Pop, Cristina A. 2022. The Cancer Within: Reproduction, Cultural Transformation, and Health Care in Romania. New Brunswick, NJ: Rutgers University Press, ISBN: 978-1978829589

Cristina A. Pop’s 2022 monograph, The Cancer Within: Reproduction, Cultural Transformation and Health Care in Romania, offers a contemporary anthropological investigation into sexual and reproductive health care in postcommunist Romania, where prevalence of cervical cancer in the population is disproportionately high compared to their European counterparts. At first glance, The Cancer Within merely offers an anthropological analysis which deepens historical background and cultural nuance to better interpret the epidemiological rates and trends of cervical cancer in Romania. Yet more than simply adding context to incidence, the findings expose and explore Romanian citizens’ present day reckoning with the exigent legacy of communism’s brutal pronatalist and patriarchal sexual and reproductive health care regimes (1946-1989). Using history as the point of entry, Pop situates Romanian cervical cancer incidence and its prevention efforts (i.e., human papilloma virus [HPV] vaccination) as an ultimate manifestation of the cobbled transition to a postcommunist medical system that “aligns the state and the market, public and private health care providers, policy makers, and ordinary women” (7). The central argument of the book posits that contemporary resistance to cervical cancer prevention efforts are less to do with cancer itself and are more a product of “systemic contingencies” of changing political, structural, and moral forces on the historical and personal unfolding of Romanian’s reproductive lives.

Structurally, the book is divided into two parts, each punctuated by an interlude that summarizes government-led or NGO-driven developments (e.g., free mobile clinics) toward – albeit ineffectual – cervical cancer prophylaxis

Part one, “Women’s, Men’s and God’s Will,” centers Pop’s interlocuters (ordinary Romanians who are subject to preventive care campaigns) and the everyday moralities that govern their sexual and reproductive lives. Chapter 1, “We All Descend from Communism,” considers the historical trauma arising from forces that shaped Romanian women’s reproductive health under communist rule. Using “reproductive life history,” Pop excavates invasive pronatalist policies that repressed female sexuality (e.g., banning contraceptives, prohibiting abortion, imposing taxes on childless couples) but aggressively endorsed motherhood (e.g., subjecting women to mandatory pelvic exams, bodily surveillance during pregnancy, termination of midwifery in favor of state-sanctioned male OB-GYN doctors). Alongside the legacy of repressive regimes, Chapter 1 also sheds light on the informal tactics that women have always used (e.g., “back-alley” abortions”) to manage fertility. Chapter 2, “Reproductive Invisibility,” locates men as subjects of changing approaches to reproduction. By cross-referencing men’s and women’s private accounts of men’s roles with state propaganda about gender expectations, Chapter 2 suggests that the cervical cancer crisis is enabled in part by extant patriarchal relations. Contemporary HPV prevention campaigns “invisibilize” the biological and moral role of men in HPV transmission, thereby exculpating male sexuality from the physical and social consequences born to women. Chapter 3, “Beyond Rationalities,” takes up God’s will as an actor within the sexual and reproductive lives of women. In the absence of support from the state or their male partners, women mobilize “lived re