Medical protocols are supposed to be scientific—evidence-based, objective. And
yet those regulating
the interaction between a healthcare provider and a reproductive-age woman
are vastly different in each European country. Our first assumption would be
that the richer countries that spend most on healthcare also have the most
medical monitoring, but the reverse is closer to the truth when it comes to
reproductive healthcare. For example, a recent EU report noted an inverse
correlation between the number of prenatal exams and a country’s GDP, though it
offers no explanation for the phenomena.

It is not only birth and pregnancy that are regulated differently across
Europe, but also access to contraception and abortion. Birth-control pills are
available over the counter in Spain, Portugal, Greece, The Ukraine, Russia,
Turkey, the UK, Slovenia, Serbia and Romania (where not only doctors, but also
social workers are able to dispense them), among other countries. The
morning-after pill can likewise be bought over the counter in most EU
countries, except Croatia and Hungary. 

It
is the latter—my native country—that is also implementing some of the EU’s
strictest and most complicated policies around abortion and access to
contraception: reflecting the impetus of a neoconservative backlash against
permissive gender roles alongside neoliberal ideas of gendered consumption.
Broadly curbing the agency of its citizens, Hungary’s strict medical protocols
extend to a tight control on the discourse around reproductive rights. For
example, the ‘promotion of abortion’ is
illegal, meaning that rights campaigners are effectively gagged.
If a pro-choice NGO or an activist group wants to avoid ‘promoting’ abortion,
they must use phrases such as ‘abortion is always a very tough decision’, or
state that they ‘do not encourage abortion’. In employing such rhetoric, they
are also coerced into reinforcing the stigma around abortion.

Although
elective pregnancy termination is legal in Hungary, it is not easily accessed.
A whole legal-medical institutional framework ensures that it is complicated
and/or traumatic in each instance. Regardless of how difficult the decision to
abort is for the individual, the procedure itself is made unnecessarily
onerous, violating and punitive (echoing the common stigmatisation of
child-free or non-heteronormative woman as ‘selfish’). If a woman follows the
Hungarian abortion legislation instead of buying abortion pills online or
visiting a foreign clinic/pharmacy, she must take part in two compulsory
‘counselling’ sessions at the ‘Family Welfare Office’. Only the surgical method
is allowed, and only in state-run facilities. But first, the pregnancy must be
confirmed by a doctor, usually via transvaginal ultrasound, as was similarly proposed
in the legislation which sparked the 2012 Virginia ultrasound
bill debate. (In Virginia, women would have had to view the fetal tissue
before termination as part of a mock informed consent policy,
or ‘A Woman’s Right to Know’). That bill sparked huge public outcry in the US,
with some even calling it state-mandated rape (as non-consensual penetration is
rape). Despite being a blatant example of institutional violence, the Hungarian
legislation—put into effect during the socialist era—is generally uncontested.

Today’s Hungarian medical profession is arguably as conservative and
authoritarian as the rest of the country’s current ruling elite (perhaps even
more so than under socialism). Concerns about women’s dignity or autonomy
are rarely aired or represented. As in other European countries, the fundamentalist Christian right (mainly
funded by
US conservative donors) are opening so-called ‘crisis pregnancy centres’ in Budapest.
These clinics rope women in through advertising free pregnancy tests and psychological
counselling, but should a client be pregnant, the anti-abortion propaganda immediately
kicks in. It follows roughly the same script as similar projects in other
countries: manipulative questioning about personal circumstances, threats about
the pseudo-medical condition ‘post-abortion syndrome’, or even (falsely)
linking abortion to breast cancer and child abuse.

Another
important conservative US actor in Hungary is the widely-criticised Komen Foundation. (Hungary’s US state
ambassador between 2001 and 2003 was none other than Nancy Brinker, the founder
of Komen and a major USA Republican Party donor.) Among other causes, Komen invests in funding the ‘Pink Ribbon’ movement and the
Mályvavirág Foundation (which is also funded by big pharma such as GlaxoSmith
Kline). The latter organisation invests mainly in raising ‘awareness’ about
cervical cancer screening, though like Komen’s, its advice does not always
accurately reflect current thinking.

Across most mainstream media, cancer screening has been promoted as an
undisputed good practice, but times are starting to change. As a 2015 study in the British
Medical Journal noted of a general policy shift in Germany,
“policy on screening people for cancer poses a dilemma:
should we aim for higher participation rates or for better informed
citizens?  Historically, screening
policies opted for increasing participation and accordingly took measures that
made people overestimate the benefits and underestimate the harms.”

Likewise,
the international media has recently brought greater public attention to debates
around the possible drawbacks of screening, especially breast cancer screening.  

Yet these complexities have not stopped groups like Komen from nudging
Hungarian women toward screening through bake-sales or pink Facebook memes
(with messages such as ‘It’s for your own good’ or ‘it only takes a few
minutes’). The visual marketing of both Mályvavirág and the Pink Ribbon
movement is strikingly similar to Komen’s: pink in all gradients, with motifs
of flowers, baking and hobby-crafts associated with traditional, domesticated
femininity.

Screenshot from the Mályvavirág (Strawberry Mousse) Blog Facebook page.

