Policy Struggle on Reproduction

• Date: 01 June 2012
• Author: Isabelle Engeli
• Published date: 01 June 2012
• DOI: 10.1177/1065912910395323
• Subject Matter: Articles

Political Research Quarterly

65(2) 330 –345

© 2012 University of Utah

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DOI: 10.1177/1065912910395323

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How best to govern the field of reproduction has launched

heated controversies for the past decades, and policy

makers in Western countries have grappled with highly

polarizing issues regarding abortion and assisted repro-

ductive technologies (ARTs). The feminist movement

defines procreation in terms of women’s right to choose

and calls into question the social obligation of mothering,

while the prolife opposition argues in favor the protection

of human embryo. Launched by the feminist claims for

liberalizing abortion in the 1960s, the controversy has

more recently been fueled and redimensioned by the

development of the new reproductive technologies. The

invention of in vitro fertilization in 1978 has indeed

offered more than medical treatment for sterility and has

unsettled the traditional family scheme by providing gay

couples (Bryld 2001) with access to reproduction.

Most West European countries have been confronted

with similar reproductive issues. Nevertheless, policies

on abortion and ART present strong variations, both in

terms of regulatory scope and content as well as in terms

of the policy-making process (Engeli 2009a; Bleiklie,

Goggin, and Rothmayr 2004; Stetson 2001). The litera-

ture has developed three main explanations for the varia-

tions in the regulation of the field of reproduction, which

are, respectively, centered on institutional arrangements,

on the party system and the presence of strong Christian

Democrats, and on the strength of the medical commu-

nity and women’s movements (Bleiklie, Goggin, and

Rothmayr 2004; Stetson 2001). Indeed several studies

addressing either the issue of abortion or the ART one

have emphasized the high complexity in regulating the

field of reproduction and stressed the interplay of explan-

atory factors that vary across countries and time (e.g.,

Latham 2002; Mazur 2002; Outshoorn 1996; Stetson

2001; Varone, Rothmayr, and Montpetit 2006). The ques-

tion remains to account for the full set of variations across

the regulation on abortion and ART. To do so, this article

aims at further developing the shift from mono-causal to

configuring thinking (Ragin 2008) and to take into

account the whole spectrum of policy preferences

involved in the regulation of the field of reproduction by

examining the policies on abortion and ART in France

and Switzerland since the 1970s. Faced with multidimen-

sional policy differences, the analysis of policies on abor-

tion and ART pleads for examining the phenomenon of

multicausality through fuzzy-set qualitative comparative

analysis (Fs/QCA). The configurational comparative

method aims at assessing the multicausal nature of social

phenomena by revealing how different causal processes

may produce similar results.

The article is organized as follows. The first section

reviews the main explanations presented in the literature

and develops seven hypotheses related to the impact of

395323PRQ

1University of Geneva, Geneva, Switzerland

Corresponding Author:

Isabelle Engeli, University of Geneva, Department of Political Science,

40 bvd du Pont d’Arves, 1211 Geneva 4, Switzerland

Email: isabelle.engeli@eui.eu

Policy Struggle on Reproduction: Doctors,

Women, and Christians

Isabelle Engeli1

Abstract

How best to govern reproduction is the subject of heated controversies and policies on abortion and reproductive

technologies present strong variations. Through fuzzy-set qualitative comparative analysis, the article explores the

interplay of institutional settings, Christian Democratic politics, women’s movement, and Christian opposition in France

and Switzerland since the 1970s. If little evidence is found for any institutional impact on policies regarding abortion

and reproductive technologies, the analysis confirms the growing influence of the medical profession over reproductive

issues and shows that the success of the women’s movement has been fluctuating while prolife opposition seems to

have gradually lost influence.

