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Abortion Care as Moral Work
Ethical Considerations of Maternal and Fetal Bodies
Johanna Schoen
Rutgers University Press, 2022
Abortion Care as Moral Work brings together the voices of abortion providers, abortion counselors, clinic owners, neonatologists, bioethicists, and historians to discuss how and why providing abortion care is moral work. The collection offers voices not usually heard as clinicians talk about their work and their thoughts about life and death. In four subsections--Providers, Clinics, Conscience, and The Fetus--the contributions in this anthology explore the historical context and present-day challenges to the delivery of abortion care. Contributing authors address the motivations that lead abortion providers to offer abortion care, discuss the ways in which anti-abortion regulations have made it increasingly difficult to offer feminist-inspired services, and ponder the status of the fetus and the ethical frameworks supporting abortion care and fetal research. Together these essays provide a feminist moral foundation to reassert that abortion care is moral work.
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Before Birth
Prenatal Testing for Genetic Disease
Elena Nightingale and Melissa Goodman
Harvard University Press, 1990

Information on prenatal testing abounds, but few books are addressed to prospective parents in need of practical guidance. In this comprehensive and sensitive account, Elena Nightingale and Melissa Goodman offer remarkably clear answers to the set of bewildering questions generated by the concerns of parenthood.

Prospective parents are given the guidance needed to make informed choices about whether or not to undergo testing and, if they elect to do so, how best to use the results. As humans, we are recipients of a rich genetic heritage. Each human cell contains 46 chromosomes with a total of 50,000 to 100,000 genes distributed among them. Such richness carries immense possibilities for error when gene replication occurs; it is therefore not surprising that gene disorders such as Down syndrome, Huntington's disease, and neural tube defects pose a major public health problem. Rapid development of sophisticated new techniques has vastly increased our ability to diagnose genetic disorders during the prenatal period. For example, the amniotic fluid sampled in the middle trimester can be tested for such biochemical abnormalities as Tay-Sachs disease. The advent of more recent techniques, such as sampling the cells of the villi of the chorion (a procedure that can be carried out in the first trimester), employing gene probes, and using ultrasonographic detection, has advanced the diagnosis of genetic disorders faster than most researchers would have thought possible.

Nightingale and Goodman carefully explain the practicalities of this potentially confusing array of prenatal tests: how they are performed, what they reveal, and what their limitations are. The book concludes with a thoughtful consideration of the economic, ethical, and legal issues related to prenatal screening. Although primarily intended to assist prospective parents, this volume is also of interest to health care providers, public health officials, and policymakers who struggle with these difficult decisions.

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Biological Relatives
IVF, Stem Cells, and the Future of Kinship
Sarah Franklin
Duke University Press, 2013
Thirty-five years after its initial success as a form of technologically assisted human reproduction, and five million miracle babies later, in vitro fertilization (IVF) has become a routine procedure worldwide. In Biological Relatives, Sarah Franklin explores how the normalization of IVF has changed how both technology and biology are understood. Drawing on anthropology, feminist theory, and science studies, Franklin charts the evolution of IVF from an experimental research technique into a global technological platform used for a wide variety of applications, including genetic diagnosis, livestock breeding, cloning, and stem cell research. She contends that despite its ubiquity, IVF remains a highly paradoxical technology that confirms the relative and contingent nature of biology while creating new biological relatives. Using IVF as a lens, Franklin presents a bold and lucid thesis linking technologies of gender and sex to reproductive biomedicine, contemporary bioinnovation, and the future of kinship.
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Bishops and Bodies
Reproductive Care in American Catholic Hospitals
Lori Freedman
Rutgers University Press, 2023
One out of every six patients in the United States is treated in a Catholic hospital that follows the policies of the U.S. Conference of Catholic Bishops. These policies prohibit abortion, sterilization, contraception, some treatments for miscarriage and gender confirmation, and other reproductive care, undermining hard-won patients’ rights to bodily autonomy and informed decision-making. Drawing on rich interviews with patients and providers, this book reveals both how the bishops’ directives operate and how people inside Catholic hospitals navigate the resulting restrictions on medical practice. In doing so, Bishops and Bodies fleshes out a vivid picture of how The Church’s stance on sex, reproduction, and “life” itself manifests in institutions that affect us all.
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Conceiving Normalcy
Rhetoric, Law, and the Double Binds of Infertility
Elizabeth C. Britt
University of Alabama Press, 2001

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.

