The power of potential: Assisted reproduction and the counterstories of women who discontinue fertility treatment

Despite their low and inconsistent rates of success, assisted reproductive technologies (ARTs) are presented by fertility clinics and constructed in media and popular culture as an effective treatment for infertility. The ways in which such technologies medicalize women's health and bodies have...

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Bibliographic Details
Published in:Social science & medicine (1982) 2021-08, Vol.282, p.114153-114153, Article 114153
Main Authors: Carson, Andrea, Webster, Fiona, Polzer, Jessica, Bamford, Sandra
Format: Article
Language:English
Subjects:
Antiretroviral therapy
Assisted reproduction
Biotechnology
Blame
Discontinuation
Discontinued
Feminism
Fertility
Infertility
Internalization
Mass media effects
Medicine
Mothers
Narrative
Narrative theme
Narratives
Popular culture
Post-structural feminism
Poststructuralism
Pregnancy
Qualitative methods
Reproductive technologies
Resistance
Social scientists
Womanhood
Women
Womens health
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Summary:Despite their low and inconsistent rates of success, assisted reproductive technologies (ARTs) are presented by fertility clinics and constructed in media and popular culture as an effective treatment for infertility. The ways in which such technologies medicalize women's health and bodies have been well documented by social scientists and feminist health researchers. However, little is known about the struggles women face in cases of “failure”; that is, when ART does not achieve its purported potential to assist women in their attempts to conceive and have the desired outcomes of conception and birth. Using a post-structural feminist interpretive framework combined with a narrative methodology, this paper critically examines the ways in which social and cultural narratives about gender and biotechnology shape women's accounts of discontinuing ART. Thirty-six interviews were conducted with twenty-two women across Canada who were at various stages of discontinuation and who utilized a variety of treatment types. Three inter-related narrative themes were developed to categorize the stories of struggle: (i) a growing desperation to be pregnant; (ii) confronting paternalistic medical expectations; and (iii) internalizing and resisting blame for treatment failures. These themes highlight both the explicit and subtle ways in which restrictive social and cultural narratives about womanhood and motherhood were perpetuated in clinical interactions, which ultimately made ending treatment more difficult. Our analysis illustrates how women navigated and resisted such narratives, through pausing or ending treatment despite provider recommendations and clinical messages. We suggest that fertility providers critically reflect on the potentially harmful language used during interactions with patients and recommend that discontinuation discussions become a recurring, normalized component of treatment protocols and patient-provider conversations so that women feel better supported to end treatment when they believe it is financially, emotionally, and physically beneficial for them to do so. •To discontinue (pause/end) fertility treatment is difficult, fraught with ambiguity.•Social and cultural values and clinical priorities shape women's experiences.•Careful clinical attention and support for discontinuation is needed.
ISSN:0277-9536
1873-5347
DOI:10.1016/j.socscimed.2021.114153