The female reproductive experience is an endless morality tale. To try for a baby is to watch yourself constantly, knowing each stage of the process involves a judgement, if not on the performance of your body, then the legitimacy of your desires. In this context — one in which there is a right time to conceive, a right way to be pregnant, a right way to give birth — infertility means more than personal loss. It has a moral dimension. You are encouraged to feel that you must have done something wrong. Perhaps it is something precise: you got too old, you should have settled down sooner, you shouldn’t have had that termination all those years ago. Or maybe it’s vaguer than that. You were arrogant to trust in your female body. Of course you’d be punished for that.
The new Serial podcast, The Retrievals, tells the story of patients attending a Yale fertility clinic. All of them experience extreme pain during an egg retrieval procedure, and all of them see their pain trivialised and dismissed. It later transpires that a nurse at the clinic has been replacing the Fentanyl that should have been used for the procedure with saline. What comes through most powerfully in the first episode, which tells the patients’ stories, is these women’s impulse to blame themselves. Having been told they received the maximum dose of pain relief, they reach for stories to explain their responses: “I’m immune to Fentanyl. It’s my fault. It’s supposed to be painful”. “There’s nothing like feeling shame,” says one patient, describing her distress at hearing women who’d experienced egg retrieval at other clinics refer to their experiences as relatively painless. “I started shutting down after hearing those stories, like this was on me. Something wasn’t right with my tolerance and my ability to handle this.”
There has been a flurry of recent books, including Elinor Cleghorn’s Unwell Women and Pragya Agarwal’s Hysterical, which explore the way in which female experiences of pain are minimised and dismissed. This is true in general terms; as podcast presenter Sarah Burton comments, “there’s a balance you have to strike as a woman patient. You have to complain just the right amount to be taken seriously, but not so much that you seem shrill. Still, your pain is more likely to be underestimated than men’s.” In this instance, however, there’s an additional level of judgement. The women attending the Yale clinic compare themselves, but not to men, and not just, as in the example above, to other women undergoing fertility treatment. They compare themselves to women who do not need to access the treatment at all.
One patient, Leah, is described as having “internalised the narrative that her body was to blame. Her body was inadequate, deficient. Her body had had miscarriages. Her body didn’t make enough eggs. Her body couldn’t cooperate long enough to get through a critical procedure”: “Oh God, my body was like, here it goes again. Not only can I not have a baby, I also can’t even just lay still with the right amount of Fentanyl.” This is not just about gendered perceptions of pain tolerance. It’s about the censure that surrounds the whole issue of female fertility: which women can get pregnant, which can’t, which women can stay pregnant, which can’t.
Much of the time, infertility and recurrent miscarriage are unexplained, but like the women who cannot understand why their maximum dose of opiates is not working, we invent reasons for then, and whatever reasons we invent tend to make women themselves the culprit. A toxic combination of ignorance and misplaced guilt then makes it easier for the fertility industry to mistreat women. Patients arrive in an already weakened state, weighed down by the fear that they have “let down” both themselves and those around them: their partners, potential grandparents, any future babies, maybe even feminism itself.
Like cosmetics, fertility is a multi-billion pound industry that capitalises on female shame. It can be an intense, multi-levelled shame — particularly for the kind of liberated, professional woman who visit clinics such as that at Yale. On the one hand, you have failed to do what is, according to the traditionalist, a woman’s main purpose; on the other, you have failed to prove the traditionalist wrong by having a baby on your own terms, in your own time. In an era that prizes freedom and choice, you are subject to the restriction and unpredictability of your own body. Your “failure” is shameful, but so, too, is your desire, a desire that is so strong that you will throw yourself at the mercy of an industry whose success rates are shockingly low.
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