main objectives
set out in the ―Women‘s Declaration on Population Policies‖ 51 (Women‘s Voices 94,
pages 639-640). Therefore, the definition and recognition of the problem by civil
society, the analysis of its causes, and the putting forward of objectives together with
proposals for solving the problem – once it started to be dealt with in the arena of
public consideration52 - is what differentiates the definition of this policy from its rival.

This is why it was relevant to identify its Subject/actor – the GWHRM – and the
social movements that determined it, as well as the alliances forged with the human
rights community, thus revealing the process through which established power relations
defined the contradiction that led to the paradigm shift. It can therefore be stated –
following Gramsci (Bucci 1988) – that the GHRHM, through the ―war of positions,‖
managed to exercise an influence that enabled its policy to take material form, based on
the power relations and the correlation of forces that was established. Thus, in the
Global Women‘s Health and Rights Movement (GWHRM) and its Declaration, the US
state came up against a contestatory response to its policy, on the basis of which the
Cairo Programme of Action was rearticulated. The formulation of the alternative policy
was therefore characterised by strictly political decision-making, and policies were
defined on the basis of these political decisions (Barret and Fudge, 1981). This analysis
concludes PART THREE of the study, and I will now proceed to the comparative
analysis of the two discourses.

51
The Declaration sets out six inter-linked objectives as ―minimum program requirements.‖ These are:
1. Reduce and eliminate pervasive inequalities in all aspects of sexual, social and economic life […] 2.
Support women‘s organizations that are committed to women‘s reproductive health and rights and linked
to the women to be served, especially, women disadvantaged by class, race, ethnicity or others factors
[…] 3. Assure personally and locally appropriate, affordable, good quality, comprehensive reproductive
and health services for women of all ages […] 4. Develop and provide the widest possible range of
appropriate contraceptives to meet women‘s multiple needs throughout their lives […] 5. Ensure
sufficient financial resources […] 6. Design and promote policies for wider social, political and
economic transformation that will allow women to negotiate and manage their own sexuality and health,
make their own life choices, and participate fully in all levels of government and society.
52
According to the theory of the sociology of action, ―A social problem does not exist until its existence
is recognised‖ and ―people start to act on it‖ until ―it gains legitimacy‖, since ―it is its entry into the arena
of public consideration‖ – with the social and political backing of state and society actors and their
institutions – ―that enables it to gain legitimacy‖ (Herbert Blumer, 298).

39
 IV. PART FOUR

4. COMPARATIVE ANALYSIS OF TWO DISCOURSES.

To complement the research work, here in PART FOUR I will proceed

to carry out a comparative and complementary analysis of the two discourses, referring
to the ―theoretical corpus‖ and the technique mentioned in PART ONE.

4.1. The Subjects/actors in the discourse.

There are two Subjects/Actors in these discourses: the US state and the
GWRHM (as part of global civil society). Both actors works as ―interpellating
subjects‖ who establish relations of inclusion or exclusion with different types of
addressees, who are the ―interpellated subject.‖

The US state, articulator of the ‗Population Control‘ discourse, sees itself as an

actor that is able – through coercion and by consensus – to influence political,
economic and social life in less developed countries, as well as representative
institutions such as the UN, in order to disseminate and implement its policy by
imposing indicators that aim to affect fertility. In this sense, it seeks to achieve
political, economic and social objectives that will polarise the political and ideological
scenario.

The GWHRM, articulator of the ―Gender and Human Rights and Reproductive
Health Rights‖ discourse, sees itself as the organic expression of a collective will that
deliberates and exercises its right to self-expression and self-determination in the
international conferences organised by the UN. These are seen as a democratic space
where the international policy of the US state can be questioned and displaced. In this
sense, the GWHRM seeks to redirect population policy to achieve historic objectives
that are political, because they imply weakening the population control policy and its
Subject.

4.2. Surface Reading

4.2.1 Analysis of the ideological elements / semantic units in the discourses

and how they are articulated around antagonistic and dichotomous hegemonic
principles.
In both discourses, there are ideological elements53 that can be grouped in the
same semantic field. These are identified below.

53
Following Landi (1992), I have analysed the semantic units (ideological elements) that appear most
frequently in the two discourses and proceeded to order them according to the semantic grouping in their
relationship of inclusion or opposition. Based on this relationship and grouping, I proceeded – following
Van Dijk – to formulate the basic proposition.

40
 In the ―Population Control‖ discourse, there are ideological elements derived
from the ideologies and theories studied in PART THREE. Those that appear most
frequently are as follows: growth of the human species, population growth, population
explosion, poor regions, reproduction, fertility, fecundity, insecurity, fertility reduction
and control, contraceptive methods, abortion, sterilization (voluntary and involuntary),
substances, incentives, aid, limits, family size, family planning programmes, national
security, instability, insecurity, development, resources, minerals, industrial
development, food, water, experiments, degeneration, poverty, the poor, survival,
structural poverty, non-viability, sex, women, children, biological quality, population
groups, race, indigenous peoples, coercion, the fittest, nature, disease, mortality, births,
subsistence and decadence54.

In this first reading, three semantic groupings can be identified:

a) Reproduction (fertility and fecundity); b) Population growth (growth of the

human species and the population explosion); and c) Insecurity (instability, non-
viability, poverty, degeneration and decadence). Thus, the basic proposition links
reproduction to population growth as a destructive force.

In the ―Gender and Human Rights and Reproductive Rights‖ discourse, the
terms that appear most frequently are: rights, gender, women, reproduction, health,
health care, sex, childbirth, abortion, contraceptives, patriarchy, discrimination,
violence, children, decisions, self-determination, family, fertility, fecundity, services,
sexuality, the exercise of rights, self-determination, the body, discrimination, family
planning programmes, human and reproductive rights, hygiene, safety, decision55.

In this first reading, three semantic groupings can be identified:

a) Reproduction (fertility and fecundity); b) Health (safety, hygiene, services);

and c) human rights and reproductive rights. Thus, the basic proposition links
reproduction to health with a clear connection to the exercise of human and
reproductive rights.

Diagram No. 1.
THE USA STATE GWHRM

54
Cf. Analytical Corpus in PART TWO. National Security Study Memorandum 200: Implications of
Worldwide Population Growth for U.S. Security and Overseas Interests (NSSM200) 1974.
55
Cf. Analytical Corpus in PART TWO. Programme of Action of the International Conference on
Population and Development. Chapter VII, United Nations A/CONF.171/13, 18 October 1994:
―Women‘s Voices ‘94‖ A Declaration on Population Policies (1993: 637-640)

41
 4.2.2. The dichotomization of reproduction and the actors

The recurrence of the ―reproduction‖ utterance in both discourses has a

relationship of semantic equivalence with another in the same field, but ―reproduction‖
acquires a different sense and meaning in the two discourses, in line with the basic
proposition.56 An inter-discursive difference thus becomes intelligible 57 and, with it, a
difference that appears as dichotomous is also produced between the addresser Subjects
involved in the discursive construction process. In other words, the ―reproduction‖
element present in both semantic fields suggests a relationship of opposition,
contradiction and conflict between the subjects – the GWHRM and the US state – that
also dichotomizes the social and political field. This will be analysed in more detail in
the section on the historic conflict situation and its dénouement. 58 However, it is
important to mention some of the ―differences of origin‖ between the actors, or
differences in the way in which their power was constituted, as these will be useful in
the comparative analysis we are starting to carry out based on the ―reproduction‖
utterance.

