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Reproductive disruptions: Infertility

Reproductive disruptions: Infertility. Transformations: Gender, Reproduction and Contemporary Society Week 14. Lecture Outline. Definitions Prevalence and causes The experience of infertility The gendering of infertility A global perspective Feminist approaches to infertility.

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Reproductive disruptions: Infertility

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  1. Reproductive disruptions: Infertility Transformations: Gender, Reproduction and Contemporary Society Week 14

  2. Lecture Outline • Definitions • Prevalence and causes • The experience of infertility • The gendering of infertility • A global perspective • Feminist approaches to infertility

  3. Medical Definitions of Infertility • Zegers-Hochschild et al (2009) • ‘a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse’ • National Institute for Health and Clinical Excellence (NICE) (2004: 10) • ‘Infertility should be defined as failure to conceive after regular unprotected sexual intercourse for 2 years in the absence of known reproductive pathology.’ [Clinical versus epidemiological definitions; Epidemiology = branch of medicine dealing with prevalence and incidence of disease in large populations]

  4. Alternative Scenarios • Woman / man who knows that s/he cannot have children for some biological reason, but doesn’t try / want to – is s/he infertile? • A woman has a diagnosed fertility problem (blocked tubes), and has a baby using IVF; is she infertile afterwards? • A woman’s male partner has no sperm at all but she has no known fertility problem. Who is infertile? Is infertility the property of an individual or a couple? • 50 year old (menopausal) woman – is she infertile?

  5. Social Definitions of Infertility • Greil (1991: 7) Infertility is not a ‘static condition’ but a ‘a dynamic, socially conditioned process whereby couples come to define their inability to bear their desired number of children as problematic and attempt to interpret and correct this situation.’ • Britt (2001): the ‘socially infertile’ • Throsby (2004: 14) ‘the active but frustrated desire for a biologically related child.’

  6. Prevalence of Infertility • Taboo topic • 8-12% of couples worldwide (medical definitions) • 50-80 million people may be experiencing infertility • Varies – as high as 33% in the ‘infertility belt’ of SSA • Male infertility at least half of all cases, may be more • Primary and secondary infertility • Miscarriage: between 1 in 6 and 1 in 4 pregnancies • Much infertility is preventable

  7. Causes of Infertility • Anatomical / genetic / endocrinological / immunological problems (primary infertility) – about 5% • Infections (tubal scarring) • Post-partum complications • Post-abortive complications (esp. ‘backstreet’ abortions) • Iatrogenic eg. unsanitary healthcare practices, infection-inducing IUDs, chemotherapy • Dietary / environmental factors • Smoking / alcohol (“sub-fertility”) • “waiting” (common concept in minority world –very woman-blaming)

  8. Experiences of infertility • ‘A man should be able to have children… to give his wife children. So because I couldn’t I wasn’t a real man … simple, straightforward … that’s why I felt an attack on my maleness… It all comes down to one word… inadequate.’ (Webb and Daniluk, 1999: 15) • ‘There are times when I don’t feel like a real woman. I wonder how am I ever going to feel that whole.’ (Earle and Letherby, 2007: 244) • ‘I was shocked and I must admit I felt a real failure (pause) I thought oh gosh I’ve failed as a mum and a wife (pause) to kill my child.’ (Letherby, 1993: 170)

  9. Gendering infertility • Beth: ‘I sent [partner] a card on Valentine’s Day last year, saying “To the world’s greatest lover” and there’s a friend of mine in here, who actually has 4 children […] and her boyfriend said, “Oh, how come I didn’t get a card saying, “Greatest lover?” and she said “You’ve got children to prove you are’. (Throsby 2004: 148) • John: […] ‘Now it’s like, “Do you have any children?” I say, “Well, no, unfortunately, my wife couldn’t have any. We’ve tried. We couldn’t”’. (Throsby 2004: 150)

  10. Infertility – a global perspective • An overlooked health problem globally • Inequitable access • Local norms and practices (religious / social) concerns around masturbation (Inhorn, Kahn) concerns around donated gametes concerns around adoption • The reproductive imperative • Global infertility networks • Reproductive technologies have gone global • NRTs can transform gender relations

  11. Feminist approaches to infertility • Global perspective • Social as well as medical infertility • (Reproductive) health care to prevent infertility • Paying attention to gender • Recognising/resisting the reproductive imperative

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