THE ART OF INFERTILITY:
A COMMUNITY PROJECT RHETORICALLY CONCEIVING FAILED FERTILITY
By
Maria Novotny

A DISSERTATION
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of
Rhetoric and Writing—Doctor of Philosophy
2017

ABSTRACT
THE ART OF INFERTILITY:
A COMMUNITY PROJECT RHETORICALLY CONCEIVING FAILED FERTILITY
By
Maria Novotny
This dissertation applies a cultural rhetorics methodological approach to the topic
of infertility, investigating how individuals narrate and memorialize their infertility journey
through visual art. While prior scholarship has examined rhetorical constructions of
infertility as discourse, this dissertation offers an alternative framework to examining the
rhetorical choices infertile individuals are confronted with when diagnosed with the
disease. This project emerged out of my collaboration with The ART of Infertility, which
is a community art, oral history and portraiture traveling exhibit using art as a visual
method to spur infertility advocacy. In this dissertation, I argue for a “research as care”
methodology where bodies of health and medicine become participants actively
constructing their narratives—both in academic research and in community health
advocacy projects. I enact this methodology by interviewing three self-identified infertile
artists who previously donated pieces of their art to The ART of Infertility. My research
participants demonstrate that art, as a form of multimodal composition, serves as an
effective tool for processing infertility as an invisible and stigmatized identity.
Additionally, participants note how composing their infertility stories through artwork
allowed them to share and more effectively communicate their struggles to conceive
with others. All three participants speak to the potential that art serves in reorienting
others, who may never face difficulty conceiving, to the experience of infertility. This
work contributes to rhetoric and composition, speaking to the potential of community

engaged rhetorical scholarship in topics of health and medicine as well as the
application of multimodal composition in marginalized health communities and technical
communication. Further, this work interdisciplinary contribution to fields such as art
therapy, medical education, women’s and gender studies and art education.

Copyright by
MARIA NOVOTNY
2017

	

To the millions of women and men who are infertile, know this.
You are not alone.
This is for you.

	

v

ACKNOWLEDGEMENTS

First, a thank you to the Department of Writing, Rhetoric & American Cultures
and the Rhetoric & Writing graduate program. You all took a gamble on me when I fist
applied to the MA program years ago. Little did you know back then that admittance into
this program was not only a ticket for a graduate degree, it was a ticket that saved me. It
allowed me to feel productive when each month I felt continually reminded of how my
body was failing me, not allowing me to become a mother. Thank you. Words cannot
express how different my life would have been if I did not have this chance.
Second, a more specific thank you to my committee. All of your mentorship and
support has been invaluable. When there have been times that I have questioned
working on such a personal project, all of you have reminded me and encouraged me
that because I felt unease, because I felt vulnerable, I needed to be brave and continue
this work. Thank you for always sharing your stories with me and reminding me that I
should share mine with others as well. I frequently am reminded of the influence of each
of you on my life.
Third, to all of my fellow academic friends who are now colleagues. Katie, Les,
Daisy, Andrea, Marilee and Beth. As my time at MSU comes to an end, I look forward to
our friendships branching out to new places and new projects.
Fourth, to my infertility community. To Liz, my big sis. We found each other at a
time when we needed each other the most. We made our misconceptions into a shared
conception with The ART of Infertility. I am so thankful that we have each other in our

	

vi

lives. To all those who participated in the dissertation – thank you. You all trusted me
enough to share and write your stories. I thank you for your bravery. And to all those
who continue to grapple with infertility, remember #artheals.
Fifth, to my family. Especially to Paul whose last words to me were “So are you a
doctor, yet?” Today, I finally am. I wish that you could be here in person to witness this.
Finally, to Kev. We did this together, along with the pups. Thank you for always
being open about our story. It has made it easier for me to do this work. Thank you for
allowing us to take time to figure out what we wanted. Thank you for choosing to stay
with me through it all. I love you and, with this chapter closed, I am so excited to see
where life may take us now.

