Introduction: Communicating Reproduction

summary:Communication should be central to histories of reproduction, because it has structured how people do and do not reproduce. Yet communication has been so pervasive, and so various, that it is often taken for granted and the historical specificities overlooked. Making communication a frame for histories of reproduction can draw a fragmented field together, including by putting the promotion of esoteric ideas on a par with other practical activities. Paying communication close attention can revitalize the history of reproduction over the long term by highlighting continuities as well as the complex connections between new technologies and new approaches. Themes such as the power of storytelling, the claiming and challenging of expertise, and relations between knowledge and ignorance, secrecy and propriety also invite further study.

tion have yet to investigate at all systematically how major traditions and innovations have depended on communication. 3 This dependence is suggested by the strong semantic relations. Digital and biological play off each other in talk of replication, cloning, and viruses. Visions of industrialized childbirth have invoked the steam press as a means of mechanical reproduction, while gossip is named for the women who once entered the birthing chamber to help. Bishop Richard de Bury's Philobiblon, a Latin manuscript completed in 1344, tells of the making of books as a kind of generation across time; we still think of books as children. 4 To interrogate these metaphors we need to take communication seriously as we historicize questions about reproduction.
What did male and female contribute, and how could they produce healthy children? How did human generation relate to that of animals and plants? What was the status of embryo and fetus, and how did it change through pregnancy? How did environment and geography affect fertility, what constituted a family, and what role should the state play? The questions may endure; form and audience have changed out of all recognition. So rather than presenting the responses as ethereal theory, we should ground the discussions in these basic transformations. Treating the promotion of even the most high-flown ideas as practical, material activities will bring them down to earth and put them on a par with other reproductive practices. Conversely, we know about the use of aphrodisiacs and obstetric analgesia, census taking, and birth control largely from evidence produced through processes of communication. To interpret this evidence fully, these processes should be front and center. In this way, recovering the conditions for communication can usefully draw various acts together.
By highlighting continuities, as well as the relations between new technologies and new approaches, thinking in terms of communication can contribute to conceptualizing the history of reproduction over the long term. Most existing histories tackle tightly defined periods while the established general frameworks are showing their age. 5 The articles in this special issue display changes and continuities in communication from medieval Europe to the late twentieth-century United States and show how these have shaped the theory and practice of making, and not making, babies. This work also shares themes, such as the roles of narrative repertoires, authority and expertise, knowledge and ignorance, secrecy and propriety, which this essay introduces. We start with technology.

Generation, Reproduction, and Technologies of Communication
Changes in reproduction can be investigated through the introduction of new communication technologies, but the relations are complex and subtle rather than direct and causal. The publication of Elizabeth Eisenstein's The Printing Press as an Agent of Change (1979) sparked a major debate about technological determinism, and historians of science were among the book's foremost critics. 6 Little attention was paid to the impact, from the mid-1400s, of the coming of print on practical medicine, where regimen and therapeutics were less obviously revolutionized by the press. Indeed, a strong case can be made that the deeper transformation took place between 1350 and 1500, as householders, friars, and practitioners began to write manuscript books that assimilated, organized, and transmitted practical medical knowledge. What had been the province of scholars in the universities now leapt the walls and assumed more everyday importance in the control of health and fortunes. Individuals took advantage of the readier availability of paper and ink and the introduction of quicker, cursive scripts to record observations and recipes to promote generation and help in forecasting outcomes. 7 This explosion of writing puts into perspective the introduction of movable type that was so central to Eisenstein's argument; but printing still made knowledge less expensive and more available. It fostered scholarly exchange and patronage, and turned "secrets of women" into market commodities, while anatomies used woodcuts and engravings to offer readers a spectacle of the interior of the body.
In succeeding centuries individual things of all kinds were crafted in ways that united nature and art. Early modern books were made of handmade paper, with type set manually and every sheet printed by human labor on a hand press. As a result, though print was potentially less errorridden than manuscript, every copy differed, sometimes substantially, from all others, even within an edition. 8 Natural objects were seen, in parallel, as coming into being through generation, a process likened to artisanal production and, in most accounts, requiring divine intervention at some point. Matrix was a word for both the mold for casting type and the womb. 9 William Harvey and other physicians and natural philosophers debated the generation of minerals, vegetables, and especially animals, but by the 1700s living beings and minerals were more often understood as arising in distinct ways.