First, we need to identify what they have in common, which is that both actors
are the addressers of discourses. The dichotomization between actors and discourses
arises because both are constituted as Subjects of social and political action and relate
to each other through conflict. The difference lies in the fact that the GWHRM is the
expression of a power that arises from and originates in civil society to claim and
defend women‘s human rights and reproductive health rights; as a contestatory Subject,
it will play a leading role in the changes brought about in population and development
policy, by including the ―gender‖ approach in it. The US state, in contrast, is the
expression of state power, ―located over and above society,‖ which prioritises
economic and political interests (its own and those of powerful economic groups and
transnational capital) in its ―areas of commercial influence,‖ over and above human
development interests. As a subject it plays the leading role in the policy of fertility
control – with a patriarchal approach – which affects women‘s human rights and
reproductive health.

Diagram No. 2.

Consequently, by relating to each other in a dichotomous way, they will re-

articulate the ―reproduction‖ utterance around poles that each exclude the other. To
analyse the configuration of the structural poles of the discourses, it is necessary to

56
The semantic utterances in the basic propositions play a condensatory role with regard to others. It is
around these that the structural poles of the discourses take shape and function as hegemonic principles.
57
In this first semantic grouping, the ―inter-discursive difference‖ is examined by identifying which is
the ―common‖ semantic utterance in both discourses, and next by relating this to utterances that are ―not
common‖ or ―absent.‖ Due to their recurrence, these also function as symbolic in one of the discourses,
but do not appear or are banished in the other, thus giving a different meaning to the propositions.
58
Cf. Infra.

42
expand the analysis of reproduction to include new articulations with other semantic
units which likewise operate as symbolic. To do this, we will proceed to the in-depth
reading.

4.3. In-Depth Reading.

From the former reading, it has become clear that the ideological element and/or
semantic utterance that plays a key role in these discourses is ―reproduction,‖ and that
this takes on a different sense and meaning in each discourse, due to the way in which
it is articulated around broader semantic units such as those present in the basic
proposition. In the in-depth reading, we will proceed step by step to identify the new
articulations that take shape around reproduction and the propositions that emerge from
these articulations, with the aim of: a) deepening our understanding of their sense and
meaning in the discourses; and b) as a result of this analysis, arriving at the symbolic
proposition of all the rest, which will shape the fundamental contradiction; the
relationship between these articulations will lead us to the structural poles of the
discourses, based on which their hegemonic principles are expressed.

4.3.1. Reproduction: its sense and meaning

Reproduction has a different sense and meaning in the two discourses,

depending on the way in which it is conceived and rearticulated in ―family planning
programmes‖ and the ―services‖ they provide.

4.3.1.1. Reproduction and family planning programmes

In the population control discourse, reproduction is linked to ―family planning‖

programmes with the aim of ―reducing fertility‖ (the growth of which should go from
slow to zero=extermination) to ―reduce family size‖ and ―limit population growth,‖ for
the economic and ideological reasons explained above. Implementation of these
programmes implies using aggressive/coercive and cultural strategies. The former
include all the ―voluntary and involuntary fertility control‖ methods, involving all
possible forms of ―services and technologies‖ that make it possible to achieve this goal,
such as compulsory abortion and sterilization carried out by means of surgical
procedures such as ―tube tying,‖ chemicals such as paraformaldehyde, injections, pills,
devices, and drugs or other substances added to water and food.

The cultural strategy is linked to this. It plays an important role because these
strategies operate by using ―persuasive‖ policies that go beyond ―family planning‖ in
the strict and coercive sense it is given by the language of ―population control,‖ as they
seeks to make ―people move in the direction we want for what they think are their own
reasons.‖ Proposals for achieving this include ensuring a minimum level of education
for women, indoctrinating young people and children (with regard to the desirability of
having smaller families), and ―to convince the masses [...] to have [...] only two
children. [...] the obvious increased focus of attention should be to change the attitudes
of the next generation‖. The strategy includes ―health festivals‖ and other cultural
activities such as music, which assist the ―free tube-tying and vasectomy campaigns‖.

43
 ―Reproduction‖ in these programmes is therefore determined more by
quantitative demographic indicators and less by the concept of human rights and
reproductive health, because they are based on a demographic assessment which took it
as given and proven that there is an inverse relationship between population growth and
economic growth. Based on this ―mistaken assumption‖ or ―universal truth,‖ depending
on the speaker‘s point of view, the population control policy established avowedly
restrictive and controlling demographic strategies and methods.

Diagram No. 3.

In the ―Gender and Human Rights and Reproductive Health Rights‖ discourse,
family planning is understood as the set of human rights-based practices aimed at
improving the health and reproductive rights of women (and men). Here the subject is
returned to the status of beneficiary of the policies. The starting point is the right of
individuals – especially women – to take decisions about reproduction, which implies
having access to contraceptive methods and being able to use them appropriately. This
comes about as a result of freedom and autonomy in decision-making and the
individual‘s self-determination with regard to their reproductive life without suffering
discrimination, coercion or violence, in line with what is stipulated in the international
documents approved at UN conferences.

Reproduction linked to health (reproductive health) is therefore understood as

the state of complete physical, mental and social wellbeing in relation to sexuality and
reproduction at every stage of life. As part of family planning, the discourse includes
sex education, the prevention and treatment of sexually transmitted infections, advice
before and during pregnancy and childbirth, and infertility treatment by means of
assisted reproduction techniques. Thus, reproductive health implies that people should
have a safe and satisfactory sex life, the ability to have children and the freedom to
decide whether, when and how frequently to have children (reproductive rights). Both
men and women have the right to be informed and to have access to safe, effective and
affordable methods to regulate fertility. They should also be able to use accessible
family planning and public health services that provide appropriate professional care to
pregnant women, enabling the delivery to take place safely and ensuring the birth of
healthy children.

44
 In this discourse, ―reproduction‖ is thus disconnected from the objective of
―reducing family size‖ and its indicators. Instead, the priority is its link with the two
basic concepts (rights – individual and collective – and reproduction) which are at the
same time constitutive elements of the ―human rights and reproductive health rights‖
discourse. In this sense, it differs from the ―population control‖ discourse because it
breaks with the latter‘s focus on the ―population and development‖ dyad by believing
that human beings are the axis of development and that their reproductive rights, as
individual rights, cannot be exercised unless the social, economic and political
conditions are in place for them to be fulfilled. This link between the individual and the
social sphere locates the debate in the field of development and implies that the
possibility of exercising these rights also depends on improving the economic, political
and social conditions in which people live and which are at the same time factors that
determine their health, together with individual and collective behaviours and lifestyles.

Diagram No 4.

Consequently, the displacement of ‗family planning programs‘ articulated by

‗population control‘ and their replacement by ‗family planning programs‘ articulated by
‗human rights‘ reveals the new sense and meaning that ―reproduction‖ takes on, which
centres on ―women‘s control over their own bodies, sexuality and reproductive life as a
fundamental human right.‖ Thus, the structural poles take shape: one that gives priority
to ―reproductive rights,‖ meaning ―reproductive autonomy exercised mainly by
women‖, versus that of ―population control,‖ meaning ―the control of bodies‖ or the
exercise of ―biopower‖59 through a power of state located over and above society.

4.3.1.2. Reproduction in service provision

With regard to ―service provision,‖ the difference between the two discourses
likewise depends on their objective, strategy and methods, which are in turn linked to
their perception of the subject (people). If the discourse views people as beneficiaries
of the policy, its sense and meaning will be different and opposed to the discourse that
views people as the object of management – in other words, as subjects deprived of the

59
The concept of biopower used here draws on Negri, A. and Hard, M. (2000).

45
right to health and the right to exercise their fundamental human rights. In the case of
women, this perception consigns them ―ad eternam‖ and in perpetuity to the ―status of
an object‖ rather than a person.

