On July 8, 2020, the US Supreme Court ruled in Trump v. Pennsylvania in favor of the Trump administration’s challenge to what is commonly known as the “contraceptive mandate” of the Obama-era Affordable Care Act. This provision of the act mandates that certain employers must provide insurance to their employees that cover a set of FDA-approved contraceptive technologies. The 2001 mandate was previously weakened by the 2014 US Supreme Court decision in Burwell v. Hobby Lobby Stores, in which the Court found in favor of the Green family who objected to four types of FDA-approved contraceptives that they argued were abortifacients (i.e., a device or medication that induces an abortion). As evangelical Christians, the Green family did not object to providing insurance coverage for contraceptives, but they did oppose the prospect of funding abortions. In the case of Trump v. Pennsylvania, the Catholic charity, Little Sisters of the Poor Saints Peter and Paul Home, refused to provide insurance coverage for all types of contraceptives, believing them to violate the God-given procreative function of sex.
In these court cases, contraceptive technologies are flashpoints in cultural fights over the role and purpose of reproduction. For the Green family and the Little Sisters of the Poor Saints Peter and Paul Home, contraceptives enable sexualities that threaten their understanding of God’s purpose for sex and a faithful adherence to godly family structures. The state, and other related parties in these cases, however, view contraceptive technologies as necessary to essential forms of citizenship and social belonging, especially for women. In the 1992 case that upheld many of the rulings of abortion, Planned Parenthood v. Casey, for instance, the court opinion averred that “the ability of women to participate equally in the economic and social life of the Nation has been facilitated by their ability to control their reproductive lives.” At odds, in these entangled legal regulations, are opposing visions of what kind of life reproductive technologies can and should enable.
This forum examines the lives that are made possible and impossible by reproductive science. Reproductive technologies are often viewed as hallmarks of scientific modernity. In vitro fertilization (IVF) and contraceptives promise mastery over conception and fertility. Ultrasounds and fetal DNA screening tests assure the health and safety of the growing fetus. And medicalized obstetrics protect the life of the pregnant mother. These technologies would seem to suggest that humanity has overcome the uncertainty and danger of conception, pregnancy, and birth. We can now have children when we want to, how we want to, and if we want to. But even these brief examples from the recent legal history of contraceptives and abortions in the United States demonstrate that reproductive science has a complex and even contradictory relationship to forms of liberation and kinship. This forum invites scholars to question narratives of progress, perfection, and triumphant secularism that are threaded through contemporary discussion of modern reproductive practices. Together the contributors ask: What notions of freedom do reproductive technologies assume? What new moral dilemmas have been opened up by these techniques? In what way has reproductive science transformed already existing questions about what is livable and what is grievable in the creation and care of new life?
Modern reproduction is inextricably tied to the creation and formation of the national body. In her essay on the pronatalist history of IVF, Laura Lovett analyzes the racial demographic anxiety that shapes national funding and regulation of IVF around the world. She highlights the case of Israel, in which the state provides free IVF treatment to women under the age of 45 in programs that are explicitly tied to struggles over land occupation. Kristy Slominski’s essay on the Christian roots of public sex education in the United States demonstrates how thoroughly national formations are intertwined with religious frameworks of reproduction and family. And pronatalism undergirds the use of other medical interventions, even when not part of official state policy. Carly Thomsen’s examination of the role of ultrasounds in the practices of Crisis Pregnancy Centers (CPCs) underlines this point. In these private, religiously affiliated centers, ultrasounds are used to discourage abortions and promote the necessity of motherhood to women seeking treatment and counseling. Those who run CPCs believe that when women are forced to see their fetus through the mediation of an ultrasound, they will be unable to refuse motherhood.
In pronatalist discourses, sectarian religion operates as part of nationalist metanarratives about the kinds of family—or even the basic imperative to have a family—that make up a healthy and prosperous nation. However, the impositions of these discourses are not set aside by simply embracing a fully technoscientific reproductive ethic. The other side of pronatalism is eugenics—a logic that turns to science to create better human societies through selective breeding. In her essay, Jenna Tonn examines the1980s radical feminist critique of IVF—feminist scientists and intellectuals criticized the use of IVF as part of a long history of government-controlled population growth and management of women’s bodies. Devan Stahl explores the moral landscape of fetal screening technologies to reveal the eugenic mindset at play in descriptions and treatments of chromosomal conditions. Even the vocabulary of these techniques—screening, abnormality, disorder—reveals the eugenic framing of health and normalcy at play. Stahl introduces a Christian ethic that reframes the ethics of screening for disability, arguing that, “persons with disabilities, therefore, are not exceptional cases of being human, but normal expressions of personhood.”
The materiality of reproduction—in its daily intimacies, struggles, griefs, and joys—affects us in ways that cannot be fully captured in the abstracts of cultural struggles and political fights. Creating new life has always been deeply personal and new technoscientific techniques have only multiplied the moral and kinship possibilities that individuals and communities must face. Several of the forum contributors offer powerful and generous insights into these dilemmas. Anna Bonnell Freidin reflects on the dangers of childbirth through a history of ancient Roman techniques for managing risk. Her piece pulls us into the “ripple effects of grief” after death in childbirth, reminding us of its hauntingly present reality in ancient Rome and for many present-day communities. She calls us to empathize with the Roman’s reliance on gods and natural knowledge to manage this risk, while also demonstrating our desire for medical assurance against such risks—and our inability to escape uncertainty and death in the midst of a global pandemic.
Michelle Wolff, writing with Aviana Zahara, demonstrates that “choices” in reproductive science—such as gender selection—offer ways of navigating “acute moral and medical concern.” Wolff details the ethical predicament Zahara’s parents balanced due to a sex-linked genetic condition that would manifest much more seriously in a child with XY than with XX chromosomes. But Zahara’s parents also were faithful to Catholic prohibitions against abortion—making the IVF creation (and potential abortion) of fetuses ethically precarious. In their essay, Wolff and Zahara offer a womanist and African theological framing that reorients our approach to this dilemma not through the liberation from bodily risk and precarity, but rather in embracing these realities in a theology of survival.
I write this introduction in the dispassionate capacity of a historian and theorist. Alongside these contributors, I affirm the need to recognize the complex, and often brutal, history of reproductive science and the need to examine its role in our lives with a certain critical distance. But I am entirely embodied. As I write this, I am seven months pregnant with my second child with the prospect of labor before me. In both my pregnancies I sought genetic screening tests. I have had a miscarriage. I have used IUDs and other forms of contraceptives to choose the timing of my pregnancies as I navigated the timelines of graduate school and the academic job market. I recognize the ethical limits of biological kinship, the false promise of complete certainty in obstetric science, and the eugenic possibilities of consumer reproductive technologies. But these realizations fade away in the face of my own desire for children, my fierce commitment to their safety, and my longing not to have to face my own death as I contemplate bringing one child into the world as I care for another. These facts are why it is not uncommon for scholars of reproduction to enflesh their experiences in their writing. It is not an accident that the contributors to this forum are women and nonbinary persons. The theories and theologies they offer us are essential as we attempt to create and use reproductive science in ways that are truly generous and liberating. But in the end, I confess that I feel the most kinship with the Roman mother, who prays to anyone and everyone who might help her come through childbirth so that she may continue to care for and love her family.