The term reproduction had been used for various kinds of producing again after destruction or consumption: in theology for bodily resurrection at the Last Judgment, in agriculture for the shooting of a pollarded tree, and in natural history for the regrowth of limbs in lower animals, our regeneration. The Comte de Buffon's successful Histoire naturelle (1749) innovatively tackled "reproduction in general" by applying the model of regeneration to the origin of whole living beings, animals and plants alike. Buffon's invocation of an internal mold linked his theory to the older craft-based tradition, but he postulated the formation of embryos from organic molecules under the influence of physical forces. Like the related speculations of Pierre Louis Moreau de Maupertuis and Julien Offray de La Mettrie, this was highly controversial. 10 The new theories of reproduction were made for conversation. Generation had long been a fashionable topic in enlightened salons and featured in books of philosophy, medicine, poetry, and imaginary travels. Polite society sought out natural philosophers for their insights into the multiplication of living individuals and populations. 11 The view that whole individuals emerged through a regular, law-like, and repeatable process that could be called reproduction gained currency only gradually-generation long remained the preferred term-but by the mid-nineteenth century reproduction provided an increasingly standard way to link the individual body and that of the species. 12 The old verb to reproduce entered common usage to refer to the multiplication of a range of things from an original plan or blueprint, usually according to a specified process that could be repeated indefinitely. Reproduction became associated with mechanization, since machines were reckoned to provide a relatively stable means of replicating texts. The woodframe hand press gave way to the sturdier iron-frame press, which could work faster and longer, and paper-making machines were developed. The most striking symbol of change was the steam press, introduced on the London Times in 1814. Railways and steamships accelerated distribution. 13 Perhaps the most telling invention was of stereotyping, which from the 1820s made a mold of the type to print multiple editions without resetting. A picture introduced into such a text was a cliché, a term then adopted for any unthinkingly repeated phrase. Innovations such as stereotyping and the cliché meant that, unlike for early modern books, copies were effectively the same. 14 Developments in printing and in understandings of reproduction, although not causally linked, were part of larger transformations in craft practices, the control of increasingly urbanized populations, and expertise. In the wake of the Napoleonic Wars states took an increasing interest in such questions and looked to new kinds of expert to navigate the changing map of knowledge and its potential for organizing families, cities, nations, and empires. A novel array of specialties, from obstetrics to embryology, described women's bodies as organized for child-bearing and justified physicians' supervision of midwives and childbirth. Ambitious doctors tried to improve the health of nations by combating abortion and infanticide. There were new places for discussing work in museums, laboratories, and surveys, new roles for specialist monographs, and a new stress on publication in journals. 15 Many of the general innovations that would transform communication about sex and reproduction were in place by the 1830s, including mechanized printing and paper production, and demands for the reform of mass education. In the United States they led to an explosion in printed materials dealing with reproduction and sex. Like so many features of the industrial revolution, however, these novelties did not fully take hold throughout the industrializing world until the second half of the nineteenth century. By 1900 all but the poorest could afford newspapers, printed on cheap wood-pulp paper rather than expensive linen, in cities throughout Europe and North America. Even small linguistic communities, such as literate urban elites outside the industrial centers, took part. Information and devices relating to pregnancy, birth, and birth control were discretely advertised in penny papers and available by mail order. The seventeenth-century Aristotle's Masterpiece achieved its greatest sales in the nineteenth century, in stereotyped editions available at a bargain price. 16 Then Marie Stopes's paean to conjugal heterosexuality, Married Love (1918), sold half a million copies in English in its first seven years and was translated into over fifteen languages, including French, German, Danish, Swedish, Dutch, Spanish, Hungarian, Arabic, Portuguese, Italian, Icelandic, Afrikaans, Gujarati, Hindi, Japanese, and Chinese. 17 Nicolas Venette's Tableau de l'amour conjugal, first published in Amsterdam in 1686, had gone into the major European languages (it was Englished as The Mysteries of Conjugal Love Reveal'd), but Stopes's book more rapidly achieved far greater scale and reach. Changes in the world of print were accompanied by other new technologies, notably photography (widely available from the 1880s), cinema (from the 1890s), and radio (from the early twentieth century). This made possible the reproduction of cheap images, sounds, and texts across the social spectrum and throughout the world.