Hungarian popular media discourse is too authoritarian and too intertwined with
big pharma to give space to the complexity of screening issues. There is a
marked discrepancy between popular media narratives and both scientific
discourse and strategic debates. Screening is instead presented not as a
decision about risk management, but within a moralistic framework as the
‘responsible’ thing to do. It remains taboo to acknowledge the risks involved
and the inadequacy of the technology (and all of this for a cancer which is comparatively
uncommon in Hungary, accounting for around one per cent of all cancer deaths.)
One could reasonably argue, as have some medical professionals themselves, that non-participation in
these programmes is a rational choice, and yet it is near universally accepted
that this screening is indeed a good, mature, responsible thing to do. It is a
non-choice, because not engaging with such technologies would violate accepted
meanings and the social norms imbued in them. 

Irrespective
of the doubtless life-saving potential of screening tests, its uncritical, passive-aggressive
promotion in Hungary further establishes the normativity of the medicalisation
of the healthy female body. Women who do not wish to
participate are denigrated as ‘uneducated’ or ‘childish’. Alongside, other
kinds of dubious and downright dangerous services and products (among them,
vaginal rejuvenation and aesthetic laser) are marketed to the public, framed as
a question of morality and good taste—as if engaging with the right
kind of healthcare consumption, affirms one’s membership of a higher social
strata.

As
highlighted in these examples, the medicalisation of the healthy female body
has become
ubiquitous, rendering the routine violation of reproductive rights almost
invisible in wider
public discourse. This means that women have to be prepared to accept
intrusion. They must not only think of their bodies as needing constant surveillance
and intervention (arising from misogynist notions of biological inferiority),
but their feminine selves must also be cultivated through care—namely enhanced
investment in self-improvement.

In
contemporary Hungary, the female subject in the media and popular culture is
often presented
as the ‘igényes nő’: a loosely adapted Hungarian version of the ‘responsible
woman’. She is a managerial, self-governing, ‘sophisticated’ and neoliberal
subject clad in increasingly
globalised visual and formal codes. This subject position has clear social and
class connotations. But just as different countries have different class
structures, the term ‘neoliberal’
should be used with caution when applied to Hungary. The governing right-wing
Fidesz party might adapt policies which are part of an economic toolkit deemed neoliberal,
but broadly speaking, the Hungarian market is still very much dependent on and subordinated
to the state. It is no wonder then that the women visible in the media who fit
the ’igényes nő’ criteria are often connected to men embedded in the state
apparatus, instead of strictly following the neoliberal individualist model of
social self-advancement through
individual means.The other feminine ideal in media discourse is the ‘női
principium’: an essentialist model popularized
by neoconservatives who, denying the socially-constructed nature of gender, project
traits like ‘nurturing’ or ‘caring’ as inherently feminine. Within both
prototypes, women
are expected to conceal their own reproductive labour.

The
demands on an igényes nő are a supposedly independent but neurotic regimen for
body and mind that privileges constant self-regulation and an endless
consumption of services and products. She is often more than a mere consumer,
with self-management turning into self-branding and then brand-building. One
example of the marketing directed at this type of woman is Hungary’s ‘Strawberry Mousse’ blog run by MSD Pharma.
The company’s flagship products include a hormonal contraceptive device, and
Gardasil, the common vaccination against the Human Papillomavirus (HPV). In the
tone of a bubbly girlfriend, the blog devotes its airtime to HPV and the
benefits of hormonal contraception alongside fashion, colourful recipes and
neurotic lifestyle tips (of course involving more consumption).

The
női princípium by contrast manifests mainly through political communication,
rather than advertising, projecting women as inherently nurturing and submissive.
Reproductive labour is therefore not labour, but the ‘natural order of things.’
This ideology has undeniable demographic implications: instead of implementing
labour market policies which privilege the inclusion of women in the workforce
(such as remote or part-time work), female bodies are instrumentalized to
reproduce the labour force.

Beyond
the governing Fidesz, political communication on this theme still operates within
the nation-state rhetorical framework: it is the duty of women to protect national integrity
and ‘the borders’ of the country. Indeed, when the Parliament debated the
proposal to discuss the ratification of the Istanbul convention, Duro Dora, one
of the token women
in the far-right party, Jobbik (who has a sticker on her laptop bearing the
text ‘the nation
lives in its wombs’) claimed in her speech that the Convention was inadequate
in preventing domestic violence as most domestic violence is committed against
the unborn in the form of abortion. Biopolitics is full of irrationalities and
paradoxes globally, and Hungary is no exception.

Far-right politician Duro Dora with the sticker ‘the nation lives in its wombs’. Credit: Magyar Narancs.

What I describe here
is not how Hungarian women live per se.
Different political and social actors of course establish their own media
discourses concerning what a woman should do and who she should be. Yet both the
above subject positions have the same effect: they erase the potential for
women to name reproductive labour as reproductive labour, and both enable
technological interventions and state surveillance to be interpreted as ‘self-care’. 

Just as media does
not exist in a bubble and visual representations both depend on and produce
social inclusions and exclusions, technology also embodies and perpetuates
social norms—media, bodies, selves are always in a complex entanglement. Both strategies
of control and strategies of resistance must therefore work with this new
notion of the self as fundamentally mediated.