PH EN ESTADO FRESCO Y ENDURECIDO

The development of assisted reproductive technologies has brought about both new possibilities and challenges for those facing troubles conceiving a child. Establishing the diagnosis of infertility is a performative act (Barad, 2007) in that it produces a series of effects on the actions and identities of people seeking parenthood by locating them in a medicalised environment where help comes in exchange for a considerable amount of compliance. The standards patients have to abide by reflect not only scientific imperatives, but also social ones.

Infertility has been the focus of a vast array of research which contends that the inability to conceive, or to bring a pregnancy to terms, are major disruptions in the lives of people all around the world (Becker, 2000; Franklin, 1997; Inhorn, 2009; Nahman, 2013; Thompson, 2005).

Although the desire for having children is more than the result of social pressure for parenthood, there are still powerful societal discourses that place children at the centre of the heterosexual nuclear family ideal (Ikemoto, 2009; Thompson, 2005). Consequently, those that cannot procreate are stigmatised, inhabiting in-between spaces (Braidotti, 1994)

of wanting to meet both the societal imperative of reproduction and their own desires for parenthood, but being unable to live up to a task that seems ‘natural’.

At a time when reproductive technologies were ‘new’ and less ubiquitous, their entanglement with women’s reproductive capacities sparked both utopian hopes and dystopian dread on the part of

feminists. Contending that their reproductive role constituted the primary source of women’s oppression, Firestone (1979) heralds the advent of ARTs as the revolutionary solution that will finally liberate women from their biological burden. Imagining a world in which children will be gestated in artificial wombs, Firestone characterises motherhood as a physical burden and social oppression that can be overcome, and a new, androgynous world will ensue. Contrary to Firestone’s hopeful narrative, Spallone and Steinberg (1987), as well as Corea (1985) envision

reproductive technologies as direct attacks on women’s bodies in

general, and their reproductive capacities in particular. Corea goes as far as referring to all medical professionals as ‘pharmacrats’, manipulating women’s bodies as a means to steal their (pro)creative agency and render them useless in a world of men and patriarchal science. The merits of these works reside in the fact that they were amongst the first to dedicate considerable attention to reproductive technologies, drawing attention to the way in which they were wielded and regulated without proper inquiries into their impact on women’s health and wellbeing (Corea, 1985; Steinberg, 1997). However, with their dualistic approach towards ARTs as either instruments of salvation or curses in disguise, as well as with their essentialised understanding of women and men,

opposing each other in a patriarchal world, these first accounts of assisted reproduction were rapidly criticised by other feminist activists and academics. As research on new reproductive technologies

accumulated, the picture that emerged was more nuanced, as was the evaluation of their impact on women, no longer seen as a unitary group of people, but as differentiated by class, race, ability, sexual orientation etc. Also, women engaging with IVF were no longer seen as solely defined by their reproductive capacities, nor as victims neutralised under the male gaze and technology.

Moving away from essentialist understandings of personhood, Thompson (2005, p.182) argues that “the subject is dependent on the constant ontological entwining between ourselves and our environment”.

While her statement can be taken as valid in a more general sense since one’s identity gains meaning by intra-acting with other agencies (Barad, 2007), Thompson here refers specifically to prospective parents

engaged with IVF, which according to her cannot be taken for granted, but have to be ‘made’. Many infertile persons engage with reproductive technologies and thus enrol in what Franklin (1997) has called an

‘obstacle course’ to highlight the emotional, physical, and financial toll infertility treatment takes on them. Franklin (1997) argues that, to

increase the acceptability of the treatment in the eyes of society and for themselves, IVF is often described by patients in terms of ‘giving nature a helping hand’, recasting it as a minor intervention into what is usually considered by most people the ‘natural’ course of things. However, Throsby (2004) points towards the ambivalent character of reproductive technologies as they not only enable the potential enhancement of fertility, but they also transform this opportunity into an imperative to try everything possible in order to achieve parenthood. The pressure to keep going is so high that those who decide or are forced to give up feel the need to employ self-redeeming, legitimising discourses. Throsby (2004, p.8) contends that “those who have undergone IVF

unsuccessfully and who have since stopped treatment find themselves occupying an ambiguous liminal space between social conformity and transgression: they have tried to conceive but have been unable to; they desire children, but are no longer actively pursuing that desire; they have brought technology into the ‘natural’ process of reproduction, but without the counterbalancing ‘natural’ outcome of a baby”.