It is easy to see technologies of communication as an independent, allconquering force for sameness. Yet these changes, like the introduction of printing itself, rendered the meanings of texts and images even less stable than before. For they were accompanied by a vast escalation in the size and diversity of audiences, who now came from an ever-expanding range of social classes, religious groupings, and political orientations. Literacy increased, particularly among women, and knowledge about sex and reproduction that had been passed down orally became available in manuals and films. This shift multiplied occasions for conversations between family members and friends, doctors and patients. "Mass culture" produced not uniformity, but a cacophony of voices and views. 18 Access to knowledge about sex and reproduction was hotly debated. Organized pressure groups such as pronatalist and eugenic societies used the new tools of statistics-surveys and reports, charts, tables, and diagrams-to campaign against national degeneration and for "good breeding." But with the line between medicine and pornography hard to draw, topics such as abortion and birth control were often framed as obscene threats to the national health, as in the much-reported trial of the freethinker Annie Besant. Publishers in London, Paris, Berlin, New York, and other cities trod a fine line between sexual knowledge, reproductive science, and erotic entertainment. Alicia Puglionesi elucidates in this issue how in the United States after 1873 firms circumvented the Comstock Laws, which decreed it illegal to mail "obscene literature and articles of immoral use," meaning contraceptives and abortifacients, and often outlawed their sale as well. Regulation was now seen as a duty of governments, which gathered statistics about births, illegitimacy, prostitution, and venereal disease and, alongside lobbying organizations, public institutions, and commercial ventures, produced a blizzard of printed regulations, posters, guides, and packaging, as well as models, exhibitions, films, and radio programs. 19 Behind the apparent uniformity of such "mass media" productions was a rich potential for diverse and often highly individual responses. Pages might be stereotyped, but readers were not. 20 More than is usually appreciated, especially for books from the machine era, these reactions have been shaped by the kind of sensory aura that Walter Benjamin evoked in a celebrated talk about the thrills of acquiring and the pleasures of owning books as physical objects and bearers of memories. 21 If collectors associated books with the circumstances in which they had been bought, or occasionally even read, their production was designed to enhance the advantages of routine ownership. As numerous letters from readers evidence, a book like Stopes's Married Love could have a transformative effect, becoming a treasured possession through which the author appeared to speak directly to the reader about achieving satisfaction. "Every heart desires a mate": from these opening words of the first chapter, Stopes created a bond, which she cemented by a willingness to draw on her own experience to help others. "In my first marriage I paid such a terrible price for sex-ignorance that I feel that knowledge gained at such a cost should be placed at the service of humanity." The unobtrusive cloth binding, smooth machine-made paper, and readable typeface-as much as the endorsements, message, and style-underlined the importance of clarity. These physical qualities identified the book-issued by a small company until it was so overwhelmed as to transfer the rights to G. P. Putnam's Sons-as modern and modest, understated even in the "Curve showing the Periodicity of Recurrence of natural desire in healthy women." To mention such things in print was controversial, but the aesthetics of production eased the reception and secured success. 22 Whether consulting a manual or leafing through one of the magazines that informed women about pregnancy, childbirth, and contraception, readers experienced the auratic qualities of paper, ink, and type: the performative power of the words and pictures on the page. Similar considerations apply to conversations and consultations, which depend on a mutual understanding of gestures and tones of voice, and are in play every time we listen to the radio, go to a movie, watch television, and surf the Internet. They are relevant, that is, to the full gamut of media through which communication about reproduction has exploded since World War II. This is when reproduction gained a stronger identity as a field of teaching and research and, in the form of artificial insemination, hospital birth, the oral contraceptive pill, population control, in vitro fertilization, and cloning, became more widely and prominently contested than ever before. 23 From textbooks to film and online video, the specificity of different media shaped experiences. The delivery scene in the German film Helga, which was screened across Europe, the United States, and the British Commonwealth from 1967, shocked viewers through the vivid immersiveness of cinema-even if critics objected that the heroine's perfect makeup was a fraud. 24 Yet intensified exchange between media became essential to large-scale success. Two years earlier, the new photojournalism put Lennart Nilsson's glossy, color pictures of fetuses on the cover of Life magazine and into the global best-seller Ett barn blir till (A Child Is Born). In this issue Solveig Jülich explores the "almost symbiotic relationship" between book publishing, magazines, and newspapers that produced this "hybrid of embryological picture story and practical advice to pregnant women" (pp. 513, 524). The photographs came out of opposition to the liberal Swedish abortion law, and were repeatedly reframed for magazine, advice book, and textbook use; when antiabortionists held them up on placards at rallies, in court, and on television; and when feminists critiqued "the power of visual culture in the politics of reproduction. specialist journals lie narratives that plot human action in space and time, within lineages and generations, and so set individual experiences about coming into being in larger frames. 26 A repertoire, drawn from biblical or classical sources or rooted in local lore, laboratory procedure, or everyday experience, has inflected what we say and how.
