Reviewed by: Tamara Cashour (The New School, New York City)
This book succeeds as a phenomenological project guided securely by Heideggerian principles, in its philosophical assessment of assisted reproductive technologies (ARTs), which conspire literally, in the making of mothers. Belu draws almost exclusively and analogously upon Heidegger’s concepts outlayed in The Question Concerning Technology (most overarchingly: the principle of Gestell [Enframing]) to fashion a critique of ARTs protocols and practices, which, since their initial inception/acceptance in the last quarter of the 20th century, have achieved globalized integration into the process of bringing a new human into the world. Although in-vitro fertilization (IVF), the premier ART, was successfully employed to fertilize a human egg in 1944; not until 1977 was an in-corpus pregnancy achieved; it’s outcome was unsuccessful. A year later in 1978, the famous ‘test-tube’ baby Louise Joy Brown was conceived via IVF technologies and successfully birthed. Today, some forty years hence, several variations of ARTs are in common use not only by heterosexual couples experiencing negative fertility, but by same-sex couples, single-mothers or fathers seeking to start a family or add an additional family member, and others who claim a banner along the now-evolved gender identity spectrum. Belu relates how the original IVF procedure has morphed into ever-more sophisticated technologies and methods designed to assist in the coming to fruition of a live birth, such as cytoplasmic transfer, the use of donor eggs and/or gestational surrogates. She also makes clear how the latter two protocols function as particularly egregious political economies which implicate younger and older women alike in a market project of conception: younger women sell their viable eggs, and surrogates of proven child-bearing capacity ‘sell’ the services of their wombs, to those [often older] women or couples who desire a child but who are either infertile, cannot physically carry to term or who simply cannot, or do not, wish to participate in the pregnancy process. The ARTs industry has succeeded in “medical fragmentation” of a women’s reproductive system into components–eggs, womb, tubes, ovaries and cycles–which are ‘optimized’ via drugs and various surgical procedures and kept primed in the manner of Heidegger’s standing reserve for use in achieving the desired goal of conception of an embryo. The reproductive parts no longer need be attached to or within the singular corpus of an intact female body, in fact, more often they are not. Such mechanistic fracturing destroys women’s bodies as wholistic “autonomous agents” according to Belu (5, 23), and has ushered in what she terms the ‘Motherless Age’.
The ‘Motherless’ Age
Belu’s use of the term motherless seems at first blush metaphysical meaninglessness[i]–an ontological dystopia or ontically obtuse ‘teaser’.[ii] Mothers are in fact in existence in our epoch–we do not lack mothers, per se, yet the traditional mother-child biological dyad relationship, which begins at conception and ends with the death of either the mother or child (some would argue against that as well), has experienced a post-modern existential crisis (if late in the game), brought on by the extended, if not ubiquitous, use of ARTs on a worldwide scale.[iii] Belu’s position sets forth (and ostensibly argues against) the phenomenological logic of ARTs which has encouraged ‘the splitting of the atom’ in relation to the term mother, historically defined as a secure subject with distinct boundaries and a single physical corporeal existence. Motherhood is now conceptually plural across an array of subjectivities that all qualify to be defined by, or at least attached to, the term. It is now possible for a baby born via gestational surrogacy to potentially have four different mothers if cytoplasmic transfer is employed: two genetic mothers (one who has lent her eggs and the other who lends her cytoplasm) (Belu, 59, fn 80), the gestational mother who bears and births the fetus, and the ‘social’ mother who rears the child (Belu, 45). In market terms, the first two mothers are the sellers, the third the worker or laborer, and the fourth and final (who is responsible for the child’s care) is the buyer, or consumer. Conversely, IVF also allows the production of offspring with no living genetic mothers at all–as viable eggs are collected from the ovarian tissue of aborted fetuses, and coaxed into near maturity via hormone stimulants. Thus a child can now be borne from a ‘mother’ who was never an actual fully grown person, much less an adult (Belu, 70). It is the offspring i.e. the child, in this process, who must ultimately face the “motherless” aspects of his/her birth. As the situation presents itself, it may even be more appropriate to use the term motherfull; the latter suffix however, conveying a generally positive connotation of maternal agency which Belu clearly argues that ARTs subvert (Belu, 79, 105).
