Coming to Grips with the Limitations of Science: Infertility and Heredity in American History

The editors regret that when this review was printed in the June issue of Reviews in American History, Margaret Marsh, coauthor of The Empty Cradle: Infertility in America from Colonial Times to the Present, was incorrectly referred to as Walsh throughout the review.

The conceptual link between these two books is their social constructionist view of science. “Scientific facts do not speak for themselves,” Diane Paul concludes near the end of her brief overview of the history of eugenics, in what might serve as a succinct summary of her own work. “They must always be interpreted in light of social assumptions and goals” (p. 114). Her synopsis of current scholarship on the subject is tendered as a contribution in an edited series on scientific subjects whose purpose is to offer synthetic studies directed at lay audiences, written in nontechnical language, and intended to emphasize the social and political milieu in which each particular scientific field or topic developed. Paul, a political scientist, presents us with a clear, economical, and competent narrative of the emergence of eugenical thinking in tandem with the science of genetics, covering, not only their fascinating and often uneasy relationship with each other, but the social and political influence of the two in the United States. The authors of The Empty Cradle, a book on the history of infertility, which joins Elaine May’s “Barren in The Promised Land” (1995) as only the second published historical work on a virtually unexplored topic, are sisters, one an established historian and the other an accomplished gynecologist. This unusual combination has resulted in a book that manages to treat sensitively both culture and medicine.

We learn that the use of medical technology to cope with involuntary childlessness has been occurring for almost 150 years. What has altered over time is technique, knowledge, and social context. Ronner and Marsh emphasize that changing attitudes toward the family, marriage, sexuality, sex roles and gender, the social and private dimension of reproduction, emotional life, and religion all contributed to how couples perceived and responded to the nature and causes of their own infertility.

In the colonial period, barrenness was viewed as an act of God. Although folk remedies existed and were sought out, in appealing to a physician for advice one always risked the possibility of being perceived as defying divine will. All men were assumed to be potential fathers, as long as they could achieve an erection, and an adequate understanding of male sterility has come about slowly, partly because of cultural resistance to the idea. A modern analogue to premodern assumptions about male potency has been physicians’ reluctance to investigate the possibility of a husband’s incapacity, often with the complicity of wives who feared undermining male pride. In coping with infertility, women have been overwhelmingly the more inclined to express dismay. Moreover, the default assumption was always that women’s bodies were defective, a theme that has persisted well into the present day. Until recently, though male disorders account for a significant percentage of couples’ inability to conceive, it was difficult to get husbands to agree to be tested, let alone treated. Only a smattering of mostly female gynecologists routinely insisted on testing husbands.

Childless colonials were compensated in part by a culture that had not yet come to value offspring with the same sentimental force that gradually emerged at the end of the eighteenth century. In addition, they were offered numerous outlets for informal adoption, so that barren couples were not necessarily condemned to life without children. Those who wished could raise neighbors’ or relatives’ excess or orphaned offspring, with relatively little fanfare and a great deal of community sanction.

The nineteenth century saw such conditions...