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Infertility around the Globe

New Thinking on Childlessness, Gender, and Reproductive Technologies

Marcia Inhorn

Publication Year: 2002

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.

Published by: University of California Press


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p. 1-1

Title Page, Copyright, Dedication

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pp. i-vi


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pp. vii-viii

PART I: Discourses and Debates

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1. Introduction. Interpreting Infertility: A View from the Social Sciences

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pp. 3-32

...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 twentyfive years have witnessed a veritable explosion of research on the social construction and cultural elaboration of women’s...

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2. The Uses of a “Disease”: Infertility as Rhetorical Vehicle

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pp. 33-51

...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...

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3. Fertile Ground: Feminists Theorize Infertility

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pp. 52-78

...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...

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4. The Psychologization of Infertility

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pp. 79-98

...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...

PART II: Gender and Body Politics

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5. Infertile Bodies: Medicalization, Metaphor, and Agency

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pp. 101-118

...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...

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6. Deciding Whether to Tell Children about Donor Insemination: An Unresolved Question in the United States

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pp. 119-133

...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...

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7. Conceiving the Happy Family: Infertility and Marital Politics in Northern Vietnam

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pp. 134-151

...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...

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8. Positioning Gender Identity in Narratives of Infertility: South Indian Women’s Lives in Context

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pp. 152-170

...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...

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9. Childlessness, Adoption, and Milagros de Dios in Costa Rica

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pp. 171-190

...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...

PART III: The Infertility Belt

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10. Problematizing Fertility: “Scientific” Accounts and Chadian Women’s Narratives

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pp. 193-214

...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...

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11. Is Infertility an Unrecognized Public Health and Population Problem? The View from the Cameroon Grassfields

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pp. 215-232

...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...

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12. Infertility and Matrilineality: The Exceptional Case of the Macua of Mozambique

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pp. 233-246

...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...

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13. Infertility and Health Care in Countries with Less Resources: Case Studies from Sub-Saharan Africa

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pp. 247-260

...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...

PART IV: Globalizing Technologies

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14. The “Local” Confronts the “Global”: Infertile Bodies and New Reproductive Technologies in Egypt

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pp. 263-282

...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...

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15. Rabbis and Reproduction: The Uses of New Reproductive Technologies among Ultraorthodox Jews in Israel

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pp. 283-297

...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...

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16. The Politics of Making Modern Babies in China: Reproductive Technologies and the “New” Eugenics

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pp. 298-314

...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-yearold 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...

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17. Conception Politics: Medical Egos, Media Spotlights, and the Contest over Test-Tube Firsts in India

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pp. 315-334

...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...


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pp. 335-340


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pp. 341-347

E-ISBN-13: 9780520927810
Print-ISBN-13: 9780520231085

Page Count: 355
Publication Year: 2002