Misconception: Social Class and Infertility in America by Ann V. Bell (review)

In this thoughtful analysis of the discourse surrounding infertility in the United States, Ann V. Bell writes about sixty-three interviews that she conducted with women of varying socioeconomic status regarding the “involuntary childlessness” (a defining term used throughout the book) that they had all experienced at some point in their lives. This brief, exploratory study raises larger questions about the economics of fertility and motherhood.

Of her interviews, Bell writes that the “women’s stories reveal the deeply embedded classist ideas about who should reproduce,” sometimes “comparing themselves to bad mothers who have children ‘they cannot afford’” (136, 137). To that end, Bell divided the women in her study into three categories: white women of low socioeconomic status (SES), white women of high SES, and black women of low SES. Early in the book, Bell explains her goal to “center rather than marginalize the infertility experiences of women of low SES” in order to “break down stereotypes,” and that she deliberately oversampled women of low SES in order to correct the imbalance (3). Throughout the book, Bell takes care to explain her sampling and analytic methods thoroughly.

The chapters of Misconception are arranged by theme, tracing the arc of the infertility experience from initial perception to coping to resolution. With her interviewees as cocreators, Bell explores topics such as achieving “good motherhood” and peer and marital contexts of infertility as lived by the interviewees. This concern for nuance seems directly oppositional to portrayals of infertility in popular culture, where it is primarily a white middle-class woman’s problem, to be remedied by medical intervention or a tidy adoption. Bell’s study also stands in contrast to popular notions of hyperfertility among women of color and women of low socioeconomic status, as she reveals equally complex approaches to infertility among low-SES participants.

Bell’s skill as an interviewer is immediately clear in her treatment of the intimate conversations she had with a range of subjects, but she acknowledges “some methodological limitations” with regard to researcher-subject concordance (145). Bell is clear about her methodology and provides assurance that she conducted each interview in good faith, despite differences in her identities as “white, educated, middle-class woman and researcher” and the various identities of the study’s participants (145). “To deal with difference,” Bell writes, she “developed techniques and skills to gain participants’ trust.” Those techniques, including “intent listening, eye contact, engagement with the participant, and easing into the topic of infertility with broad, general questions,” made these intimate conversations possible while preserving the comfort and dignity of the participants (146). Interviewing this way was also personally important to many of the women interviewed—Bell writes that “several participants thanked me for the opportunity to talk, as many had never discussed their fertility issues with anyone else” (146). Here, oral history shines as a research tool for gathering information as well as for giving voice to narratives previously unheard.

Bell recruited interviewees for the study in southeastern Michigan and notes some difficulty in reaching out to women in a category she intended to be a fourth grouping: black women of high SES. But, she writes, “despite extensive efforts to recruit such participants, in the end I was only able to interview three women fitting that category, not enough for conclusive, rigorous comparison” (10). In part, she attributes this difficulty to the possibility that “wealthy black women may be less willing to participate in research because their infertility experiences are absent from mainstream discourse; thus, they feel alone and silenced” (11). This reasoning further highlights the importance of Bell’s goals to center narratives of nonwhite women as well as women of low SES.

Previously, most literature on the subject of infertility tended to focus on the stories of white women of high SES and to oversimplify the feelings and experiences of infertility. Further, there is relatively little in the way of serious oral historiography to precede Bell...