Margaret Marsh often deals with bodies of knowledge while Wanda Ronner deals more with women’s bodies. One’s a historian; the other is an obstetrician-gynecologist.
Two Haddonfield, N.J., sisters whose careers appear unrelated–unless you’re writing a book on the history of infertility in America.
Then the Temple University history professor and the physician affiliated with Pennsylvania Hospital might be the perfect duo, combining intellect and expertise to tell the cultural, medical and scientific story of not having babies in this country.
Their new book, “The Empty Cradle,” traces the treatment of infertility from botanical remedies to in-vitro fertilization. They have written an academic tale of ego and experiment, science and stereotypes, and, of course, sex.
Not summer-beach reading, the book (Johns Hopkins University Press) is a hefty presentation of what we know about reproduction, how we came to know it and, perhaps most importantly, what we’ve thought about it as a nation.
“In the colonial period, people thought about children in a different way than we do now,” says Marsh.
“Having children was a community responsibility. If you could not have children of your own, you still had children — your relative’s children, orphaned children; households even exchanged children. In the 19th and 20th Centuries, the family is defined by the husband and wife having children.
“And children, for lack of a better phrase, became private property.”
Large families were the rule in colonial times. But, according to the authors, a couple’s childlessness in the early 1700s was “a source of personal sorrow” but “not a compelling societal concern” or a “pressing interest to most physicians.”
So, while the community cared about children in the 1700s, it did not care much about the inability to have babies. It would not be until the mid-1800s that childlessness became a societal and medical concern.
As it goes about its chronological dig through ovulatory disorders, sperm motility and blocked fallopian tubes, the book also punctures some historic medical reputations, comments on women’s roles and shatters a myth or two — including what experts have called the current “epidemic of infertility.”
“What we all keep reading in the ’90s is everyone is infertile,” says historian Marsh, 50, the older sister.
That simply is not true, the authors say. Married couples with infertility problems numbered 10 to 13 percent of all married couples 100 years ago, and the percentage is about the same in the 1990s.
In fact, Marsh and Ronner say that, if the short view is taken, the incidence of infertility has “decreased” in the United States in the last 30 years. That may be due to better and quicker treatment of sexually transmitted diseases like gonorrhea, suggests Ronner, 44, the physician.
Neither author/sister is sure why so many insist that infertility is more of a problem today.
“Changes in the culture,” they write, “rather than scientific advances or greater technological expertise, have been and still are the forces most likely to bring a rush of infertile patients to clinicians’ offices.”
It was not until the mid-1800s that women began seeking a doctor’s help for childlessness — roughly the same time that the society at large became interested in couples not having babies.
“Not reproducing became everyone’s business,” says Marsh, “because the birthrate started dropping among middle-class white women. It went from seven (children per woman) to five to about three by the end of the 1800s, and the social commentators were nervous about the middle class not having enough children and the poor having too many.”
And it was not until the 1930s that doctors could provide any significant assistance, because it wasn’t until then that the scientific world began to understand the female reproductive system. That assistance was accelerated in the 1960s with the first use of fertility drugs.
(In the 1930s, fertility specialists did understand that men “bore a share of the responsibility” for childlessness, but the specialists disagreed on exactly what to do about it. The first artificial insemination with donor sperm was successfully conducted in 1934; the woman had twins.)
Nothing notable happened on the fertility front in 1987, but it was then that Marsh and Ronner began talking about writing a book together on infertility.
At a history conference, Marsh was telling a colleague about how nice it would be to share a project with her sister, the gynecologist. Maybe a book. The colleague suggested a history of infertility. About the same time, Ronner learned about a grant for an obstetrical and gynecological history paper.
But that’s too simple, because “The Empty Cradle” was more than serendipity. Marsh had written two books, one on female anarchists and the other on women in the suburbs. She also was living through her own infertility problem — severe endometriosis.
