Paper short abstract:

Drawing on my recent fieldwork I highlight ways in which an intervention attempting to increase access to reproductive health care for vulnerable individuals may also be instrumentalised and serve state institutions and health professionals to surveil and control socially excluded populations.

Paper long abstract:

The Roma health mediation programme is a state-run 'Roma inclusion' programme that aims to empower communities and improve access to care. One of the programme's focus points is to educate Romani women on contraception. Taking into consideration the Romanian political and social context, this paper highlights how the emphasis on family planning is not based on needs identified by communities themselves, but on perceptions of need that have been shaped by the majority about Roma communities as sources of infection and dirt, and as a demographic threat. While conducting fieldwork in Romania I often heard people say, 'gypsies have too many children'. Aside from the difficulty of verifying such claims (lack of ethnically segregated data; difficulty in drawing meaningful ethnic boundaries), the notion of higher fertility rates among Romani women must be recognised as part of as a orientalist construct of overly 'primitive' and sexualised 'Roma'. Drawing on interviews and fieldwork observations, I suggest that the educational approach of Roma health mediation is premised the individual 'choice' of having many children, ignoring poverty and other complex community determinants that may impede access to contraception in this highly heterogeneous and disadvantaged minority population. Health mediation founders where its greatest potential strength lies: rather than acting as a community-led emancipatory project, it has allowed itself to be appropriated as an instrumental approach to curb Roma fertility rates. It thereby unintentionally perpetuates racist discourses and assists state institutions to surveil and control Roma communities.