	

vii

TABLE OF CONTENTS
LIST OF FIGURES…………………………………………………………..………………….x
PROLOGUE.…………………………………………………………………………………….1
The House….…………………………………………………………………….………1
CHAPTER 1……………………………………………………………………………………..4
LIVED EXPERIENCE OF INFERTILITY AS RHETORICAL INQUIRY…………….……..4
Rhetorics of Infertility: A Discursive Framework……………………………………………12
Rhetorical Construction of Infertility………………………………………………….13
Historical Constructions of Infertility…………………………………...…………….14
Contemporary Rhetoric to Normalize & Stabilize Infertility………...……………..18
Infertility as Rhetoric: An Embodied Framework……………………………..…………….20
Conclusion………………………………………………………………………………...……24
CHAPTER 2……………………………………………………………………………………26
RESEARCH AS CARE: A FEMINIST REVISION TO STUDYING BODIES IN
RHETORICS OF HEALTH AND MEDICINE…………………………………………...…..26
Part I: Origins of Research: Lived Experience, Infertility & Queer Rhetoric……………..28
Part II: Embodied Unease……………………………………………….……………………35
Part III: Research as Care………………………………………………………….………...37
Conclusion……………………………………………………………………………………...41
CHAPTER 3……………………………………………………………………………………43
ART-I-FACTS INQUIRY AS A STORYTELLING METHOD………………………………43
The ART of Infertility…………………………………………………………………….….…47
Community-Engaged Practices of Making & Rhetorical Inquiry……….…………49
Drawing on Relationships to Design the Study………………………….…………52
Art-i-Facts Method…………………………………………………………..………………...54
Participant Input After Interview……………………………………………………...56
Conclusion……………………………………………………………………………………..57
CHAPTER 4……………………………………………………………………………………59
ART AS A RHETORICAL REPRESENTATION OF INFERTILITY’S
REORIENTATION.........................................................................................................59
Meet Sara......................................................................................................................62
Meet Adi.........................................................................................................................68
Meet Meg.......................................................................................................................73
Conclusion……………………………………………………………………………………..80
CHAPTER 5…………………………………………………………..………………………..82

	

viii

ART AS A RHETORICAL APPEAL TO ORIENT VIEWERS TO
INFERTILITY……………………………………………………………………………..……82
Sara: Making Visible “All Those Needles, All That Medicine”…………………………….84
Adi: Vulnerability & Making Visible the Pain of Infertility…………………………………..90
Meg: Challenging Dominant Narratives of Infertility Success…………………………….96
Conclusion……………………………………………………………………………………...99
CHAPTER 6…………………………………………………………………………………..101
TAKEAWAYS, IMPLICATIONS & LIMITATIONS…………………………………….…..101
Interdisciplinary Takeaways…………………………………………………………..…….102
Art-Making Facilitates Moments to Process Identity……………………………..103
Art Acts as a Communicative Tool for Patient-Centered Support……………....106
Art Makes Infertility Matter…………………………………………………………..109
Implications for The ART of Infertility……………………………………………………....112
Community Art Workshops as Multimodal Public Rhetoric……………………...115
Curation as a Rhetorical Practice…………………………………………………..116
Limitations of Study…………………………………………………………………………..119
Demographics of Infertility…………………………………………………………..119
Outside Viewer Interpretation of Artwork…………………………………………..121
Infertility as an In-Flux Identity………………………………………………………122
Art as Research………………………………………………………………………123
Conclusion…………………………………………………………………………………….124
AFTERWARD………………………………………………………………………………...127
BIBLIOGRAPHY………………………………………….………………………………….137

	

ix

LIST OF FIGURES

Figure 1. “Beating the Clock”………………………………………………….……………….4
Figure 2. A love branch created at the workshop………………………….……………….50
Figure 3. “Failed IVF #1”………………………………………………………………..…….63
Figure 4. “Innocence” …………………………………………………………………………70
Figure 5. “Mixed Media”…………………………………………………………………...… 71
Figure 6. “Bloodlines”…………………………………………………………………..….… 75
Figure 7. Label for “Bloodlines”………….……………………………………………..…….76
Figure 8. “My Consent”…….………………………………………………………………… 77
Figure 9. Lines of poetry emerging from “My Consent”…….……………..………………78
Figure 10. “HSG”……………………………………..….………………………….…………91
Figure 11. “Contact”……………………………..…….………………………………………93