In the ―population control‖ discourse, the services to be provided are aimed at

reducing fertility to control population growth, and therefore ignore the individual‘s
right to decide. This is particularly so for women, who are subjected to coercive
procedures and methods for controlling their fertility. In most of the recorded cases in
less developed countries, this happened without their knowledge and consent, and
quality of care, hygiene and safety was absent.

The services are designed to control the bodies and thus the fertility and lives of
women and their offspring. Poverty is to be combated by killing the poor in their
mother‘s womb. It is clearly established that ―the aim is to eliminate the poor rather
than poverty.‖ With this in mind, direct support policies were implemented through
bilateral agreements between states, which in turn facilitated those that were
implemented indirectly through NGOs and private clinics.

The former type of policies, said to be part of the ―fight against poverty,‖ were
implemented through ―conditional aid.‖ The condition was to meet the indicators and
targets for the number of people who should be sterilized, by implementing ―Family
Planning Programmes.‖ This type of ―aid‖ in exchange for forced sterilization was
implemented aggressively in the 1960s and ‘70s, through the ―Alliance for Progress‖
(humanitarian food aid with the aim of sterilizing women) 60 and during the military
dictatorships in Latin America which carried out the ―Condor Plan.‖ 61 In the post-
―Washington Consensus‖62 period of the 1980s, now in more democratic contexts with
neoliberal governments, conditional aid continued under other arrangements and with
the backing of the ―Law on Sexual and Reproductive Rights.‖ This enabled family
planning programmes to be institutionalized in several countries which enacted in law
the resolutions and action plans approved in the Women‘s Conferences organised by

60
The ―Alliance for Progress‖ was a US economic and social assistance programme for Latin America
(1961-1970). It deployed aggressive strategies in the area of sterilization and ―supported the construction
of [...] hospitals, clinics and water-purification projects throughout Latin America.‖
http://www.america.gov/st/develop-english/2011/March/20110307144645nerual1.765078e-02.html
61
Through the Condor Plan, the United States CIA coordinated operations with the top echelons of the
military dictatorships in the Southern Cone of the Americas (Chile, Argentina, Brazil, Paraguay,
Uruguay and Bolivia). It was carried out in the 1970s and ‘80s (Paredes 2004).
62
Based on the assumption that the welfare state is responsible for economic stagnation (the lost decade
of the ‘80s), the fiscal deficit and the inefficiency of public services, the Washington Consensus (Moreno
2004) promotes the shrinking of the state, untrammelled access for transnational capital and the
privatisation of public services. The objective (Ponte, 2005: 313) is to reduce the role of the state as the
guarantor of basic social rights by delegating its regulatory role to the ―free market‖ and making
individuals responsible for their ―capacity‖ to access health, education and social security services.
Therefore, social goods such as health, education and social security, formerly achieved as rights, began
to be questioned and gradually transformed into articles of merchandise. In the area of health, the reform
process adopted various arrangements to create a market with the expectation of investment and
profitability in cost-benefit terms. The reform of the organisation and management of health services also
took place by means of decentralisation, which would supposedly lead to more efficient management.
This reform targeted one of the key spaces of the health / disease / care process with the aim of
encouraging competition between health services and, indirectly, the involvement of financial capital in
the health market.

46
the UN. Some of these programmes were just as aggressive as in the past, as pointed
out in the report of the Latin American and Caribbean Committee for the Defence of
Women‘s Rights (CLADEM: 2003, 2004).63

In the ―Gender and Human Rights‖ discourse, services are intrinsically linked to
a different perception of people as service users. In other words, people are given back
their right to decide and are seen as subjects with the capacity to fully exercise their
fundamental human rights, including rights linked to reproductive health. They
therefore cease to be seen as objects. This led to changes in the approach and
arrangements for service provision and government policies for direct support to
improve the conditions in health care services and revolutionise their practices, as they
redefined the health sector‘s obligations in primary health care to include a)
information, education and communication on human sexuality, reproductive health
and responsible paternity; b) information about and access to family planning methods
that are appropriate, safe, effective, affordable and accepted as a result of an informed
decision, c) safe pregnancy, childbirth and postnatal services and the elimination of
maternal health risks, which was the key demand with regard to women‘s health during the
International Decade for Women, 1975-1985, d) abortion prevention and treatment of the
consequences, e) prevention and appropriate treatment of infertility, f) prevention,
diagnosis and treatment of sexually transmitted infections (STIs), including HIV/AIDS,
and of breast cancer and other diseases of the reproductive organs, g) elimination of
harmful behaviours such as female genital mutilation, sexual violence and sex trafficking,
h) developing mechanisms for participation by the community, and especially women, at
all levels of the health care system, i) encouraging men to be responsible in all aspects of
sexual and reproductive health, civil society and the community in general, paying
particular attention to empowering women to defend reproductive rights (ICPD
Programme of Action, 1994, Chapter VII, Paragraphs 7.6, 7.7, 7.8, 7.9, 7.11).

Following this line of action, policy-makers and planners were given a (non-
binding) mandate and several countries implemented health system reforms that
changed administrative structures through decentralisation processes to improve the
quality of the service. Thus, service provision is directly related to the continuity of
care and improvements in quality.

Diagram No. 5.

63
In the 1990s in Peru, for example, the ―National Population Plan 1998-2002,‖ financed by USAID and
UNFPA, stated that ―birth control, sex education and the ‗gender perspective‘‖ should be linked. 320,000
women were sterilized in Peru during the Fujimori government with the backing of the ―Law on Sexual
and Reproductive Rights‖ (CLADEM 2003, 2004).

47
 4.3.1.3. The structural poles of the discourses and how the main
Subjects/actors articulate these with the hegemonic principles

We have seen how ―reproduction‖ is one of the constitutive elements in both

discourses, and that this can be articulated, dismantled and re-articulated differently by
the main Subjects and/or actors around broader semantic units such as those we have
analysed with regard to family planning and services. These shape new structural poles
which can in turn be re-articulated around ―meta utterances‖ which contain all the
previous ones and express what we have called in this study the ―articulatory
principles‖ of the discourses: ―Population Control‖ and ―Gender, Human Rights and
Reproductive Health Rights.‖

Diagram No.6.

Consequently, the hegemonic principles are the fundamental structural poles of the
discourses that contain the fundamental contradiction. This organises the social world
in dichotomous terms, because the actors and/or Subjects that are the addressers of the
discourses relate to each other through conflict, opposition and confrontation. Here,
through language, the discourses pose a dilemma which – in this research study – is
constituted and operates as historical and political, because it defines the resolution of
the conflict over ―population policy‖ in terms of power relations. This leads us to a
final consideration of the relationship between the structural poles of the discourses and
the main Subjects/actors who produce them.

