- Infertility: Tracing the History of a Transformative Term by Robin E. Jensen
From the revelation that ovulation occurs midcycle, rather than during menstruation, to the arrival of the chemical pregnancy test and the Pill, the twentieth century has brought dramatic transformations in the science and medical [End Page 817] management of female fertility. As rhetorician Robin Jensen’s Infertility reminds us, however, processes of medicalization tend to enfold, rather than eviscerate, older cultural conceptions of the body, health, and disease. Beginning with late nineteenth-century theories of infertility grounded in moral physiology and closing with the rise of late twentieth-century reproductive technologies, Jensen shows how ideas about trade-offs between female fertility and women’s participation in traditionally male spheres have persistently imbued popular and medical infertility rhetoric.
Analyzing scientific theories of female infertility from the late nineteenth century to the present that assume the culpability of the infertile woman, Infertility will be of particular interest to feminist historians of gender and reproductive medicine. Jensen attends especially to the tensions between scientific accounts that portray fertility as under the control of a woman’s agency and those conceptualizing fertility as a mechanistic process outside her control. Bringing the history of rhetoric to bear on popular and scientific texts and images in the infertility literature, Jensen shows how at any point in time, reigning theories of infertility embrace “mixed metaphors” (p. 17) that incorporate both poles of this problematic, producing a slippery discourse of female infertility that shifts between rhetorics of blame and empowerment.
The terms “barren” and “sterile”—“infertility” did not arrive until the twentieth century—presage this dynamic. “Barren,” according to Jensen, carries implications of “unnatural” and conveys connotations of the woman’s moral failure (p. 19). “Sterile,” a term introduced in the early nineteenth century, suggests instead that the body is “in need of technical-mechanical diagnosis and repair” by a physician and eschews insinuations of maternal culpability (p. 28). Despite nineteenth-century medical writers’ new preference for the term “sterile,” however, Jensen shows how the older conventions of moral physiology retained narrative power. The resulting discourse constructed the involuntarily childless woman as at once powerless and culpable for her condition.
The book’s most compelling material traces the legacy of “energy conservation” theories of women’s fertility in twentieth-century medical models of infertility. American physician Edward H. Clarke, in his 1873 Sex in Education, famously excoriated educators for submitting female students to the same schedule of mental labor during adolescence as their brothers.1 Educating girls and young women, he argued, sapped their reproductive energy, leading the best prospective young mothers to produce fewer offspring, with dire consequences for the race. Jensen traces such ideas to a broad substratum of energetic theories for explaining the mental and physical differences between the sexes within nineteenth-century medical and evolutionary thought.
In a marvelous chapter on psychogenic theories of women’s infertility, Jensen shows how in the 1930s and 1940s, psychoanalytic explanations took up elements of energy conservation theories, now recast in the language of hormones and chemistry, to offer a psychosomatic account of infertility. Freud acolyte Helene [End Page 818] Deutsch, in her 1945 The Psychology of Women, proposed that infertility and pregnancy loss were a result of a woman’s conflicted relations with her mother, or of otherwise deranged psychosexual development.2 According to the psychogenetic theory of infertility, which Jensen shows had a remarkable array of adherents among psychoanalysts and obstetricians in the 1940s, only through proper adjustment to, and fulfillment of, her role as a child bearer could a woman resolve her infertility and attain psychological health.
The arrival of new clinically powerful tools for the management of infertility by the 1970s and 1980s seemingly put energetic and psychogenic theories of infertility to rest. Today, as Jensen shows, the mantra has become time. Women are enjoined to track their ovulatory cycle and to reproduce early or risk facing a punishing biological clock. Yet, in infertility medicine’s continued focus...