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Embodying Culture: Pregnancy in Japan and Israel (Studies in Medical Anthropology)
Embodying Culture: Pregnancy in Japan and Israel (Studies in Medical Anthropology)
Tsipy Ivry
Rutgers University Press, 2009
312 pp., $32.95

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Elrena Evans


The Meaning of (Gestating) Life

Pregnancy in Israel and Japan.

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Ivry's descriptions of Japanese mothers practicing taikyô with their unborn babies reminded me of reading the Bible to my daughter, moments after I discovered I was pregnant. I felt it was important to surround her with Scripture right from the very start. Who am I to say that one needs ears to hear the Word of God?

Although Japanese pregnancy culture embraces the growing child as a current—not future, or potential—person, and the abortion rate is lower than it is in the United States, abortion is not rare in Japan. "To this day abortions are available practically on demand in Japan," Ivry writes, though there are limitations on how far into a pregnancy abortion can be performed. Ivry stresses that "the assumption underlying prenatal care in Japanese medical institutions seems to be that a woman who goes to them for prenatal care wants her pregnancy. Otherwise she would have found a way to dispose of it earlier."

This assumption that a woman seeking prenatal care intends to keep her pregnancy does not hold true for the Israeli experience. Israeli pregnancies, Ivry argues, are understood through the lens of "geneticism," whereby the random assemblage of genetic material is the dominant factor in determining pregnancy outcome. The role of the Israeli mother is to try and determine the fetus's genetic makeup through a battery of prenatal diagnostic tests, and then to act according to the information she receives. Prenatal diagnosis is both widespread and aggressive, and in the event of an "abnormal" diagnosis, abortion is expected.

Ivry categorizes pregnancy for Israeli women as a "risky business." Unlike the mother-baby dyad of Japanese pregnancies, Israeli pregnancies are strictly woman (not mother) and fetus. "When a woman walks into my office and says 'I'm pregnant,'" Ivry quotes an Israeli ultrasound expert as saying, "I don't touch her. I don't say anything to her, I open a new card, and I write that I recommend an abortion. Then I sign her up on a paper that says that she is aware of all the testing that exists. Now we can begin to talk."

This attitude characterizes the experience of pregnancy for Israeli women, Ivry says. With more and more prenatal diagnostic tests available for consumption, Israeli ob/gyns encourage women to keep looking for "deformities" throughout the duration of the pregnancy. Because the fetus does not become a baby—a person—until the moment of birth in Israeli understanding, pregnancy is seen as a state of limbo, with potential babies being gestated by women who have the potential to become mothers.

Ivry describes an Israeli advertisement for the ultrasound company Alkoa, depicting a pregnant women with a see-through womb. The image is captioned: "Alkoa gives birth to perfection." I was frankly horrified by Ivry's accounts of this aggressive prenatal testing. She describes an event she attended where pregnant women and their partners were viewing a slideshow of ultrasound images: "For each and every 'normal' organ," Ivry writes, "[the lecturer] shows pictures of the same organ deformed (with no indication of how rare they are)"; clearly, "the overall impression of the lecture is that a myriad of deformities and abnormalities occur all the time."

When pregnant Israeli women contemplate amniocentesis, a diagnostic test that can identify chromosomal abnormalities but carries with it the risk of miscarriage, Israeli ob/gyns routinely frame the decision thus, Ivry tells us: women must weigh the grief of losing a healthy child against the grief of bearing a child with a disability. Nowhere is the grief over losing a disabled child so much as even mentioned; it is taken for granted that a disabled child is unwanted. As for the disabled community in Israel, Ivry notes that "Israelis with disabilities are often quoted in the media as supporting the diagnostic endeavor to prevent the birth of other people who would suffer the kind of life that they endure."

Ivry concludes that biomedical technologies are not only medicalizing the experience of pregnancy, they are pushing bioethical decisions into the hands of the women who undergo these "routine" tests, turning them and their partners into "moral pioneers." That's one way to put it.

Elrena Evans is the author of This Crowded Night, forthcoming this year from DreamSeeker Books.

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