Infertility around the Globe

Infertility around the Globe: New Thinking on Childlessness, Gender, and Reproductive Technologies

Marcia C. Inhorn
Frank van Balen
Copyright Date: 2002
Pages: 355
https://www.jstor.org/stable/10.1525/j.ctt1ppfk5
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  • Book Info
    Infertility around the Globe
    Book Description:

    This exceptional collection of essays breaks new ground by examining the global impact of infertility as a major reproductive health issue, one that has profoundly affected the lives of countless women and men. Based on original research by seventeen internationally acclaimed social scientists, it is the first book to investigate the use of reproductive technologies in non-Western countries. Provocative and incisive, it is the most substantial work to date on the subject of infertility. With infertility as the lens through which a wide range of social issues is explored, the contributors address a far-reaching array of topics: why infertility has been neglected in population studies, how the deeply gendered nature of infertility sets the blame squarely on women's shoulders, how infertility and its treatment transform family dynamics and relationships, and the distribution of medical and marital power. The chapters present informed and sophisticated investigations into cultural perceptions of infertility in numerous countries, including China, India, the nations of sub-Saharan Africa, Vietnam, Costa Rica, Egypt, Israel, the United States, and the nations of Europe. Poised to become the quintessential reference on infertility from an international social science perspective,Infertility around the Globemakes a powerful argument that involuntary childlessness is a complex phenomenon that has far-reaching significance worldwide.

    eISBN: 978-0-520-92781-0
    Subjects: Anthropology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. PART I DISCOURSES AND DEBATES

    • ONE Introduction. Interpreting Infertility: A View from the Social Sciences
      (pp. 3-32)
      Frank van Balen and Marcia C. Inhorn

      After decades of scholarly neglect, human reproduction, as a biological phenomenon that is socially constituted and culturally variable through space and time, has slowly gained the attention of social scientists from a variety of disciplines. Largely as a result of the feminist movement and the entrance of greater numbers of women into the academy, the past twenty-five years have witnessed a veritable explosion of research on the social construction and cultural elaboration of women’s reproductive experiences (Greenhalgh, 1995a). From menarche to menopause, few aspects of the human reproductive life cycle, particularly as it pertains to women, have been left unexamined...

    • TWO The Uses of a “Disease”: Infertility as Rhetorical Vehicle
      (pp. 33-51)
      Margarete Sandelowski and Sheryl de Lacey

      Infertility is a topic that evidently offers something for everyone. Since the advent in the late 1970s of in vitro fertilization (IVF) techniques to enhance fertility and to bypass physical and biological impediments to procreation, infertility has increasingly attracted the attention of a diverse and growing constituency, including behavioral, biological, and social scientists; scholars from the practice disciplines; ethicists, theologians, lawyers, and legislators; social activists and cultural critics; and journalists and television commentators. Indeed, the interest in infertility has engendered some strange bedfellows; for example, feminists have found themselves allied with pro-family (and often antifeminist) activists to denounce assisted reproductive...

    • THREE Fertile Ground: Feminists Theorize Infertility
      (pp. 52-78)
      Charis M. Thompson

      Infertility poses a prima facie tension for feminists. On the one hand, even in an age of decreasing birthrates, voluntary childlessness, and increasing rates of infertility, involuntary childlessness is recognized as one of the greatest forms of unhappiness and loss an adult woman might endure. Infertility is frequently experienced by would-be fathers as a source of deep sorrow and as a threat to desired kinship roles and masculinity. Nevertheless, the burden of involuntary childlessness is considered especially heavy for women, and prominent feminists have long called for it to be taken seriously as a feminist issue (Birke, Himmelweit, & Vines, 1990;...

    • FOUR The Psychologization of Infertility
      (pp. 79-98)
      Frank van Balen

      One of the most intriguing aspects of the study of infertility is its relationship with psychology, in particular, the various contrasting ways in which the causality of the relationship between psychological problems and infertility has been interpreted. Since biblical times, it has been noted that involuntarily childless women, such as Sarah, the wife of Abraham, frequently showed behavior that would be interpreted today as a sign of psychological problems. As there was in the past little knowledge about the process of human reproduction, various ideas about the origin of infertility have existed throughout Western history. One of these was the...

  4. PART II GENDER AND BODY POLITICS

    • FIVE Infertile Bodies: Medicalization, Metaphor, and Agency
      (pp. 101-118)
      Arthur L. Greil

      From the vantage point of the discourse of medicine, infertility is the failure to conceive a child after twelve months of unprotected intercourse. From the vantage point of American infertile women, however, infertility is a major disruption in one’s projected life course, a failure to live up to normative notions about what it means to be an adult woman in American society, and a challenge to the stability and quality of social relationships. Such personal and social tragedies are frequently the occasion for cultural dramas in which important themes and tensions in a society are brought into clear relief (Becker,...

