Reproduction: Antiquity to the present day, edited by Nick Hopwood, Rebecca Flemming and Lauren Kassell (New York: Cambridge University Press, 2018) pp. 730. $125.00.
Caroline Rusterholz, Wellcome Trust Research Fellow, Faculty of History, University of Cambridge
Reproduction Antiquity to the present day is a massive, interdisciplinary and highly ambitious publication featuring 44 chapters, 40 exhibits – each consisting of a short essay focused on an image and artefact – and about 70 authors from different fields including history, demography, sociology, history of art, philosophy and theology, among others. Edited by Professor of History of Science and Medicine Nick Hopwood, Senior Lecturer in Ancient History Rebecca Flemming and Professor of History of Science and Medicine Lauren Kassel, all based at Cambridge University, this impressive collaboration reassesses the history of reproduction from Graeco-Roman antiquity to the twenty-first century from a Western perspective. The volume results from the work of Cambridge’s Generation to Reproduction Group, an interdisciplinary project led by Cambridge historians of medicine and biology, funded by the Wellcome Trust, which started in 2004. This group of researchers have organised a wide range of seminars, reading groups and workshops, and one of these workshops provided the impetus for this ground-breaking volume. The collection is beautifully illustrated and highly accessible.
The coherence of the volume lies in its sustained focus on a set of key questions: when and where did ‘generation’ and ‘reproduction’ begin and end, what did people mean when they talked in these terms, and how and why were their beliefs and actions like or unlike those that went before and came after? (17) This volume traces the transition from generation to reproduction and focuses on the Mediterranean, Western Europe, North America and their empires. It dates this change in terminology to the mid-eighteenth century. Generation, a ‘looser framework for discussing procreation and descent’ (4), appeared in written productions when authors drew on different ancient discourses in philosophy, medicine and agriculture to try to make sense of the issue of ‘coming to be’. In so doing, they paid attention not only to human beings and their souls but also to plants, animals, stones and minerals. Reproduction progressively replaced generation in the mid-eighteenth century and signified, in contrast, how things were re-produced. This new meaning centred mainly on living organisms and the process of perpetuating species. This gave rise to a focus on population, its quality and quantity.
The volume is divided into five parts. As a historian of the modern period, my review will concentrate on parts IV and V. Part IV, ‘Modern Reproduction’, traces the meaning of reproduction in the industrialised world of the nineteenth century up until the Second World War, while Part V, ‘Reproduction Centre Stage’, shows how reproduction became paramount on the national and international levels after the war and how it was always contested. Since then, two somewhat contrasting phases of change have occurred: an acceleration of the medicalisation of reproduction, which gave rise to a challenge to this medicalisation by feminism and social movements from the 1960s onwards. In the context of fertility decline in Western countries from 1870, with the exception of France whose fertility decline was already in train by 1800, and fears about degeneration, nation-states became worried about the quality, namely the ‘fitness’ of the population, and quantity of their population and the prospect of depopulation in their colonial possessions. In this context, procreation became a battleground. In addition, population became an international and global problem over the twentieth century; fears around population growth fuelled the creation of international organisations and philanthropic foundations aimed at curbing this increase, where population experts such as demographers, geographers, birth control campaigners, economists and ecologists shared knowledge and devised international family planning campaigns (Alison Bashford). These family planning campaigns prescribed the new technologies of contraception and abortion that had developed from the second quarter of the twentieth century onwards (Jesse Olzynko-Gryn and Nick Hopwood); some of the campaigns relied on coerced contraception. However, as the century advanced, reproductive rights as human rights became the key motto of international organisations, which emphasised ‘reproductive health’ and choice under pressure from feminist activists.
In these two rich parts of the book, we learn that the breeding of animals inspired eugenic thinking and that artificial insemination saw fertility specialists join forces with animal physiologists (Sarah Wilmot). Reproduction and sex became separate due to campaigning movements that included neo-Malthusians, eugenicists and radical sex reformers (Lesley Hall). Despite strong opposition from the medical profession, governments and the Catholic Church, birth control campaigners advocated the use of contraception and thus made the concept of limiting births a possibility. In so doing, they paved the way for the provision of contraception that would become acceptable in the interwar years. While the dissemination of information on birth control, partly carried out by birth control campaigners, increased dramatically in the first half of the twentieth century, ignorance was still the dominant frame for understanding how individuals acquired knowledge about sex and reproduction and who produced information on these subjects, especially in Britain (Kate Fisher).
Simon Szreter and Christina Benninghaus touch upon the issue of infertility; Szreter does so via new estimates of the prevalence of venereal diseases as potential contributors to the fertility decline in Britain, while Benninghaus argues that infertility took a modern meaning in the years around 1900. She reveals that while the female body became the object of increasingly invasive intervention, national differences existed with regard to the male body. In Germany, sperm testing was first practised in the 1880s, whereas the practice was rare in Britain. Female sterility was perceived to be connected to gonorrhoea transmitted to an ‘innocent wife by a promiscuous husband’ (462). Over the years, new medical technologies such as artificial insemination, glandular extracts and later hormones and transuterine tubal insufflation became routine medical practice for treating ‘sterile’ couples. These developments and the new faith in scientific medicine boosted patients’ expectations and accounted for the increasing number of patients seeking fertility treatments. Sterile couples looked to medicine to overcome their condition before IVF, but IVF did represent a watershed moment in that it gave birth to a private flourishing new industry (Nick Hopwood).
In the colonies, reproduction also had a prominent place in the political agenda of imperial powers, and women became the sustained targets of state intervention (Philippa Levine). Low fertility was at once perceived as an asset for settlers who considered locals a nuisance to be eliminated or relocated, and as a problem in colonies that relied on local labour. Maternal mortality was deplored, and childbirth became increasingly medicalised in the colonies and in the metropole. In continental Europe, hospital births became common practice by the 1960s. However, as Salim Al-Gailani argues, the medicalisation of birth was not imposed on passive women patients by all-powerful male obstetricians. Demand for it shaped the provision of maternity care, even when the maternal mortality rate was higher in hospital than at home. With hospital births gaining prominence, antenatal care expanded, and prenatal diagnosis and screening for defects became routine practice in the last quarter of the twentieth century, generating new stress for mothers-to-be (Ilana Löwy).
This volume shows the necessity to consider the history of reproduction from an interdisciplinary perspective. It is a must-read for students and scholars interested in the issue of reproduction.