A large literature exists on the anthropology of birth and the technologies associated with birth practices (see the entry Medicalization and the Naturalization of Social Control for a review of some of this research). Research has also demonstrated the lengths to which women are driven to try to overcome infertility (Inhorn, 1994; Kielmann, 1998). Much of this research, like many of the materials cited above, highlight the global, local, political, and economic strategies associated with the introduction of technological interventions, while at the same time documenting local responses to and experiences with both indigenous and newly imported technologies.
In recent years the systematic development and implementation of assisted conception and the new reproductive technologies has generated a rather different body of research that focuses on the technologies themselves as objects of knowledge and on what they make possible. The effects of these technologies on the lives of women who use them, on their partners, and on the new forms of kin relations they permit, are integral to these analyses. But so too is a reflective examination of contemporary society and the impact of science on society—such research comes under the umbrella of "science as culture, cultures of science" (in Franklin's 1995, idiom). This approach is concerned less explicitly with political economies, and focuses instead on the scientific enterprise itself, on its impact on human relationships in late modernity, and at times on policy-making. Politics, power relations, and the reproduction of hegemonies are part of this research, but so too is the way in which biomedical technologies, despite objectification of the body and body parts, can enable individual agency (Cussins, 1996; Lock, 1998). Overt national interests are less evident in this research, as is the way in which the adoption of technologies is a sign of modernization and rationalization. But inevitably, given the globalized economy and the protean spread of values associated with the idea of modernity as it took shape originally in Europe, there are links between research into the new high-tech biomedical technologies and studies based in locations other than where these technologies are developed.
Marilyn Strathern was perhaps the first to use the discourse associated with the new reproductive technologies to reflect critically on the classical categories of anthropology. She noted early in the 1990s the power of these technologies to challenge received wisdom in the social sciences about an inherent dichotomy between nature and culture, and between biological and social reproduction. Taking the concept of culture to be "the way people imagine things are," Strathern analyses official debates in the United Kingdom about assisted conception focusing on how the representation of persons and individuality that are used in these debates displaces other ways of representing human communities. She uses her years of experience as an anthropologist in Papua New Guinea to create a critical argument. Strathern's thesis is that when humans reproduce themselves, no matter in what way this is achieved, they inevitably do so with already existing and specific forms of themselves and of genealogy making in mind (Strathern, 1992, p. 10). She highlights how in Euro-America ideas about particular social arrangements, notably the nuclear family, in theory inform the way in which reproductive technologies will be put into practice. This is so because the nuclear family and inter-generational ties of blood are understood as "natural" and indisputable, and technology may, therefore, be used to bring about the "natural" family when Nature itself fails to do so. But, as Strathern points out, new reproductive technologies also permit us to challenge what is assumed to be "natural," in particular, who can be counted as "natural" mothers and fathers.
Overcoming infertility, whether male or female, is set up as a matter of individual choice in contemporary society. Individuals become consumers of the new products of human gametes and fertilized embryos, a market enhanced through technological manipulation, advertising, and promotions. These medicalized objects become absorbed into the enterprise culture in which we moderns participate. Strathern argues that above all the new technologies "enable" rather than simply producing products per se; they carry the connotations of service. Moreover, these technologies broach a distinction between body and machine believed to be unassailable—they permit the creation of hybrids of nature and culture (p. 47). We are now able to artificially intervene into what have been represented as supremely natural processes—whether it be in order to create embryos in vitro and then re-implant them into either the woman who donated the egg or into another woman for gestation; to genetically modify fetuses created in vitro before re-implantation; or to manipulate the process of dying.
Sarah Franklin, like Marilyn Strathern, uses a cultural account of assisted conception and the uncertainties associated with these new technologies to reflect on anthropological theory about kinship and reproduction. Reciprocally, she uses anthropological insights to produce a critical account of assisted conception (Franklin, 1997). See also Edwards, Franklin, Hirsch, Price, and Strathern, (1993) and Franklin and Ragone, (1998). Franklin shows how media and popular representations about reproductive technologies inform subjective knowledge and experience. She argues that in vitro fertilization (IVF) is portrayed as a "hope technology," and notes that both failure (which is very high in IVF clinics) and success is continually subject to re-definition. Failures can be a "relative success" under certain circumstances. And retaining hope and "hope management" are key to the practice of this technology (Franklin, 1997, p. 158).
Handwerker reports how, in China, despite the existence of the one-child policy, to have no children is regarded with disfavor. She documents resort to IVF clinics by women whose infertility means that they are stigmatized. But Handwerker also makes it clear that some Chinese women deliberately choose to remain single or not to have children. This research is one of an increasing number of recent publications that highlight the contradictions and ambiguities associated with the new reproductive technologies. Prominent is the way in which some women respond by embracing the possibilities that the technology offers, while others resist or are indifferent to technological intervention (Handwerker, 1998; see also Cussins, 1996). Lock tracks the history in Japan of several hundred years of a "planned family" and how the implementation of reproductive technologies carried out under government and medical guidelines show continuities with the past so that only the reproduction of the "natural" family is permitted. Use of sperm donors and surrogate mothers are prohibited except under very exceptional circumstances when close "biological relatives" are made use of as substitutes (Lock, 1998).
Becker (2000) has analyzed an increasing politiciza-tion of infertility together with a consolidation of the industry of reproductive technology in the United States. She shows how the staggering array of medical options now available to women and men have profound financial and emotional impacts on consumers of these technologies. Her interviews with hundreds of infertile people make clear that the majority question the claims made for the technologies and how they are put into practice— patients become vigilantes as they act out their ideals of informed choice and autonomy. However, even in the world of high-tech medicine men are often protected from the "stigma" of infertility, and the assumption all too often remains that the "problem" lies with the woman. Becker concludes that despite experimentation with reproductive technologies people strive to achieve continuity and normalcy and the idea that the family is biologically based is upheld as is the ideal of a two-parent family as the reproductive unit. Lewin (1998) has shown how lesbian couples to some extent emulate these ideals when they make use of reproductive technologies.
Becker argues that when people believe themselves to be infertile, they embody the idea that they have a disability and resort to technology to overcome the problem. At the same time, they resist the way in which the medical world transforms their whole life into an infertility problem. Becker concludes, as do other researchers, that "technology as a template of culture is one arena in which normalcy is both resisted and reaffirmed and through which the enactment and transformation of cultural practice occurs" (Becker, 2000, p. 250). One other feature of Becker's research is that she has been involved personally with the technology about which she writes, as has Layne (1996), whose research comprises a biographical and autobiographical account of her experiences with a neonatal intensive care unit.
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