A few authors argue that IVF patients have to constantly manage their visibility and perform in what is considered an ‘appropriate’ manner to a multiplicity of audiences. Thompson (2005) refers to this as ‘passing’

when discussing the standards prospective parents need to meet when interacting with medical professionals. More explicitly, parents are required to show ‘civility’ as a marker of respectability and being in control in order to convince reproductive professionals of their fitness to

become parents and to meet the ideal of the nuclear, heterosexual family. To be ‘in control’ is in fact an overarching demand in terms of managing one’s infertility treatment. Throsby’s (2004) findings highlight the fact that while the desire for a child is respectable and encouraged to a certain point, ‘going too far’ is often envisioned as transgressing the boundaries of rationality and moderation.

Irrespective of the cause of infertility (male, female, or unknown), women’s bodies are the focus of medical treatment, which emphasises the heavily gendered character of assisted reproduction. Thompson’s (2005) concept of ontological choreography caters to this work centred on women, who, as part of their IVF treatment, become engaged in a complex entanglement of knowledge, practices, personnel, and medical devices, all put to work in enacting infertility as a comprehensive,

discrete illness with its own manifestations and treatment. This

choreography is based on the use of various apparatuses that deploy women as ‘objects’ with different ontological statuses: at one point in time they may be infertility patients with a medical history, only to later become a set of organs visualised through the ultrasound, or the welcoming, depersonalised container of ‘beautiful’ embryos. It is this instability of women’s ontological status during infertility treatment that has sparked serious concerns about the gendered assumptions underlying their status as patients. Thompson (2005) argues that

rationality and moderation are something women are often considered to lose during the process, with the mainstream medical discourse

identifying the hormonal medicine prescribed for women as the cause of this loss, and disregarding the overall stress brought about both by infertility and its treatment. According to Throsby (2004), passing as

‘reasonable’ is also a stake for those women who struggle to put an end to their treatment, irrespective of the outcome. These expectations echo long-standing discourses about women as emotional and prone to excesses of various kinds mostly due to their biology, which needs to be managed and contained (Martin, 2001).

Franklin (1997) draws attention to a constant concern in feminist scholarship on reproduction related to women’s agency once engaged with IVF. Irrespective of the cause of infertility, she contends, it is still

women who undergo the procedure, during which they become objectified and experience feelings of disembodiment. In contrast to Franklin (1997), Thompson (2005) employs a perspective that sees IVF as a rite of passage from childlessness to motherhood, and IVF patients as agents empowered by objectification. In this unexpected move that challenges the agency-objectification dichotomy, Thompson argues that sometimes achievements require one’s self-reification. The fact that IVF patients accept the temporary loss of their subjectivity and delegate decision making is compatible with the idea that they act according to their own desires and do what needs to be done. Of course, this does not settle all the issues of disempowerment in terms of reproduction, but it allows discussions of agency to move beyond its presumed opposition to objectification. Indeed, returning to Barad (2007), even the term

‘objectification’ seems inappropriate, since everything, including inanimate objects, are entangled in intra-actions through which they affect the universe around them.

Academic scholarship on IVF indicates that the labour performed by women undergoing IVF is not only related to the medical aspects of achieving pregnancy, but also to passing as deserving motherhood. A few authors have noted that, especially with the development of novel technologies of genetic testing, IVF is seen by the general public as a luxury service to which only the well-off have access and who thus engage in ‘baby-shopping’ (Franklin and Roberts, 2006; Modell, 1999;

Throsby, 2004). Throsby (2004, p.87) draws attention to the particular case of infertile women who, on the one hand, are accused of

selfishness for ‘pursuing’ a childfree life, and on the other are blamed for engaging in reproductive treatments that ‘corrupt’ the reproductive endeavour through the involvement of money. According to Throsby (2004), being an IVF patient is a continuous negotiation of personal desires and societal expectations, and putting on the right performance is a matter of gaining legitimacy as a prospective parent. Despite the temporary self-objectifications women undergo in medical settings, a few authors have signalled that there is little they can leave to chance in their relationship with the outside world because, despite a growing number of IVF patients, assisted reproduction is still imbued with considerable

stigma (Becker, 2000; Franklin, 1997; Inhorn, 2009; Nahman, 2013;

Throsby, 2004).

The research presented in this section highlights the diversity of social and medical practices that enact the status of ‘patients’, triggering the formation of a certain type of identity defined by societal

expectations. Reproductive technologies, procedures and standards, gender stereotypes, the nuclear family ideal, anxiety about

commercialised reproduction, these all constitute a material-discursive apparatus that shape the terrain patients have to navigate. My research expands on these, giving an account of the practical and discursive challenges patients face in a context of ambiguous legislation and little institutional help. I present their experiences as illuminating both the complexity of ova provision in Romania, as well as their impact on patients’ identity construction. In my data chapters I also explore what it means to ‘go too far’ for Romanian IVF patients in need of ova, and how they negotiate the boundaries of legitimacy in the face of a strict regime of altruistic provision. Thus, I now move on to discussing some of the most relevant issues in relation to third party reproduction.

2.3 Third party reproduction in free and commercial