The Subject category64 is useful to refer to the interpellations based on which,

on the one hand, the US state constitutes itself as the interpellating Subject of
―population control‖ and, on the other, the GWHRM constitutes itself as the
interpellating Subject of ―Gender, Human Rights and Reproductive Health Rights.‖ It

64
This category, coined by Althusser (op. cit.), is related to that of the „functioning‟ of ideology.
Ideology ―interpellates‖ and constitutes individuals as subjects, and they in turn give the ideologies
material form through different practices that operate through ―apparatus‖ – various state and society
institutions and organisations – which Althusser calls ―ideological state apparatus‖ and Gramsci calls
―hegemonic apparatus.‖ This makes it possible to break with the instrumentalist view of power and
situate it instead in terms of ―power relations,‖ as well as breaking with ―topological‖ views of social
reality. Consequently, the ―individuals‖ who are interpellated and constituted as subjects act through
identity collectives, which may be ―movements,‖ ―governments,‖ ―parties‖ or ―pressure groups‖
(economic, religious, cultural, gender, age, ethnic, etc).

48
also refers to the Subject that they constitute through their interpellations: the
interpellated subject.

In the first case, the interpellations made to ―affect reproduction,‖ ―limit

fertility,‖ ―reduce the number of families‖ and, consequently, ―limit population growth‖
– all articulated around the ―hegemonic principle‖ of population control – were not
utterances made by the US state alone. These interpellations were produced earlier,
when the eugenicist and neo-Malthusian ideologies took material form as the ―US
demographic orthodoxy‖ in the Office of Population Research headed by Notestein.
This interpellated members of the US government and its main agents operating
through the state apparatus65 until it managed to constitute itself as a Subject and, as
such, officially legitimated the ―population control‖ policy in 1961 and used it to
interpellate others.

In the second case, the interpellations operated in a two-way relationship

because, on the one hand, the GWHRM constituted iself as a Subject as a result of the
interpellations coming from feminist movements articulated from and in civil society,
and thus interpellated and was interpellated by these movements that articulated it as
their organic representation. As such, it became constituted as the interpelling Subject
of the ―political project‖ (―Women‘s Voices 94 Declaration on Population Policies‖).
With this project, it interpellated the representatives of states, seeking to disqualify the
policy of its adversary by presenting its project as a political and social demand coming
from civil society, using the language of ―what is democratic‖ to oppose the ―anti-
democratic‖ nature of a policy which, being articulated by a power located over and
above society, does not represent it and, on the contrary, seeks to ―control‖ society.
Consequently, the discursive construction poses another dilemma that is expressed
between these two poles of the ―democratic‖ and the ―anti-democratic.‖ This can be
resolved if a ―third‖ Subject starts to act: the member states of the United Nations.

In the discursive dispute, the representatives of states are thus situated and
located around this dilemma: they either identify themselves with ―what is democratic‖
– i.e., the ―historic project‖ of an alternative population and development policy
formulated in the ―Women‘s Voices 94‖ Declaration on Population Policies – or they
identify themselves with the ―antidemocratic‖ policy of population control. Through
the ―interpellatory interplay,‖ the utterances thus seek to resolve the dilemma by
aligning the third subject either with the GWHRM or with the US state.

Through their interpellations, the main Subjects/actors thus seek to produce

recognition effects in the third subject, around one of the poles. Therefore, if their
interpellations are effective, they ―interpellate‖ once the ―opening up of the inter-
discursive field‖ has taken place. Here, a choice of ―population policies‖ is offered and
the interpellated subjects ―take sides‖ (as happened in the Cairo consensus) and align
themselves with the one that appears to possess ―verisimilitude‖ 66; thus, the re-
articulations of the third subject around one of the poles will also take place.

65
The CIA, the US Army, USAID and others analysed above in PART THREE.
66
In discourse, verisimilitude does not refer epistemologically to the ―truth‖ or ―falsity‖ of the utterances
but rather to the power effects produced by a discourse, which presents itself as a ―universal truth.‖

49
 The effectiveness of the GWHRM lies in having articulated human rights and
reproductive health rights around ―what is democratic‖. This is what gives it legitimacy
in the dispute with its rival, because it situates and identifies the latter with ―what is
anti-democratic‖. It is around the sense and meaning of ―what is democratic‖ that the
alternative population policy is identified and expressed, and at the same time
interpellates and constitutes other subjects that operate to oppose population control.

Diagram No 7.

4.4. The ideological unity of the discourses and the discursive matrix

From the way in which the ideological elements or semantic utterances are
articulated around the hegemonic principles, the ideological unity of the discourses can
be defined and their discursive matrix can be elucidated.

In the two discourses that are the subject of this study, there is a dispute around
the ideological elements that play a condensatory role with regard to the others.
Although they belong to the same semantic field, such as ―reproduction,‖ ―family
planning,‖ ―services,‖ etc, they are grouped in the discourses in a relationship of
exclusion due to the way in which they are linked to the discourses‘ two ―hegemonic
principles,‖ which are ―Population Control‖ and ―Gender, human rights and
reproductive health.‖ According to Laclau (1986: 115), if this happens, ―we find
ourselves with a relatively unified discourse.‖ Likewise, the ideological matrix in the
two discourses is characterised by being binary and refers to an arena of conflict, power
relations and power effects produced by the social and political actors involved in the
conflict, whose discourses thus dichotomize social and political reality.

Of course, the process of social and political struggle may or may not lead to
changes in a certain ideological matrix. In the process analysed, it seems that what has
changed in the ―population and development‖ discourse is the internal organisation of
the ideological elements in the matrix over the period from 1961 to 1994. This
organisation is what gives sense and meaning to the central propositions in the
50
discourses produced from 1945 to 1974-1994 (Population Control) and from 1968 to
1994 (Gender and Human Rights and Reproductive Health Rights).67 This leads us to
analyse the effectiveness and power effects of the discourses and the discursive process
in order to better understand the polarity of a binary ideological matrix.

4.4.1. The power effects of the discourses and the interpellatory and
interpellated Subjects.

To produce power effects, the interpellations must be effective, meaning that

they must constitute individuals – including addressees – as Subjects in the social
process of producing sense and meaning.

4.4.1.1. The power effects of the “population control” discourse

The power effects of the discourse of the US state are related to its addressees
and refer to different periods of time and contexts. To start with, its interpellations were
effective, because they constituted economic and political actors (politicians and
governments of other states) as subjects once they accepted and identified with
―population control.‖ This is because the US state‘s economic and commercial interests
in ―poor regions‖ of the world are the same as the interests of the groups with
transnational economic power, meaning that the latter not only supported but also
promoted this policy. They therefore constituted the principal pro-addressees, together
with the political leaders and governments of less developed countries who have an
affinity with US policy, who took measures to help to secure political and social
stability in their countries, ―combating poverty‖ by means of ―fertility reduction‖
strategies with the support and (conditional) aid provided by ―international
cooperation.‖ Consequently, an initial power effect of the US state discourse is the
potential and capacity that power confers upon it to implement its policy through
bilateral relations.

Having constituted these two actors as subjects, it then sought to interpellate

other states and/or those considered the ―disputed third party‖ (those who are
―undecided‖ and therefore the principal para-addressees) by means of the power
structures at the UN, making sure that its ―organic intellectuals‖ (inclusive pro-
addressees) deployed political influencing strategies to advocate for the United States
position in the preparations for the International Conferences on Population and
Development, drawing up draft declarations and plans that served to legitimate
population control policy at the Summits. Once these were approved, states could enact
national legislation and take direct action to implement the policy.

67
The propositions in binary opposition are expressed in different ways and with metagroups that once
again regroup the semantic fields and which allude to ―democratic‖ and ―antidemocratic‖ alternatives as
the dilemma: either the ―democratic‖ project triumphs, meaning that the ―alternative population policy‖
is approved and states vote to ―constitutionalize‖ human rights and reproductive health rights, so that the
policy can then be deployed by governments in their countries to benefit the people; or the
―antidemocratic‖ project prevails and the human species is controlled in various ways through the
―population control‖ policy, which serves the economic and political interests of hegemonic elites who
act through the state. Faced with this dilemma, the UN is called on to fulfil its mandate and resolve the
conflict in favour of the alternative project.

