Sarah Franklin, March '18 - available to download as a PDF.
From its inception in the 1980s the social study of IVF has consistently identified distinctive emotional patterns and cycles, and one of the striking features of a literature that now extends from Margaret Sandelowski’s pathbreaking monograph A Child in Mind in the 1980s to Marcia Inhorn’s 2015 study of Cosmopolitan Conceptions is the consistency of these patterns over time. The patterns and cycles of the IVF journey are primarily structured by two different types of encounter: the encounter with infertility, followed by the encounter with IVF. I studied exactly these two junctures in my own research, conducted in the late 1980s, on early IVF consumers in the UK, and I found this same typical emotional pattern. The initial encounter with infertility comes as a shock and creates a deep sense loss, betrayal and anger – often compared to a bereavement. In the aftermath of this first bewildering encounter comes a second – entry into the rollercoaster world of IVF, with all its crazy U-turns, setbacks, cul de sacs, elations-followed-by-devastation -- and always the complicated business of enough but not too much hope. In the same way the first encounter happens in stages – at first a bit of a worry about not getting pregnant, eventually the formal diagnosis of infertility – so too the encounter with IVF changes over time, often unexpectedly, veering from hopeful to hopeless, so that ultimately what the process of pursuing fertility treatment feels like for almost everyone is a series of complicated and exhausting emotional steps that may or may not ultimately lead to parenthood and which require extraordinary effort, commitment and sacrifice to keep going.
Recently in ReproSoc we’ve had two sessions devoted to some of the new ways the emotional architecture of ART journeys can be represented, and this has raised some important questions for us, not least as we are increasingly involved in infertility outreach and engagement events like the Timeless events we’ve run with The Liminal Space at the Fertility Show and Fertility Fair in London this past year. Last week in ReproDoc, our long-running film series, we watched One More Shot (Moskin 2017) a new documentary film available on Netflix, Vimeo and Amazon that explores the topsy-turvy reproductive experiences of Noah and Maya, a young California couple, as they first encounter their infertility and then enter the complicated world of IVF. Noah is also the Director of the documentary, which was produced by Maya, and which is being marketed as both a ‘raw and honest’ look at fertility treatment, and an effort to raise public awareness about this condition that affects millions of people, yet remains both stigmatised and marginalised. Yesterday in Christ’s College we hosted Dr Shantel Ehrenberg from the University of Surrey who presented her incredible two stage Lecture-Performance of ‘(in)fertile territories’ to a small audience as part of her peer-edited choreographic practice, and in preparation for a repeat performance at our conference in June. ‘(In)fertile territories’ explored the encounter with infertility as an initial sense of failure, disappointment, panic and betrayal followed by a second confrontation between ‘soft bodies’ and the ‘hard objective facts’ of medical diagnosis. Working with the theme of visual self-reflection, and using film and video, live dance performance, and lecture-style powerpoint slides, Shantel’s powerful improvisational choreography used repeated movements, or ‘phrases’, to create a language of bursting and containing, leaping and falling, swirling, lifting, letting go, and struggling to come to terms with the ‘deeply rooted and complex assumptions’ that are exposed through the encounters with both infertility and IVF.
I will be writing more about both of these fascinating recent efforts to try to represent what is difficult and hard to describe about the reproductive journeys that feel so personal and private but which are at the same time so revealing about public and political life. So for now these are just some initial thoughts. What both of these efforts had in common, and what struck me very forcefully watching them, is how remarkably similar the emotional patterns and cycles are now to the ones I wrote about so long (30 years) ago. Indeed Shantel’s project actually included quotes from Embodied Progress, and I could have substituted direct quotes and sub-headings from that book repeatedly during One More Shot. The question our astute visitor Mianna Meskus asked in discussion when this point came up after watching the film was ‘what does it tell us about the wider society that these patterns have remained the same over such a long time’? This is a great question because it returns us to a methodology at the heart of both feminist and reproductive studies, namely the effort to ask ‘what do the structures of intimate personal feelings tell us about the wider institutional structures that shape our world’?
