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Despite establishing the gendered construction of infertility, most research on the subject has not examined how individuals with such reproductive difficulty negotiate their own sense of gender. I explore this gap through 58 interviews with women who are medically infertile and involuntarily childless. In studying how women achieve their gender, I reveal the importance of the body to such construction. For the participants, there is not just a motherhood mandate in the United States, but a fertility mandate—women are not just supposed to mother, they are supposed to procreate. Given this understanding, participants maintain their gender by denying their infertile status. They do so through reliance on essentialist notions, using their bodies as a means of constructing a gendered sense of self. Using the tenets of transgender theory, this study not only informs our understanding of infertility, but also our broader understanding of the relationship between gender, identity, and the body, exposing how individuals negotiate their gender through physical as well as institutional and social constraints.

Despite the fact that, statistically, women of low socioeconomic status (SES) experience greater difficulty conceiving children, infertility is generally understood to be a wealthy, white woman's issue. InMisconception, Ann V. Bell overturns such historically ingrained notions of infertility by examining the experiences of poor women and women of color. These women, so the stereotype would have it, are simply too fertile. The fertility of affluent and of poor women is perceived differently, and these perceptions have political and social consequences, as social policies have entrenched these ideas throughout U.S. history. Through fifty-eight in-depth interviews with women of both high and low SES, Bell begins to break down the stereotypes of infertility and show how such depictions consequently shape women's infertility experiences. Prior studies have relied solely on participants recruited from medical clinics-a sampling process that inherently skews the participant base toward wealthier white women with health insurance. In comparing class experiences,Misconceptiongoes beyond examining medical experiences of infertility to expose the often overlooked economic and classist underpinnings of reproduction, family, motherhood, and health in contemporary America.

There is a wealth of literature demonstrating the presence of bias throughout the American health care system. Despite acknowledging such presence, however, little is known about how bias functions within medical encounters, particularly how providers grapple with bias in their patient counseling and decision-making. We explore such processes through the case of contraceptive counseling, a highly raced, classed, and gendered context. In-depth interviews with 51 health care providers reveal that providers use four primary strategies to navigate and minimize bias in their care—using scientific rationale, employing “safe” biases, standardizing counseling, and implementing patient-centered care. Paradoxically, using these strategies can exacerbate rather than resolve bias. Understanding these bias management strategies reveals provider-held biases, how they manifest within appointments, and the potential consequences for patients’ health autonomy. Such knowledge informs interventions that promote contraceptive use among women in the United States, addresses bias in health care broadly, and thus ultimately helps combat health disparities.

Contraception is a vital component of women’s reproductive health, but not all women use it consistently and effectively. Many studies explore individual-level barriers to contraceptive use, yet interactional barriers are important to understand since contraception is primarily obtained through provider-patient interactions. Thus, through interviews with 86 women and 51 providers in the United States, we employ a framework of biomedicalization to study how such interactions, including the knowledge bases that inform them, shape women’s contraceptive decision-making. We find that when women’s embodied knowledge and providers’ biomedical knowledge differ, providers’ preferences supersede women’s. Providers, however, overlook this hierarchy, instead viewing their relationships with patients as empowering equal partnerships. This pattern precludes women from achieving their desired contraceptive method and highlights the process through which women’s concerns become barriers to contraceptive use. Moreover, these findings reflect how provider-patient hierarchies continue to thrive despite purported patient-centered care models.

Since its medicalization, resolutions around infertility have shifted. Adoption, once considered the natural solution to infertility, is now deemed secondary to medical treatments. Beyond noting this preferential order, little is known about the relationship between medicalized infertility and adoption. To explore this relationship, this study examines why adoption is seen as second best and how the medical institution contributes to that image. Through interviews with 88 infertile individuals in the U.S., the findings not only reveal the ideological foundations of adoption and medicine, but also the power of such foundations. Individuals draw on notions of biological privilege and pronatalism to inform their understandings of adoption and medicalized infertility—adoption remains a stigmatized process for failing to adhere to such prescriptions, yet medicine is revered for maintaining them. In exploring how individuals and the medical institution use these ideas to inform their decision-making and practice, the findings ultimately demonstrate the falsehood of those images.