51
 However, despite these efforts, the initial ―power effect‖ produced by the
discourse entered into crisis at the Bucharest Conference (1994), where the policy of
population control was called into question and delegitimised by various actors who
formed the ―historic oppositional block‖ referred to in PART THREE. Here, what
needs to be stressed with regard to ―power effects‖ is the loss of hegemonic capacity by
the dominant discourse, whose interpellations no longer produced constitutive effects
once the unity of the discourse had broken up. This enabled the ideological sphere to be
transformed as a result of the entry and intervention of alternative discourses, which
reorganised and disputed the ideological elements under a new form of articulation and
based on a different interpellation. These discourses were produced by the Group of 77,
and in this scenario the GWHRM constituted itself as an organised force and the
organic expression of the contestatory discourse.

In an attempt to restore its hegemony in response to what happened at

Bucharest, the US state rearticulated the ideological elements in its discourse and took
up the same hegemonic principle as the contestatory discourse of the GWHRM,
affirming ―the President's concern that population policy is a human concern intimately
related to the dignity of the individual and the objective of the United States is to work
closely with others, rather than seek to impose our views on others‖ (NATIONAL
SECURITY COUNCIL, WASHINGTON, D.C. 20506).

Thus, by including the interpellations that referred to ―human rights and sexual
and reproductive health rights‖ in the ―population control‖ discourse, it sought to
rearticulate the discursive unity of its discourse without changing its hegemonic
principle. To structure this ―new unity,‖ it penetrated human rights institutions with
financial support from the Rockefeller and Ford Foundations (Petras, 2001), and
promoted and organised – together with the power structures of the UN – the
International Conferences that took place during the ―UN Decade for Women‖ (1975-
1985). Thus, it seems to have decided to approach a new para-addressee: women.

Consequently, until the end of the 1980s and in a context in which a historic
meaningful event took place – the break-up of the socialist system and the defeat of the
counter-addressee, the main enemy identified with ―communism‖ – the US state seems
to have managed to rearticulate the ideological unity of its discourse by absorbing the
contestatory discourse‘s most symbolic ideological elements and implementing
programmes aimed at ―educating‖ women and ―indoctrinating‖ the masses.

What the US state did was therefore to rearticulate the ―real‖ policy of
―population control‖ – which was already being implemented – by including the most
symbolic ideological elements of the ―virtual‖ (unimplemented) policy of ―gender,
human rights and reproductive health.‖ In this way, the ―population control‖ discourse
included a new group of elements in its semantic field which enabled it to make new
discursive references to interpellate women as an ―identified group‖ in an inclusive
way, shifting them from being a ‗para-addressee‘, ignored due to its status as an
―object,‖ to becoming a pro-addressee. With this ―modus operandi‖, it sought to
achieve another effect: to break up the ―social unit‖ of women organically linked to the
GWRHM, in order to separate it as an identified group from its Subject; and thus
identify and position the GWHRM as a negative addressee (or adversary that had
brought together antiglobalisation movements, with which the population control

52
discourse continued to maintain a relationship of ―exclusion‖ because it identified them
as ‗radicals,‘ ‗terrorists,‘ ‗fundamentalists,‘ and other terms that function as substitutes
for ―communism‖).

Hence, with regard to the first manifestation of the crisis of hegemony, it can be
said by way of a partial conclusion that what the US state did – in order to rearticulate
its hegemony – was to move its discourse from the pole of its ―spirit‖ to the pole of its
―letter.‖ Following Faye 1974, the poles of a discourse can be represented as a
horseshoe: at one of its extremes is the ―spirit‖ of the discourse (Kratos/State,
Government) and at the other the ―letter‖ of the discourse (Demos/People). Thus, when
the US state rearticulated the most symbolic elements of the contestatory discourse in
its discourse on population control, it approached the pole of the ―letter‖ (at one
extreme of the horsehoe); and it distanced itself from this extreme of the horseshoe
when it turned back to the pole of the ―spirit‖. 68 Because of this, ―population control‖
can be thought of as an ideologeme.69

However, because the population control discourse articulated other elements

that are likewise disputed by other alternative/contestatory discourses clearly identified
with ―class projects‖ and ―anti-Imperialist‖70 and other interpellations, by 1994 it was
obvious that it had lost hegemony and entered the organic crisis that would lessen its
power effects in comparison to the contestatory discourse.

To understand this kind of political process known as the ―dispute for

hegemony,‖ Gramsci wrote: in a ‗war possession‘ once a counter hegemonic actor
gained the discourse battle, and its interpellation have been constituted such a ‗religion
of people‘ and ‗produced a moral and intellectual reform‘, the counter hegemony
discourse has effects of power to dismantling the dominant hegemony (Cited by
Mouffe, 1980. This also happened because there have been produced material
condition of possibility to decline the hegemonic discourse (Ibid).

It can therefore be concluded that at the Cairo Conference the

counterhegemonic discourse achieved power effects sufficient to dismantle the
dominant discourse, as we will see in the next section.

4.4.1.2.The power effects of the “Gender, Human Rights and Reproductive

Health” discourse

The power effects or effectiveness of the ―Gender, Human Rights and

Reproductive Health‖ discourse are: a) its ability to dismantle the dominant discourse
and provoke its organic crisis; and b) its ability to bring about a ―moral and intellectual

68
This shift also seems to be related to the two-party system and whether the US government was
controlled by Republicans or Democrats. This demonstrates indisputably that discourses interact with
political systems.
69
For Cross (1997), the ideologeme is a semiotic-ideological microsystem that is generated in discourse
and spreads or filters into various social discourses or discursive practices as a result of its frequent
recurrence. The relationship between the semiotic and the ideological is given by the fact that certain
outstanding semes can be recognised in the ideologeme and these in turn make it possible to detect a
certain ideology. The ideologeme condenses the dominant thought in a given society at a given moment
in time. It is therefore a signifier with ideological connotations.
70
On the concept of Empire, Cf. Negri, A. and Hardt, M. 2000.

53
reform.‖ Thus, the power effects are measured by ―the hegemonic capacity of a
discourse‖ and this is achieved by ―integrating interpellations that differ in scope and
nature – some classist, others non-classist (gender-based) – in a relatively structured
whole‖ (Ipola 1982: 103). The various interpellations produce power effects by
constituting (individuals as) subjects, leading to the articulation and constitution of a
―collective will‖ which becomes the Subject of change.

Consequently, the power effect or effectiveness of the GWHRM discourse is

explained by its capacity to constitute a collective will that goes beyond the movement
that determines it – the GWHRM itself – and is expressed through the vote of 179
states who by (unanimous) consensus adopt the Cairo ―Programme of Action‖ at the
International Conference on Population and Development (1994). Its interpellations,
differing in scope and nature, produce a paradigm shift in the way in which the
relationship between ―population‖ and ―development‖ is understood, giving these two
concepts a new sense and meaning different to that of previous international
conferences on population. This happened when, in opposition to previous
demographic approaches, the conference addressed the issue of population and
development in a way that delegitimated the emphasis on reducing population growth
and linked it to human development, sustainable development and the focus on gender
in development.

