Sooner or Later: Age, Pregnancy, and the Reproductive Revolution in Late Twentieth-Century America (2016)
This is a tale of two epidemics. The first, an epidemic of teenage pregnancy, caught the attention of American physicians, lawmakers, and the media in the early 1970s. Headlines across the country announced the crisis of rising teen pregnancy rates, while Congress debated what could be done to reverse the trend. Implicit in this panic was the suspicion that those who became pregnant as teenagers were also those whose reproduction was least desirable. Politicians argued that pregnant teenagers were the welfare queens of the future, doomed to a lifetime of economic dependency. During this same period, Americans began panicking about a potential epidemic of infertility in the United States. But the group most at risk for infertility fell at the opposite end of the reproductive and social spectrum: older women, aged thirty-five and over, who had delayed childbearing. Enter the metaphor of the "biological clock," first articulated in 1978 to capture a generation's fear of running out of time. New medical research documenting the decline of fertility with age further heightened anxiety that a "desirable" group of women – white, educated, and middle-class – were at risk of losing out on motherhood altogether. My dissertation brings together the history of these two "epidemics," arguing that they are examples of the same phenomenon – the pathologization of untimely pregnancy in late twentieth-century America. As the lives of women were transformed by the social, economic, and technological changes of the 1970s, normative beliefs about the timing of pregnancy underwent a radical realignment. I argue that the emergence of highly effective technologies to prevent pregnancy created an illusion of reproductive control and an expectation that all pregnancies be planned with precision. As a consequence, untimely pregnancies — whether it was a teenage girl becoming pregnant too soon, or a woman over thirty-five attempting pregnancy too late — became a new target of cultural and medical intervention. Chapter One explores medical and cultural ideas about the postponement of parenthood before 1970. I demonstrate that over the course of the twentieth century, concerns about the obstetric risks of delayed childbearing gave way to new conceptions of genetic risk as it related to maternal age. Ultimately, it was this combination of obstetric and genetic risk that made the older mother such an attractive target for medical intervention. Chapter Two demonstrates how age-related infertility came to displace obstetric and genetic risk as the primary hazard associated with older parenthood. For many women, the new expression "biological clock" perfectly encapsulated this fear of declining fertility. Initially used by feminist writers in the late 1970s, the metaphor soon became a symbol of gendered difference at the heart of a post-Reagan backlash against second-wave feminism. Chapter Three interprets the so-called epidemic of teenage pregnancy through the lens of the middle-class "reproductive script." I argue that in the 1970s and 1980s, educators, family planning experts, and government officials came to a consensus that the problem of teenage pregnancy was best understood as a failure to plan. The chapter will conclude with an examination of several "Life Planning Curriculums," an approach to teenage pregnancy prevention that aimed to reinforce middle-class ideals about career development and family formation. The final two chapters seek to understand the various ways in which reproductive technologies have been deployed to control reproductive time. Chapter Four examines how technologies like the at-home ovulation test and in vitro fertilization were marketed as solutions to the growing trend of delayed childbirth. As these technologies were adopted to address infertility later in life, they reinforced cultural anxieties about the connection between advancing age and fertility. Chapter Five suggests that family planning and medical professionals became fixated on contraception, particularly long-acting reversible contraceptives such as Norplant and Depo-Provera, as the best solution to teenage pregnancy. The dissertation closes with an epilogue reflecting on the transformation of delayed pregnancy from a social crisis into a cultural norm, which comes at the cost of the continued marginalization of early motherhood. I argue that our uncritical embrace of reproductive technologies has influenced normative assumptions about the "ideal" timing of fertility at both ends of the reproductive (and social) spectrum. With the emergence of new technologies such as egg freezing, it is imperative that we think critically about the ways in which technological optimism has obscured alternative policy solutions that address the complex social roots of untimely pregnancy.
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Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences
Science, Technology and Human Values
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NTM: Zeitschrift für Geschichte der Naturwissenschaften, Technik und Medizin
Historical Research: The Bulletin of the Institute of Historical Research
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