Reproductive Geographies

Bodies, Places and Politics

Marcia England, Maria Fannin, Helen Hazen, Marcia R. England, Maria Fannin, Helen Hazen

• Publisher: Routledge
• Year: 2018
• ISBN:
  9780429772054
• Edition: 1
• Topic: Physical Sciences
• Subtopic: Geography
• Index: Geography

The sites, spaces and subjects of reproduction are distinctly geographical. Reproductive geographies span different scales - body, home, local, national, global - and movements across space.

This book expands our understanding of the socio-cultural and spatial aspects of fertility, pregnancy and birth. The chapters directly address global perspectives, the future of reproductive politics and state-focused approaches to the politicisation of fertility, pregnancy and birth. The book provides up-to-date explorations on the changing landscapes of reproduction, including the expansion of reproductive technologies, such as surrogacy and intrauterine insemination. Contributions in this book focus on phenomenologically-inspired accounts of women's lived experience of pregnancy and birth, the biopolitics of birth and citizenship, the material histories of reproductive tissues as "scientific objects" and engagements with public health and development policy.

This is an essential resource for upper-level undergraduates and graduates studying topics such as Sociology, Geographies of Gender, Women's Studies and Anthropology of Health and Medicine.

part I

Bodies

1 Making an “embryological vision of the world”

Law, maternity and the Kyoto Collection

Maria Fannin

Lynn Morgan’s 2009 account of American embryo collecting, Icons of Life, describes the creation of embryo collections in the U.S. and Europe over the course of the late nineteenth and early twentieth centuries. Embryos were obtained by doctors, most often from women who had miscarried a pregnancy or whose pregnancies were discovered after hysterectomy. Preserved in formalin or other chemical solutions and prepared for examination, the specimens provided teaching and research resources to study embryo morphology and development over time. ¹ These collections, Morgan argues, were essential to the establishment of embryology as a science. Embryo collections informed the medical study of pregnancy but also helped shape the development of other sciences, from evolutionary biology to genetics. Collections of embryonic material could be seen as continuous with the practices of anatomists from an earlier age who sought to collect and preserve specimens of humans and animals—and their body parts—for display and study. Embryo collections also sit at the cusp of the genetic and molecular sciences that would soon begin to dominate the study of human development. As Morgan writes, embryological collections inaugurated what would become the central role played by biology—surpassing chemistry—in late twentieth-century science. The embryological collections of the nineteenth and twentieth centuries sought to probe the “genesis” of life and its variability and could be said to anticipate the molecular and genetic sciences to come.

This chapter focuses on the social and spatial history of the Kyoto Collection, a collection of embryonic material established in 1961 by Dr Hideo Nishimura at Kyoto University in Kyoto, Japan. In doing so, I extend the insights of Morgan’s influential social history of the making of embryo collections by scientists in the U.S. and Europe to their counterparts in Japan. Like other embryo collections, the Kyoto Collection, as it is now known, was part of twentieth-century efforts to systematically study human development from conception to birth. It also aimed to illustrate variation across embryos deemed to be normal as well as the presence of developmental “anomalies”. Much of the material in the collection originated from elective termination of pregnancies, made possible by the legalisation of abortion in Japan under the 1948 Eugenics Protection Law. The collection now houses over 44,000 human embryos and foetuses and is considered the largest human embryo collection in the world. Japan’s post-war history of eugenic policy, innovations in the medical surveillance of pregnancy and abortion practice helped shape the development and reception of the collection.

Geographical accounts of archival and museum collections emphasise how relations between collectors and objects, and the collections themselves, reveal the spatial and historical preoccupations of curators and collectors (Hill 2006). At its inception, the Kyoto Collection differed from previous embryo collections. Whereas Morgan describes the collection of embryos in American embryological collections as somewhat ad-hoc and opportunistic, drawing on the goodwill of specific doctors through a relatively small network to build up a collection, Nishimura was able to enrol a large number of doctors who would regularly send materials to Kyoto accompanied by demographic and behavioural data about the women from whom the material had originated, and they carried out these tasks over a considerable period of time. The acquisition of material for the Kyoto Collection continued well into the latter half of the twentieth century. At a time when most other embryological collections in Europe and the U.S. had long ceased actively collecting specimens, the Kyoto Collection continued.

