Misconception Fatigue: Towards an Embodied Rhetoric for Infertility Advocacy

Abstract

Equitable access to fertility care remains precarious and often dependent upon definitional rhetoric of infertility, which insurance policies and state legislators use to determine access to alternative family building options. This article builds upon prior rhetorical scholarship on infertility by applying an embodied rhetorics framework to capture the resilience infertile persons exhibit when faced with barriers to build their family. To do this, I share a series of texts self-identified infertile advocates produced as they reflected on their encounters with barriers to accessing care and building their families. As a disease that requires self-disclosure as a form of advocacy, I analyze the visual and written texts produced through an embodied rhetorics framework. These texts are forms of public advocacy in that they make visible the multiple embodied misconceptions infertile persons navigate when trying to build one’s family. I discuss these texts as illustrating “misconception fatigue” which is affective toll that accumulates when advocating for one’s reproductive right to have a family. I conclude by encouraging other rhetorical scholars committed to reproductive justice to adopt an embodied rhetorics framework to their scholarship and develop participatory research projects to support the advocacy needs of marginalized reproductive health communities.

Notes

1 I would like to express thanks to Megan Faver Hartline, Katie Manthey, and Phil Bratta who took time to read this article and provide generous feedback. A heartfelt thank you to RR reviewers Michelle Eble and the two other blind reviewers who took time to engage with the ideas of this piece and construct helpful reviews. Finally, additional gratitude must also be extended to the infertility advocates who decided to participate in this photovoice project and make visible vulnerable moments in their infertility journeys.

2 One IVF cycle is defined as ovarian stimulation, egg retrieval and embryo transfer. The cost of those procedures varies by the individual’s insurance coverage, provider, and medication needs. Hence, the range of costs. See Marissa Conrad’s article “How Much Does IVF Cost?” Forbes Health, 28 Sept. 2021.

3 RESOLVE: The National Infertility Association offers the most accurate reporting of state-by-state insurance coverage for fertility treatment. For instance, the organization offers up-to-date data on insurance coverage per state on their website under the page “Insurance Coverage by State.”

4 The ACA does not cover fertility related treatments as reported by health insurance reporter Louise Norris.

5 Alternative family building refers to other methods of conception and/or accessing options such as adoption or surrogacy to have a family. Alternative family building options may be needed for heterosexual couples experiencing infertility but also include queer couples and single parents by choice.

6 The Institute for Women’s Policy Research defines reproductive rights as “having the ability to decide whether and when to have children” (n.p.). This definition asserts that there is a fundamental right to have a family/child, if one so desires. This assertion is also supported in a reproductive justice framework which includes the right to a family as one of its three tenets.

7 The World Health Organization defines infertility as “a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular.” The American Society for Reproductive Medicine defines infertility as “the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.”

8 To be clear, I am not suggesting embodied identity and embodied rhetoric as interchangeable terms. Rather, my use of embodied identity is informed from how Knoblauch and Moeller define “embodiment”. For them, “embodiment is more than ‘simply’ the experience of being with a body but is instead the experience of orienting one’s body in space and among others…the result of objects and being acting with and upon each other” (8). Embodied identity, in the context of infertility, is the meaning-making of coming to learn/see oneself as infertile. Embodied rhetoric, however, examines the potential actions and production of knowledge that is exerted because one sees identifies as infertile.

9 Advocacy Day is an event coordinated by RESOLVE: The National Infertility Association where the infertility community talks to Members of Congress about increasing family building options and access to care (“Advocacy Day,” RESOLVE: The National Infertility Association, 2022).

10 All photovoice submissions analyzed for this article are included in the appendix.

11 I would like to note the distinctions between reproductive health, reproductive rights, and reproductive justice to be accountable to the individual histories of each term: reproductive health, reproductive rights, and reproductive justice. My use of the term ‘right to have a family’ is informed from Loretta Ross and Rickie Solinger’s definition of reproductive justice that asserts “reproductive justice goes beyond the pro-choice/pro-life debate and has three primary principles: (1) the right to have a child; (2) the right now to have a child; and (3) the right to parent the children we have [in safe communities and conditions]” (9). When I use the term the ‘right to have a family’ it is drawing upon these three tenets central to reproductive justice and acknowledges the history in advocating for the reproductive experiences of women of color and other multiply marginalized individuals.

12 It should be noted that other infertility stakeholders have more recently adopted a reproductive justice approach to discussions of infertility. For instance, the March 2023 publication of Fertility and Sterility focused explicitly on moving beyond recognizing the racial and ethnic disparities in women’s reproductive health and have pushed for more action-oriented approaches that seek to align with the reproductive justice movement.

13 By collective fatigue, I refer to the multiple experiences of fatigue represented the photovoice submissions. These include financial, emotional, and even physical fatigue. Collectively, they produce the experience of misconception fatigue.

14 The toll of various treatments, doctor appointments, and time devoted to attempting to become pregnant can physically impact an infertile person and contribute to fatigue.

15 A 2020 Forbes article written by Pragya Agarwal documents the retaliation some women in the workforce face when actively attempting to become a parent and how discrimination is heightened for women who need assisted reproductive technology to become pregnant.

Additional information

Notes on contributors

Maria Novotny

Maria Novotny is an Assistant Professor of English at the University of Wisconsin-Milwaukee. Her research considers how reproductive health patients advocate for health care through her collaborations with The ART of Infertility. Her co-edited collection Infertilities, A Curation portrays the myriad voices and perspectives of individuals who experience infertility and difficulty in family building using art and writing as mediums for personal expression. Other scholarship related to the intersections of infertility, rhetoric, and advocacy has been published in Community Literacy Journal, Peitho, and Technical Communication Quarterly.