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Cosmopolitan Conceptions
IVF Sojourns in Global Dubai
Marcia C. Inhorn
Duke University Press, 2015
In their desperate quest for conception, thousands of infertile couples from around the world travel to the global in vitro fertilization (IVF) hub of Dubai. In Cosmopolitan Conceptions Marcia C. Inhorn highlights the stories of 220 "reprotravelers" from fifty countries who sought treatment at a “cosmopolitan” IVF clinic in Dubai. These couples cannot find safe, affordable, legal, and effective IVF services in their home countries, and their stories offer a window into the world of infertility—a world that is replete with pain, fear, danger, frustration, and financial burden. These hardships dispel any notion that traveling for IVF treatment is reproductive tourism. The magnitude of reprotravel to Dubai, Inhorn contends, reflects the failure of countries to meet their citizens' reproductive needs, which suggests the necessity of creating new forms of activism that advocate for developing alternate pathways to parenthood, reducing preventable forms of infertility, supporting the infertile, and making safe and low-cost IVF available worldwide.
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The End of Sex and the Future of Human Reproduction
Henry T. Greely
Harvard University Press, 2016

“Will the future confront us with human GMOs? Greely provocatively declares yes, and, while clearly explaining the science, spells out the ethical, political, and practical ramifications.”—Paul Berg, Nobel Laureate and recipient of the National Medal of Science

Within twenty, maybe forty, years most people in developed countries will stop having sex for the purpose of reproduction. Instead, prospective parents will be told as much as they wish to know about the genetic makeup of dozens of embryos, and they will pick one or two for implantation, gestation, and birth. And it will be safe, lawful, and free. In this work of prophetic scholarship, Henry T. Greely explains the revolutionary biological technologies that make this future a seeming inevitability and sets out the deep ethical and legal challenges humanity faces as a result.

“Readers looking for a more in-depth analysis of human genome modifications and reproductive technologies and their legal and ethical implications should strongly consider picking up Greely’s The End of Sex and the Future of Human Reproduction… [It has] the potential to empower readers to make informed decisions about the implementation of advancements in genetics technologies.”
—Dov Greenbaum, Science

“[Greely] provides an extraordinarily sophisticated analysis of the practical, political, legal, and ethical implications of the new world of human reproduction. His book is a model of highly informed, rigorous, thought-provoking speculation about an immensely important topic.”
—Glenn C. Altschuler, Psychology Today

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Homeland Maternity
US Security Culture and the New Reproductive Regime
Natalie Fixmer-Oraiz
University of Illinois Press, 2019
In US security culture, motherhood is a site of intense contestation--both a powerful form of cultural currency and a target of unprecedented assault. Linked by an atmosphere of crisis and perceived vulnerability, motherhood and nation have become intimately entwined, dangerously positioning national security as reliant on the control of women's bodies. Drawing on feminist scholarship and critical studies of security culture, Natalie Fixmer-Oraiz explores homeland maternity by calling our attention to the ways that authorities see both non-reproductive and "overly" reproductive women's bodies as threats to social norms--and thus to security. Homeland maternity culture intensifies motherhood's requirements and works to discipline those who refuse to adhere. Analyzing the opt-out revolution, public debates over emergency contraception, and other controversies, Fixmer-Oraiz compellingly demonstrates how policing maternal bodies serves the political function of securing the nation in a time of supposed danger--with profound and troubling implications for women's lives and agency.
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Integrating Family Planning Training into Medical Education
A Case Study of St. Paul's Hospital Millennium Medical College
Lia T. Gebremedhin
Michigan Publishing Services, 2017
This case study chronicles the integration of pre-service training in contraception and comprehensive abortion care into the medical school and OBGYN residency training program at St. Paul’s Hospital Millennium Medical College (SPHMMC) through an authentic partnership with the University of Michigan. The case study showcases the key elements that were crucial in the successful implementation of the SPHMMC program, which has now become mainstream and has been emulated in eight other medical schools in Ethiopia through the University of Michigan’s Center for International Reproductive Health Training (CIRHT).
 
