This ground-breaking rhetorical analysis examines a 1987 Massachusetts law affecting infertility treatment and the cultural context that makes such a law possible

Elizabeth C. Britt uses a Massachusetts statute requiring insurance coverage for infertility as a lens through which the work of rhetoric in complex cultural processes can be better understood. Countering the commonsensical notion that mandatory insurance coverage functions primarily to relieve the problem of infertility, Britt argues instead that the coverage serves to expose its contours.

Britt finds that the mandate, operating as a technology of normalization, helps to identify the abnormal (the infertile) and to create procedures by which the abnormal can be subjected to reform. In its role in normalizing processes, the mandate is more successful when it sustains, rather than resolves, the distinction between the normal and the abnormal. This distinction is achieved in part by the rhetorical mechanism of the double bind. For the middle-class white women who are primarily served by the mandate, these double binds are created both by the desire for success, control, and order and by adherence to medical models that often frustrate these same desires. The resulting double binds help to create and sustain the tension between fertility and infertility, order and discontinuity, control and chaos, success and failure, tensions that are essential for the process of normalization to continue.

Britt uses extensive interviews with women undergoing fertility treatments to provide the foundation for her detailed analysis. While her study focuses on the example of infertility, it is also more broadly a commentary on the power of definition to frame experience, on the burdens and responsibilities of belonging to social collectives, and on the ability of rhetorical criticism to interrogate cultural formations.

Although voluntary childlessness has come to be accepted as permissible, the "normal" plans of most American couples include parenthood. Having a child is still seen as a rite of passage to adulthood. When a couple finds out that they are infertile and that life is not going to go according to plan, they  ask, "why me?"  Greil explores not only "why me?"  and the difficulty of finding a satisfying answer, but other questions as well. Why do women and men respond differently to infertility?  Do gender differences play a role in the experience of infertility?  How has medical technology affected the experience of infertility?  Why are infertile couples so committed to the goal of having biological children?

Greil argues that the complexity of infertility comes from its changing statusÐÐit is no longer considered a provate problem but a medical problem that can be solved. The human body is thought of as a finely-tuned machine and infertility is just a mechanical problem.  In America, the author claims, those who suffer from medical problems become subject to cultural beliefs about the nature of illness and the role of the sick. This includes the belief that the sufferer should do everything in his or her power to get better; in the cae of infertility the infertile couple should do everything possible to have a baby. What results is often painful, humiliating, and never-ending treatment programs. But infertile couples are reluctant to stop treatment because new techniques are being developed, and there is always next month. Couples do not consider themselves infertile forever, they consider themselves "not yet pregnant."

Greil explores the effect that infertility has on men and women, and why men seem to accept infertility more easily than women. Women see infertility as failure, they see themselves as incomplete. Men, seeing infertility more frequently as something they cannot change, ask why worry about it?  Greil also explores what effect these attitudes have on the couple's marriage, on relationships with their relatives, and with their fertile friends.  Infertility is not just a medical problem, it is a personal and emotional problem that affects all other aspects of the couple's life. This is a thorough investigation of what fertility means to contemporary American couples.