Keywords

gender, abortion, reproductive technologies, public policy, European politics, fuzzy-set qualitative comparative analysis

Engeli 331

institutional settings, the configuration of the party sys-

tem, and the policy preferences of main actors in the

field, that is, the medical community, women’s move-

ments, and the prolife movement. The second section dis-

cusses the advantages of using Fs/QCA to better

apprehend the complexity in regulating abortion and ART

and presents the operationalization of the variables and

data used in the analysis. The third section discusses the

analysis of the policies on abortion and ART in France

and Switzerland since the 1970s and shows that even if

little evidence is found for a systematic and independent

institutional impact on policies regarding abortion and

reproductive technologies, the analysis confirms the

growing influence of the medical profession over repro-

ductive issues and shows that, on the contrary, the success

of the women’s movement has been more fluctuating

while the prolife opposition seems to have gradually lost

influence on the abortion issue.

Explaining the Complexity in

Regulating Abortion and ART:

Institutions, Politics, and Policy

Networks

Policy making in the reproduction field comprises com-

plex phenomena in which various factors interact. The

literature offers three main explanations for the variations

in the regulation, which are, respectively, focused on

institutional arrangements, on party system and politics,

and on the strength of the medical community and wom-

en’s movements (Bleiklie, Goggin, and Rothmayr 2004;

Stetson 2001). Drawing on the literature, this section

develops seven hypotheses to explain divergence among

countries and sectors, regarding (1) institutional arrange-

ments and (2) the path-dependency effect, (3–4) politics

and the party system, and policy networks composed of

(5) the medical community, (6) women’s movements,

and (7) the prolife movement.

Institutional Arrangements

Among the explanatory factors of reproductive policies,

the effect of institutional factors has been the one most

thoroughly assessed. Most comparative research tends to

conclude that institutional settings per se do not exert

any independent influence on policy content and thus

cannot, in isolation at least, account for variations in

reproductive policies (Bleiklie, Goggin, and Rothmayr

2004; Engeli 2009a; Stetson 2001; Rothmayr et al.

2004). Rothmayr et al. (2004; also see Stetson 2001) do not

identify any systematic patterns in the impact of institu-

tional settings according to the classical typologies of politi-

cal systems (consensus vs. majoritarian democ racies,

federalist vs. unitary systems, parliamentary vs. presi-

dential systems). However, institutional factors may

exert an indirect impact on the regulation of reproduc-

tion. Drawing on Timmermans’s (2001) argument,

greater institutional opportunities may enhance the

involvement of various actors with competing interests

that, in turn, will lead to different policy content than in

the case of a lower number policy arena dominated by one

major actor (Engeli 2010; Varone, Rothmayr, and

Montpetit 2006).

In addition, previous decisions may well exert a well-

known effect of path dependency (Pierson 2000), in

which posterior decisions follow the trajectory of the ini-

tial ones. According to Mooney (2001, 675), policies

with a moral dimension “are not less than the legal sanc-

tion of what is right and wrong, the validation of a par-

ticular set of fundamental values.” Indeed, the discussion

of moral values and social norms implied by the regula-

tion of ART and abortion often occurs within a context of

high politics that appeals to a broad and polarized audi-

ence (Green-Pedersen 2007). It could be thus easier and

electorally less costly for governments to stick with prior

decisions than to drive major policy change that could

lead to clash of absolutes across the electorate (Tribe

1990).

Taken together, these literatures on reproductive poli-

cies suggest two hypotheses about the impact of institu-

tional arrangements on the regulation in the field of

reproduction. A higher level of institutional access should

favor the elaboration of restrictive policies by allowing

for a greater number of policy actors promoting restric-

tive preferences, as argued by Varone, Rothmayr, and

Montpetit (2006; Hypothesis 1). On the contrary, the out-

put of the policy-making process should be positively

influenced by any prior liberal policy in the field

(Hypothesis 2).

Politics and the Configuration of

the Party System

Pointing out that reproductive issues have a moral

dimension, some scholars argue that the presence of

Christian Democrats may well lead to more restrictive

policies in the reproduction field, while the presence of

strong Social Democrats is often shown as a potential

alliance partner for women’s movement and their claims

in the reproductive field (Fink 2009; Minkenberg 2002).

On the contrary, other scholars argue that political parties

prefer to stay out of heated debate on reproductive issues

as they may lead to internal division and serious electoral

loss (Blofield 2006; Burns 2005; Rothmayr et al. 2004).

Accordingly, the strong presence of Christian Democrats

should prevent the elaboration of permissive policies

(Hypothesis 3), while Social Democrats government