The Bible has been the main source of origin stories in the Western world for the last two millennia. The book of Genesis, and the Old Testament passages dealing with the descent of the House of David, explained human generation and the succession of generations. The New Testament began with the virgin birth; Christ's marriage of human and divine attributes, and his status as heir to David's line, was affirmed as a matter of faith. Through the Middle Ages, illiteracy and the lack of vernacular bibles limited access, but reading aloud in monastic communities was accompanied in the thirteenth and fourteenth centuries by a vast expansion of Dominican and Franciscan preaching. Model sermons circulated in written texts, and preachers' exegesis of scripture was reinforced by the confession of individual sins. 27 Until at least the seventeenth century more Europeans heard than read about generation. Devotional art in churches and households also told Old and New Testament stories, most spectacularly about the cult of the Virgin Mary. Reformation iconoclasm curbed the use of pictures among Protestants, but Catholic regions knew no such inhibitions.
Images of Eve and Mary still serve as a visual shorthand for reproductive ideas, while the Bible continues to shape modern narratives, particularly through the emergence of universal history in the Enlightenment. Though often targeted against traditional religion, the evolutionary epics of the nineteenth century, such as Herbert Spencer's System of Synthetic Philosophy (1862-96) and Ernst Haeckel's Natürliche Schöpfungsgeschichte (Natural history of creation, 1868), drew much of their narrative drive and explanatory ambition from scripture. Cosmologies surveying development from the creation of the solar system to the rise of civilization have been a major publishing phenomenon of the modern age. Glossy books, television series, films, and computer games still trace an arc from stars to societies, often via the development of the embryo. The Bible was never the only source. Around the same time as preaching expanded, medieval romances began to draw on national histories for characters and plots. The earliest known version of the complex of stories that grew up around the children of the Roman Emperor Octavian was written in Old French in the thirteenth century, and is found in English, Italian, and German too. Octavian and his wife the empress are childless, until she persuades him to found an abbey dedicated to the Virgin Mary and is rewarded with the conception of twins. But Octavian's mother tricks him into believing his wife has been unfaithful with a baseborn knave, whose bloody head he throws on her bed. Though Octavian threatens to kill her and her twins, they are exiled instead, and after many adventures he recognizes his children. 29 Tales of Caesar's birth and Nero's pregnancy similarly informed the patrician culture of late medieval Florence, which developed the themes of fertility, inheritance, lineage, and legitimacy in diverse models of generation. 30 Written on parchment, romances and histories were read aloud in gentry and merchant households. With the coming of print, shortened and simplified stories circulated more, and cheap ballads and chapbooks were recited or sung. 31 Broadsides and title pages, often illustrated, were tacked on posts and pinned to walls. Other literary genres include wonder books that traded on the enduring fascination with extraordinary births, 32 and romances and novels that satirized generation, from the physician François Rabelais's mid-sixteenth-century Pantagruel to Laurence Sterne's mid-eighteenth-century Tristram Shandy. Sterne united an account of the generation and birth of its author with explicit jokes about type, paper, and print. Over two centuries later, Michael Winterbottom's A Cock and Bull Story translated the same pun on the narratives of generation and of communication into the language of cinema, so that the film and the "making of" documentary merged into one. As the persistent teaching and discussion of Tristram Shandy suggests, technologies of communication can traverse centuries and continents, yet often play on the intimate exchange of spoken words. Writing and speech have always been bound up together. Even a monk or professional scribe might write into the margin of the text he was copying some tip from an oral story, as Peter Murray Jones and Lea Olsan show in this issue for generation rituals in medieval manuscripts. Printed works envisaged reading aloud, as Thomas Raynalde, the English editor of The Womans Booke (1545), discussed here by Jennifer Richards, anticipated in his prologue to women readers. But there was no simple gendering of women as speaking while only men read and wrote. As Richards discovered, Raynalde's expectation was borne out by a manuscript dialogue in which two women critique what they have read.
