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Conceiving Infertility: How Social Class Shapes Infertile Experiences

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Conceiving Infertility: How Social Class Shapes Infertile Experiences Conceiving infertility: How social class shapes infertile experiences by Ann Victoria Bell A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy (Sociology) in The University of Michigan 2012 Doctoral Committee: Professor Karin A. Martin, Co-Chair Associate Professor Renee Anspach, Co-Chair Professor Pamela J. Smock Assistant Professor Lisa Kane Low © Ann Victoria Bell 2012 To Tony ii Acknowledgements This project would not have been possible without the help, support, and love of a number of people. My gratitude extends far beyond the following words, but they are the least I can do to extend my sincere thanks. My co-chairs, Renee Anspach and Karin Martin, went above and beyond in their mentorship, and I cannot thank them enough. Their advising exceeded the dissertation itself to prepare me as an academic scholar. From one-on-one meetings to lunches to phone calls, Karin and Renee were always there for me to make sure I succeeded. Renee took the time to help me improve my writing through line-by-line edits and frank, but necessary, constructive criticism. Her knowledge of the field and breadth and depth of her network and references is impressive and contributed to several of the references listed in this manuscript. I owe a very special thank you to Karin. I call her my “guardian angel” for all that she has done for me. As my undergraduate advisor who got me interested in Sociology and research to my current mentor, I would not be where I am professionally without her guidance and assistance. I admire her more than words can say. I only hope to be half the scholars, mentors, and teachers that Karin and Renee were to me. Thank you, as well, to Pam Smock and Lisa Kane Low. Pam’s encouragement and support helped me through the dissertation as well as the doctoral program. I appreciate her honesty and sincerity. I had the opportunity to know Lisa in several iii different capacities: as her student, assistant, and advisee. I am indebted to Lisa for teaching me how to be a teacher. In addition to providing me with wonderful mentors, the Sociology program also provided me with wonderful friends. In terms of this research project I am especially indebted to Jennifer Torres and Jamie Small. Jen knows this project as well, if not better, than me. Her knowledge and advice helped to improve the research and analyses. I do not know where to begin to thank Jamie. Her friendship and support mean the world to me and got me through the program. I would not be where I am today without the incredible love and support from my family. Thank you, Dad, for teaching me how to think critically and reminding me that even Mickey Mantle strikes out sometimes. Thank you, Mom, for always being there to listen and always knowing what to say. This book could not have been written without the bravery and willingness of the participants to come forward and share their stories. Thank you to the sixty-three women I interviewed. I only hope that I did justice to their experiences and that change may happen because of them. I have saved my most generous thank you to the end. Thank you for everything, Tony. From constant words of encouragement, to posting flyers, to driving to interviews, to making late dinners, to listening to my brainstorming, and to giving up so much to support me, I thank you and am forever indebted. I owe this project thanks for revealing to me the fragility of reproduction. If it weren’t for it, I would perhaps not have the most precious people in my life, Abigail and Fiona. Thank you, both, for showing me what is important in life and making it complete. iv Table of Contents Dedication .......................................................................................................................... ii Acknowledgements .......................................................................................................... iii Chapter One: Introduction: Conceiving Infertility ....................................................... 1 Who is infertile: The construction of the ‘good’ and ‘bad’ mother ................................ 4 What infertility is: The medicalization of infertility and its consequences ................... 9 About this study ............................................................................................................ 14 About this book ............................................................................................................. 22 Chapter Two: Why Women Want to Mother .............................................................. 24 Why women want to mother ......................................................................................... 27 Conclusion .................................................................................................................... 36 Chapter Three: Negotiating Motherhood : How Women Construct Themselves as ‘Good’ Mothers ............................................................................................................... 39 Negotiating motherhood ............................................................................................... 42 Context matters: Claiming and conceptualizing the ‘good’ mother ......................... 42 Not just good, but better: The practice of comparative mothering ........................... 51 Conclusion .................................................................................................................... 60 Chapter Four: Trying to Mother ................................................................................... 62 Trying to mother ........................................................................................................... 66 Recognizing childbearing difficulties ........................................................................... 75 Conclusion .................................................................................................................... 80 Chapter Five: The Lived Experience of Infertility ...................................................... 83 The lived experience of infertility ................................................................................. 85 Internalization of norms ............................................................................................ 85 Peer context .............................................................................................................. 87 Marital context .......................................................................................................... 95 Social support ......................................................................................................... 103 Talking about childbearing difficulties ................................................................... 110 Conclusion .................................................................................................................. 118 Chapter Six: Resolving Infertility ............................................................................... 120 Medicalization of infertility ........................................................................................ 123 Attitudes toward medical solutions ......................................................................... 123 Exclusion and inclusion: Inequalities within the medicalization of infertility ....... 129 Beyond medicalization: Other options to resolve childlessness ................................. 146 Conclusion .................................................................................................................. 153 Chapter Seven: Coping with Infertility ...................................................................... 155 The effects of medical exclusion and inclusion .......................................................... 156 Coping with infertility ................................................................................................. 163 Future goals ................................................................................................................. 174 Conclusion .................................................................................................................. 179 v Chapter Eight: Conclusion: Reconceiving Infertility ................................................ 181 Why and how class matters......................................................................................... 181 Why these findings matter .......................................................................................... 185 Limitations and future research .................................................................................. 189 References ...................................................................................................................... 192 vi Chapter One Introduction: Conceiving Infertility When I met Angie, a Black, homeless, 25-year-old, she was desperately yearning for a child. She told me she wanted a child so that she could “receive love,” something that was missing from her own upbringing. Angie had been trying to become pregnant through unprotected intercourse for nearly eight years before realizing that something might be “wrong.” Her childlessness makes her feel “abnormal” among her peers, since most of them already have several children. In fact, Angie does not know anyone who has had difficulty with childbearing. She told me that while marriage is not important to her, the lack of a commitment makes her fearful that her partners will leave her once they
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