Fertility, Reproduction and Sexuality: Social and Cultural Perspectives Series

Nominated for the 2007 Book Prize by the Council on Anthropology and Reproduction (AAA) Reproductive disruptions, such as infertility, pregnancy loss, adoption, and childhood disability, are among the most distressing experiences in people’s lives. Based on research by leading medical anthropologists from around the world, this book examines such issues as local practices detrimental to safe pregnancy and birth; conflicting reproductive goals between women and men; miscommunications between pregnant women and their genetic counselors; cultural anxieties over gamete donation and adoption; the contested meanings of abortion; cultural critiques of hormone replacement therapy; and the globalization of new pharmaceutical and assisted reproductive technologies. This breadth - with its explicit move from the “local” to the “global,” from the realm of everyday reproductive practice to international programs and policies - illuminates most effectively the workings of power, the tensions between women’s and men’s reproductive agency, and various cultural and structural inequalities in reproductive health.

Assisted reproductive technologies such as in vitro fertilization have provoked global controversy and ethical debate. This book provides a groundbreaking investigation into those debates in the Islamic Middle East, simultaneously documenting changing ideas of kinship and the evolving role of religious authority in the region through a combination of in-depth field research in Lebanon and an exhaustive survey of the Islamic legal literature. Lebanon, home to both Sunni and Shiite Muslim communities, provides a valuable site through which to explore the overall dynamism and diversity of global Islamic debate. As this book shows, Muslim perspectives focus on the moral propriety of such controversial procedures as the use of donor sperm and eggs as well as surrogacy arrangements, which are allowed by some authorities using surprising and innovative legal arguments. These arguments challenge common stereotypes of the rigidity and conservatism of Islamic law and compel us to question conventional contrasts between ‘liberal’ and Islamic notions of moral freedom, as well as the epistemological assumptions of anthropology’s own ‘new kinship studies’. This book will be essential reading for anyone interested in contemporary Islam and the impact of reproductive technology on the global social imaginary.

“[S]heds light not only on the obstacles to making motherhood safer, but to improving the health of poor populations in general.”—Social Anthropology Since 1987, when the global community first recognized the high frequency of women in developing countries dying from pregnancy-related causes, little progress has been made to combat this problem. This study follows the global policies that have been implemented in Sololá, Guatemala in order to decrease high rates of maternal mortality among indigenous Mayan women. The author examines the diverse meanings and understandings of motherhood, pregnancy, birth and birth-related death among the biomedical personnel, village women, their families, and midwives. These incongruous perspectives, in conjunction with the implementation of such policies, threaten to disenfranchise clients from their own cultural understandings of self. The author investigates how these policies need to meld with the everyday lives of these women, and how the failure to do so will lead to a failure to decrease maternal deaths globally. From the Introduction: An unspoken effect of reducing maternal mortality to a medical problem is that life and death become the only outcomes by which pregnancy and birth are understood. The specter of death looms large and limits our full exploration of either our attempts to curb maternal mortality, or the phenomenon itself. Certainly women’s survival during childbirth is the ultimate measure of success of our efforts. Yet using pregnancy outcomes and biomedical attendance at birth as the primary feedback on global efforts to make pregnancy safer is misguided.

All cultures are concerned with the business of childbirth, so much so that it can never be described as a purely physiological or even psychological event. This volume draws together work from a range of anthropologists and midwives who have found anthropological approaches useful in their work. Using case studies from a variety of cultural settings, the writers explore the centrality of the way time is conceptualized, marked and measured to the ways of perceiving and managing childbirth: how women, midwives and other birth attendants are affected by issues of power and control, but also actively attempt to change established forms of thinking and practice. The stories are engaging as well as critical and invite the reader to think afresh about time, and about reproduction.

The genealogical model has a long-standing history in Western thought. The contributors to this volume consider the ways in which assumptions about the genealogical model—in particular, ideas concerning sequence, essence, and transmission—structure other modes of practice and knowledge-making in domains well beyond what is normally labeled “kinship.” The detailed ethnographic work and analysis included in this text explores how these assumptions have been built into our understandings of race, personhood, ethnicity, property relations, and the relationship between human beings and non-human species. The authors explore the influences of the genealogical model of kinship in wider social theory and examine anthropology’s ability to provide a unique framework capable of bridging the “social” and “natural” sciences. In doing so, this volume brings fresh new perspectives to bear on contemporary theories concerning biotechnology and its effect upon social life.