One More Shot is a well-made and emotionally engrossing film that delivers a no-holds-barred account of its makers’ arduous and often harrowing reproductive journey from brutal disappointment through painful isolation and repeated failure to eventual success. Key to the engaging storyline is the honesty of the portrayal, which not only includes scenes of the couple’s relationship under severe strain, and their repeated devastation in the wake of yet another negative pregnancy test, but the process of administering enemas, the endless daily injections, the constant confusion and doubt mixed with unending determination to succeed, and the strain of financial insecurity.
The objective of this documentary, in the words of the film produciton team, is ‘to promote communication and understanding, and remove the taboo from this subject. Our hope is that our audience will walk away from our film no longer afraid of having an honest dialogue about infertility.’ Their film is dedicated to the millions of infertile couples who ‘often suffer in silence, confused by the various interventions available, and live in constant fear that their dream of having a family may never be realized.’
Shantel Ehrenberg’s ‘(in)fertile territories’ addresses similar themes of loss, pain, anger, betrayal, isolation and suffering. Both the lecture content of the performance and the choreographed movements back grounded by projected images offer vivid interpretations of the initial experience of shame and failure followed by the effort to re-empower and re-emerge, transformed, on a new and different path. Whereas the first part of ‘(in)fertile territories’ is built around a non-narrative, multi-dimensional mapping of the complex experience of coming to embody barrenness, the second part offers a more traditional first-person narrative recounting Ehrenberg’s painful journey from hopeful, would-be mother into a relationship that brought this promise even closer, only to discover how very far away she was from any chance of becoming pregnant due to an inherited form of early menopause. Behind her as she reads her personal story is a continuous video clip of Ehrenberg dancing her journey back to a new self on a new path, in a series of scenes set in the very places that were most important to her in what now feels like a separate earlier life.
The lecture-performance is a demanding genre – of the viewer as well as the performer. And the sense of too many things happening at once, that don’t all add up, manages to convey an aspect of the fertility journey no single format could achieve, namely its polyphony, excessive simultaneity, and over-determined complexity. The feeling that it is not actually possible to take in everything that is going on all at once is part of the power of Ehrenberg’s method as well as per performance. This method also allows the piece to continue to evolve, and to be used in a variety of formats – from formal performance in a large theatre space, to intimate settings like a classroom, a support group, or a conference.
Both One More Shot and (In)fertile territories depict the complicated state of (in)fertility bewilderment that derives in part from the extent to which the hoped for solution (IVF) so often recapitulates, and indeed intensifies, the original pain and suffering it is intended to relieve. This dynamic – in which IVF both takes away much more than its users expected it to, while at the same time also taking over their lives to an extent they never anticipated -- was one of the main findings of my research on IVF 30 years ago. To answer the question of what the feelings of ‘having to try’ and that IVF was the ‘only choice’ or that IVF was ‘completely taking over’ and that it was ‘impossible to know when to reach an end point’ are telling us about the wider society, I focussed on both the role of self-esteem and of reproductive agency in my account. Like many other feminist scholars working in this area in the 1980s, I argued against the view that pursuing IVF was simply proof of victimhood, or of women being ‘duped’ by patriarchal ideology, and instead tried to reveal the conscious strategies they were using to protect and empower themselves.
One of the main differences between Ehrenberg’s project and the documentary film is the extent to which she wants to go beyond the depiction of her own experience to show how the feelings that structure the encounter with both infertility and IVF can be used to reveal a much wider picture of social norms and expectations. This isn’t the aim of One More Shot, which has a more naive objective of sharing as helping. But sharing isn’t helping if we aren’t also challenging some of the main sources of the problems that these intensely painful and confusing IVF journeys so vividly reveal. These are the ‘deeply rooted and complex assumptions’ Ehrenberg is trying to grapple with, which include all of the ways in which infertility feels like a private, personal challenge when in fact, like any other form of inequality and social exclusion, the feeling is itself diagnostic of wider social structures we need to be able to name and identify and change.