| Demographic transition theorists posit that, beginning in the 1960s, biomedical contraceptive technologies and foreign countries, the United States in particular, have been primarily responsible for changes in medical fertility control ideas and practices in Peru. This dissertation argues that biomedical technologies and transnational political actors have played a role, but not always in the ways that demographic transition theorists indicate. The mass distribution of contraceptives such as the pill and the intra-uterine device, for example, depended on the existence of US-funded birth control organizations. However, these birth control organizations did not justify their existence in Peru only in terms of the promotion of development, but also by making appeals to the integrity of the family, values that many local physicians cherished. In addition, biomedical knowledge concerning the control of fertility began to be applied long before the 1960s, and not all of it originated in the United States nor was it all oriented towards the limitation of birth rates. Moreover, demographic transition theory's assumption that financial calculations were the primary reason for the prevention or spacing of births overlooks other factors, such as marital strife, that also affected the desire for offspring. Through archival material and oral histories in Peru and the United States, this dissertation raises questions about the ideologies and practices of medical experts, and their interactions with state agencies, foreign governments, the Catholic Church, and people who had abortions. |
