+O The ner't reproductive technologíes and f emale inf ertilit,y: 1íberal, radical and Poatstructuralist feninist approaches By: Anne Barrie Supervisor: Dr. Margie RiPPer A thesis presented to the Faculty of Arts of the University of Adelaide for the Degree of Master of Arts (vüomen's Studies) University of Adelaide lfomen's studíes Department april 1995 ? ? COI¡TENTS Declaration Acknowledgments ABSTRACT PÀRT 1: THE llElr REPRODUCTIvE TECIIIfOLOGIES Al¡D INFERTILITY 1 The new reproductive technologies: overview and definition 1 2 Fernale infertility: medical definition 1 3 Femal-e infertility: personal and social itnplications 2 4 Female infertility and Vilestern pronatalism 4 PÀRT 2z REPRODUCTM LfBERÀLISM 1 Reproductive liberalism: overview 5 2 The concepts of 'choice' and 'eontrol' 7 3 unlinited procreative liberty I 4 The right to privacy 10 5 Summary of reproductive liberalism 11 PART 3: RADICÀL FEMIIIISM 1 Radical feminism: overview T2 2 The concept of 'pat:i-iarchy' L7 3 Some past abuses of women by the medical profession 19 4 The medical profession as patriarchal institution 2T 5 Male control of female reproduction 23 ( a) I'fary O'Brien's theory of 'reproductive consciousness' 23 (b) The 'Baby M' surrogacy case 25 6 The l-anguage of the NRTS 27 7 The experimental nature of the NRTs 30 (a) Some reported side-effects of reproductive medicine 31 (b) Disnissal of feminist concern by the rnedical profession 33 (c) 'Milieu control' . 35 (d) The failure of rvF 36 8. The concept of informed consent' . 38 9. The issue of 'choice' . 41 10. The concept of 'autonomy' in reproductive decision-making 44 11. Gender inequality: privileging of nale reproductive goals 45 L2. The eugenic potential of the NRTS 49 13. Prenatal- genetic screening and the concept of 'choice' . 51 14. Abuse of NRTs in the Third vlorld 55 15. The international surrogacy industry 59 (a) The liberal pro-surroçlacy argument 61 (b) The'body-as-property' principle 62 PÀRT 4z RÀDICAL FEMINIST RESISTANCE TO THE NRTS 1 Practical strategies . 64 2 Political and social objectives 65 69 PART 5: SttMllÀRY SO FAR PART6:THEPRoBLE}lsAssocIATEDwIrHRADICÀLFEMINISI{ 72 1 The proþIem with 'PatriarchY' 75 2 The probtem of essentialism PARTT¿THEBEI|EFITSoFAPoSTSTRUCEURåLISTAPPRoACH 81 1. The redefinition of 'Power' The decentred subject 82 2. 83 Language and meaning 3. 84 4. Discipline PART 8: REPRESENTATIONS OF INFERTILITY 86 1 overview coverage 88 2 Representations of infertility: ne\{spaper 94 3 The discourse of 'social faílure' ' 99 4 The discourse of 'biotogical instinct' discursive 101 6 'Social failure' and 'biological instinct': interaction 105 PÀRT 9 : St llltARY AND CONCLUSIONS ENDIf OTES REFEREITCES APPE¡{DIX A GLOSSARY OF TERIIS Dec laratíon This work contains no material which has been accepted for the award of any other degree or diptorna at any other university or tertiary institution and to thê best of my knowledge and belief cc¡ntajns no naterial previously published or !ùritten by another person except where due reference is made in the text. I give consent to this copy of my thesis, when deposited in the university Libraryn being available for Ioan and photocopying. AcknowledgmeDts The eventual completion of this thesis owes much to my supervisor Dr. l,[argie Ripper who was full of great ideas and enthusiasrn at all the righi ti¡es and has been unbelievably patient and eternally understandinq. AIso, thanks to ltelen for spending a lot of her tine listening to me babble about aII sorts of things. Thanks also to Liz who successfully dragged me back to reality when I began to drift. ABSTRàCT In pronatalist Western culture motherhood is defined as the primary role and responsibility of vlomen. In such a society female infertility ís constructed through medical discourse and popular media as a problem - more specificalty as a medical problem for which medical technology is the only ans\¡ler. Such a view is supported by the discourse of reproductive liberatism which promotes the NRTS as Iiberating for women because they supposedty increase the options and choices available, therefore allowing women greater self- determination, autonomy and control. Radical feminists, particularly those associated with the FINRRAGE organisation' vehemently disagree with reproductive tiberals arguing instead that because the NRTS are designeã within a patriarchal system they are exploitative, not' only of the vùomen directly involved, but also of lvomen worldwide. FINRRAGE writers and others argue the'choices'offered by the NRTS are coercive and culturally forced and therefore reduce lvomen's autonomy and self-determination. Through international networking and information sharing radical feminists aim to actively resist the increasing medicalisation of women's lives. The