Belu establishes ontological erasure of the ‘mother’ in the original etymological sense, at virtually every turn, particularly in Chapter 4 wherein she engages and privileges Heidegger’s concept of enframing over Aristotle’s causal concepts of physis and techné, in the argument over whether IVF processes ‘assist’, or ‘replace’, natural conception. Belu does not so much detail the legal ramifications of determining “the spark of life” (Belu, 61)[iv], but urges phenomenological clarity and currency as it might reroute a prevailing cultural attitude of “complacency” toward human artificial reproduction. We shrug off the extent of IVF’s practical ramifications for humanity, because we persist in (along Aristotelian lines), and even dote on, the misunderstanding of the role of technological prowess as a handmaid to, and not creator of, human life. This is of course, the “forgetting of the clearing” (Lichtungvergessenheit) which Heidegger says chiefly enables the chokehold of Enframing. As we do not do what Heidegger urges: “experience its unthought essence first of all”, or else we broach it superficially, we cannot see “the extent that the essence of enframing does not appear as the danger, and the essence of the danger does not appear as Beyng [sic]”; which “accounts for our misunderstanding” [of] above all technology” (Belu, 12-13, 21, fn. 26).
Citing the wry ‘twist’ of analogizing Aristotle’s male-active/female-passive principle of nature to IVF procedures within our causa efficiens-hegemonic techno-modernity (Belu, 68), Belu seriously implicates the medical establishment in the authority of its arché position, which allows it to usurp the agency of a natural mother in order to supervise the engineering of life. Ultimately, in the motherless world, the mother-effect, a term first coined by Kelly Oliver,[v] obliterates both the participation of the ‘real’ mother and ‘mother nature’, such representatives of our lingering cultural dedication to biological ownership. Moreover, these absences are “covered over” in the persistent need to preserve normativity: the arché role of the fertility doctor and the techné role of the IVF procedure are minimized as the birthed child is attributed to nature’s grace, or termed something like a miracle “Child of God”. Belu states:
IVF participants (the women, doctors, and media) can be seen to reproduce the mother-effect, caught up in a play of affirming the significance of technology for conception and gestation, yet undermining this significance in the final product, calling it (mother) nature (Belu, 71).
A Feminist Phenomenology of ARTs
In her zeal to establish a feminist phenomenology for ARTS, Belu details various reproductive enframing processes, where human life is engineered from start to finish (challenged forth). It is still startling to read, in 2017, how, after a woman’s body is shot through with hormones [via extremely painful injections] to spur superovulation (wherein her ovaries will produce up to 10 eggs or more at once) that “the eggs are then sucked out of the woman’s ovaries” and
fertilization is engineered in the Petrie dish. These procedures reveal the woman’s reproductive body as passive, fungible material, a biological system that is broken up into its component parts of uterus, tubes, eggs, endometrium and hormone cycles that are worked upon by the technités (Belu, 66).
Belu notes as well the striking ambivalence toward women, such as surrogates and/or egg/cytoplasm donors, who have offered up their body and/or its reproductive components to the commercial market toward the end goal of a live birth.[vi] Often, a woman’s psyche is outrightly neglected as it undergoes this process. The woman is treated as a “purely functional” resource (Belu, 32). Feenberg terms this autonomization, “the interruption of the reflexivity of technical action, its impact on the user, so that the subject can affect the object of technical production seemingly without being affected in return.” (Belu, 32). Heidegger’s concept of fungibility rears its significance in an extremely ugly duality in this situation: the laboring subject is also the object of technical imposition, yet any mental or physical distress she may encounter in her dual role is downplayed or remains unaddressed by the life-engineers (Belu, 32).
Belu is also keen to cite the lack of medical follow-up studies over the years on certain groups of women who have participated in any part of the IVF process (Belu, 58, fn 66). She particularly notes the plights of young women egg donors (27) which have not been studied in depth. Moreover, there is a lack of research on the children who have been borne from these procedures, in terms of issues surrounding their mental and physical health (58, fn 66).
Ultimately, Belu sufficiently establishes patriarchal bias of IVF procedures, particularly when healthy women undergo IVF in the service of men whose sperm are unhealthy or otherwise deficient (Belu, 35), or when cross-fertilization (the use of sperm from many different men in a ‘lottery’ setup in order to determine which will fertilize a woman’s egg) is employed (Belu, 34). However, she misses an opportunity to make certain inroads as to how ARTs may functionally chip away at patriarchy; she instead places their use and control firmly in the hands of patriarchy as powerful instrumentum.
