Infertility: Tracing the History of a Transformative Term by Robin E. Jensen (review)

Robin E. Jensen opens Infertility: Tracing the History of a Transformative Term with a reference to the story of Louise Brown, the first baby born from in vitro fertilization. I found myself reading Infertility with a different story in mind, Margaret Atwood's The Handmaid's Tale, recently adapted for television by Hulu. Early in the first season, handmaid Offred visits a doctor who confirms that she remains fertile but is not pregnant. A pregnancy is unlikely because most of the men are sterile, but as Offred reminds viewers in a voiceover, "There's no such thing as a sterile man anymore. There's only women who are fruitful and who are barren" (Season 1, Episode 4). Although voiced in the context of a fictional dystopia in which infants are rare commodities and a conservative Christian sect governs what was the United States, Offred's reminder speaks in many ways to the history of the term "infertility" so meticulously charted by Jensen. Most notably, Offred's recognition that women are the source of infertility parallels what Jensen describes as the assumption taken by contemporary fetal origins research, that "women—regardless of their race, class, religion, or nation of origin—hold the sole responsibility for infertility, miscarriage, and birth defects in their offspring" (160). In Infertility, Jensen approaches the rhetorical history of infertility with an eye toward how ideas percolate over time, reappearing and combining with newer arguments and appeals, thus explaining why and how the commonplace of women's responsibility for fertility and fetal outcomes accepted in seventeenth-century maternal impressions theory recirculates in both fetal origins research and The Handmaid's Tale.

Jensen's exemplary practice of rhetorical history refuses to engage in simplistic analysis. By drawing from what philosopher Michael Serres describes as "repetition" or "echoes" of past topoi, Jensen approaches the transdisciplinary rhetoric of infertility as a study of rhetoric that is "in, through, over, and according to time" (4). What this means in terms of the structure of Infertility is that while each chapter has a clearly delineated focus, Jensen is careful to note where ideas begin percolating and flowing in differing combinations. With the exception of the first chapter that focuses on the development of the two foundational metaphors—barren and sterile—that continue to inform contemporary understandings of infertility, Jensen consistently works to draw the reader's attention to how old ideas are repositioned in new narratives. The result is a rhetorical history of infertility that highlights the complexity of the processes of medicalization and moralization, and, importantly, it reveals that "appeals to medicalization often do not align with the elimination of appeals to morality and moralizing" (14).

In the first chapter's exploration of foundational metaphors, Jensen offers a detailed analysis of how barren and sterile metaphors position women differently regarding involuntary childlessness. The barren metaphor, developed in part in a 1651 guidebook for midwives, situated women as farmers of a sort who had the ability to monitor their bodies and regulate their emotions and behaviors until the seeds contributed by men sprouted. Metaphors based on sterility, on the other hand, took women out of the picture, focusing instead on the mechanics of the cervix and other reproductive parts. The tension between these two metaphors forms what Jensen describes as an "unstable foundation" for articulating women's reproductive abilities as the metaphors hold divergent understandings of responsibility and blame (37). Following this first chapter, Jensen turns to four key discursive moments in the construction of (in)fertility: the rise of the nineteenth-century narrative of energy conservation and its transformation in the twentieth century into a narrative that focused on infertility as a moral issue; the appeals to hormones in the 1930s and 1940s (what Jensen identifies as the first step in infertility's medicalization); the Freudian understanding of psychogenic infertility that extended the chemical narrative of hormones; and, finally, the emergence of its clinical...