Unfathomable Life: Pregnancy in a hyper-medicalized age

Unfathomable LifePregnancy in a hyper-medicalized age Anna Hartford (bio) You shouldn't think too much about it." I was in the office of my gynecologist, who had always struck me as an under-thinker. But now I agreed with him. I had overanalyzed the question of whether to have a child, and the process had not led to any resolve, only to a knot of fear and uncertainty. Yet when I stepped back everything was quite simple: I loved someone, I wanted his child, I wanted our family. At the time I was thirty-two. I assumed that once I stopped contraception I would conceive, almost by accident. I would follow my gynecologist's advice and scarcely think about it, and soon I would become a mother. I imagined myself as a pregnant woman, and then as a parent, who recognized how little any of it was in my [End Page 33] control; who did not fall for god-complex delusions about how every flap of my wing would reverberate through the life of my child, indefinitely. As it turned out, a very different future lay ahead of me, and with it, a very different self. To "fall" pregnant, as the British expression goes: how lovely and passive; merely yielding, surrendering, to a pervasive force. But for some reason, I would not fall. Stepping into my fertility doctor's room for the first time, some two years later, felt not unlike stepping onto a treadmill that forever picked up speed and would never let me off. The doctor paged enthusiastically through booklets explaining tier upon tier of treatment options: ovulation inductions and inseminations and regimens of hormonal injections; tubal and uterine surgeries; in vitro fertilizations, in which sperm and egg cells are joined in a laboratory; genetic tests and analyses; donor eggs and donor sperm and surrogacy. I had entered a place of branching choices and alternatives, of fierce debate and moral judgment and conflicting information, of endless recalculations of risks and benefits. My cherished notions of surrender and acceptance—with their convenient implications of innocence—soon gave way to a state of constant alertness, deliberation, anxiety, and research. ________ risk has a complicated relationship to knowledge. In one respect, risk concerns precisely what we do not know: its fundamental nature is uncertainty. But risk also implies insight: a recognition of what might transpire, even a glimpse of how likely it is. In an important sense, a guaranteed outcome is not "risked," nor is an outcome that is utterly unforeseen. All pregnant people make choices that impact the prenatal environment—anxiously navigating an ever-expanding array of partly understood dangers that arise from plastics to phthalates to pesticides. Experts now advise a "precautionary principle," which favors avoidance under most circumstances. New realms of epigenetics have opened up new realms of threat. Every move you [End Page 34] make potentially increases the risks of your child's future cancer or infertility or IQ loss or ADHD; every move is potentially defining the life that is possible for them. This anxiety can take on additional dimensions for those in fertility treatments. Not only because there is all the more information, but also because there is all the more choice. To inform your decisions, you are obliged to consult "the information." Blogs and websites, sure, but for the more ambitious lunatics among us, studies upon studies comparing the outcome of different treatment approaches: the number of embryos, the ongoing pregnancies, the miscarriages, the live birth rates, the proportion of major birth defects, the early childhood development. Reddit threads unspool around articles on PubMed, comparing outcomes for different strategies. Occasionally someone in the comments wearily begins their post with "I'm a statistician," and explains that the rest of us have been profoundly misinterpreting a study's conclusions. We are not dissuaded, though. We spend thousands of hours frantically finding more of the wrong studies to misinterpret, and reading everyone else's misinterpretations of them. You are afraid of so many things at once—of nothing working at all, of miscarriage, of harm to the embryos, of pregnancy complications, of the menacing unknowns hanging around new, invasive technologies—and each option...