Following Ducrot (Op. Cit.), this enables us to address an important

characteristic of political discourse: that of having legal effects and being the source of
creation of rights and duties, which are produced by the ―illocutionary act‖ 71. To be
successful, the illocutionary act (or speech-act)72 depends – according to Austin (1992)
– on conditions that are not just discursive but also extradiscursive, both institutional
(agreements) and conventional (pacts). At the institutional and conventional level the
illocutionary act took material form through the approval of the Cairo Declaration and
Programme of Action, which required previous pacts (of varying sorts) between the
Subjects and actors who participated in the process of social and political struggle.
Consequently, it can be stated that one of the power effects of the GWHRM discourse
was expressed at the Cairo Conference in the form of this ―legal effect,‖73 which
constituted the (moral) source of the rights and duties created for the UN member
states.

In a situation of conflict and power relations, the success of the speech-act also
requires the speaker to have an authoritative voice and to be invested with the authority
to speak, and for this it requires legitimacy (Ducrot, Op. Cit.). The authoritative voice is
therefore not a given but is constructed and deconstructed in keeping with its capacity
to produce power effects on recipients/addressees. The construction of this authority
requires the prior constitution of a interpellating subject (the GWHRM); and, as a result
of this, it requires effectiveness in the articulation/constitution of the interpellated
subject (the addressees). This produces a two-way relationship whereby the
authoritative voice is authorised and viceversa. The legitimacy thus constructed by the
GWHRM was put to the test at the Cairo Conference.

71
Also known as a ―constative utterance‖
72
Also known as a ―performative utterance‖
73
Although it is true that the mandates agreed at the UN are not binding, this does not reduce the
importance of the effectiveness of the speech-act as the contestatory discourse acquires material form.

54
 The legitimacy achieved by the GWHRM also allows us to refer to the
discursive practice as ―the relationship of the speaker with what it says‖ because ―this
overlap (not only) confers authority and an authoritative voice‖ but also makes visible
other power effects related to the verisimilitude 74 and trustworthiness75 of this discourse
and its Subject, allowing it to introduce its most heartfelt demands in the Cairo
Programme of Action.

Consequently, by way of a partial conclusion, we can state that the power

effects of utterances and interpellations have to do with the relationship between the
addresser and what it says, as well as the relationship established between the addressee
and what is said, the image of the addresser and the image of the addressee, and the
conditions of production of the utterance: a whole ―modus operandi‖ that leads to the
effectiveness of the discourse which, in the case of the GWHRM, was expressed in the
illocutionary act.

4.5. The historic conflict situation and the political dénouement in

population policies

The historic conflict situation is given by the ―political resolution‖ of population

policy that posed the dilemma in terms of the contradiction expressed around the
hegemonic principles of the two discourses that acted as vehicles for population
policies: the ―real‖ policy, implemented from 1961 to 1994; and the ―virtual‖ policy,
which gradually gained legitimacy until it was constituted as the ―real‖ policy from
1994 onwards. The relationship between the two demarcated the conflict between the
Subjects, and the power relations established in the social and political struggle were
what put an end to the conflict in relative terms. In other words, the conflict did not go
away with the approval by consensus of the ―Programme of Action.‖ Instead, the
conflict between the Subjects was redefined. States approved a mandate which is not
binding, although it set the course for implementing the new ―population and
development policy.‖

In this sense, the ―Programme of Action‖ can be understood as the real

expression of population policy. It alludes to the construction of a specific praxis in the
building of a system of rights and obligations among states and societies as the result of
the interaction between the enunciation of the policy and the power effects that arise
from its implementation (as a material form of the discourse). This led to the
organisation and functioning of the current system of population policies, in which the
―population and development‖ dyad continues to feed back into eminently political
discourses that are consequently dichotomous, because the social conditions of
discursive production in the current globalisation scenario arise in a context in which
political forces are being reshaped and polarities or economic and social gaps between
developed and less developed countries, between classes, gender, ethnic groups, etc,
are becoming wider. This gives rise to new contradictions and dilemmas that could well
constitute new discourse-structuring poles, ―regenerating‖ the binary matrix; and

74
Verisimilitude refers to the representative dimension of language in its descriptive component, through
which it constructs reality ―just as it is.‖ This dimension produces verisimilitude.
75
Trustworthiness is linked to the speech-act and the intersubjective relationship between the addresser
and its addressees, based on the representation of reality.

55
whenever there are contradictions, the economic, social and political field will be
dichotomized.

Subjects, their discourses, and discursive practice in the field of ―population and
development policy,‖ the issue and object of which is ―territory, population and
resources,‖ will therefore continue to articulate/rearticulate and disarticulate ideological
elements in dispute around ―hegemonic principles‖ which, due to the nature of the gaps
mentioned above, will acquire new sense and meaning. There is evidence of this in the
events and new challenges posed by globalisation in the 21st century.

Consequently, discourses can be rearticulated around the new contradictions

that emerge in the current context of globalisation and bring a new sense and meaning
to population policies, which could either be ‗anti-natalist‘ or ‗pro-natalist‘. The
direction taken by the policy will depend on the power relations that are established
during the reconfiguration of state structures, subjects and actors around the world, and
between the pro-globalisation and anti-globalisation movements that are likewise
reconfiguring civil society. What is certain is that the current context of globalisation
has reconfigured power relations and is tending to shift paradigms in different arenas
such as that of geopolitics, where ―sovereign‖ national states have increasingly less
power over the issues of ―territory, population and resources.‖ In this new context,
health policies and public health clearly depend increasingly on the political dimension:

The political dimension is in itself one of the factors that determine health […] Today it
is showing its relevance because it conditions the distribution of social determining
factors themselves. Health is political because its own social determining factors are
vulnerable to political intervention and dependent on political action. In that sense,
ideology, power and politics influence people‘s health (Franco G. A and Álvarez D.A
2008: 282).

Therefore, based on the comparative analysis I have undertaken of the two discourses
on population policy, it can be stated that the political dimension, process and factors
play a decisive role in the definition and redefinition of any policy, whether on
population or some other issue. In this study, I have tried to show that politics itself
determines whether the gender focus, the exercise of fundamental human rights
(individual and collective), human and sustainable development, and consequently
health, are included in population policy.

4.6. Partial conclusions

By means of the comparative analysis of the discourses, I have studied two

ways of addressing population policy through discursive practice, tracing the threads of
how this practice constructs reality through the social process of the production of
meaning. The analysis compared the Subjects/actors that produced the discourses and
analysed the ideological elements/ semantic units that articulate them around opposing
hegemonic principles. These define the fundamental contradiction around which the
structural poles of the discourses are constructed based on a binary discursive matrix,
which expresses and is expressed in the polarization of the actors. The comparative
analysis enables us to understand how the sense and meaning of the social construction
of discourse produces a paradigm shift and a new re-articulation of population policy.

56
 V. PART FIVE

5. FINAL CONCLUSIONS

5.1. We have seen that, in discursive practice, the GWHRM and the US state
built relationships with their social conditions of existence and related to each other
through the conflict that took place in the process of social and political struggle and in
the space of the International Conferences organised by the UN. The conflict relations
have been examined through language, showing that the discourses are polarised,
because they identify and order the social and political world differently by means of
opposing hegemonic principles: ―Population Control‖ and ―Gender and Human Rights
and Reproductive Health Rights‖.

Consequently, the study has shown that, rather than being ―plucked out of the
air,‖ the two discourses can be understood as a form of social existence of social,
political and ideological struggles, and the power relations established during the
process of social discursive production, which refers to certain historical and social
conditions of production. Based on these, I have tracked the ―footprints‖ of the
respective discursive production processes, describing, in the field of their direct
production: a) the respective theories and ideological tendencies on which they were
based; b) the problems they sought to address and resolve; and c) the different
scenarios/spaces and apparatus through which their social and political practices were
organised and materialised in the quest for hegemony, thus revealing the conditions of
circulation and reception where the power effects of the discourses are produced.