The number of embryos collected by Nishimura thus greatly exceeded those of other embryo collectors. The embryos in the Kyoto Collection were brought together in what one researcher described as a “random manner” by numerous doctors from around Japan. Physicians sending specimens were not asked to select specimens based on specific criteria (for example, whether the foetus was alive or dead when removed from the pregnant woman’s body or whether it was visibly normal or abnormal). Because of this, the Kyoto Collection is considered by researchers to be “representative of the total intrauterine population in Japan” (Nagai et al. 2016, 112). This argument is based on the view that embryos collected primarily from miscarriage were more likely to be abnormal (and thus unviable); those collected primarily through elective termination, like the embryos in the Kyoto Collection, would represent an “unbiased intrauterine population”, a quality that renders the collection valuable for population-based study (Kameda et al. 2012, 48). Together, the collection of biological materials and behavioural data was informed by a kind of “epidemiological reason” (Reubi 2018) that shaped how collectors and curators of the study envisioned their work as leading to a better understanding of the health and development of the Japanese population.

The study of population through the application of epidemiological reason is often told in histories of medical geography through the iconic figures of John Snow or William Budd, rather than through the efforts of anatomists and tissue collectors. Yet the collectors and curators of preserved human tissue aimed to glean the truth of the body’s health through the mapping, classification, comparison and analysis of the body’s interior. These practices often drew analogies between territory and body and sought to understand how the body was related to and influenced by its environment, including the intrauterine environment. In this way, anatomical study of the body was also a kind of cartographic practice, generating a spatial conception of the body and its relation to other forces within, outside and across the body’s supposed boundaries of interior and exterior. In linking the collection of embryos to the broader social practices surrounding the body and the political and legal spaces of abortion, studies of human tissue collections also demonstrate how parts of bodies were made into scientific objects. As Morgan (2004, 4) writes,

Transforming women’s calamities into embryo specimens was a cultural achievement that was possible only because most people attached little (if any) moral importance to dead human embryos. In the early 1900s, non-viable human embryos were valued only by embryologists, which made it relatively easy to render them anonymous and a-social.

The creation of embryo collections can reveal the changing moral value of bodies and body parts. They can also reveal changing geographies of reproduction as the end of a pregnancy, whether intended or not, moves into the space of the clinic and is “medicalised”. Medical and anatomical collections and their contemporary counterparts, tissue and cell biobanks, are thus important resources for understanding the history and geography of medicine, and for exploring the bodily geographies of contemporary science and technology.

Morgan’s history of embryo collections reveals how these collections became potent visual resources in struggles over reproductive politics in the United States. Inspired by Morgan’s work, this chapter asks why and how the Kyoto Collection began actively collecting specimens—and continued to collect them—long after many other embryological collections in the U.S. and Europe had ceased collecting embryos. What social, economic and regulatory conditions made embryo collecting possible in Japan? And how is this collection of preserved embryos regarded today? Embryo collections, and collections of human biological materials in general, are critical, I argue, to understanding the reproductive geographies of contemporary science.

Creating the Kyoto Collection

Hideo Nishimura’s early research focused on the anatomy of bullfrogs and was influenced by the work of Friedrich Kraus, an Austrian internist whose book General and Special Pathology of the Individual (1926) provided inspiration for engaging in “studies of development as the basis of human life” (Tanimura 1996, 3). Accounts of Nishimura’s career during the 1940s emphasise how the war made accessing scientific journals published abroad extremely difficult; after the war Nishimura’s work shifted to experimental embryology, where he began to focus his attention on the “intrauterine environment”. His interest at the time was on the effects of exposure to chemicals such as nicotine, caffeine and aminoazobenzene derivatives (then used in the treatment of bacterial infections and as a bright yellow dye) on the development of mammalian embryos and foetuses. By 1960, his research assistant Takashi Tanimura recounts that his work had become increasingly concerned with developmental processes in the human embryo and foetus, influenced by the emerging research from the U.S. and Europe on embryo development.