foltowing literature review highlights the main issues associated with the liberal and radical arguments and attempts to 90 some way tolvards grasping how the two theoretical stances can arrive at such disparate conclusions about the NRTS. The section following this discusses some of the difficulties associated with the radical feminist perspêctive on the NRTS, especially the concept of 'patriarchy' and the essentialising tendencies of radical feminist theory. I then outline the benefits of poststructuralism in general, and then attempt to use a deconstructive ãpproacn in order to examine one of the more interesting aspects of inlertility. That is, the popular construction of infertility-as- crisis, and the 'desperation' for a baby which results from this. I concl-ude by briefly suggesting how poststructuralist theory when used in relation to debate on the ne\{ reproductive technologies can be useful- for feminist Politics. PART 1: TEE trEYI REPRODUCTIVE TECHXOLOGIES AI|D IIIFERT 1. TIIE NEW REPRODUCTIVE TECNNOIJOGIES: OVERVIEW AIID DEFINITION The world,s first ,test-tube baby' Louise Bro\dn was born in Eng 1978. Since then approxirnately fq000 babies have been conceived through the much publicised in vitro fertilisation (M) technique worldwide (Klein, 1989). However while IVF is the most well-known it constitutes only a small part of the wider field of the 'new reproductive technotogies, (NRTS) defined in a us congress Report as: anything to do with the manípulation of the gametes leggs or sperml or the fetus, for rdhatever purpose, from conception other than by sexual union, to treatment of disease in utero, to the uftimate manufacture of a human being to exact specifications Thus the earliest procedure ís artificial insemination; next artificial fertilization next artificial implantation in the future total extra corporeal qestation and finally, what is popularly meant by lreproductive] engineeríng, the production - or better, the biological manufacture - of a hunan being to desired specification. (us congress Report' cited by Hanmer, 1983, p. L83 ) . The NRTs thus include techniques from artificial insemination and surrogacy through to in vitro fertilisation and gamete- and zygoLe intrafallopian transfer (GIFT and ZIFTIPROST), and a range of reläted teehniques from electronic foetal monítoring (EFM), ultrasound' preimplantation diagnosis, sex selection and selective abortion to genetic maniputation, cloning, cryopreservation and the possibil'ity of ectogenesis (see 'Glossary of Terms' for specific descriptions and definitions ) . such technologies are being developed by medical scientists supposedly in response to women's denands for them, and because they potentially create new options for motherhood and assist in overcoming the perceived crisis of female infertility. 2. FEM.AI.E INFERTILITY: ilEDICÀI DEFINTTION The most commonly accepted medical definition of female infertility is 1 NRTs and infertilitY the inability of a l,ùoman to conceive within 12 months of ceasing contraception.Infertitityisreportedtoaffectupto15percentof Australian couples (wood, 1985) - that is, heterosexual married or cohabiting coupJ-es. The main medically identified causes of infertility in women are the blockage of one or both FãIlopian tubes' endometriosis, anovulation and ovar.ian disease. Male factors such as azospernia or oligospern:ia are also obvious contributors (l{ood, 1985)' currently, around 16 percent af all M attempts involve fertile women with subfecund male partners (Laborie, 1988). Thege causes are aII taken to be medical indicators for the use of IvF and/or its related techniques, GIFT and ZIFTIPROST (see Àppendix A for details and explanation). within this medical model female infertility is assumed to have a physiologíca1 aetiology whose treatment requires medical intervention' Female infertility is thus nedically defined as an individual case problem with a medical-technological solution. For involuntarily childless lromen however, infertility is a far more complex phenomenon than its medical diagnosis indicatest it has personal and social consequences as weII and potentially represents a major life crísis' 3. FEMÀLE INFERTILITY: PERSONAI AI{D SOCIAI IUPLICATIONS Nursing and sociological literature suggests that parenting is an expected life goal of many adults. It is part of the progression through the ,normal' events of lifespan development - marriage, fanity, career - which many people take for granted' Such events can be refused si-nce fulfilling alternatives to them do exist, but for people who accept them they represent the potential for self- actualisation and control over life. Parenthood for many presumably brings personal pleasure but it also has desirable socially 2 NRTs and infertilitY constructed