In the case of the ―Population Control‖ discourse, the post-World War II context
was favourable to the US state, enabling it to articulate its political, economic and
military hegemony and position itself in the international arena to deploy population
control by means of coercion and consensus. Likewise, the context of the ―Cold War‖
meant that in its discursive practice it constructed ―enemy‖ adversaries and its relations
with them were antagonistic. The adversary operates and is identified in the discourse
with ―communism‖. The US state acted to prevent this adversary from interpellating –
ideologically and politically – the growing mass of dispossessed people in less
developed countries and exercising influence in these ―poor regions of the world‖
identified as areas of economic and political interest to the United States.

In these areas the poverty situation, aggravated – according to the US state – by

the fast pace of ―population growth,‖ generates objective (and subjective) conditions of
political, economic and social instability. This is why ―fertility reduction‖ is the priority
―political-demographic‖ task. Thus, the US state focused and targeted its policy at the
reproductive subject par excellence: women. As a result of this discursive production
process, ―Population Control‖ took material form as a policy. 76

76
This policy – although articulated differently – was not new in the sense that it continued an
interpellatory trend in the field of ―population control‖ that began at the end of the 19th century and
carried on throughout the 20th. Depopulation and eugenics policies had already been developed by
organisations such as the International Family Planning Federation, which initially emerged as a
subcommittee of the Eugenics Society and represents the merger of the eugenics movement and the birth
control movement, whose relationship is based on a commitment to prevent ―the undesirables‖ from

57
 By analysing this ―population policy‖ in concrete and historical terms, I have
tried to show and argue that the US state, in close connection with political and
economic power structures and their respective apparatus of hegemony, ―managed‖ the
reproduction of the population (life, death, reproduction). Far from being the ―ultimate
beneficiary‖ of a policy concerned with its welfare, the population instead became an
―instrument‖ used to achieve ―other‖ objectives, as defined and formulated in
―MEMORANDUM 200,‖ better known as the ―Kissinger Report‖. This policy entered
an organic crisis and lost hegemony due to the actions of the contestatory Subject.

The ―Gender and Human Rights and Reproductive Health Rights‖ discourse
was articulated in response to the former discourse in order to challenge it, in three
interlinked dimensions of sense and meaning:

Firstly, it was produced in the context of the Cold War, which had given rise to
a specific ―dominant‖ discursive formation favourable to ―population control.‖ The
capability of the GWRHM as a Subject, as well as the power effects of its discourse, is
rooted in its ability to de-structure this discursive formation, leading to the emergence
of another, based on the expression of ―other‖ interpellations. These enabled the
constitution and social and political action of (an)―other‖ Subject(s) which, by
interacting with reality, altered the political and ideological arena at the end of the 20 th
century, generating a new discursive formation and breaking up the ―hegemony of the
dominant discourse.‖ In other words, it produced a double power effect.

Secondly, the exercise of ―population control‖ is made visible and identified –

by the contestatory Subject – as generating and rearticulating patriarchal practices and
ideologies. These take material form in the device of ―fertility control,‖ revealing the
power relations that mediate the social (and historical) constructions established
between the genders. In the timeframe of our study, this power is exercised and
functions by restricting the (individual and collective) human rights of the female
gender and – clearly – the right to reproductive health. 77 Consequently, the ―Gender‖
demand in the discourse not only implies making these power relations visible but also
challenging them and acting to change them. This gives a specific sense and meaning to
the debate on population and development policies, which penetrates the political-
ideological arena and consequently the established institutional power structures.

Thus, it is in this ―discursive dispute‖ that the discourse of ―Gender and Human
Rights and Reproductive Health‖ and its Subject gradually gained legitimacy, an
authoritative voice and authority, until finally, in the post-Cold War context, the
―unipolarity‖ and consequent neoliberal ―democratisation‖ that took place in a more
globalised context, shaping a new discursive formation, generated objective and
subjective conditions for a multiplicity of scattered discourses – as a result of the

multiplying. It currently represents and coordinates various national family planning organisations and it
is the largest international private agency in the field of population control by means of family planning.
To start with it received funding from the Rockefeller Foundation and later from USAID and the World
Bank (Embid, A. 2000: 118-119).
77
The power relations that are established between the genders allow us to understand why it is possible
to violate a certain norm, such as the International Covenant on Economic, Social and Cultural Rights
(United Nations 1966), which recognises ―the right of everyone to the enjoyment of the highest
attainable standard of physical and mental health‖ (Article 12, clause 1) and the human rights of specific
vulnerable groups (including women and children).

58
rupture of the previous discursive formation – to attempt to reorganise the ideological
field and dispute hegemony by rearticulating an alternative population policy. This was
defined by bringing together and mainstreaming the most heartfelt claims and demands
formulated by the GWHRM in the ―Women and Population Policies‖ Manifesto
(1992). As a demand that arose from organised civil society, it had the capacity to
enter78 the United Nations system, interpellate the member states in 1994, and bring
about the paradigm shift.

Having said this, it is important to refer to some other aspects of the ―dispute for
hegemony‖ that took place between the actors in the process analysed.

5.2. The dispute for hegemony between the two discourses has been
understood as the most openly political phase in the confrontation that took place in the
process of social and political struggle, involving the (unstable) power relations
established between the actors, and in the different scenarios in which significant
events in the production of meaning took place and significant discursive footprints
were registered.

With regard to the actors, the dispute was defined when the discourse of
―population control‖ lost its interpellatory and constitutive capacity and entered an
organic crisis that was expressed in the break-up of its ―hegemonic principle‖ and thus
the loss of its hegemony; while the counter-hegemonic discourse of ―Gender and
Human Rights‖ managed to impose itself in the social, political and ideological arena.

With regard to the confrontation settings, I have analysed and located the
dispute for hegemony in the spaces where the most relevant events in the production of
meaning took place and where the significant footprints of discursive production were
registered. These are, firstly, the International Population Conferences organised by the
United Nations that were held in Bucharest (1974) and Cairo (1994); and secondly the
International Human Rights Conferences held in Tehran (1968) and Vienna (1991), and
the ―UN Decade for Women‖ Conferences held in Mexico (1975) and Amsterdam
(1984). It was at these latter conferences that the unity of the interpellatory discourse
was rearticulated and its efficacy and power effects became capable of breaking up the
unity of its rival.

The ―footprints‖ registered at the Tehran Conference (1968) represent a

milestone because women‘s control over their own bodies, their sexuality and
reproductive life was introduced and defined as a fundamental human right. This was
the first time that ―gender‖ was linked to ―human rights‖ and it led to the rupture
between the feminist movement and the neo-Malthusian movement. Thus, women‘s
human rights were introduced as new ideological elements to be taken into account in
population policies. This would have significant power effects in dismantling the
dominant discourse, as became evident at the Bucharest Conference (1974), when the
ideological unity of the dominant discourse was broken up by the counter-hegemonic
action of a ―historic block‖ which introduced new hegemonic principles such as the

78
From the theories of ―Collective Action,‖ which have sufficient empirical evidence, we know that not
every demand can or has the capacity to ―enter‖ a certain system in order to be addressed. To achieve
this, it is necessary for the Subject/actor to be legitimate and to have reorganised power relations in such
a way as to ―checkmate‖ the system (Blumer, H. 1971: 298-306).

