I know that there must be an emerging sociological/ anthropological/ feminist literature on ART somewhere out there; I haven’t taken the time to look into it since my own dissertation project is entirely different. But someday I’d like to.
I did stumble across a fascinating essay in a book I’ve been trying to read since January (I’m so glad it’s an anthology – at least it’s in bite-sized pieces): Women Writing Culture, edited by Ruth Behar and Deborah A. Gordon (University of California Press, 1995). The essay, titled “A Tale of Two Pregnancies,” is by Lila Abu-Lughod, an anthropologist who works with Bedouin women in Egypt. When she began her fieldwork, she was not even interested in pregnancy or ready to think about it; when she was, however, she found that she would need ART in order to conceive. In this essay, she describes in beautiful and evocative language the social practices around pregnancy and childbirth among her Bedouin friends and research partners, contrasting these with her own experience of ART through Western medicine. I’ve excerpted below some of my favorite passages from the essay.
“The [pregnant Bedouin] women worked hard, lifting heavy cooking pots, carrying their other children on their backs, washing clothes, and walking long distances to visit friends and relatives. Pregnancy hardly seemed to interfere. At the end… these women suddenly produced infants who…were lovingly swaddled and lying close to them. Or so it seemed. Except that every older woman who told me her life story mentioned a miscarriage or a stillbirth.
“My pregnancy, in contrast, was the ultimate late-capitalist U.S. achievement: assisted by the most recent advances in reporductive technology, monitored from egg production to fetal heartbeats with the help of ultrasound and hormonal analysis, and expensive. I was one of the fortunate women in her late thirties for whom in vitro fertilization succeeded on the first try… warned by my books about pre-eclampsia, prevented from carrying heavy objects by my husband, pampering myself by lying down to allow blood to flow to my placenta, counting my calcium milligrams, balancing my green and yellow vegetables…
“If I had not known Kareema and the other women in Egypt who had shared their lives with me, I would not have been able to shake my head and laugh at myself for the fuss I was making. I also might not have felt so lucky.” p. 340
(I love how she contrasts the two social/physical/technological worlds, as well as the jolt of familiarity in the details of her description of IVF – even though I never underwent IVF myself, I have immersed myself in infertility blogs for so long that it feels almost like an ethnographic field experience in its own right.)
Abu-Lughod goes on to describe the fertility treatments that her friends in Egypt offered her once she did start trying to conceive, which included stepping back and forth over an empty coffin seven times, and peering into an old brick well until she could see her own eye reflected in the water. She describes her inner attitude thus: “In matters mysterious, like religion and reproduction, one finds oneself uncertain enough about the truth to be half willing to ‘go native'” (p. 343).
Again with the familiar (which she describes so elegantly):
“When I returned home after a year in Egypt, I entered that new world that has become familiar to so many women of my generation and class in the U.S. – the world of laparoscopies, tubal adhesions, endometriosis, amniocentesis, and other such unpronounceables; the world of busy doctors in white coats who inspect and prod and shine lights at parts of you that you cannot see; the world of procedures that, they inform you absentmindedly, might cause slight cramping… I joined well-dressed women with bags under their eyes who spent the early morning hours waiting their turn to have blood drawn from bruised veins and to lie back in darkened rooms with their legs in stirrups so their ovaries could be scanned on grainy black-and-white screens.”
After her retrieval, Abu-Lughod was told they had six eggs. Five fertilized, although one disintegrated before transfer day. A two-egg transfer resulted in a healthy twin pregnancy.
She reflects on the experience of reading a manuscript she’d written on “Reproduction” prior to her IVF experience, and I think this is the part I really love and would love to hear others’ thoughts on: “I could have longed for the more natural character of these women’s experiences of becoming pregnant and having babies. I could have viewed pregnancy as an alienation of my body by the medical establishment. But I thought of Donna Haraway, the feminist historian of science, who keeps insisting that it is dangerous for feminists, nostalgic for an organic wholeness, to condemn and reject science and technology. Such associations of the natural with the feminine have been essential to women’s confinements to the body and the home; and such rejections of science leave it in the hands of others who may not have women’s interests at heart…” (pp. 345-6. emphasis my own).
She comments on the role of ultrasounds in connecting her to the experience of her pregnancy, noting that feminists often decry “the panoptic gaze the ultrasound technologies afford the male medical establishment” (basically, men in positions of power being able to stare into a woman’s body in a detached sort of way, while she is in a completely passive role, so that this practice becomes another way of controlling women and women’s bodies) but offering in contrast her own experience of relief at seeing in the ultrasounds that her babies were ok.
And I think this is what I found so thought-provoking about this essay – here is someone who has moved back and forth between different cultural worlds, in which social practices around pregnancy, child-birth, and mothering differ greatly, and who now reflects on those differences from a broader point of view than many of us are afforded. I am struck by the ambivalence she touches on around the role of technology in reproduction. Abu-Lughod chooses to value technology and embrace its role in giving her the opportunity to become pregnant, while at the same time she consistently keeps reminding the reader of the material and class privilege associated with ART. She faces head-on her nostalgia or impulse towards a more “natural” path to parenthood, while acknowledging the losses experienced by her research collaborators in the absence of more highly technological medical services.
I would love to hear thoughts and comments from others on these themes. Do you long for a more “natural” path to parenthood? What does “natural” mean to you? Would you forego the opportunity for all ultrasounds (and, for that matter, blood tests and pee sticks) if it meant you could conceive without any outside assistance? How do we manage these tensions and ambiguities in other spheres of our lives not related to reproduction?