Nishimura was also, Tanimura suggests, influenced by reports of the effects of thalidomide on developing embryos. Thalidomide was sold in Japan until 1962, nearly a year after the drug had been removed from the market in some other countries (Lenz 1988). The global thalidomide disaster, in which pregnant women were prescribed medication to treat nausea that was later found to cause serious problems in the developing foetus, including missing or malformed limbs, was identified as a turning point in Nishimura’s interest in developmental processes. Nishimura’s professional activities at this time also included a key role in the establishment of the Japanese Teratology Society, where teratology is defined as the study of abnormal development. In 1961, Nishimura visited the U.S. where he intensified his interest in the development of the human embryo that would shape the rest of his career. In that same year, he began collecting embryos and foetuses from the termination of pregnancies carried out by doctors around Japan.

Collecting embryos was made possible in part through the coordination of the Japanese Medical Association, which sent invitations to physicians licensed to perform abortions to request their participation. In Nishimura’s obituary in 1996, it was noted that his “work was assisted by… more than 200 Japanese medical practitioners” (Nishimura 1996, 1137). But in fact the number of practitioners who contributed to his collection was much larger. Around 1,400 doctors registered initial interest in participating in the development of the collection, and of these over 970 doctors described as highly skilled in obtaining quality specimens sent materials to Nishimura to be retained for future study (Nishimura et al. 1968; Kameda et al. 2012). Nishimura and his team described these physicians as “willing to provide us with better specimens; an arrangement that allowed us to obtain standardized data on normal and abnormal human development during the stages of organogenesis, based on specimens derived from healthy pregnancies” (Nishimura et al. 1968, 281).

Most of the embryos in the collection were from pregnancies terminated in the first trimester. Once the materials were brought to Nishimura’s laboratory, they were measured, assessed for developmental “stage” according to a classification schema developed from the Carnegie Collection of embryos (known as the Carnegie Stages), and examined for anomalies. Biographical information about the mother was also sent to Nishimura, including the mother’s age, marital status, number of pregnancies, whether she was employed or unemployed, smoked or used alcohol or other drugs including medications, whether the pregnancy ended through “spontaneous or artificial abortion”, the mode of delivery and any symptoms of infection or radiation exposure experienced during pregnancy (Kameda et al. 2012, 51). Embryos were sent from 21 prefectures across six districts of the country, and more than 95 per cent of the embryos in the Collection were sent between 1960 and 1979.

The high number of specimens collected was a result of the coordination of physicians and the bodily contributions of pregnant women on a scale much more extensive than that available to other embryo collectors. Nishimura’s work was effective in amassing the largest embryological collection in the world in part because of the coordination of a number of Japanese clinicians and the institutional support of both the Japanese Medical Association as well as domestic and overseas funders, including the U.S. National Institutes of Health (Tanimura 1996). Nishimura’s ability to call on the medical networks of his contemporaries in clinical practice is evidenced by the scale and coordination of collection. ² However, the scientific success of collecting was not solely the work of a charismatic individual or a set of dedicated clinicians, but was also shaped by the broader social context of Japanese women’s access to abortion during the height of the collection’s acquisition of materials.

Eugenic theories in Japan

Eugenic theories circulating in Japan in the latter part of the nineteenth and early part of the twentieth centuries targeted women’s bodies as “a strategic site in which constitutional improvement of the Japanese ‘race’ could be made” (Otsubo 2005, 61). Historically high literacy rates enabled mass media dissemination of eugenic theories and popularised concerns over hygiene, nutrition and “eugenic...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Table of Contents
• List of illustrations
• List of contributors
• Acknowledgements
• Introduction: A call for reproductive geographies
• part I: Bodies
• part II: Places
• part III: Politics
• Conclusion: Reproductive bodies, places and politics: Future directions
• Index