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ORIGINAL PAPER
Expectant Israeli Fathers and the MedicalizedPregnancy: Ambivalent Compliance and CriticalPragmatism
Tsipy Ivry
Æ
Elly Teman
Ó
Springer Science+Business Media, LLC 2008
Abstract
This article addresses the medicalization of pregnancy in Israel and itseffects on the experiences of Jewish-Israeli men who participated in various stagesof their female partners’ prenatal care. The highly medicalized arena of Israeliprenatal care, with its strong emphasis on prenatal diagnostic testing, provided thecontext in which the men’s accounts of their interactions with reproductive bio-medical authority, practitioners and knowledge were understood. It is suggested thatthe anthropological scholarship on reproduction assumes that men benefit from themedicalization of pregnancy and birth and comply with medicalization. Women, onthe other hand, are often depicted as being subjected to harmful medical surveil-lance and responding to it in degrees, ranging from compliance to resistance, andmediated by pragmatism. Data derived from participant observation in multiplearenas and from 16 in-depth interviews with Israeli men whose female partners werepregnant or had recently given birth suggest that although some Israeli men regardthe biomedicalization of pregnancy positively, most tend toward varying degrees of criticism. It is suggested that men’s responses to reproductive biomedicine are farmore complex than portrayed to date in the existing scholarship and that men’sresponses to biomedicalization reveal complex power negotiations.
Keywords
Medicalization
Á
Pregnancy
Á
Men
Á
Israel
Á
Biomedicine
T. Ivry (
&
)Department of Sociology and Anthropology, University of Haifa, Mount Carmel,Haifa 31905, Israele-mail: tsipy.ivry@gmail.comE. TemanScience, Technology and Society Center and Beatrice M. Bain Research Group,University of California, Berkeley, Berkeley, CA 94720, USA
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Cult Med PsychiatryDOI 10.1007/s11013-008-9099-x
 
Introduction
While many women who gave birth 30 years ago or more may describe pregnancyand childbirth as lonely experiences, both medical practitioners and pregnantwomen in Israel today would agree that Israeli expectant fathers, much like theirAmerican and European counterparts (Draper2002,2003; Sandelowski1994), are now participating in these processes as never before. When prenatal care is highlymedicalized, as it is in Israel, it means that ‘‘participation’’ entails men repeatedlyencountering the technology, practitioners, knowledge and authority of reproductivebiomedicine as they accompany their female partners to prenatal care checkups,sonograms, prenatal diagnostic testing (PND), and hospital birth.Men’s participation brings up important questions regarding men’s responses tobiomedical authority and their role within the negotiations of power that are part andparcel of the biomedicalization of reproduction. Men’s experiences and attitudestoward reproduction have become increasingly central to our understanding of thecomplexities of pregnancy and birth from a sociocultural perspective. In thefollowing, we examine how men navigate their participation in biomedicalizedpregnancies.Expectant Fathers in the Anthropological LiteratureIt is only recently that ethnographic research exploring the experiences of expectantfathers has begun to emerge in anthropological literature. Anthropologists of reproduction have primarily concentrated on women’s navigations of the nexusof gendered power structures that Ginsburg and Rapp (1995) term ‘‘the politics of reproduction.’’ After all, it is women and not men in whose bodies gestation andbirth literally occur, and it is often the female body that becomes the site in whichmedical interventions are practiced to resolve problems of ‘‘other’’ patients or quasi-patients, such as medical interventions due to male-factor fertility problems (Lorber1989) or fetal surgery (Casper1998). When men
are
addressed in this literature, it is usually in the context of theirinvolvement in pregnancy-related medical activities, typically obstetrical ultrasoundscans (Draper2002; Georges1997; Sandelowski1994). Men are also discussed in the context of their participation in the dramas of decision-making surrounding theoption to undergo amniocentesis (Browner and Preloran1999; Rapp1999), in birth education courses (Reed2005; Sargent and Stark 1989) and in the birth event itself  (Draper2003; Jordan1993,1997; Reed2005). Yet, most scholars tend to analyze the attitudes, positions and interactions of expectant fathers with biomedicine in adirection that is strikingly different from that in the women-centered literature.Specifically, many of the major works on women and reproduction examine theway in which medicalization, the process by which human experiences are redefinedas medical problems (Friese et al.2006; Zola1972), subjugates women to biomedical scrutiny in assorted reproductive contexts, from infertility to pregnancyand birth (Becker2000; Davis-Floyd2004; Franklin1997; Martin2001; Rothman 1993,2000; Thompson2002). Whereas medicalization is overwhelmingly
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conceptualized as being harmful to women in much of this literature, studies thatfocus on expectant fathers seem to group men and biomedicine on the same side of the patriarchal divide. Consequently, men are depicted as considerably lessthreatened by reproductive biomedical practices.Moreover, while paying close attention to the nexus of power within which theymaneuver, anthropologists of reproduction have accounted for women’s variedresponses to medicalization. The complex negotiations documented in these studiesare best conceptualized in the concept of ‘‘biomedicalization,’’ a reframing of theprior term to account for the interactive nature of the medicalization process and theintricate power relations between biomedicine and its consumers (Clarke et al.2003; Friese et al.2006). Women’s responses to biomedicalization are theorized in such accounts as ranging in degrees from acceptance to resistance (Davis-Floyd2004; Martin2001; Root and Browner2001). In lieu of the complexity and range of  these accounts of women’s encounters with biomedicine, studies that focus onexpectant fathers tend to see male partners as generally benefiting from themedicalization of pregnancy and birth.Men and Reproductive BiomedicineThe relative benefits that male partners can obtain from the medicalization of pregnancy are particularly emphasized in ethnographic accounts of expectantfathers’ participation in sonograms and hospital birth. Much like in the psycho-logical literature, in which men are often depicted referring to their peripheral rolein pregnancy and birth as a source of feelings of inadequacy, fear, jealousy anduselessness (Coltrane1996; Linton2000), the anthropological literature portrays men as suffering a ‘‘reproductive deficit’’ (Sandelowski1994, p. 234) in their lack of access to the direct embodied experience of the fetus. Representing a potentiallyhelpful compensation for this discrepancy, it is suggested that reproductivetechnologies, particularly the sonogram, can function as ‘‘proxies’’ of embodimentfor men (Draper2002, p. 779). Ultrasound, Draper claims, gives the expectant father‘‘the potential
. . .
to have the same visual access to the baby as his partner, thusequalizing their respective positions as knowers of the baby’’ (p. 782).Sandelowski’s account of American men during ultrasound scans goes a stepfarther in describing the ‘‘equality’’ achieved by epistemologically privilegingvisual access over embodied experience. She shows how the circumstances of fetalultrasonography ‘‘tend to preserve a certain patriarchal arrangement of power andauthority’’ (Sandelowski1994, p. 239). Ultrasound itself, she claims, serves toexclude women by making them more and more invisible while the ‘‘independentfetus floating in space’’ (Petchesky1987) takes center stage. Sandelowski (1994) suggests that this exclusion of the pregnant woman, who often lies in the supineposition without a direct view of the sonogram while her male partner is impartedinformation by the doctor, sometimes makes the woman herself feel ‘‘left out’’(p. 238). Keeping in mind the empowerment ultrasonography seems to afford men,Draper’s (2002, p. 790) suggestion that men use the scans as rituals to help them
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