Sex is often regarded as a dangerous business that must be rigorously controlled, regulated, and subjected to rules. Sexual acts that defy acceptable practices may be seen as variously defiling, immoral, and even unnatural. They may challenge and subvert both cultural preconceptions and the social order in a politics of sexual transgression that threatens to transform permissible boundaries and restructure bodily engagements. This collection of essays explores acts of sexual transgression that have the power to reconfigure perceptions of bodily intimacy and the social norms of interaction. Considering issues such as domestic violence, child prostitution, health and sex, teenage sex, and sex with animals across a range of settings from contemporary Oceania, the Pacific, South Africa, and southeast Asia to Euro-America, this book should interest all those who question the "naturalness" of sex, including public health workers, clinical practitioners and students of sex, sexuality, and gender in the humanities and social sciences.

In the Sitapurdistrict of Uttar Pradesh, an agricultural region with high rates of infant mortality, maternal health services are poor while family planning efforts are intensive. By following the daily lives of women in this setting, the author considers the women’s own experiences of birth and infant death, their ways of making-do, and the hierarchies they create and contend with. This book develops an approach to the care that focuses on emotion, domestic spaces, illicit and extra-institutional biomedicine, and household and neighborly relations that these women are able to access. It shows that, as part of the concatenation of affect and access, globalized moralities about reproduction are dependent on ambiguous ideas about caste. Through the unfolding of birth and death, a new vision of "untouchability" emerges that is integral to visions of progress.

Child prostitution became one of the key concerns of the international community in the 1990s. World congresses were held, international and national laws were changed and concern over "cemmercially sexually exploited children" rose dramatically. Rarely, however, were the children who worked as prostitutes consulted of questioned in this process, and the voices of these children brought into focus. This book is the first to address the children directly, to examine their daily lives, their motivations and their perceptions of what they do. Based on 15 months of fieldwork in a Thai tourist community that survived through child prostitution, this book draws on anthropological theories on childhood and kinship to contextualize the experiences of this group of Thai child prostitutes and to contrast these with the stereotypes held of them by those outside their community.

Interest in the study of kinship, a key area of anthropological enquiry, has recently reemerged. Dubbed ‘the new kinship’, this interest was stimulated by the ‘new genetics’ and revived interest in kinship and family patterns. This volume investigates the impact of biotechnology on contemporary understandings of kinship, of family and ‘belonging’ in a variety of European settings and reveals similarities and differences in how kinship is conceived. What constitutes kinship for different publics? How significant are biogenetic links? What does family resemblance tell us? Why is genetically modified food an issue? Are ‘genes’ and ‘blood’ interchangeable? It has been argued that the recent prominence of genetic science and genetic technologies has resulted in a ‘geneticization’ of social life; the ethnographic examples presented here do show shifts occurring in notions of ‘nature’ and of what is ‘natural’. But, they also illustrate the complexity of contemporary kinship thinking in Europe and the continued interconnectedness of biological and sociological understandings of relatedness and the relationship between nature and nurture.

Babies are not simply born—they are made through cultural and social practices. Based on rich empirical work, this book examines the everyday experiences that mark pregnancy in the US today, such as reading pregnancy advice books, showing ultrasound “baby pictures” to friends and co-workers, and decorating the nursery in anticipation of the new arrival. These ordinary practices of pregnancy, the author argues, are significant and revealing creative activities that produce babies. They are the activities through which babies are made important and meaningful in the lives of the women and men awaiting the child’s birth. This book brings into focus a topic that has been overlooked in the scholarship on reproduction and will be of interest to professionals and expectant parents alike.

How and to what extent have Islamic legal scholars and Middle Eastern lawmakers, as well as Middle Eastern Muslim physicians and patients, grappled with the complex bioethical, legal, and social issues that are raised in the process of attempting to conceive life in the face of infertility? This path-breaking volume explores the influence of Islamic attitudes on Assisted Reproductive Technologies (ARTs) and reveals the variations in both the Islamic jurisprudence and the cultural responses to ARTs.

Contemporary Dutch policy and legislation facilitate the use of high quality, accessible and affordable assisted reproductive technologies (ARTs) to all citizens in need of them, while at the same time setting some strict boundaries on their use in daily clinical practices. Through the ethnographic study of a single clinic in this national context, Patient-Centred IVF examines how this particular form of medicine, aiming to empower its patients, co-shapes the experiences, views and decisions of those using these technologies. Gerrits contends that to understand the use of reproductive technologies in practice and the complexity of processes of medicalization, we need to go beyond ‘easy assumptions’ about the hegemony of biomedicine and the expected impact of patient-centredness.

