Anticipatory Governance of Low Fertility: IVF Subsidies, Pronatalism, and the Remaking of Stratified Reproduction in Taiwan

• In Event: Medical Sociology Section Roundtables
  In Refereed Roundtable (90 minute): Table 3. Reproductive Health

Abstract

This paper examines Taiwan’s subsidization of in vitro fertilization (IVF) as a form of anticipatory governance in response to ultra-low fertility. While traditional pronatalist measures emphasize childcare expansion, parental leave, and family allowances, recent years have witnessed the growing medicalization of population policy through public financing of assisted reproductive technologies (ARTs).

Drawing on 30 in-depth interviews and extensive archival research, I trace two waves of “techniques of futuring” that shaped Taiwan’s IVF subsidy program. During the first wave (2004–2020), policymakers resisted linking IVF subsidies to demographic decline. Demographers, feminists, and public health scholars framed low fertility as a structural welfare issue rather than a medical problem, and IVF remained largely a self-pay market, with limited subsidies for low-income families.

The second wave began in 2021, when Taiwan’s fertility rate again ranked among the world’s lowest. IVF subsidies were expanded and reframed as part of a response to demographic crisis. Although initially justified in terms of quality improvement and risk prevention, the policy was rebranded under public pressure as a measure to address declining birth rates. Subsidies for women under 45 were introduced alongside guidelines promoting single-embryo transfer, presenting the policy as equitable, risk-reducing, and population-enhancing.

However, the program also remakes stratified reproduction. Subsidies apply only to heterosexually married couples using their own gametes, excluding single women, lesbian couples, and those relying on donor gametes. By tracing this transformation, the paper demonstrates how IVF subsidies become instruments of anticipatory governance, reshaping reproductive inequality while embedding biomedical solutions within pronatalist policy.

Author

• Chia-Ling Wu, National Taiwan University