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 Globe makes a powerful argument that involuntary childlessness is a complex phenomenon that has far-reaching significance worldwide.
Part I. Discourses and Debates
1. Introduction. Interpreting Infertility: A View from the Social Sciences
Frank van Balen and Marcia C. Inhorn
2. The Uses of a "Disease": Infertility as Rhetorical Vehicle
Margarete Sandelowski and Sheryl de Lacey
3. Fertile Ground: Feminists Theorize Infertility
Charis M. Thompson
4. The Psychologization of Infertility
Frank van Balen
Part II. Gender and Body Politics
5. Infertile Bodies: Medicalization, Metaphor, and Agency
Arthur L. Greil
6. Deciding Whether to Tell Children about Donor Insemination: An Unresolved Question in the United States
7. Conceiving the Happy Family: Infertility and Marital Politics in Northern Vietnam
Melissa J. Pashigian
8. Positioning Gender Identity in Narratives of Infertility: South Indian Women’s Lives in Context
Catherine Kohler Riessman
9. Childlessness, Adoption, and Milagros de Dios in Costa Rica
Gwynne L. Jenkins with Silvia Vargas Obando and José Badilla Navas
Part III. The Infertility Belt
10. Problematizing Fertility: "Scientific" Accounts and Chadian Women’s Narratives
11. Is Infertility an Unrecognized Public Health and Population Problem? The View from the Cameroon Grassfields
12. Infertility and Matrilineality: The Exceptional Case of the Macua of Mozambique
13. Infertility and Health Care in Countries with Less Resources: Case Studies from Sub-Saharan Africa
Part IV. Globalizing Technologies
14. The "Local" Confronts the "Global": Infertile Bodies and New Reproductive Technologies in Egypt
Marcia C. Inhorn
15. Rabbis and Reproduction: The Uses of New Reproductive Technologies
among Ultraorthodox Jews in Israel
Susan Martha Kahn
16. The Politics of Making Modern Babies in China: Reproductive Technologies and the "New" Eugenics
17. Conception Politics: Medical Egos, Media Spotlights, and the Contest over Test-Tube Firsts in India
Marcia C. Inhorn is Associate Professor in the Department of Health Behavior and Health Education, School of Public Health, International Institute, and the Department of Anthropology at the University of Michigan, Ann Arbor. Her books include Quest for Conception: Gender, Infertility, and Egyptian Medical Traditions (1994) and Infertility and Patriarchy: The Cultural Politics of Gender and Family Life in Egypt (1996). She is coeditor of The Anthropology of Infectious Disease: International Health Perspectives (1997). Frank van Balen is Associate Professor of Education and in the Faculty of Social and Behavioral Sciences at the University of Amsterdam. He is the author of three books in Dutch on childlessness, infertility, and new reproductive technologies, as well as a large number of articles on these subjects in international journals.