Men and women have shared some of the most significant stories about generation with physicians, midwives, and other healers. Often cast as illness and birth narratives, these encounters tend to be described as oral transactions, but the presence of paper records, diagnostic scans, or online databases suggests a more complicated picture. The physician Sir Théodore Turquet de Mayerne (1573-1655) used to meet his exclusive clientele in the presence of bound volumes of his own medical records, which he would ostentatiously consult. 34 At the other end of the social scale the early modern mountebank, selling remedies on the street, posted bills to advertise his services and displayed paper testimonials from those he had cured. 35 The patients in the casebooks of the astrologers Simon Forman and Richard Napier, which survive from 1596 to 1634, frequently asked about pregnancy and disease. The astrologer would refer to his casebook, like Mayerne, but to judge the cause of the disease also wrote out astral charts there and then. 36  With the rise of scientific medicine in the nineteenth century, those words from the bedside physician were increasingly grounded in the authority of charted data. Yet after the alleged "disappearance of the sick-man," 37 the voices and narratives of patients and pregnant women reemerged from the 1970s and were recovered from the past. As Wendy Kline shows in this issue, books by home birth activists bid for authenticity with exemplary stories first heard over the telephone or recorded on cassette tape. Obstetric narratives pitched tales of technological progress against those aspirations to retake control.
Research on reproduction has commonly chosen or had to resist a science fictional frame, most often Mary Shelley's Frankenstein (1818) or Aldous Huxley's Brave New World (1932). Two years later, when Gregory Pincus and Ernst Enzmann claimed to have fertilized mammalian eggs in vitro, the New York Times wrote of Huxley's "fantasy made real" and, in homage to the fictional inventor of the key cloning process, presented the Harvard biologists as "two Bokanovskys." 38 In postwar reporting on "test-tube babies" newspapers juxtaposed Frankenstein fears with intimate stories of desperate couples hoping to conceive via technomedical adventures, and these eventually won out. 39  phone apps dramatize dilemmas of reproductive choice and coercion: today babies are planned, or avoided, as much on screen as in bedrooms or clinics. 41

Authority and Expertise
In debating who could say what about generation and reproduction, expertise was increasingly at stake. Long central to historical writing on medicine, it can best be investigated by studying the acts of communication in which it was claimed or challenged. In education, specialized practice, and the public sphere, people were variously qualified to speak and write on reproduction by experience, skill, examinations, and authorship. Did one need a medical degree or a midwife's license; a textbook, advice book, or journal article to one's name; to have given birth, or attended a birth? The rise of research placed a premium on novelty, and the expansion of the press generated ever more appetite for news. Formal training and qualifications gained importance, but education systems marginalized reproduction long after other aspects of medicine and biology were taught, and the value of experience has been reasserted time and again.
With the medieval establishment of medical faculties, scholars developed specific tools for the exegesis of ancient knowledge on generation. Commentaries and questions for disputation served to harmonize the various opinions in an expanding corpus of writings by Aristotle, Galen, and those Arabic authors, preeminently Avicenna, who worked to reconcile them. The skills thus cultivated are exemplified in manuscript copies of scholastic works such as Giles of Rome's De formatione corporis humani in utero (On the formation of the human body in the womb) completed between 1285 and 1295. Giles attempted to harmonize competing views on the maternal and paternal contributions and on the timing of ensoulment. 42 This had little direct impact on conception and childbirth at the time.
Yet, as Monica Green has argued, doctors soon began to claim practical expertise on the basis of their understanding of ancient texts and their experience as learned medical practitioners. From the early fourteenth century physicians linked to the medical school of Montpellier asserted their competence to diagnose and treat infertility, with the emphasis on the womb, whence they expanded into the treatment of women's diseases as a whole. 43 Physicians' treatises of practical medicine circulated as manuscripts to which lay readers and healing practitioners looked for guidance. 44 The doctors disparaged midwives and other women, though compared with antiquity, few women had the occupational title of midwife in Europe before the sixteenth century; "midwife" seems to have been less a medical function and more a social role. 45 Rarely recorded in writing, female attendants' experiential knowledge was shared by imitation or word of mouth. However, as Jones and Olsan show, these women employed birthing rituals and amulets, which not only involved male clerics and borrowed motifs from Christian liturgy, but were also written down for further circulation and later copied into remedy books for household use.
