This item is accessible only to the Washington University community.
Off-Campus WUSTL Users: Click the “Off-Campus Download” button below. You will be prompted to log in using your WUSTL Key.
Research Mentor and Department
Dr. Carolyn Sargent
In recent years, India's assisted reproductive technology (ART) market has grown beyond the government's ability to regulate it and raised new issues of ethical practice. Hyderabad, the capital of Andhra Pradesh, has experienced a technology boom in the last decade and is now host to a burgeoning ART industry catering to elite infertile couples. The core questions motivating this ethnographic study were: How did the clinics in question originate? How do medical staff view the services they offer to clients? How do doctors negotiate uncertainty and perform ethical relationships with clients? In the summer of 2014, I spent three months observing consultations with patients, outpatient procedures, and laboratory work at three ART clinics in Hyderabad. Infertility, childlessness, and adoption are highly stigmatized in India for a variety of socioeconomic reasons, and pursuing treatment is emotionally and financially exhausting. Doctors construct their authority by citing statistical outcomes for treatments based on patients’ medical conditions. Statistics are intended to temper expectations and encourage caution, but in practice they act as evaluations of the inherent quality of patients’ bodies and present a misleading world of potential “opportunities” to desperate infertile couples. Doctors try to compensate the power imbalance in clinical interactions by emphasizing transparency and consent documentation. However, they face pressure to abandon this model of care when patients compel them to fulfill their moral obligation to give them a child by any means. Fertility clinics participate in advanced selection against female children and reiterate the Indian state’s exploitative relationship with poor and female bodies. At the same time, doctors carry the burden of healing the stigma and suffering of their patients and are powerful advocates for the infertile.