The cultural construction of motherhood represents women of low socioeconomic status (SES) as excessively fertile, placing them outside of the infertility discourse. Previous research on infertility reinforces poor women's exclusion by focusing on the experiences of women receiving medical treatment, typically women of high SES. In this article, the author explores how 20 poor and working-class women negotiate their experiences of infertility. In-depth interviews expose the contextual experiences of infertility among women of low SES, specifically revealing the structural inequality apparent within those experiences. The women are not passive objects of dominant discourses; they are active subjects in resisting, redefining, and accepting the discourses according to their contexts. Women of low SES are outsiders—within to dominant understandings and resolutions to infertility. Their unique insights not only provide a more nuanced understanding of infertility but they also begin to deconstruct the stratified system of reproduction.

ObjectivesUnintended pregnancy is an individual and public health problem with significant social and economic consequences. The literature has established that parents, especially mothers, play an important role in shaping the contraceptive attitudes and behaviors of young women and could therefore affect the likelihood of their daughter experiencing an unintended pregnancy. However, research has yet to fully explore the nuances of how mothers influence their daughters with respect to contraception.MethodsWe conducted a mixed methods study to explore the impact of mothers on women’s contraceptive attitudes and behaviors. In-depth interviews were conducted with 86 women of reproductive age to identify potential patterns and explore the nature of mothers’ influences. We then analyzed medical and prescription claims for a cohort of 9813 pairs of women (mother–daughter proxies) enrolled in Medicaid, to determine if such patterns of contraceptive use held in a larger sample.ResultsIn-depth interviews reveal how and why mothers shape women’s contraceptive attitudes and behaviors, particularly highlighting the nuances of communication, knowledge, and relationships. The statistical claims data supported such findings on a broader scale. For instance, across several types of contraceptives, including oral, injectable, and long-acting reversible contraceptives (LARCs), young women were significantly more likely to use a particular method if an older woman in the household (mother proxy) also used that method (AOR (95% CI) 1.99 (1.67–2.37), 2.06 (1.58–2.68) and 2.83 (1.64–4.88) respectively).Conclusions for PracticeThis study fills a gap in the literature regarding the nuanced ways in which mothers influence women’s contraceptive behavior. In turn, it supports the importance of familial context—especially the influence of mothers—in contraception decision-making and suggests that interventions aimed at improving access to and uptake of effective methods of contraception consider this context in their design and implementation.

The social construction of gender is based on the idea of difference, and nowhere is this difference more pronounced or essentialized than in the area of reproduction. Research reinforces such divergence, as men are seldom included in studies of reproduction, and when they are included, studies often highlight their differences from women’s experiences. While such differences do exist, it is important to have a more nuanced understanding of reproduction, including examining why there is such difference, as well as recognizing similarities. Thus, in centering rather than marginalizing men’s voices in reproduction, this study reveals the commonalities across reproductive experiences. Through 43 in-depth interviews with men and women who have experienced infertility, the findings reveal that infertility has both physical and emotional implications for men as it does for women. Ironically, men’s reconciliation with those parallels further silences their experience and perpetuates difference. Exposing such effects extends understandings of infertility, reproduction, and gender.

Objectives. We examined risk behaviors of female drug users, comparing those who reported recently having had sex with women (recent WSW), those who reported previously having had sex with women (former WSW), and those who reported never having had sex with women (never WSW). Methods. We used data from the Risk Evaluation and Assessment of Community Health III Study. Adjusted odds for predictors of WSW status were determined via multinomial logistic regression analyses. Results. Of the participants, 75% were never WSW, 12% were former WSW, and 13% were recent WSW. In comparison with never WSW status, significant predictors of recent WSW status were living away from one’s parents as a child (adjusted odds ratio [OR]=3.05; 95% confidence interval [CI]=1.07, 8.67) and recently having been paid for sex by men (adjusted OR=4.02; 95% CI=1.67, 9.68). Also, recently having been paid for sex by men was a significant predictor of former WSW status as opposed to never WSW status (adjusted OR=3.97; 95% CI=1.65, 9.59). Conclusions. The recency with which they had sex with women is one of the facets influencing the risk profile of WSW. The diverse characteristics of the WSW population need to be incorporated into future studies and risk interventions targeting this group.