From 1450 printed treatises on generation reinforced manuscript claims of male expertise. As midwife was recognized as an occupation in the sixteenth century, obstetric books became more emphatic than their scholastic antecedents about the limitations of women's knowledge. The most reprinted work of its kind, Eucharius Rösslin's Rosegarden, nevertheless helped literate German midwives to function within a structure of civic regulation; the many vernacular editions also instructed laypeople in practical knowledge of generation. 46 As well as finding women readers, Raynalde's revised translation drew on the De fabrica of Andreas Vesalius (1543) to put into wide circulation the latest and most sophisticated images of the organs of generation. Vesalius's expertise as dissector was thus enlisted in pictures made to complement and correct ancient textual authority, and to establish a canonical image of the genitals as natural and fashioned by God. 47 Through the seventeenth century, midwifery texts, often illustrating the birthing room as well as fetal presentations and abdominal anatomy, displayed knowledge that male and female practitioners contested. 48 During the eighteenth century the medical cosmologies of learned practitioners and their patients diverged, as studies of reproduction participated in the rise of the microscopical, surgical, and demographical techniques characteristic of the discipline-oriented world of scientific research and teaching. Advanced instruction was given in obstetrics, anatomy, and physiology through the nineteenth century, and these disciplines also fostered most research. Yet the first experimental physiologists excluded reproduction as intractable, though it remained a more central concern of gynecology, even zoology. The physiology of reproduction was not staked out as a field until Francis Marshall's textbook of 1910, with its expansive vision encompassing academic biology, clinical medicine, agriculture, and through endocrinology, the pharmaceutical industry too. Such research still struggled for legitimacy and hence for government funding through the twentieth century. 49 The creation of a mass readership changed the communication of research at the same time as this became an activity for which numerous scientists were paid. Late eighteenth-century novels had expressed skepticism about Buffon's theories and exploited experiments by the priest and natural historian Lazzaro Spallanzani on artificial insemination. 50 But major claims could still pass without wider comment. In 1827, when the Prussian professor Karl Ernst von Baer discovered the definitive mamma-lian ovum in his mentor's house bitch with an ordinary microscope and without a laboratory, he announced the result in a Latin letter to the St. Petersburg Academy of Sciences and a small demonstration at an early meeting of the Association of German Nature Researchers and Physicians the following year. 51 The work inspired a generation of embryologists and had many indirect effects, but received little immediate public recognition. In the decades around 1900, by contrast, the much expanded French medical, literary, and general press lamented that country's declining birthrate and the specter of national degeneration in relation to reports of ovariotomy, on the one hand, and various doctors' claims to artificial insemination, on the other. In 1885, when the Paris medical faculty somewhat hypocritically turned down a doctoral thesis on that topic, newspapers ran articles on "baby factories" that would "remove the pater from paternity"; the previous year, a novel, Le faiseur d'hommes (The man-maker), had already explored public distrust of this extraordinary science. 52 In such an open and contested field, of such high public interest, as reproduction, the general press often played key roles. New contraceptives have recently been tested in the media as much as the clinic; trials of "male pills" foundered, not least, on the difficulty of promoting new masculinities in this forum. 53 During the nineteenth century, the journal article became the dominant medium for pressing discovery claims. After World War II, codes of conduct, including embargoes, preserved journals as crucial nodes in this system, but everything did not begin or end with them. 54 Oral communication, for example, still mattered. Medical research had always relied on conversation, 55 and from the 1970s (gene) "cloning by press conference" made the fortunes of research programs and companies. 56 In July 1978 newspapers and magazines, radio and television persuaded almost (but not quite) everyone that the first IVF baby had been born before the scientific paper was even written; a full account was not published for another two years, though many experts heard and reported on a symposium in January 1979. 57 It had not always been so easy, especially for women, to discuss such topics beyond the family. Opponents of female medical education had regarded the prospect of their examining the sex organs and learning about procreation and development, particularly in male company, as what the German anatomist Theodor Bischoff called "a gross offense against decency and good manners and … a shameless abandonment of all feminine delicacy of feeling." 58 But the many women reluctant to broach intimate matters with male professionals created opportunities for physicians of their own sex. Doubly qualified by gender and (more or less recognized) medical examinations, female doctors followed the lead, in Germany, of Hope Bridges Adams with her Frauenbuch (Women's book) of 1896 and carved out a niche as authors of advice. 59 By this time American women had been writing and lecturing about sex and reproduction from various perspectives for decades. 60 Feminists organized new networks from the 1960s, when the potential of medical science to control fertility was widely advertised just as the authority of scientific medicine was challenged as never before. Bypassing mainstream publishing and malestream medicine, they gave alternative, even countercultural, stances on sex and reproduction. 61 By the 1980s many of these were becoming standard, but had also provoked a backlash, especially against the legalization of abortion. 62 Authority could be grounded in other skills than knowledge or experience of reproduction. For centuries some artists had their primary training in, for example, illustration or model making, and then had to negotiate, often with medically more qualified practitioners, the right this gave them to produce images of bodies. 63 As Jülich shows, Nilsson built on, but also played down, his status as a celebrity photographer when the publicity for A Child Is Born presented him as a white-coated scientist at the microscope and as having contributed to discoveries (pp. 516-17). After World War II health communication became a field of expertise in its own right. 64 Without a communication strategy, no new intervention in reproduction, at individual or population level, now stands a chance.