The innovative approach, founded on the values of sustainable capacity building through academic partnership and centered on improving access to dignified women’s reproductive health care through effective pre-service training, has the potential for expansion to other countries with high rates of maternal mortality and morbidity. In this case study, we spell out the best practices, which we hope will inspire academic medical centers in the Global South, global health departments/centers internationally, and the reproductive health community at large.
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International Surrogacy as Disruptive Industry in Southeast Asia
Whittaker, Andrea
Rutgers University Press, 2019
During the last two decades, a new form of trade in commercial surrogacy grew across Asia. Starting in India, a “disruptive” model of surrogacy offered mass availability, rapid accessibility, and created new demands for surrogacy services from people who could not afford or access surrogacy elsewhere.
 
In International Surrogacy as Disruptive Industry in Southeast Asia, Andrea Whittaker traces the development of this industry and its movement across Southeast Asia following a sequence of governmental bans in India, Nepal, Thailand, and Cambodia. Through a case study of the industry in Thailand, the book offers a nuanced and sympathetic examination of the industry from the perspectives of the people involved in it: surrogates, intended parents, and facilitators. The industry offers intended parents the opportunity to form much desired families, but also creates vulnerabilities for all people involved. These vulnerabilities became evident in cases of trafficking, exploitation, and criminality that emerged in southeast Asia, leading to greater scrutiny on the industry as a whole. Yet the trade continues in new flexible hybrid forms, involving the circulation of reproductive gametes, embryos, surrogates, and ova donors across international borders to circumvent regulations. The book demonstrates the need for new forms of regulation to protect those involved in international surrogacy arrangements.
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Labor of Love
Gestational Surrogacy and the Work of Making Babies
Jacobson, Heather
Rutgers University Press, 2016
While the practice of surrogacy has existed for millennia, new fertility technologies have allowed women to act as gestational surrogates, carrying children that are not genetically their own. While some women volunteer to act as gestational surrogates for friends or family members, others get paid for performing this service. The first ethnographic study of gestational surrogacy in the United States, Labor of Love examines the conflicted attitudes that emerge when the ostensibly priceless act of bringing a child into the world becomes a paid occupation.  
 
Heather Jacobson interviews not only surrogate mothers, but also their family members, the intended parents who employ surrogates, and the various professionals who work to facilitate the process. Seeking to understand how gestational surrogates perceive their vocation, she discovers that many regard surrogacy as a calling, but are reluctant to describe it as a job. In the process, Jacobson dissects the complex set of social attitudes underlying this resistance toward conceiving of pregnancy as a form of employment. 
 
 
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Learning to Dance
Advancing Women’s Reproductive Health and Well-Being from the Perspectives of Public Health and Human Rights
Alicia Ely Yamin
Harvard University Press
This book promotes understanding of how the fields of health and human rights can better work together, including both addressing human rights implications of reproductive health interventions and fostering rights-based policies and laws relating to sexuality and reproductive health. A decade after the groundbreaking Cairo Conference on Population and Development a serious gap remains between the reproductive health and human rights fields. Too often, despite using the same language, the two fields do not seem to share the same understanding or strategies. In order to better understand the links and synergies between reproductive health and human rights as well as the continuing gaps between the two fields, this book brings together twelve experts to compare how each field traditionally approaches a situation that presents both public health and human rights implications. Six case studies, illustrating a range of issues in sexual and reproductive health, are analyzed by both a public health expert and a human rights expert, and a separate essay synthesizes the convergences and divergences between the two approaches and points to ways forward.
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Legitimating Life
Adoption in the Age of Globalization and Biotechnology
van Wichelen, Sonja
Rutgers University Press, 2019
The phenomenon of transnational adoption is changing in the age of globalization and biotechnology. In Legitimating Life, Sonja van Wichelen boldly describes how contemporary justifications of cross-border adoption navigate between child welfare, humanitarianism, family making, capitalism, science, and health. Focusing on contemporary institutional practices of adoption in the United States and the Netherlands, she traces how professionals, bureaucrats, lawyers, politicians, social workers, and experts legitimate a practice that became progressively controversial. Throughout the past few decades transnational adoption transformed from a humanitarian response to a means of making family. In this new manifestation, life becomes necessarily economized. While push and pull factors, demand and supply dynamics, and competition between agencies set the stage for the globalization of adoption, international conventions, scientific knowledge, and the language of human rights universalized the phenomenon. Van Wichelen argues that such technoscientific legitimations of a globalizing practice are rearticulating colonial logics of race and civilization. Yet, she also lets us see beyond the biopolitical project and into alternative ways of making kin. 