The issue of abortion forces a confrontation with the effects of poverty and economic inequalities, local moral worlds, and the cultural and social perceptions of the female body, gender, and reproduction. Based on extensive original field research, this provocative collection presents case studies from Thailand, Cambodia, Burma, Vietnam, Bangladesh, Indonesia, and India. It includes powerful insight into the conditions and hard choices faced by women and the circumstances surrounding unplanned pregnancies. It explores the connections among poverty, violence, barriers to access, and the politics and strategies involved in abortion law reform. The contributors analyze these issues within the broader conflicts surrounding women's status, gender roles, religion, nationalism and modernity, as well as the global politics of reproductive health.

Nighttime for many new parents in the United States is fraught with the intense challenges of learning to breastfeed and helping their babies sleep so they can get rest themselves. Through careful ethnographic study of the dilemmas raised by nighttime breastfeeding, and their examination in the context of anthropological, historical, and feminist studies, this volume unravels the cultural tensions that underlie these difficulties. As parents negotiate these dilemmas, they not only confront conflicting medical guidelines about breastfeeding and solitary infant sleep, but also larger questions about cultural and moral expectations for children and parents, and their relationship with one another.

Following networks of mothers in London and Paris, the author profiles the narratives of women who breastfeed their children to full term, typically a period of several years, as part of an 'attachment parenting' philosophy. These mothers talk about their decision to continue breastfeeding as 'the natural thing to do': 'evolutionarily appropriate', 'scientifically best' and 'what feels right in their hearts'. Through a theoretical focus on knowledge claims and accountability, the author frames these accounts within a wider context of 'intensive parenting', arguing that parenting practices – infant feeding in particular – have become a highly moralized affair for mothers, practices which they feel are a critical aspect of their 'identity work'. The book investigates why, how and with what implications some of these mothers describe themselves as 'militant lactivists' and reflects on wider parenting culture in the UK and France. Discussing gender, feminism and activism, this study contributes to kinship and family studies by exploring how relatedness is enacted in conjunction to constructions of the self.

Juxtaposing contributions from geneticists and anthropologists, this volume provides a contemporary overview of cousin marriage and what is happening at the interface of public policy, the management of genetic risk and changing cultural practices in the Middle East and in multi-ethnic Europe. It offers a cross-cultural exploration of practices of cousin marriage in the light of new genetic understanding of consanguineous marriage and its possible health risks. Overall, the volume presents a reflective, interdisciplinary analysis of the social and ethical issues raised by both the discourse of risk in cousin marriage, as well as existing and potential interventions to promote “healthy consanguinity” via new genetic technologies.  

Zsuzsa Berend presents a methodologically innovative ethnography of SurroMomsOnline.com, the largest surrogacy support website in the United States. Surrogates’ views emerge from the stories, debates, and discussions that unfold online. The Online World of Surrogacy documents these collective meaning-making practices and explores their practical, emotional, and moral implications. In doing so, the book works through themes of interest across the social sciences, including definitions of parenthood, the symbolic role of money, reproductive loss, altruism, and the moral valuation of relationships.

This volume provides intimate anthropological accounts of Muslim men’s everyday lives in the Middle East, Asia, Africa, and diasporic communities in the West. Amid increasing political turmoil and economic precarity, Muslim men around the world are enacting nurturing roles as husbands, sons, fathers, and community members, thereby challenging broader systems of patriarchy and oppression. By focusing on the ways in which Muslim men care for those they love, this volume challenges stereotypes and showcases Muslim men’s humanity.

Minority populations are often regarded as being ‘hard to reach’ and evading state expectations of health protection. This ethnographic and archival study analyses how devout Jews in Britain negotiate healthcare services to preserve the reproduction of culture and continuity. This book demonstrates how the transformative and transgressive possibilities of technology reveal multiple pursuits of protection between this religious minority and the state. Making Bodies Kosher advances theoretical perspectives of immunity, and sits at the intersection of medical anthropology, social history and the study of religions.

Infertility and assisted reproductive technologies in India lie at the confluence of multiple cultural conceptions. These ‘conceptions’ are key to understanding the burgeoning spread of assisted reproductive technologies and the social implications of infertility and childlessness in India. This longitudinal study is situated in a number of diverse locales which, when taken together, unravel the complex nature of infertility and assisted conception in contemporary India.