“It is well footnoted and there is a good index.”—Vern L. Bullough Technology And Culture
"Extremely well-written, innovative, and timely, Infertility Around the Globe
is a definitive work. Together, the authors use infertility as the lens to examine numerous compelling social issues, generating a powerful argument that infertility is a globally significant phenomenon. This volume will attract anthropologists and other social scientists interested in the study of reproduction, as well as anyone interested in gender studies, women's studies, and international health."—Carolyn Sargent, co-editor of Childbirth and Authoritative Knowledge: Cross-Cultural Perspectives
"This groundbreaking, interdisciplinary book will change how infertility is theorized and how intervention programs are designed. It will become the primary sourcebook for international and comparative research in a variety of cultural settings. Reading this book was a distinct pleasure."—Lynn Morgan, co-editor of Fetal Subjects, Feminist Positions
"A stunning achievement. Through its richly textured ethnographic accounts, this book beautifully explicates the universals and particularities of involuntary childlessness in disparate world regions. It challenges the myopic view that the heartbreak is limited to advanced industrial societies. This book is a much-needed antidote in a field mostly characterized by polemic and untested assumptions."—C. H. Browner, UCLA School of Medicine
"Scholarship on infertility too often has been culture-bound, focusing on Western versions of biosocial reproductive problems and on technological solutions. This innovative volume decenters that perspective, with studies on the ostracism of elder childless men in Kenya, political suspicions of vaccination campaigns in the Cameroons, new reproductive technologies for ultraorthodox use in Israel, and China's emergent eugenics. It enlarges the 'public' in public health."—Rayna Rapp, co-editor of Conceiving the New World Order: The Global Politics of Reproduction
Council on Anthropology and Reproduction Book Prize, Society for Medical Anthropology
Gay Becker is Professor in Residence, Social and Behavioral Sciences and Medical Anthropology, at the University of California, San Francisco. She has been studying infertility and reproductive technologies for more than twenty years, a project that grew out of her own experience with infertility. Her work includes a general study of people's experiences with infertility, which has resulted in the publication of three University of California Press books: Healing the Infertile Family: Strengthening Your Relationship in the Search for Parenthood, Disrupted Lives: How People Create Meaning in a Chaotic World, and The Elusive Embryo: Consuming the New Reproductive Technologies. She is also the author, with Robert Nachtigall, of several articles on donor insemination. For four years, she served as editor of the Society for Medical Anthropology's journal, Medical Anthropology Quarterly.
Aditya Bharadwaj is Research Fellow at Cardiff University, Wales, having recently completed his doctorate in the Department of Sociology at the University of Bristol. His dissertation, "Conceptions," examines infertility and the increasing use of new reproductive technologies in India. In the past, he has studied the medical management of childbirth, maternal nutrition, and immunization in India. His research on infertility is an outgrowth of his overall research interests in reproductive health care issues, qualitative research methods, and the anthropological study of India. His current research is in the area of new genetics and population screening for susceptibility to genetic diseases in the United Kingdom.
Sheryl de Lacey is Senior Lecturer in the School of Nursing and Midwifery at Flinders University in South Australia and an affiliate with Reproductive Medicine Services offered by the University of Adelaide. She has contributed to the development of practice and policy in the field of infertility and assisted reproduction through membership in several national ethics committees and policy-making councils over the past fifteen years. Her work includes reviews of how information for children should be regulated, surrogacy, counseling and issues of access in assisted reproduction, and the long-term health effects of assisted reproduction. Her research includes study of the experience of egg donors and a discourse analysis of infertility and in vitro fertilization failure.
Pamela Feldman-Savelsberg is Associate Professor in the Department of Sociology and Anthropology, Carleton College. She has conducted research on women's reproductive health care in Cameroon since the early 1980s. Her work focuses on the social conditions that give rise to fear of infertility. Extensive field research in a rural Bamiléké chiefdom as well as research in European archives has resulted in numerous publications, including Plundered Kitchens, Empty Wombs: Threatened Reproduction and Identity in the Cameroon Grassfields (University of Michigan Press, 1999). Current research on urban Bamiléké women's ethnic associations, social networks, and reproductive strategies is supported by an Andrew W. Mellon Fellowship in Anthropological Demography and by theNational Science Foundation.
Trudie Gerrits is a medical anthropologist and health educator, working as a researcher and lecturer in the Medical Anthropology Unit of the University of Amsterdam. She is project assistant for the Gender, Reproductive Health and Population Policies Project, an international action research project that aims at generating innovative knowledge about women's and men's needs regarding reproductive health services. From 1985 to 1990 she worked at the Ministry of Health in Mozambique, and in 1993 she conducted a study on social and cultural aspects of infertility in Mozambique, about which she has published a number of articles. She was an initiator and organizer (with Frank van Balen) of an international conference, Interpreting Infertility: Social Science Research on Childlessness in a Global Perspective, held in Amsterdam in November 1999. She has six-year-old IVF twins, Carmen and Jaap.