59
―New International Order‖ and ―Gender and Human Rights and Reproductive Health
Rights‖ in the population debate. These de-legitimised the ―Draft World Population
Plan of Action‖ (WPPA), which focused on limiting population growth by means of
reproduction indicators and direct policies to deal with fertility.

The contestatory action and discourse significantly affected the population

control discourse because, once it had been dismantled, it was no longer able to
produce constitutive effects as the dominant, hegemonic discourse, and this is the sign
of its ―organic crisis‖. Consequently, it no longer ―circulated‖ at the next Conferences
organised by the UN, such as those during the Decade for Women, where women
gradually won new rights and – together with their organic expression, the GWHRM –
undertook the task of rearticulating an alternative population policy, between 1975 and
1994.

In this process, an important discursive footprint was registered at the Nairobi

Conference (1985), because family planning programmes were linked with the ethical
critique of the demographic approach to population control programmes, advocating
alternatives against the dominant norm and rearticulating a new norm of human rights.
The GWHRM worked toward this objective at the UN World Conference on Human
Rights (Vienna 1993), while women in various countries took up the human rights
framework and began developing the analytical and political tools that together
constitute the ideas and practices of women‘s rights. At this Conference, states agreed
that women‘s human rights should be considered an inalienable, integral and indivisible
component of universal human rights and that efforts should be made to promote them,
since a violation of women‘s specific rights is equated with a violation of human rights.

Based on these gains, the ―Women‘s Declaration on Population Policies‖ was

drawn up and debated in Cairo. It was able to produce a rupture in population policy, as
a clear manifestation of the ―power effects‖ produced by the contestatory discourse.
Thus, a change of meaning in population policies occurred.

It is therefore possible to state that the social and political struggle is the
midwife of a process of discursive deconstruction and construction. Firstly, on the level
of deconstruction, the hegemonic principle of ―population control‖ is broken apart and
it enters a crisis of hegemony as the dominant discourse; secondly, there is a process of
discursive construction as the ―Gender and Human Rights‖ discourse is formulated and
then solidifies, gains strength and is ultimately enshrined in the United Nations, finally
winning the battle of the discourses in Cairo in 1994.

5.3. By focusing on analysing the hegemonic and counter-hegemonic

discourse on population policy, my research underlines how important political factors
were – and continue to be today – in the definition and resolution of this policy,
because if ―politics is the gaining and exercise of power,‖ the way in which this power
is used by states, governments or civil society actors will define the relationship of
social and political forces that do or do not identify with and have a commitment to
people‘s health needs and demands. In this study, the focus has been on the demands
related to ―Gender, women‘s human rights and reproductive health rights‖.

60
 Considering the above, my study of population policies in the light of the
process of social and political struggle shows that decision-making deriving from
political power – in a globalised context – plays a decisive role in how public health is
viewed and addressed. To paraphrase the Pan American Health Organisation, public
health depends to a great extent on politics and the actors involved in it (PAHO, 2002).

In this sense, the role of politics can be recognised as a determining factor in

health (Hunt 2006, and Milio 1986). Its influence is imposed through public policies,
the effect of which will be positive when they are based on human rights (Franco et al
2008). If the political factor seeks to ensure that universal human rights, social justice
and political, economic and social rights are guaranteed when the determinants of
health are addressed, people‘s health will constitute the key focus of the policy (WHO
2007). This is illustrated in the case we have studied in the arena of the human rights
and reproductive health rights claimed by the GWHRM, and agreed and approved at
the International Conferences organised by the UN, which ―shaped an appropriate
framework for public health activities previously unrecognised either by the biomedical
sciences or by classical public health‖ (Ibid.). Consequently, it can be stated that the
paradigm shift in the arena of population and development policy also constituted
(following Gruskin and Tarantola, 2002) a ―new paradigm of health and human rights‖
in relation to women‘s health.

Consequently, by studying the political dimension through the lens of

―population and development policy,‖ it is possible to visualise its links with public
health, since ―public health in the current globalised context should focus on the study
of the social, political and economic processes that determine the arrangements adopted
by the organised social response in health, and focus on the inter-relationship between
the different organisations involved in the health system‖ (Frenk, 1994).

By studying the policies that affect health (such as population control) and their
consequences, as well as the policies that promote and define it through the Cairo
―Programme of Action‖ (1994), it is possible to illustrate the relations of influence that
exist between the political factor, health and public health.

The political process and debate in the area of ―population and development
policy‖ thus promoted actions in favour of public health and fed back in an
intersectoral and interdisciplinary way into public health policies on gender inequality,
human rights violations and sexual and reproductive health, bringing various state and
society actors and sectors and different disciplines together to implement the Cairo
Programme of Action (Lori S. Ashford: 2001).

5.4. Another aspect that should be stressed is that by studying the ideological
elements involved in the concepts of ―demography‖ and ―health‖ and their relationship
with the determining factor of politics in an integrated way, it is possible to identify the
definition and implementation of a population policy that questions the power that is
established ―over and above society‖ and highlight the importance of the powers
emerging from civil society that lead to a new re-articulation (in a new way) of the
principles of fundamental human rights, economic, social and cultural rights, and
participation in the development of public policies (MARKS: 2000) that gives new
meaning to public health (and transforms it).

61
 5.5. The comparative analysis of the discourses also allows us to state that
people‘s health, particularly the health of the most vulnerable groups, is affected by
policies outside the arena of health, or policies that go beyond the sphere of health and
are the result of the decisions taken by institutions with political power. Implementation
of the ―population control‖ policy was based on the exercise of such power; conversely,
the counter-hegemonic action which changed that policy drew its power from society
through collective action, determined some of the key guidelines in population and
health policy from the ―ideological and political arena,‖ and consequently affected the
health system.

The approach to the problems of population and health policy therefore situates
the sphere of politics as a determining factor in health. Its articulation poses the
challenge of addressing and resolving health problems on the political agenda, and
achieving the development of public policies aimed at improving people‘s health
conditions which, based on human rights and by means of mechanisms for the
construction of citizenship and political participation, go beyond actions that seek to
prevent the infringement of such rights in health systems (Mann JM et al 1994).

5.6. Bearing in mind that the modern concept of public health focuses more
on the factors that determine health, my study illustrates that the determining factor of
politics and the ―population policy‖ that was consequently defined on the basis of
political decisions played a significant role over and above other determining factors.
The population control policy affected women‘s physical, psychological and sexual
health and violated their rights. In its turn, the alternative policy which focused on a
new approach to ―population and development‖ brought about an improvement in
health conditions for women. Even so, women – especially in less developed countries
– are still victims of the inequities and inequalities inherent in the gender relations
defined by power relations, and this is aggravated by the conditions of economic,
social, cultural and institutional development that are important determinants of health.

If public policy is defined as ―the broad framework of ideas and values within
which decisions are taken and action, or inaction, is pursued by governments in relation
to some issue or problem‖ (O Neill and Pederson, 1992 cited by Fiona Adhead and
Allison Thorpe 2009: 11), it can be affirmed that although the policy defined in Cairo –
described as a set of guiding principles to be followed by states – is not binding and
thus does not guarantee that action will be taken, it is clear that the change in the
discursive formation has helped public health policies in various countries. This is
indicated in studies by researchers which show the significant progress that has been
made in the sphere of human and reproductive rights, although significant differences
still exist in less developed countries, in line with the points made in the previous
paragraph.

Copenhagen, May 2011

62
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