Book Review: Egg Freezing, Fertility and Reproductive Choice by Baldwin

Egg Freezing, Fertility and Reproductive Choice: Negotiating Responsibility, Hope and Modern Motherhood (2019) by Kylie Baldwin, published by Emerald Insight.

Kylie Baldwin is Senior Lecturer in Medical Sociology at De Montfort University where she is part of the Centre for Reproduction Research. Her research explores the emergence and use of novel technologies concerned with fertility extension, fertility monitoring and genetic conservation. She has a particular interest in reproductive ageing and older motherhood. She tweets @drkyliebaldwin

Review by Heather Griffiths, 22nd October 2020.

The social construction of a responsible mother – in the UK context at least – is one who is also a responsible citizen. She has a good job (that can be done part-time), a home (that they own) and a husband (as responsible parenting is heteronormative). Put another way, responsible mothering is framed in a gendered, classed and heteronormative way favouring a particular type of middle-class woman. Unless, that is, the middle-class woman leaves it ‘too late’.

It is this constructed and inaccurate stereotype that Kylie Baldwin critiques in her study on ‘social egg freezing’; a term Baldwin adopts to portray the ‘socially constituted nature’ of the technology and women’s reproductive ‘choices’. She positions this in opposition to normative descriptions such as ‘elective’ egg freezing to highlight and critique the ‘neoliberal discourse of individual choice’ (p.12) that surrounds women’s reproductive choices more broadly. The book aims to better understand how women who freeze their eggs ‘determine and negotiate their mothering desires’ (p.21) and, more significantly, how this is ‘mediated and constrained not only by wider socio-political and market contexts but also their intimate encounters with (non)reproductive partners’ (p.21). As Baldwin argues, the narrative around women ‘delaying’ or ‘putting off’ motherhood is not only ‘inaccurate’ but ‘hurtful and deeply neglectful’ of the socially constructed ‘constellation of factors which exist beyond the control of women as individuals’.

There has been a significant increase in the number of egg freezing cycles performed in the UK and across Europe in recent years. On the first page, the book cites data from the UK Fertility Regulator, the Human Fertilisation and Embryology Authority (HFEA) who report a 460% increase in the number of egg cycles between 2010 and 2016. Yet despite this surge in popularity, there is very little evidence of how successful this procedure is as so few women return to use their eggs in fertility treatment. To try and understand what motivates women to freeze their eggs, Baldwin interviewed 31 women who she described as ‘pioneering users’ – those who already had or were considering freezing their eggs.  She asked them how they arrived at their decision, how they perceived the risks and benefits of the procedure, and how they experienced the medical side of the process.

The book provides a chronological story of these women’s experiences, beginning with a discussion around their motivations for choosing egg freezing, charting the often long and emotional decision-making process. This is followed by their experience of the physical and psychological impacts of the procedure itself, documenting the often messy and uncomfortable medical procedures women endure as they embark on what is essentially the first half of an IVF cycle. The findings section concludes with a shorter reflection as participants explain how social egg freezing impacted their lives and future relationships.

The emphasis throughout the book is that, rather than being irresponsible by delaying motherhood, these women are experiencing a ‘social infertility’ as they struggle to build the life they envisaged for themselves and their future children. Paradoxically, Baldwin finds that these women engage in social egg freezing precisely in order to adhere to normative constructions of responsible motherhood, as it gives them more time to create the stability and security they feel they need in order to start a family.

A significant part of this struggle involved finding a suitable and willing partner to start a family with. Several interviewees described how they had ‘wasted’ their fertile years with unsuitable partners and one of the most salient topics for me was the idea that for many of these women, life had not gone as predicted – the were living a ‘life unexpected’. None of the participants identified with the career woman stereotype, rather they felt ‘sadness’ and ‘shame’ about being single and childless. They knew they were ‘running out of time’ but felt that the men in their lives did not feel the same way. Baldwin introduces the perfectly apt term of ‘panic partnering’ to describe these women’s reluctance to settle for someone who was not right for them, simply in order to start a family. She also sensitively accepts the biological limitations of women’s (and men’s) fertility but ensures the focus remains firmly on the ‘disparity between men and women’s attitudes toward commitment and parenthood’.  As this extract exclaims:

‘These women’s use of egg freezing, and delay in pursuing motherhood, was not the outcome of a uni-directional choice made by women as individuals but was significantly shaped by the relationships women had, or wanted to have, with men as well as men’s attitudes toward commitment, fatherhood and the timing of parenthood.’ (p. 141)

As a gender scholar, I was pleasantly surprised to discover that the gendered inequality of reproduction was a central tenant of Baldwin’s thesis but I would have liked to see a little more engagement with the feminist theories that explain this. I am reluctant to describe this as a weakness, however, as medical sociological research informed by feminist theory is a sub-genre within the wider field.

Nevertheless, this research makes visible a group of women often overlooked in medical sociology and social science research more widely. It is hard to describe the participants as a marginalised group, by Baldwin’s own admission, these are the stories of socially privileged women who are seeking ‘hegemonic ideals of heterosexual marriage’. As such, Baldwin points out that social egg freezing is a ‘highly exclusionary’ practice and thus only an option for middle-class women. As a result, the sample lacks diversity which Baldwin addresses by situating the practice in a neoliberal logic which ‘individualises wider social problems’. Irrespective of their social privilege, the powerful and evocative stories of these women offer a valuable insight into the complexities of this very personal yet also public issue.

As the full title suggests, this is more than just a book about women freezing their eggs. Rather it uses the experience of social egg freezing to highlight wider social constructions of gender roles, where reproduction is still largely considered a woman’s individual responsibility; in this case a responsibility that is shaped and reasserted by advanced reproductive technologies. As Baldwin argues, these (intersectional) gender inequalities around reproduction are perpetuated not only by socio-economic conditions but, more widely, by a neoliberal logic that ‘rewards individual agency and action’, encouraging women to take back control and do something about this very ‘personal’ issue. As Baldwin concludes, ‘No woman “wants” to freeze her eggs or “chooses” this option lightly without first considering or exhausting other possibilities’ (p. 139). It is an expensive, emotionally draining and physically demanding process that these women often endure alone. The message throughout this book is that reproduction should not be considered an individualised process and certainly not just a woman’s responsibility. I endorse the final call of this book – that perhaps it is now time to direct more research toward understanding men’s reproductive ‘intentions, practices and behaviours’ as social infertility is more than just a ‘women’s issue’.

Dr Heather Griffiths is a Postdoctoral Research Assistant at the Centre for Diversity Policy Research and Practice at Oxford Brookes University. Heather’s research interest are broadly around gender and work, work-life balance and feminist organisational theory. She is currently working on an EPSRC funded project looking at the underrepresentation of women in university spinout companies and developing publications from her PhD thesis on gender norms and flexible working. Heather tweets via @flexiblephd.

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