Arthur L. Greil is Professor of Sociology and Health Policy at Alfred University, Alfred, New York, where he has taught since 1977. His main research interests are in the areas of reproductive health, adult socialization and identity change, and the sociology of religion. His book, Not Yet Pregnant: Infertile Couples in Contemporary America (Rutgers University Press, 1991), deals with themes of gender and the experience of infertility and is based on the qualitative analysis of interviews with both partners of infertile American couples. He has also published a number of other articles on infertility, including a major review of the literature on infertility and psychological distress. He became interested in infertility as a result of his own experiences, and he and his wife have two adopted children, Robby, seventeen, and Maddie, ten.
Lisa Handwerker, a medical anthropologist, is Visiting Scholar in the Institute for the Study of Social Change at the University of California, Berkeley, and an adjunct professor in the Department of Anthropology at California State University, Hayward, and the Community Studies Department at the University of California, Santa Cruz. She has published numerous articles on female infertility and reproductive technologies in China and on feminist biomedical ethics. An activist, she sits on the Board of the National Women's Health Network and is a member of the Berkeley Health Commission. In addition, she is a consultant in health, organizational development, and fund-raising.
Marcia C. Inhorn is Associate Professor in the Department of Health Behavior and Health Education, School of Public Health, International Institute, and the Department of Anthropology at the University of Michigan. A medical anthropologist, her primary research interests are in the areas of gender and health, particularly women's reproductive health. Her major research project examines the plight of infertile women and men in urban Egypt. She has written two books on this subject, Quest for Conception: Gender, Infertility, and Egyptian Medical Traditions (1994) and Infertility and Patriarchy: The Cultural Politics of Gender and Family Life in Egypt (1996), both published by the University of Pennsylvania Press. Quest for Conception won the Society for Medical Anthropology's Eileen Basker Prize for outstanding research in the area of gender and health. Currently, she is completing a book titled Egyptian Mothers of Test-Tube Babies: Gender, Islam, and the Globalization of New Reproductive Technologies, which examines the global spread of new reproductive technologies to the developing world. Following the stillbirth of identical twin daughters, she went on to bear two living children, Carl, six, and Justine, three.
Gwynne L. Jenkins is Assistant Professor of Anthropology and Women's Studies at the University of Kansas. Her primary research interests are the politics of international health programs, nationalism and health, lay perceptions of health and health care, and the production of reproductive decision making in the clinical encounter and social life. Her dissertation, "The Bureaucratization of Birth: Midwifery Programs, National Health Care, and Local Birth Conventions in Rural Costa Rica," won a Presidential Distinguished Doctoral Dissertation Award from the University at Albany-State University of New York in 1999. She recently received a grant to study the experience of infertility and decision making in selective reduction among new reproductive technologies in the United States. Her next research project concerns the history of female sterilization policy in Costa Rica and its political use in discourses of modernization and nationalism.
Susan Martha Kahn is Senior Research Director of the Hadassah International Research Institute on Jewish Women at Brandeis University, where she is also Adjunct Assistant Professor in the Departments of Anthropology and Near Eastern and Judaic Studies. She received her M.A. in Middle Eastern studies and her Ph.D. in social anthropology from Harvard University. Her book, Reproducing Jews: A Cultural Account of Assisted Conception in Israel (Duke University Press, 2000), won a National Jewish Book Award (2000), and her dissertation, on which the book is based, won the Foundation for Jewish Culture's 1998 Musher Prize, awarded biennially for an outstanding dissertation on Jewish life in Israel or America.
Lori Leonard is Assistant Professor of International Health at the Johns Hopkins School of Public Health. She received M.S. and Sc.D. degrees in health and social behavior and population and international health from Harvard University. She has worked in sub-Saharan Africa for nearly fifteen years, first as a Peace Corps volunteer in Zaire (now the Democratic Republic of the Congo) and Chad and later on public health research and intervention projects in Chad, Mali, and Senegal. Much of her research has been on the Sara of southern Chad; her dissertation was on the meaning and management of infertility among the Sara, and she has written a series of articles on female circumcision among the Sara, including a chapter in the edited volume, Female "Circumcision" in Africa: Culture, Controversy, and Change (2000). Her interests include women's and reproductive health, STD and HIV prevention, community health, and qualitative research methods.
