Authors

Discussion

Soviet prenatal diagnostics began to be institutionalised in the 1980s, when medical geneticists joined forces with the Ministry of Health to institutionalise prenatal diagnostics in the hope of improving collective health. Their efforts to intervene medically in the creation of healthy Soviet citizens were a response to a major biopolitical problem, namely high perinatal and infant mortality. It was also a response to the decay of the health system, which was severely underfunded in those years. The prospect of substantial savings to the health system from a healthier population was therefore an attractive one, and a strong argument for medical geneticists to obtain funding for the establishment of prenatal diagnostics.

This background and argumentation led to prenatal diagnostics that were mainly focused on cost avoidance, leaving embryos as beings with a conditional existence. While in the last decade of the Soviet Union, due to the lack of material resources, there was no mass screening and thus only a limited practical application of these ideas, from an epistemological point of view, the joint engagement of medical genetics and the Ministry of Health enforced a biologisation of citizenship, which would be granted mainly to those who were not a burden on the community.

With the collapse of the USSR, the union-wide strategy of medical engineering broke up into many, necessarily very different ones, as the former Soviet republics differed greatly in terms of the state of their health care systems and medical genetic services, but also in terms of perinatal mortality and the general health of the population. Using the case of the post-Soviet Baltic states, this paper explores how health care systems were reformed and new regimes of prenatal screening were established in the 1990s. It examines how the relationship between citizenship and (prenatal) health care was disrupted and renegotiated in the aftermath of the Soviet collapse.