Book Review: Reproductive Technologies as Global Form - Ethnographies of Knowledge, Practices and Transnational Encounters
Reproductive Technologies as Global Form: Ethnographies of Knowledge, Practices, and Transnational Encounters
Published by University of Chicago Press
ISBN-10: 3593391007, ISBN-13: 978-3593391007
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This book follows on from a workshop that took place in Berlin five years ago, bringing together anthropologists who study the use of reproductive technologies in different parts of the world. The aim of the 2008 event was to discuss the 'transnationalisation' of IVF and other assisted reproduction technologies.
The book, like the workshop, pays close attention to how understanding of fertility treatment as a global phenomenon is generated. In particular, it is concerned with the process of knowledge production and the role of ethnography - a research method used by anthropologists - in exploring how medical technologies function in various cultural settings.
As such, reading 'Reproductive technologies as global form' provides insights into what ethnographers find out about 'national IVF-cultures' during their fieldwork, but it also invites us to engage with theoretical considerations of an academic discipline. This may attract some readers, but it will discourage others.
Contributors to the volume vary in terms of the extent to which they 'theorise' local encounters with reproductive technologies. Some elaborate at great length on epistemology, others seem almost too descriptive. Most chapters, however, tell a story that is accessible to a non-specialist reader, without compromising scholarly value.
The volume contains accounts from ethnographers based mainly at German and British universities, with individual contributors from Austria, Portugal and the United States. The list of countries in which the anthropologists have conducted the work they draw on is more varied and includes Spain, Hungary, Romania, Turkey, India, Sri Lanka and Mali, as well as the Middle East.
There is also variation in terms of techniques and practices examined. Different chapters of the book describe gamete donation, surrogacy, intrauterine insemination and IVF, showing how patients and medical professionals in specific cultural contexts approach legal prohibitions and social stigma in their quests to create babies.
A common element underlying many of the ethnographic case studies is the involvement of various 'reproductive actors' in international travel. It is the complexity of these cross-border endeavours that the contributing authors seek to illuminate.
The book, as a whole, tracks 'emerging transnational forms of mobility, competition, inequality and collaboration' in reproductive medicine. The premise is that a detailed examination of specific cases in which the users of biomedical technologies move from one place to another has an important potential to enhance our understanding of the globalisation of these technologies.
And continually drawing our attention from 'the local' to 'the global', and vice versa, the collection does help to delineate the complicated link between the two. International and cultural differences in how reproductive technologies are received become simultaneously erased and perpetuated, sometimes in surprising ways.
With their research encompassing Europe, Asia and Africa, the contributing anthropologists shed light on some compelling issues on the world map of assisted reproduction. The ones I personally found most absorbing highlight the moral dilemmas that underlie the decisions of how to deal with unwanted childlessness.
For example, Zeynep Gürtin shows how Turkish IVF practitioners, accountable to both their local patients and the global scientific community, struggle to reconcile the international guidelines to lower embryo transfer numbers with their resource-poor patients' desires for multiple pregnancies.
In another chapter, Viola Hörbst describes how infertile men are allowed to bring the semen needed for treatment 'from home', which allows them to bypass restricting laws surrounding sperm donation and the cultural intolerance of male infertility in Mali. Elsewhere, Marcia Inhorn explains how some Iranian women temporarily divorce their husbands and marry sperm donors to avoid the social stigma of both single motherhood and adultery.
Ethnographies that specifically address cross-border travel are equally eye-opening. Among other practices, we learn about Hungarian emigrants going back to their country of origin to receive fertility treatment, American women travelling to Lebanon for extra payment to anonymously donate their eggs, and Israeli doctors coming to Romania to treat egg donors and taking the gametes back home.
The reader should bear in mind that despite its gripping accounts this remains a scholarly book. It is not uncommon for footnotes to take more than half a page, which provides a plethora of incredibly useful references for those interested in studying specific topics further, but can make the read flow less well for everyone else.
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