 
 
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The Oocyte Economy
The Changing Meaning of Human Eggs
Catherine Waldby
Duke University Press, 2019
In recent years increasing numbers of women from wealthy countries have turned to egg donation, egg freezing, and in vitro fertilization to become pregnant, especially later in life. This trend has created new ways of using, exchanging, and understanding oocytes—the reproductive cells specific to women. In The Oocyte Economy Catherine Waldby draws on 130 interviews---with scientists, clinicians, and women who have either donated or frozen their oocytes or received those of another woman---to trace how the history of human oocytes' perceived value intersects with the biological and social life of women. Demonstrating how oocytes have come to be understood as discrete and scarce biomedical objects open to valuation, management, and exchange, Waldby examines the global market for oocytes and the power dynamics between recipients and the often younger and poorer donors. With this exploration of the oocyte economy and its contemporary biopolitical significance, Waldby rethinks the relationship between fertility, gendered experience, and biomedical innovation.
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Romancing the Sperm
Shifting Biopolitics and the Making of Modern Families
Diane Tober
Rutgers University Press, 2019
The 1990s marked a new era in family formation. Increased access to donor sperm enabled single women and lesbian couples to create their families on their own terms, outside the bounds of heterosexual married relationships. However, emerging “alternative” families were not without social and political controversy. Women who chose to have children without male partners faced many challenges in their quest to have children. Despite current wider social acceptance of single people and same sex couples becoming parents, many of these challenges continue.
 
In Romancing the Sperm, Diane Tober explores the intersections between sperm donation and the broader social and political environment in which “modern families” are created and regulated. Through tangible and intimate stories, this book provides a captivating read for anyone interested in family and kinship, genetics and eugenics, and how ever-expanding assisted reproductive technologies continue to redefine what it means to be human.  
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Sex in an Age of Technological Reproduction
ICSI and Taboos
Carl Djerassi
University of Wisconsin Press, 2008
Carl Djerassi is one of “the fathers of the Pill”—he was awarded the National Medal of Science for the first synthesis of a steroid oral contraceptive—and has had a prolific additional career as a writer of fiction, plays, and dialogues about science. In these two plays, ICSI and Taboos, he dramatizes the social transformations and contested viewpoints created by advances in reproductive science and technology.
            Two of the most startling developments in contemporary science have radically disrupted the historical connection between sex and reproduction: in vitro fertilization and intracytoplasmic sperm injection (ICSI)—an assisted reproductive technique that directly injects a single sperm into an egg. The word play ICSI—designed for classroom readings—presents, in the format of a contentious talk-show dialogue, the science of direct-injection fertilization and the ethical issues connected with it. A DVD included in the book provides video of the ICSI injection process as viewed through a microscope, to be used in performances of the ICSI one-act dialogue. Taboos, a full-length play,turns the screws on characters that reflect a polarized America. Two couples—lesbian partners and a conservative husband and wife struggling with infertility—must make choices in a drama that examines the disjunction of sexual reproduction and the physical act of sex.
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Studies on the effectiveness of endoscopic surgery in reproductive medicine
Jan Bosteels
Amsterdam University Press, 2014
In the present doctoral thesis the evidence-based fundament for the shift from tubal reconstructive surgery to ART for treating tubal infertility is investigated. There is no randomised comparison between ART and reconstructive tubal surgery. Doing a laparoscopy in all cases of subfertility is not sensible given the availability of alternative and reliable diagnostic procedures to study tubal patency. The effectiveness of hysteroscopy for treating female subfertility is limited to some specific indications. There are many knowledge gaps in our current understanding of the effectiveness of hysteroscopic interventions in the treatment of subfertile women. These should be studied preferably by pragmatic randomized studies. The use of anti-adhesion barrier gels may decrease the incidence and the extent or severity of intrauterine adhesions following hysteroscopic surgery in subfertile women, but data on pregnancy and live birth rates are missing. Recent years have witnessed an increase in the number and the methodological quality of published reports of randomized studies on reproductive surgery. This may be linked to the CONSORT statement. The pros and cons of evidence-based practice in reproductive surgery are discussed at the end of this doctoral thesis.
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Tangled Diagnoses
Prenatal Testing, Women, and Risk
Ilana Löwy
University of Chicago Press, 2018
Since the late nineteenth century, medicine has sought to foster the birth of healthy children by attending to the bodies of pregnant women, through what we have come to call prenatal care. Women, and not their unborn children, were the initial focus of that medical attention, but prenatal diagnosis in its present form, which couples scrutiny of the fetus with the option to terminate pregnancy, came into being in the early 1970s.

