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Bell, A. V. “‘It’s Way Out Of My League’: Low-Income Women’s Experiences of Medicalized Infertility.” Gender & Society 23, no. 5 (January 2009): 688–709.


This article reviews dominant ideologies of motherhood, analyzes relevant policies and provides data from 20 in-depth interviews with women of low socioeconomic status (SES) to explore infertility experiences among economically disadvantaged women. The author argues that low SES women have been left out of discussions of infertility in the U.S., due to social constructions of poor women and women of color as “highly (and uncontrollably) fertile,” and white, middle- to upper-class women suffering from infertility and in need of specialized treatment. This discourse is reflected in historical and contemporary policies and practices that relate to fertility.  For example, Medicaid covers contraceptive methods but not infertility treatments, while private insurance often covers infertility treatments but not certain contraceptive methods. This does not reflect the reality of infertility, the author argues, since just as many low SES women experience infertility as do higher SES women. However, because of the stereotype that infertility occurs among the dominant groups, many low SES women experience infertility outside of the normative discourse and are unable to attain medical treatment to resolve the issue. Furthermore, such policies and practices reinforce the notion that women who adhere to social norms are “fit” to be mothers, whereas those who do not are “unfit.” Thus, the dominant ideologies of motherhood and fertility become normalized and naturalized by policies that reify them. The author argues that, to truly understand infertility, we must move beyond medicalized understandings and examine the lived experiences of women facing infertility in their own contexts.


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Legislation/policy   Government regulation   Race/ethnicity: African American/Black   Assisted reproductive technology   Intersectionality   Health care   Pregnancy