Abstract
My project explores how misoprostol, a uterotonic medication, is transforming the technological, political, and professional landscape of population governance in Francophone Africa. Although misoprostol has been widely recognized as an essential obstetric medication, its application remains highly contested precisely because it disrupts medical and legal authority over pregnancy, delivery, and abortion. Drawing on ethnography in Burkina Faso and Senegal, I investigate how transnational stakeholders harness misoprostol toward the achievement of neo-Malthusian demographic targets related to maternal health and fertility. I study how misoprostol's promotion within the private health care sector reinforces unequal distributions of obstetric care according to residence, wealth, social capital, and access to technology. I argue that access to misoprostol cannot simply be boiled down to its availability in pharmacies, or its affordability on the market. Portrayals of misoprostol as a " magic bullet, " while hopeful about the drug's potential to reduce maternal mortality, insufficiently capture the complex transnational politics that shape how and where it is available and used (or not), and by whom. This project explores how a pill that promises to reduce maternal mortality by placing obstetric care directly " in women's hands " simultaneously opens and forecloses possibilities for reproductive justice in Francophone Africa.