The Pursuit of Parenthood: Reproductive Technology from Test-Tube Babies to Uterus Transplants, by Margaret Marsh and Wanda Ronner

As its title might suggest, Margaret Marsh and Wanda Ronner’s book traces the history of artificial reproductive technologies in the US from the 1940s to the present. The sisters mobilise their respective historical and clinical expertise to create a compelling narrative that manages to include thorough explanations of the science of artificial reproductive technologies and enlightening details about the personalities and experiences of the key figures responsible for developing them.

Historical content often comes at the expense of demonstrating what is at stake from a scientific perspective. One of this book’s merits is the way that the authors manage to present both aspects without losing any depth. In a clear and engaging style, they elucidate how the technologies they describe operate, and place them in the social, political and ethical landscape in which they were developed. Their analysis of changing attitudes towards infertility – from the immediate aftermath of the Depression to the end of the Second World War, the burgeoning wave of feminist responses to family-making in the 1970s and on to the career- and consumer-driven 1980s – is especially thought-provoking. A particular strength of the book is in conveying the trajectory of the US’ arrival at an unregulated private fertility industry. Adopting a wide perspective, the authors paint a powerful picture of how the industry began to boom in a relatively short period of time, and how patients are potentially exposed to risk as the push for ever more innovative products continues.

Marsh and Ronner also draw attention to aspects of American social and political approaches to family-making that have long remained unchanged, particularly the way that the work of parenting continues to fall heavily on women. The authors highlight that while fertility treatments have frequently been framed as a means of enabling women to delay parenthood in order to further their careers, “significant social, cultural, and political changes” (as opposed to just more technological interventions) are desperately needed. To truly enable gender equality, they argue, we need “equal parenting by husbands and partners; flexible work arrangements…and universal, affordable, and excellent childcare”. On this point, they make good use of their interviews with patients and researchers to highlight what might otherwise get lost, namely the human stories at the heart of this history.

Yet certain details do get lost in this wide-ranging account. We hear much about the leading researchers, and there are compelling mentions of the lab assistants (often women) who supported their work. The authors acknowledge the importance of these figures, who frequently go unreferenced in other texts, but I still found myself wanting to know more. So, too, with the discussion of how it was assumed, during the early development of in vitro fertilisation, that access would be universal. While the book traces how considerations of justice and accessibility were in fact subsumed by a consumer-driven mandate, more could have been said about access and inequality. But these are topics that might fill another volume. Marsh and Ronner provide an intriguing account of the arrival and expansion of the fertility industry and a call to create a robust regulatory framework to respond to the technological progress to come.

Claire Horn is a Wellcome researcher on artificial wombs, abortion and reproductive care in the School of Law at Birkbeck, University of London.

The Pursuit of Parenthood: Reproductive Technology from Test-Tube Babies to Uterus Transplants
By Margaret Marsh and Wanda Ronner
Johns Hopkins University Press, 288pp, £22.00
ISBN 9781421429847
Published 1 October 2019