The Reproduction of Stratified (Assisted) Reproduction

This chapter considers epidemiological, historical, and ideological forces that constructed infertility as a “white” ailment and in vitro fertilization (IVF) as a treatment for the infertility of white professional women in their late 30s, 40s, and beyond. The author begins with a case from her own practice and then returns to IVF’s origins in the United States in the 1980s to show how in its practice and its technical details it reproduces race and class inequalities. Ultimately, the author argues that IVF grew out of an ideology of stratified reproduction, in which the fertility, reproduction, and motherhood of white, professional women was valued and that of poor women and women of color was not. While usual bioethical analyses of infertility treatment focus on the questions raised in sensational cases, here the author considers the race and class coding of infertility as a moral issue because, as she concludes, it is a question of whose lives matter.