    • SIX Deciding Whether to Tell Children about Donor Insemination: An Unresolved Question in the United States
      (pp. 119-133)
      Gay Becker

      As many as one in eight married couples in the United States experience difficulty conceiving a child, leading more than one million women a year to seek infertility treatment (SART, 1998). Although inadequacies associated with sperm are causal or contributory to almost half of all infertility, there has been little if any effective treatment for male infertility until the 1990s. As a result, the artificial insemination of women with the sperm of donors who are usually anonymous has been widely practiced in many countries for almost half a century. It is estimated that as many as thirty thousand children a...

    • SEVEN Conceiving the Happy Family: Infertility and Marital Politics in Northern Vietnam
      (pp. 134-151)
      Melissa J. Pashigian

      Infertility in northern Vietnam is a serious issue because it threatens to hinder the development of ties that are believed to bind the conjugal unit, to link that unit to the previous generation, and to connect the living to the dead. Childlessness in a married couple challenges the very purpose of marriage in northern Vietnam, where the birth of children is intended to build the nuclear family unit, to fulfill extended-family expectations for filial piety, and to ensure the happiness and security that come with assuming well-established and well-recognized reproductive and gender roles. In this chapter I argue that to...

    • EIGHT Positioning Gender Identity in Narratives of Infertility: South Indian Women’s Lives in Context
      (pp. 152-170)
      Catherine Kohler Riessman

      How, in a context such as India where strong pronatalist attitudes mandate motherhood, do women construct gender identities when they cannot be mothers? Making babies is how women are expected to form adult identities the world over, and in non-Western “developing” societies the gendered consequences of infertility can be grave (Inhorn, 1994; Unisa, 1999). Psychological theories consider maternity the central milestone in adult female development (Ireland, 1993). Yet women find ways to compose lives that accommodate, and sometimes resist, dominant definitions. How is this identity work done as women move into and beyond the childbearing years?

      Recent work on adult...

    • NINE Childlessness, Adoption, and Milagros de Dios in Costa Rica
      (pp. 171-190)
      Gwynne L. Jenkins, Silvia Vargas Obando and José Badilla Navas

      Costa Rica has been celebrated as an international success story in health development (Harrison, 1981). Among its many successes, Costa Rica has achieved one of the “earliest and fastest … fertility transitions in the developing world” (Rosero-Bixby & Casterline, 1994, p. 439). Declining birthrates, increasing acceptance of family planning, and diminishing “ideal” family size have been lauded by demographers and health specialists as part of the overall picture of health “modernization.” For this tiny country of 3.3 million people, the creation of a health profile rivaling the “developed” world is a point of national pride.

      As in other so-called developing nations,...

  5. PART III THE INFERTILITY BELT

    • TEN Problematizing Fertility: “Scientific” Accounts and Chadian Women’s Narratives
      (pp. 193-214)
      Lori Leonard

      Large portions of Central Africa have long been characterized by unusually low fertility. Before the turn of the twentieth century, European explorers and colonial administrators noted the “fragility,” even depopulation of some Central African societies, and historical demographers have since substantiated these claims (Caldwell & Caldwell, 1983; Headrick, 1990; Romaniuk, 1968). Despite recent increases in fertility in some Central African states, women in this region continue to bear fewer children than expected for a largely noncontracepting population and fewer children than other African women of similar social and economic circumstances (Cohen, 1993; Frank, 1983; Tambashe, 1992; United Nations, 1991).

      Knowledge of...

    • ELEVEN Is Infertility an Unrecognized Public Health and Population Problem? The View from the Cameroon Grassfields
      (pp. 215-232)
      Pamela Feldman-Savelsberg

      Many women in Cameroon, a sub-Saharan country located on the “hinge” between West and Central Africa, experience impediments to bearing healthy children. Results from the 1998 Demographic and Health Survey (DHS) demonstrate that despite recent decreases, 5.5 percent of married women between the ages of thirty-five and forty-nine still suffer primary infertility. In addition, 29 percent of Cameroonian women have had an “unproductive pregnancy” (i.e., miscarriage [22%], stillbirth [6%], or abortion [5%]) (Fotso et al., 1999, pp. 47–49). All of the approximately two hundred fifty diverse ethnic groups that constitute Cameroon’s population highly value children and women’s childbearing. Thus...

