Abstract
In this book, Robin Jensen provides a fascinating exploration of the rhetorical history of infertility in Euro-American contexts. Utilizing a wide range of what she refers to as ‘discursive fragments’ (scientific and lay texts, speeches, interviews and newspaper articles), Jensen shows the historical continuities and discontinuites in the rhetorical construction of infertility from the seventeenth to the 21st century. The aim of the book is to ‘present a compilation of interrelated, pertinent discursive fragments’ (p. 11) that shows the ways in which infertility has historically been constituted in/through rhetoric. Jensen provides a deft and impressive weave of shifting rhetorical ecologies pertaining to infertility, including social evolutionary theory and the ‘energy conservation model’ of the early 20th century, chemical and hormonal theories of infertility prevalent in the 1930s and 1940s, Freudian psychoanalytic narratives of ‘psychogenic infertility’ popularized in the 1950s and the emergence of the transdisciplinary field of ‘infertility studies’ in the 1960s and 1970s.
The book is organized in five chapters. Chapter 1 presents the historical predecessors of the term ‘infertility’, showing how understandings and metaphors of infertility shifted from organic concepts of ‘barrenness’ in the 17th century to inorganic tropes of reproduction as a mechanical process associated with the term ‘sterility’ in the mid-19th century. Chapter 2 demonstrates the continued influence of social evolutionary theory and the work of Herbert Spencer in constructions of infertility in the early 20th century. It shows the ways in which an ‘energy conservation’ model underpinned (racialized) understandings of women’s reproductive health and warranted calls for women to forgo higher education and careers in order to safeguard the ‘vital forces’ (p. 39) required for successful reproduction. Chapter 3 explores the early- to mid-20th century reshaping of infertility rhetoric inaugurated by advancements in reproductive endocrinology and chemical and hormonal theories of infertility, which reconstituted infertility as a ‘product of chemical interactions’ (p. 72) that could be synthetically remedied. This era thus marked the initial medicalization of infertility, though this process was ‘neither unidirectional nor predetermined’ (p. 73).
Chapter 4 is a fascinating exploration of the influence of psychoanalytic theory, particularly as espoused by Helene Deutsch, as an extension of chemical theories of infertility. By the mid 1900s, psychoanalytic theory was integrated into a variety of academic and medical disciplines and also functioned as a popular explanatory mode in public and lay discourses. The notion of ‘psychogenic infertility’, inspired by the work of Deutch and popularised by the 1950s, ascribed infertility to women’s dysfunctional or abnormal pyschological processes. These psychogenic explanations interestingly served to extend chemical theories by accounting for medical cases of so-called ‘unexplained’ infertility. Problematically, psychoanalytic theories worked to once again position women (rather than men or couples) as the primary source/cause of conception difficulties, making women personally responsible for infertility. Psychoanalytic narratives also worked to extend the remit of medical disciplines, so that not only women’s bodies but also their minds, desires and innermost subjectivities became objects of scrutiny, discussion and policing. This is a particularly rich chapter, most notably in its tracing of the ‘hermeneutics of the reproductive female’ that arose out of entanglements between medical and psychological discourses and modes of practice.
Chapter 5 focuses on the rhetorical landscape of the second half of the 20th century, showing how in this period the integrated field of ‘infertility studies’ arose as a transdisciplinary practice. Importantly, this chapter shows how (in)fertility became constructed through a rhetoric of clinical and scientific time, efficiency and urgency and the ways in which women’s bodies became increasingly disciplined according to reproductive ‘regimes of time’ (p. 131).
Throughout the book Jensen shows that the ‘medicalization’ of infertility is never a stable, linear or final process, but rather functions as a set of entangled rhetorical layers or historical sediments that become folded in and over subsequent layers. As a result, mapping the shifting historical rhetorical ecologies of infertility does not deliver a linear or optimistic narrative of progress in which science triumphs over old ideas. Nor does it deliver a story in which outdated ideas about women and the gender politics of infertility are ‘overcome’. Instead, Jensen superbly shows the ways in which diverse historical rhetorics – including medical, scientific, mainstream media, psychoanalytic and lay iterations – compete, converge and collude as ‘moving, relational, affective’ (p. 13) currents which continue to echo in contemporary debates and constructions of infertility.
Ultimately, the book shows the ways in which moral warrants and ideological politics continue to shape rhetorics of infertility in ways that are disempowering to women. For example, despite increased research and recognition of male factor infertility, women’s bodies continue to be constructed as the dominant sites and sources of ‘infertility’ debates, moral policing, treatment and interventions. Jensen underscores that ‘science does not speak for itself’ (p. 164) and rhetorical ecologies operate in complex, non-deterministic ways, often working to recycle historical tropes and narratives that carry continued ideological utility. For example, so-called ‘cutting edge’ contemporary Fetal Origins research involves the ‘percolation of arguments about the inimitable dangers of the corrupted womb’ (p. 158) which resonate with the ‘false science’ of the 17th century in which maternal impressions (i.e. women’s innermost thoughts, fantasies and desires) were believed to ‘imprint’ onto their unborn children, resulting in miscarriage, monstrous deformities and other pregnancy/birth complications. In a similar fashion, Jensen argues that Foetal Origins research casts the uterine environment as critical in determining the lifelong health of children. As a result, this scientific narrative opens a rhetorical space for the re-emergence of long-standing beliefs that women’s preconception and pregnancy-related behaviours, lifestyles and pursuits are potentially at odds with their reproductive duties and lives. In this way, we see the tenacity of ideological tropes which converge at different historical points with medical, scientific and psychoanalytic rhetorics to police women’s lives via a series of moralizing narrative warrants.
What is surprisingly missing from the book is any sustained engagement with feminist discourses of infertility or any reference to the implications and resonances of the book for feminist politics. Also, while perhaps outside the remit of this particular piece of scholarship, what is also missing here is any sense of women’s own voices and efforts to negotiate the sticky politics of infertility rhetoric. While Jensen emphasizes the importance of ‘lived, emotional experiences’ (p. 167) of infertility, it is these experiences which are most glaringly absent from this account. There is a great deal of scope for future work in this area which explores the ways in which the contested rhetorical ecologies of infertility are lived and contested by women in their everyday lives. To sum up, Infertility: Tracing the history of a transformative term is an important book. It will be critical reading for scholars, researchers and postgraduate students interested in the rhetorical, ideological and discursive politics of reproduction, bodies/embodiment and gendered power relations.