Using an entirely new conceptual vocabulary through which to understand men’s experiences and expectations at the dawn of the twenty-first century, this path-breaking volume focuses on fatherhood around the globe, including transformations in fathering, fatherhood, and family life. It includes new work by anthropologists, sociologists, and cultural geographers, working in settings from Peru to India to Vietnam. Each chapter suggests that men are responding to globalization as fathers in creative and unprecedented ways, not only in the West, but also in numerous global locations.

In the last forty years anthropologists have made major contributions to understanding the heterogeneity of reproductive trends and processes underlying them. Fertility transition, rather than the story of the triumphant spread of Western birth control rationality, reveals a diversity of reproductive means and ends continuing before, during, and after transition. This collection brings together anthropological case studies, placing them in a comparative framework of compositional demography and conjunctural action.  The volume addresses major issues of inequality and distribution which shape population and social structures, and in which fertility trends and the formation and size of families are not decided solely or primarily by reproduction.

Recent literature has identified modern “parenting” as an expert-led practice—one which begins with pre-pregnancy decisions, entails distinct types of intimate relationships, places intense burdens on mothers and increasingly on fathers too. Exploring within diverse historical and global contexts how men and women make—and break—relations between generations when becoming parents, this volume brings together innovative qualitative research by anthropologists, historians, and sociologists. The chapters focus tightly on inter-generational transmission and demonstrate its importance for understanding how people become parents and rear children.

Elite Malay women’s polygamy narratives are multiple and varied, and their sentiments regarding the practice are conflicted, as they are often torn between personal and religious convictions. This volume explores the ways in which this increasingly prominent practice impacts Malay gender relations. As Muslims, elite Malay women may be forced to accept polygamy, but they mostly condemn it as women and wives, as it forces them to manage their lives and loves under the “threat” of polygamy from a husband able to marry another woman without their knowledge or consent; a husband that is married but available.

Motherhood in Mexico is profoundly shaped by the legacy of colonialism. This ethnography situates motherhood in a critical global health analysis of maternal health inequalities and interventions in the southeast state of Chiapas. Using a transitional life course framework, it demonstrates how the transition to motherhood is never complete. Once a good mother is defined, she becomes undefined, the goal posts moved, and the rules confronted.

Miscarriage is a significant women's health issue. Research has consistently shown that one in four pregnancies end in miscarriage. This collected volume explores miscarriage in diverse historical and cultural settings with contributions from anthropologists, historians and medical professionals. Contributors use rich ethnographic and historical material to discuss how pregnancy loss is managed and negotiated in a range of societies. The book considers meanings attached to miscarriage and how religious, cultural, medical and legal forces impact the way miscarriage is experienced and perceived.

What does it mean to be a man in our biomedical day and age? Through ethnographic explorations of the everyday lives of Danish sperm donors, Being a Sperm Donor explores how masculinity and sexuality are reconfigured in a time in which the norms and logics of (reproductive) biomedicine have become ordinary. It investigates men’s moral reasoning regarding donation, their handling of transgressive experiences at the sperm bank, and their negotiations of gender, sexuality, intimacy, and relatedness, showing how the socio-cultural and political dimensions of (reproductive) biomedicine become intertwined with men’s intimate sense of self.

As a biological, cultural, and social entity, the human fetus is a multifaceted subject which calls for equally diverse perspectives to fully understand. Anthropology of the Fetus seeks to achieve this by bringing together specialists in biological anthropology, archaeology, and cultural anthropology. Contributors draw on research in prehistoric, historic, and contemporary sites in Europe, Asia, North Africa, and North America to explore the biological and cultural phenomenon of the fetus, raising methodological and theoretical concerns with the ultimate goal of developing a holistic anthropology of the fetus.

The concept of “Waithood” was developed by political scientist Diane Singerman to describe the expanding period of time between adolescence and full adulthood as young people wait to secure steady employment and marry. The contributors to this volume employ the waithood concept as a frame for richly detailed ethnographic studies of “youth in waiting” from a variety of world areas, including the Middle East Africa, Asia, Europe, Latin America and the U.S, revealing that whether voluntary or involuntary, the phenomenon of youth waithood necessitates a recognition of new gender and family roles.

After the revolution of 2011, the electoral victory of the Islamist party ‘Ennahdha’ allowed previously silenced religious and conservative ideas about women’s right to abortion to be expressed. This also allowed healthcare providers in the public sector to refuse abortion and contraceptive care. This book explores the changes and continuity in the local discourses and practices related to the body, sexuality, reproduction and gender relationships. It also investigates how the bureaucratic apparatus of government healthcare facilities affects the complex moral world of clinicians and patients.