    • TWELVE Infertility and Matrilineality: The Exceptional Case of the Macua of Mozambique
      (pp. 233-246)
      Trudie Gerrits

      In the scarce literature on infertility in Africa, negative consequences for the infertile couple—in particular for the infertile woman—are generally stressed. Anthropological studies on social and cultural aspects of infertility in Botswana (Mogobe, 1998), Egypt (Inhorn, 1994, 1996), The Gambia (Sundby, 1997), and Nigeria (Koster-Oyekan, 1998; Okonofua, Harris, & Odebiyi, 1997; Onah, 1992) show that when pregnancy does not occur, it leads to many problems at the personal, conjugal, family, and community levels. Infertile women, and sometimes infertile men as well, describe their lives without children as meaningless, fruitless, miserable, shameful, or unhappy. Moreover, they speak about feelings of...

    • THIRTEEN Infertility and Health Care in Countries with Less Resources: Case Studies from Sub-Saharan Africa
      (pp. 247-260)
      Johanne Sundby

      To what extent will the meaning, causes, consequences, and treatment of infertility differ according to culture, context, and socioeconomic environment? And what are the challenges if the aim is to promote a more equitable world, including better care for those couples who are affected by infertility? In the developed part of the world, infertility has become an important issue in the public debate. In the developing countries, infertility is still an issue that receives little public policy attention. One reason for this is the developed world’s preoccupation with increasing population growth; infertility has been seen as one way of reducing...

  6. PART IV GLOBALIZING TECHNOLOGIES

    • FOURTEEN The “Local” Confronts the “Global”: Infertile Bodies and New Reproductive Technologies in Egypt
      (pp. 263-282)
      Marcia C. Inhorn

      Since the birth in 1978 of Louise Brown, the world’s first test-tube baby, new reproductive technologies (NRTs) have spread around the globe, reaching countries far from the “producing” nations of the West. Perhaps nowhere is this globalization process more evident than in the nearly twenty nations of the Muslim Middle East, where in vitro fertilization (IVF) centers have opened in small, petro-rich Arab countries such as Bahrain and Qatar and in much larger but less prosperous North African nations such as Morocco and Egypt. Egypt provides a fascinating locus for investigation of this global transfer of NRTs because of its...

    • FIFTEEN Rabbis and Reproduction: The Uses of New Reproductive Technologies among Ultraorthodox Jews in Israel
      (pp. 283-297)
      Susan Martha Kahn

      What are the contemporary attitudes toward new reproductive technologies (NRTs) among ultraorthodox Jews in Israel? Ultraorthodox Jews have embraced the practical and theoretical challenges presented by NRTs and have created innovative if often contradictory rulings about their appropriate use. That they inhabit a world governed by ancient traditions and rooted in a two-thousand-year-old legal system has not prevented them from adapting the newest technologies to their way of life, including the latest techniques to conceive persons.

      In this chapter, I argue that the phenomenon of NRT use among ultraorthodox Jews in Israel is instructive on many levels. We learn something...

    • SIXTEEN The Politics of Making Modern Babies in China: Reproductive Technologies and the “New” Eugenics
      (pp. 298-314)
      Lisa Handwerker

      Since the late 1980s, there has been increased interest in and use of new reproductive technologies (NRTs), resulting in a “new” eugenics in the People’s Republic of China. In March 1988 in Beijing, a thirty-nine-year-old woman from rural China gave birth to China’s first test-tube baby. By December 1993, one of China’s major teaching hospitals had produced more than fifty test-tube babies through the combined efforts of in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT). In other cases, babies have been conceived with the help of donated eggs, donated embryos, artificial insemination (Chao, 1988), sperm intrafallopian transfer (SIFT), and...

    • SEVENTEEN Conception Politics: Medical Egos, Media Spotlights, and the Contest over Test-Tube Firsts in India
      (pp. 315-334)
      Aditya Bharadwaj

      The history of in vitro fertilization (IVF) in India is arguably as old as the history of IVF itself. Its origin has been controversial and its subsequent development no less so. In vitro fertilization laid the foundation for assisted conception in India and created a terrain on which wars for the legitimate ownership of the first “test-tube baby miracle” are being fought.¹ The story of the first IVF baby in India has exposed scientific intolerance to knowledge claims that do not pass under the gaze of peer review. Assisted conception in India today is a contested terrain in part because...

  7. CONTRIBUTORS
    (pp. 335-340)
  8. INDEX
    (pp. 341-347)