Melissa J. Pashigian is currently completing her Ph.D. in anthropology at the University of California, Los Angeles. Her dissertation, "Conceiving the 'Happy Family': Infertility, Gender and Reproductive Experience in Northern Vietnam," analyzes the social construction of infertility and its relationship to the politics of reproduction in Hanoi and its surrounding provinces. Her research interests include gender in socialist and postsocialist societies, the politics of reproduction, and the global proliferation of new reproductive technologies.
Catherine Kohler Riessman is Research Professor in the Department of Sociology, Boston College. She is Professor Emerita at Boston University. Her research and publications in medical sociology focus on women's health, gender and divorce, qualitative methods, and the narrative study of lives. She conducted fieldwork in South India in 1993-1994, supported by the Indo-American Fellowship Program (Fulbright), and has written a series of publications on women, power, and infertility in the South Indian context. Her methodological specialty is narrative. She is the author of Narrative Analysis (Sage, 1993) and Divorce Talk (Rutgers University Press, 1990) and editor of a collection on qualitative methods in social work. She has applied narrative methods in studies of disruptive life events, including divorce, chronic illness, and infertility. She has three grown children and two grandchildren.
Margarete Sandelowski is Professor in the School of Nursing at the University of North Carolina at Chapel Hill and a Fellow of the American Academy of Nursing. Her research is in the area of technology and gender, especially reproductive technology and technology in nursing. She has published widely in nursing and social science anthologies and journals. One of her books, With Child in Mind: Studies of the Personal Encounter with Infertility (University of Pennsylvania Press, 1993), was awarded the 1994 Eileen Basker Memorial Prize for exemplary work in the field of gender and health from the Society for Medical Anthropology of the American Anthropological Association. Her latest book, a social history of technology in nursing, is titled Devices and Desires: Gender, Technology, and American Nursing (University of North Carolina Press, 2000).
Johanne Sundby is Associate Professor, Section for Medical Anthropology, Institute of General Practice and Community Medicine, University of Oslo. She is a physician specializing in gynecology and obstetrics, with research training in both epidemiology and medical anthropology. She teaches international health in postgraduate programs and supervises students majoring in reproductive health from Norway and several African countries. Her Ph.D. dissertation in community medicine is titled "Infertility: Causes, Care and Consequences," and she has since written several books on infertility and women's health. She was the leader of the Norwegian government's Commission for Women's Health for two years. She has conducted studies on infertility in both Norway and Africa and is currently involved in a project in Tanzania in collaboration with Ulla Larsen of the Harvard School of Public Health. She is infertile herself and adopted a son born in 1974. To substitute for the lack of more children, she enjoys being a competitive dogsled musher with ten lovely Siberian huskies.
Charis M. Thompson is Assistant Professor in the Department of the History of Science at Harvard University. She works on selective pronatalism in the area of human reproductive technologies and population policy, as well as in ex situ (zoo) and in situ biodiversity conservation.
Frank van Balen is Associate Professor in the Department of Education, Social and Behaviorial Sciences Faculty, University of Amsterdam. After working as a student counselor and planner in the Dutch university organization, he received a grant in 1988 to begin research on involuntary childlessness in the Netherlands. Following the 1991 publication of his dissertation, "A Life without Children: Involuntary Childlessness, Experience, Stress, and Adaptation," he conducted several quantitative and qualitative studies on various aspects of involuntary childlessness, including the epidemiology of infertility, treatment-seeking behavior, the development of IVF children, the prospects of new reproductive technologies, and infertility counseling. He was an initiator and organizer (with Trudie Gerrits) of an international conference, Interpreting Infertility: Social Science Research on Childlessness in a Global Perspective, held in Amsterdam in November 1999. He has one IVF daughter, Roosmarijn, seventeen, and another daughter, Veerle, fifteen, who was conceived just a month after a failed IVF attempt.