Belu’s introductory chapter states her intent to devise a feminist phenomenology of ARTs and summarizes content of succeeding chapters. Chapters 2-6 each open with a brief abstract which functions as a sort of a mini-“Heidegger 101” for the uninitiated. Belu weaves each chapter’s argument in strong relation to stated Heideggerian terms or tenets, which she evidences have proven themselves as prescient ontological reasoning vis-a-vis ARTs proliferation. The book’s through-line leads from Belu’s attempt to solidify a binarist interpretation of Heidegger’s concept of Enframing as partial or total–which reinterpretation holds serious implications for female agents as they experience reproductive enframing via the IVF process; to an engagement of Heideggerian thought with Aristotelian concepts of physis and technê in determining the authority of IVF procedures to ignite “the spark of life” (Belu, 61); continuing through technophilic and technophobic representations of modern-age childbirth; and culminating in Belu’s ‘solution’ (to what she perceives are complications and difficulties caused by technical childbirth) via poiésis. Belu’s compelling argument and concluding proposal in themselves embody Heidegger’s concept of safeguarding,[vii] the idea that Being (life) is granted as a gift, which we must foster and husband via Heidegger’s suggestions of meditation, waiting, and careful use of artisanal methods, rather than mindless challenging forth via quantization, endless ordering and stockpiling. ARTs processes, Belu is saying, are often hell-bent on a singular result (conception of Life) while heedlessly disregarding of the suffering of those (mothers) who are used or even abused, to obtain such result.
Belu’s Heideggerian Debt
Acknowledging Heidegger’s The Question Concerning Technology as a key resource,[viii] Belu is quick to note that Heidegger “writes virtually nothing about reproductive technology” although from his chronological position in history he does foresee processes of “artificial breeding of human material” (witness his 1954 essay Overcoming Metaphysics). Whether Heidegger’s comment of foresight launched this book (given current ART practices), Belu does not make clear, but the extended analogy of enframing to reproductive enframing holds sway. Throughout, Belu engages phenomenologically with select other philosophers, both of antiquity (Aristotle, and to a lesser extent, Plato) and modernity (Arendt, Feenburg, Oliver, Marcuse, Ruddick, others).
Couching “Motherless Age” as a Useful/Critical Resource
Heidegger, Reproductive Technology and the Motherless Age is first and foremost a phenomenological critique of social (medical) practices which have in the 21st-century become institutionalized. That is to say, ARTS are now viewed as mainstream medical procedures marketed to women of all strata as viable options for live birth, rather than “luxury” alternatives to natural sex in the service of conceiving a live human. It is still the case however, that women who enjoy economic freedom and possess excellent health insurance to pay for the still-astronomical cost of these procedures, are most often slated to benefit from the ARTS industry.[ix]
As such, this book will most likely not find a table or shelf position in the reading rooms or professional libraries of ARTS medical professionals. Such industry professionals are essentially selling a service [technological assistance] to produce a product [a live birth], in Belu’s overwhelming view. Yet some women (including the range of ARTS participant mothers) do not have a problem with this type of economic exchange, and in fact happily undergo these procedures in committed fashion, hoping for a successful outcome. A major drawback of this book is that Belu virtually ignores the scores of women and men whose lives changed toward the better via the use of ARTS technologies by granting them children–however and by whomever these children were conceived, gestated and borne. Belu sets up an overarching negative polemic of Technology (ARTS Doctor) vs. Subject (Patient) at the beginning of her argument; such polemic holds sway until the end of the book. Additionally, Belu concerns herself neither with individual case studies reflecting either positive or negative outcomes, nor with applications of ARTS to male-gendered subjects. Finally, Belu’s text is also woefully deplete of statistical input; while it does remain primarily a work of critical theory, a chart or two inserted to support her claims–particularly those regarding ARTS damages to the psyches and physical bodies of women–would not hurt. (In her defense, Belu does state that the industry itself has largely failed to undertake either national or international studies that would statistically emphasize the negative aspects of ARTS (Belu 58, fn 66)). Ultimately, Belu’s phenomenological argument holds many truths, which are corroborated by a number of current texts on this issue which are more sociological and/or statistical in nature, in particular: Reassembling Motherhood: Procreation and Care in a Globalized World, also published in 2017.