Tangled Diagnoses examines the multiple consequences of the widespread diffusion of this medical innovation. Prenatal testing, Ilana Löwy argues, has become mainly a risk-management technology—the goal of which is to prevent inborn impairments, ideally through the development of efficient therapies but in practice mainly through the prevention of the birth of children with such impairments. Using scholarship, interviews, and direct observation in France and Brazil of two groups of professionals who play an especially important role in the production of knowledge about fetal development—fetopathologists and clinical geneticists—to expose the real-life dilemmas prenatal testing creates, this book will be of interest to anyone concerned with the sociopolitical conditions of biomedical innovation, the politics of women’s bodies, disability, and the ethics of modern medicine.
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The UM-CIRHT Framework for Integrating Comprehensive Contraception and Abortion Care Competencies into Health Professions Education
Solomon W. Beza
Michigan Publishing Services, 2018
This framework document describes the strategy used by the Center for International Reproductive Health Training at the University of Michigan (UM-CIRHT) to integrate preservice family planning and comprehensive abortion care training into health professional schools' curricula. The program is designed to ensure acquisition of requisite competencies so that partner schools can graduate competent health professionals able to deliver high-quality, comprehensive reproductive health services to women.

The framework is intended to provide guidance on how the programmatic and operational strategies for family planning and comprehensive abortion care could be extended in countries or institutions that seek to replicate the UM-CIRHT model in their settings. It may be adapted to the local context of individual countries and institutions.

This framework document is produced by UM-CIRHT with funding from an anonymous donor. 
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The Wombs of Women
Race, Capital, Feminism
Françoise Vergès
Duke University Press, 2020
In the 1960s thousands of poor women of color on the (post)colonial French island of Reunion had their pregnancies forcefully terminated by white doctors; the doctors operated under the pretext of performing benign surgeries, for which they sought government compensation. When the scandal broke in 1970, the doctors claimed to have been encouraged to perform these abortions by French politicians who sought to curtail reproduction on the island, even though abortion was illegal in France. In The Wombs of Women—first published in French and appearing here in English for the first time—Françoise Vergès traces the long history of colonial state intervention in black women’s wombs during the slave trade and postslavery imperialism as well as in current birth control politics. She examines the women’s liberation movement in France in the 1960s and 1970s, showing that by choosing to ignore the history of the racialization of women’s wombs, French feminists inevitably ended up defending the rights of white women at the expense of women of color. Ultimately, Vergès demonstrates how the forced abortions on Reunion were manifestations of the legacies of the racialized violence of slavery and colonialism.
 
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