Yet communication was never only about the speaker, writer, broadcaster, or photographer; it always presupposed skills in listeners, readers, and viewers too, as the history of images shows. Vesalius had valued pictures as less instructive than a private lesson, but better than texts, while Harvey mistrusted illustrations as unable to do justice to observation. By the early 1800s most researchers demanded new pictures to support new claims and understood vivid images as easing access. But were pictures powerful, their messages so alluring they needed to be controlled; or weak, hence presupposing so much expertise they would mean nothing without extensive interpretation? Some still rejected book illustrations lest they fool readers into thinking mere pictures could ever substitute for practical experience. Others argued that images embodied conventions unintelligible to the untrained; a few promoted models as more suitable for midwives or laypeople than flat pictures. As visual education proceeded apace, however, the greater concern, not least among Catholics, was that pictures might excite the senses of the young or otherwise give readers ideas. 65 Knowledge and Ignorance, Secrets and Silences Potentially so exciting, knowledge of generation and reproduction was often shrouded in silence or framed as secret. Its history is thus marked by complex relations between knowledge and ignorance. It is also entangled with histories of the body and of sexuality, for which Michel Foucault, despite all the challenges to his research, established the framework of a long-term shift from external sanctions to self-control. Discourse on sex was problematized, he argued, but in fact proliferated. Language was a technology of power, exercised through the churches, the state, the schools, and the family, but silences spoke volumes, and ignorance was produced as well as knowledge. 66 Christian doctrine and the ecclesiastical authorities forbade sex outside marriage, and the ideals of family and nature provided the norms against which sexual and procreative deviance was defined. In the decades around 1700, at least in England, secularizing imperatives relativized sexual norms and virtue began to be understood as instilled from within a person rather than imposed from without. Sex became a private matter and individuals-especially gentlemen-were free to do what they liked in bed, provided this was considered "natural" and did not harm the general good. At the same time, newspapers, pamphlets, novels, and prints broadcast and debated the private lives of individuals more publicly than ever. Ignorance about sex and reproduction-among the young, women, and people in other times and places-also became a dominant trope. 67 Women's knowledge-both of women's bodies and possessed by women-had long been secret. From the thirteenth century, manuscripts collected "secrets of women" from learned texts and practical traditions. Where "books of secrets" advertised recipes for experiments ranging from the functional to the fabulous, "secrets of women" detailed the mysteries of generation. 68 The expansion of print led to a proliferation of sexual facts and a rhetoric of secrecy; women's authority became dubious as their bodies became more private and shameful. 69 By the eighteenth century, (young) women were presented as in need of advice. This ignorance was no mere absence of knowledge, but through the nineteenth and for much of the twentieth century often a state suffered in the face of ambiguous and contradictory messages or maintained in the service of a desired innocence and respectability. 70 while claiming authority over midwives' training and disparaging lay incomprehension, was reluctant to intervene. Spearheaded by mavericks and freethinkers who spent time in or were threatened with prison, Neomalthusian campaigners broke official silence and challenged obscenity laws by giving lectures and publishing advice. In 1854 the German medic, zoologist, and radical politician Carl Vogt justified including some reproductive physiology in a large tome of "familiar letters" on the grounds that a false "prudery" had left the field to books "in duodecimo or even smaller format." He dismissed their guidance on family limitation, sex selection, and VD as products of "shameless charlatanry" and "the crassest ignorance." 77 But the heterodoxy of many high-circulation writers helped them inform and often empower readers without devaluing existing practice altogether (Puglionesi).