Conclusion: Interdisciplinary Dialogue/Action is Needed
In conclusion, this text reflects the state of dialogue, conversation and problem-solving among the disciplines in place to move civil society forward: that is to say, these types of interdisciplinary activities are still in their infancy. Inter- and trans-disciplinary dialogue between and among medical ARTS professionals, academic philosophers, sociologists and social workers, ethics consultants and economists to improve the conditions and levity for all those across the board who seek to conceive/bear a child could only work for the good of these persons, and ultimately, for the human race. Unwittingly, Belu’s critical stance points the way forward toward such a dialogue even as her text concludes in what technophiliacs might consider highly Ludditian fashion: with an accent on waterbirth as an alternative to technologically-ruled live births. (A water birth assumes there is something to be born, whether technology has assisted in conception/gestation or not).
As we move into an ever-increasing technologically-mediated age for nearly every human activity or thought, a return to Heidegger’s prescient phenomenological warning to humanity is seemingly warranted. This, Belu accomplishes, with deft reverence to Heideggerian principles.
Dr. Belu ethically provides a short epilogue to her main text, explaining her position on Heidegger’s Black Notebooks (as revealing of his anti-Semitism.) Belu points out, but does not de-crypt, Heidegger’s “equivocation” (Belu, 122) regarding the ontic or ontological origins of machination. Confirming Heidegger’s conflation of machination and “World Jewry” (via causality) as “racist and condemnable” (Belu 122), Belu nevertheless finds that Heidegger’s expression/espousement of a political stance that is overwhelmingly viewed as reprehensible does not specifically deconstruct the actual application of the phenomenological principle of enframing to a study of ARTS as implicated in women’s reproductive processes (Italics mine).
[i] See Michael Wheeler, “Martin Heidegger”, The Stanford Encyclopedia of Philosophy (Fall 2017 Edition), Edward N. Zalta (ed.), https://plato.stanford.edu/entries/metaphysics/. Section 5. “Is Metaphysics Possible?”
[ii] Belu explains her quasi-titular use of the term motherless thusly: “I do mean…that in the age of reproductive enframing the figure of the mother is being replaced by various technologies and maternal figures who perform maternal work. In this new context, almost anyone can be seen to be a mother–so that no one is the mother” , 51.
[iii] Linda G. Kahn and Wendy Chavkin, “Assisted Reproductive Technologies and the Biological Bottom Line” in Reassembling Motherhood: Procreation and Care in a Globalized World, (New York: Columbia University Press, 2017), Kindle version,39. The authors note the sociobiological implications of the proliferation of ARTs use from 1978-2012, during which period “five million babies had been born worldwide using IVF”. See also Belu, 25.
[iv] Belu offers an explorative footnote in this regard. See fn 14, 75.
[v] Kelly Oliver, Technologies of Life and Death: From Cloning to Capital Punishment (New York: Fordham University Press, 2013). Oliver defines mother-effect as “the result of the absence of a real mother who is therefore mythologized and romanticized as the origin and plentitude of Nature, but whose disappearance is a prerequisite for the myth itself”, 57.
[vi] The one exception to this ambivalent treatment of the female ‘resource’ is the surrogacy market in India, whose surrogacy clinics take great pains to ensure that their ‘worker’ mothers (gestational surrogates for wealthy individuals and couples) are “as comfortable as possible, healthy, well feed, well rested, entertained, and well paid” See Belu, 50; Bailey, 19.
[vii] See Martin Heidegger, Building, Dwelling, Thinking p. 352 in The Question Concerning Technology and Other Essays, trans. William Lovitt (New York: Harper & Row, 1977) (http://designtheory.fiu.edu/readings/heidegger_bdt.pdf) and Michael Wheeler, “Martin Heidegger”, Stanford Encyclopedia of Philosophy, Section 3.4, https://plato.stanford.edu/entries/heidegger/.
[viii] Belu also references, to a lesser extent, material from Heidegger’s earlier essays The Danger, The Turning and Building, Dwelling, Thinking, (as well as Being and Time) the first two of which he drew upon significantly in writing The Question Concerning Technology.
[ix] Reassessing Motherhood notes the lack of agency for women situated in disadvantaged economic strata in terms of their ability to choose ARTS procedures for their own wombs, rather than lending their own wombs to those women who can easily afford to “purchase” their services. A double standard based on economic capability is firmly in place in which poor women are implicated as “tools” for economically secure women. This produces a “double whammy” for women from underdeveloped countries, who find themselves in the position of “seller”, although this phenomenon is not necessarily a Western/underdeveloped nation problem. See pp. 185, 224 and 295..