Biopolitics of Reproduction: Involuntary childlessness and Justice in Pakistan

Abstract

Although reproductive health is generally accepted as a basic human right, infertility is considered as a personal rather than public health issue. In Pakistan, neglect in childbearing is a serious threat to the wellbeing of people and couples. This is because having children is closely linked with social legitimacy and marital stability. This study employs a qualitative design to explore the perspective and management of infertility by the Pakistani health system under the reproductive health umbrella. This analysis draws on Foucauldian biopower and reproductive justice and is based on in-depth interviews with public health officials and medical practitioners from the policymaking and health care institutions. The findings suggest that infertility is widely acknowledged as an important issue, yet it does not appear on the health agendas and policy priorities for international development. These policies are dominated by family planning, maternal health, and prevention of STIs. Thematic analysis shows entrenched institutional and cultural biases: medical discourses often reinforce gender essentialism through the oblivion of male infertility and the blaming of women. These findings indicate that the exclusion of infertility from the public health system in Pakistan reflects a biopolitical strategy that privileges demographic control over reproductive justice and requires systemic policy reforms and gender-inclusive health care.