Obstacles to the Establishment of a Policy to Combat Infertility in France, c. 1920-1950

Fabrice Cahen

Introduction

Infertility has lacked social visibility in modern France. This is evident in the lack of detailed historical research on the topic, which in turn doubtless reflects the scarcity of institutional or personal sources for the history of infertility. While historians have explored several different aspects of the history of procreation, from demography and population policies to gender and religion, the history of infertility often still has to be pieced together from scattered information in texts ostensibly on different topics.[1] Most existing publications tend to focus either on the first known experiments with artificial fertilization in the eighteenth century, or on the emergence of sperm banks in the second half of the twentieth century. There is also much sociological research on the development of assisted reproductive technologies in recent decades, especially their ethical aspects. This research has provided invaluable information about the genesis of these new procreative techniques and the moral debates they generated, especially the Artificial Insemination by Donor (AID) system institutionalized in France in 1973.[2] However, little is known about medical approaches to infertility before the 1970s, even though this context is vital to understanding contemporary practice.

This chapter attempts to remedy some of these gaps in our understanding by outlining the political, social, and medical contexts of attempts to combat infertility in France between 1920 and 1950. The first part of the chapter sets out the initial identification of involuntary childlessness as a ‘problem’ in the late nineteenth century, and then traces the collective mobilization of established hospital physicians and their attempts to manage and treat infertility. It then describes and analyses the creation of new infrastructures and the improvement in diagnostic capacities during the interwar years. It argues that the history of medical approaches to infertility in this period must be seen as part of the broader effort to encourage French people to turn to hospitals for help with reproductive dysfunction. Finally, it charts efforts to build a large-scale and general public system of medical treatments for infertility. Around the 1940s, the state seemed to begin to recognize and encourage endeavours to combat infertility, but, at best, these attempts achieved only partial success. The chapter ends by considering some of the historical causes and social consequences of the concentration of medical treatments for infertility in private hands throughout most of the twentieth century.

As this overview suggests, my focus in this chapter is on the material and institutional structures set up to treat reproductive disorders, rather than specific medical practices or the individual experience or social significance of involuntary childlessness. I am particularly concerned to analyse the development of medical approaches to involuntary childlessness in the context of an emerging centralized welfare state which attached particular importance to both the health of the population and to family order, and which sought to promote preventative medicine as a means of addressing reproductive issues. Here, two processes converged: the medicalization of society and state involvement in the field of ‘human life’, the concept of ‘state’ here being extended to subsidiary political bodies such as urban authorities. Therefore, rather than focusing on the ‘bioethical’ debate (which may be partly anachronistic), this chapter explores the ‘biopolitical’ issues surrounding the early days of medically assisted procreation, drawing on Foucault’s notion of biopolitics as an apparatus of control extended over whole populations. Provided it is deployed in relation to specific social and political historical contexts, this global framework is a useful means of exploring debates around both the ‘quantity’ and the ‘quality’ of populations, and sheds light on the functioning of population policies. In considering why reformers were unable to raise political and financial support for their efforts to address the needs of infertile households, and were only partially successful in their aims of generating certain kinds of public medical services and political involvement, it becomes evident that the history of attempts to tackle involuntary childlessness illuminates the contradictions between the aims of different agencies and authorities involved in formulating policies around health and population.

  • [1] gratefully thank Catriona Dutreuilh, who corrected the first version of this text, and TraceyLoughran and Gayle Davis for their scrupulous reading, highly relevant comments, and patientediting work. F. Cahen (*) Institut national d’etudes demographiques, PARIS, Francee-mail: This email address is being protected from spam bots, you need Javascript enabled to view it
  • [2] © The Author(s) 2017 199 G. Davis, T. Loughran (eds.), The Palgrave Handbook of Infertilityin History, DOI 10.1057/978-1-137-52080-7_11
 
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