Abstract
Misconception is a small package with a big surprise inside. Ann Bell challenges the deeply ingrained cultural belief that infertility is a problem only white, middle-class women experience because of their nearly exclusive representation in reality television as the women undergoing artificial reproductive therapies. Bell argues that infertility is not only a medical problem but also a social process that is shaped by a variety of factors, including class- and race-based ideas about reproduction, family, medicalization of birth, and social preconceptions about what constitutes a family.
Bell’s main premise is to center the lived experiences of women of lower socioeconomic status (SES), in contrast to the marginalization they often feel as the result of negative stereotypes of low-SES families’ fertility. The author poignantly contests these assumptions through 58 in-depth interviews with women from diverse racial and socioeconomic backgrounds. Participants in the study were women between the ages of 18 and 44 who have been involuntarily childless for 12 months prior to the interview. Bell uses the medical definition of infertility as the criteria for ultimately determining women’s eligibility as study participants. The author then divided the participants into groups based on a variety of demographic factors like income, education, household income, and parental SES. Using feminist methodologies, Bell brings to light previously untold stories of involuntarily childless women’s struggles with the “motherhood mandate” and being a “good” mother. Throughout their interviews, women express feeling a social pressure to become a mother from a very young age. They also express feelings of inadequacy or failure as a woman if they fail to conceive a child. Furthermore, it is not enough for these women to be mothers, but they have to be “good” or “better” mothers than other parents around them.
Findings in Misconception are ordered in six chapters. Chapter one explores why women want to mother and the motherhood mandate that places pressure on women to do so. Interviewees, regardless of SES, by and large state that they want to be a mother because of innate desire, claiming they are “supposed” to be mothers. For lower SES women, being a mother fills the void of affectionless childhoods with the unconditional love of their children. Chapter two examines how women achieve the label of a “good” mother, including being a better mother than those around them and being financially stable. Interviewees describe “good” mothers as those who are actively engaged in their children’s lives, self-sacrifice, and have unconditional love for their children. Chapter three describes the women’s efforts to conceive. Bell adeptly challenges the societal idea of the hyperfertile poor woman of color. In contrast, Bell finds that lower SES women and women of color have the same or higher rates of infertility, compared to their higher SES counterparts. Lower SES women do intend and voluntarily try to become pregnant. The key, according to Bell, is that they perceive the process of infertility differently from higher SES and white women. Bell argues that lower SES women’s experiences with infertility differ so much that their experiences would not be captured by conventional survey measurements for intent to conceive.
Chapter four depicts the lived experiences of infertile higher and lower SES women. Unlike other research on infertility today, Bell approaches the subject with sensitivity and understanding of the social bias women face, not just the medical aspect of infertility. Poor women and women of color are depicted in the media as hyperfertile, while society depicts infertility stereotypically affecting white, middle-class and higher women. This faulty assumption leads to an overgeneralized picture of infertility, using the dominant (read white, middle-class) group’s experience as a proxy for all women while rendering invisible the experiences of low-SES and minority women. Rather, infertility should focus on between- and within-group variation. Women often reported seeing images of hyperfertility on television shows. Bell deftly shows how the uniqueness of infertility of women lies in the diverse experiences of various groups of women and calls for a need to “recontextualize” women’s experiences by taking into account differences in peer support, social bias, marital norms, and how infertility is constructed according to the dominant group’s ideas of race, class, and gender.
In sum, Misconception is a story of the countless unexamined experiences of marginalized women who struggle with reproductive challenges. Overall, this is a well-written book, concisely addressing the intersections of race, class, and gender in the arenas of motherhood and medicine. This book can be used as a tool for teaching not only family but also the medicalization of reproduction and the experiences of disenfranchised groups of women. This book is a must-read for family and reproductive scholars and students alike.