Things could be said about sex, pregnancy, and familial resemblance within a household that could not be said in a pub or on the street, and vice versa. Early modern graffiti, ballads, and jokes breached these norms, but the authorities often objected more to political and religious than to sexual content. Conversation may have been franker in single-sex settings, while chaperones reduced opportunities for exchange between the sexes. Puglionesi shows that to evade the Comstock Laws and inhibitions about women's reading on reproduction, agents selling subscriptions to publications advertising contraceptives hinted on doorsteps at what potential subscribers might find inside their books and magazines.
Mobile, capitalist societies increasingly relied on printed presentations of medical knowledge, but also created new kinds of group reading. In the 1970s members of the Santa Cruz Birth Center shared knowledge derived from childbirth books, as they recalled for Kline. Classes, voluntary associations, informal networks, and conferences facilitated the exchange of information, much as household, family, and parish connections must earlier have done. Second-wave feminists made that connection as they valorized the knowledge of women in past centuries and critiqued its demonization and usurpation by men.
Despite the rhetoric of revolution from the darkness of sexual ignorance, many conventions have long histories. We can only conjecture as to the antecedents of the "English translation of a midwifery manual . . . purchased at New Age Natural Foods in San Francisco," and wonder if Rahima Baldwin wrote Special Delivery (1979) as a dialogue in part to echo earlier genres (Kline, pp. 544, 553). It is clear that for all the innovation, books such as Aristotle's Masterpiece were a force of continuity through major changes. They were legitimate conduits of secret knowledge. 77. Quoted in Hopwood, Haeckel's Embryos (n. 20), 50. * What unnameable thing did Lady Mary ask Anna to buy from the village pharmacy? As the millions worldwide who follow the country-house television drama Downton Abbey will know, the answer was hidden inside a small brown bag. We never see the contents, but Lady Mary's romantic entanglements make it clear that the embarrassed maid has been asked to purchase a contraceptive. It is 1924, and Lady Mary has learned the technical details of modern birth control from a book by Stopes. 78 The slim volume is as familiar downstairs as upstairs-in an earlier episode the scheming maid Edna is shown (improbably) to have a copy of her own. 79 But it is a different matter when Anna's husband Mr. Bates opens a box in their lodgings, and discovers the book with Stopes's name on the title page, together with a contraceptive device. He accuses Anna of trying to prevent them from having children, but Anna, ever the innocent, is just keeping the items for Lady Mary, who as a marriageable heiress cannot afford to have her sexual experiments known. 80 Mainstream television offers diverse contemporary audiences ways of working through issues in their own lives. Even so conservative a drama as Downton, with its stress on family, marriage, inheritance, legitimacy, and sex, provides viewers with regular, repeated occasions for discussion and debate. 81 If one point needs to be stressed, it is that communicating reproduction-especially in the seemingly globalized, homogenized world of the modern mass media-is a story of gaps and silences, of misunderstandings and misreadings. Or perhaps not reading at all, at least by the producers. For despite the attention given Stopes, the book Anna hides is revealed on screen as Married Love, which has little to say about contraception that Lady Mary would have found useful. Somewhere else in that great house there must be a copy of the sequel, Wise Parenthood, which includes a frank description and depiction of the vaginal insertion of a cervical cap. 82 In our world, as in Downton's Yorkshire, communication and reproduction are intertwined. In both, communication is as uncertain and messy as reproduction can sometimes be: more than most knowledge, understandings of reproduction have, metaphorically at least, often been half-concealed in brown paper or (less tantalizingly) in learned Latin or technical jargon. Talk about reproduction is caught up in differentials of authority, rank, class, and gender. Lady Mary tells Anna, "I don't think one should rely on a man in that department, do you?" and Anna appears to agree: "Suppose I was a working woman with eight children, and I didn't want any more. Wouldn't I have the right?" A real-life Anna would more likely have accepted that in matters of contraception, her husband should take the lead, but the underlying argument rings true. 83