Embodying Culture: Pregnancy in Japan and Israel (review)

Embodying Culture offers a systematic comparison of the management of pregnancy in Israel and in Japan. Tsipy Ivry, an Israeli anthropologist who spent a considerable amount of time in Japan, has herself experienced pregnancy in both countries. In this volume she shares interviews she carried out with doctors and with pregnant women, as well as observations she conducted at a variety of pregnancy-related events in Israel and in Japan. The overall conceptual frame for this project is Ivry’s contention that science both shapes and is shaped by culture. Despite the comparable medical education, state of scientific knowledge and technology prevailing in the two countries, local beliefs and understandings deeply inform medical practice.

Ivry is particularly interested in attitudes toward pre-natal testing. Her core thesis is that pregnancy management in Israel is driven by anxiety regarding the possibility of reproductive “catastrophe” –malformation of the fetus—and, consequently, by the sense of an imperative to use all possible diagnostic techniques to ascertain the fetus’s genetic soundness, for the sake of making the best possible decision regarding the continuation or termination of the pregnancy. In Japan, by contrast, pregnancy management emphasizes the malleability of the fetus—the notion that the maternal “environment” contributes to a healthy, full-term baby. Thus, managing the pregnancy focuses on the mother’s diet, activities, stresses, and so on.

In the Israeli case study, which was confined to self-identifying secular and traditional Jews, Ivry argues that the pervasive concern in Israel with “Jewish” genetic diseases shows that “geneticists . . . became trapped in Zionist attempts to define the Jews through a distinct biology, and an explicitly eugenic endeavor to heal the Jews of this biology” (p. 42). Doctors often view “pregnancy as a predetermined game of chance over which the gambler (the pregnant woman) has no influence whatsoever. She can only get rid of the unwanted outcome” (p. 51). Perhaps because of this inherent sense of helplessness, the Israeli pregnant woman tends to be viewed as “hysterical” regarding the possibilities of fetal abnormalities and “totally dependent on her authoritative ob-gyn” to provide extensive testing (p. 47). This “hysteria” leads to women being portrayed (by their husbands and by others) “as spoiled, as requiring excessive care that women living in less modernized areas of the world can do without” (p. 200). In sum, Ivry describes the Israeli “trivializing” (p. 225) of pregnancy, such that the well-being of pregnant women is seen as immaterial to the health of the fetus, and the pregnancy itself is reduced to being merely part of women’s wider contribution to the national mission.

In Japan, contemporary anti-eugenic ideologies stand in stark contrast to the highly pro-eugenic practices and beliefs of pre-war and wartime Japan. Women and doctors believe the maternal–fetal bond to be so complete that very few women would even contemplate aborting because of fetal abnormalities. Pre-natal testing—attention to the genetic status of the fetus—is thus understood as not particularly relevant. Rather, pre-natal attention focuses on how well the woman carries out the task of creating a healthy environment for the baby inside her. “The common denominator . . . is the assumption that the body cannot handle the pregnant situation by itself; it needs help” (p. 132, italics in the original). Japanese women make far more pre-natal visits to the doctor than do Israeli women. These visits document the mother’s weight gain and other indicators of a pregnancy that will lead to a healthy birth. Japanese women are encouraged to document every aspect of their lives during pregnancy in a booklet that will continue to be used to record the baby’s vaccinations and other milestones later on.

Embodying Culture does a good job of laying out a clear and compelling argument. The quotes from interviews and pregnancy books as well the observations of pregnancy events and pre-natal visits are rich and interesting. However, I do have a few reservations concerning gaps in laying out the...