	

x

PROLOGUE

The House
I sit right now in the room that was to be the baby’s. We bought a cozy, twobedroom, two-story house with the intention for the blue bedroom to be ours. The
mauve colored room we would repaint and would be for the baby. The blue bedroom
was slightly larger than the mauve. We intentionally selected this room with the rationale
that a bassinet could comfortably be set up next to our bed. The mauve colored room
was smaller but had a walk-in closet able to host the baby’s port-a-bed, bouncer and a
long lasting diaper supply.
Today, though, we conceal our hopes for the mauve colored room. A guest bed
is setup for our friends and parents to visit. This room has often served as an oasis for
each of us at different points in our marriage when the pain of conceiving has pushed us
apart – pushed us to two separate beds. We don’t like admitting this but that is part of
our truth, part of our story.
Next to the bed in the mauve colored room is a desk where I sit and write and
work. Books are stacked on the desk. Not in any order. Just placed on the desk. Where
the desk and bed have been placed is where we planned to put the crib. Now, we fill
that area with what we think may be our new life. A life filled with professional promise
and a life where a guest bedroom will always be needed. We will be the future aunt and
uncle that can provide a retreat for a niece, nephew, or even sister or brother. Our
house will serve as an escape for others, not ever fully becoming a home.

1

Walking into this house I sometimes remember the thoughts I had when we
purchased it. The room downstairs that now has bookshelves and dog toys scattered
about was to be the baby’s playroom. It attached to the kitchen and would have let me
prep dinner and play with the baby as we waited for you to come home from work. I
imagined hearing you pull into the drive away. I would give the stew in the crockpot a
quick stir and then pick up baby Henry or baby Sophia from the play mat in the other
room, anchoring the baby to my hip and having my free hand raise the baby’s hand as
to wave to you from the backdoor.
Now, that image appears more like an illusion than a premonition. The house
symbolizes something different now than what it represented when we first purchased it.
The very terms of making and sharing a home together have changed. We first
purchased it as a symbol of family extension and growth. Today, we sit in the rooms of
our house trying to make sense of the symbol it now represents.
***
I wrote this piece in November 2013. I was 27. At that time, I was finishing my
MA degree in Critical Studies in Literacy and Pedagogy. Secretly though, I was
desperately trying to get pregnant — month after month, year after year, came period
after period. I wrote about these moments to create a memory. Today, these memories
seem like a shadow of my past. Reading “The House” once again and writing this
epilogue tears roll down my cheeks.
Today, spring 2017, I am still not pregnant and my desperate desire to conceive
has subsided. I read “The House” and I see how different my life today could be. I
donated this piece of creative writing to The ART of Infertility. When it is exhibited, I

2

discretely watch people read it – attempting to read their face, body positioning for any
signs of affect. “The House”, just like this dissertation, is an offering to the millions of
other infertile women and men who have felt this whole-consuming, invisible pain.
I share with you “The House” as a moment to mark the beginning of this journey
to my exploring infertility as rhetoric. I first shared this piece of writing in my Queer
Rhetorics course. Here, I learned that my story matters. In this doctoral program, I found
courage to share my story with others. Now, with the tools and rationale for why the
stories of infertility matter, I invite you to read on and learn more.

3

CHAPTER 1
LIVED EXPERIENCE OF INFERTILITY AS RHETORICAL INQUIRY

I would say infertility is without a doubt a roller coaster.
— Sara, The ART of Infertility participant

Every month, you're like, "What?" Even if you have the diagnosis, there's
still part of you that is shocked. It's always shock. I haven't met anyone
who's not shocked. Even with the worst diagnosis, somehow we have this
insane primal hope that we can overcome it.
— Meg, The ART of Infertility participant

I begin this chapter with a piece of art that I created as I finished this dissertation.

Figure 1. “Beating the Clock”

4

The image above is titled “Beating the Clock” and is a piece of blackout poetry inspired
by “My Consent,” created by a participant in this dissertation and appears in Chapter 4.
“Beating the Clock” was created at a blackout poetry workshop hosted by The ART of
Infertility in conjunction with National Infertility Awareness Week. For those unfamiliar
with blackout poetry, it is an artistic process that requires relatively little technical skill.
Individuals begin by selecting a page of text, circling a variety of words and phrases that
appear to be personally significant on the page. A stencil is selected and traced over the
variety of words and phrases circled. The stenciled image is cut out and all the
remaining uncircled words and phrases that appear on the page are blacked out. All
that remains is a stenciled image and the pre-selected words. These words serve as the
piece of poetry.
In “Beating the Clock” I cut out the stenciled image and after blacking out the
words, Mod Podged™ the image to a painted canvas. The piece of poetry reads:
Beating the Clock
unpredictable and inflexible
Ph.D.
female
time
is physically grueling.
I share this piece now, in this first chapter, as it serves a retrospection on the six
years I have devoted towards my doctorate rather than working on the building of a

5

family. I share this piece not out of regret, but instead, to document how infertility forces
one to make a series of choices frequently not visible nor well understood by others.
Specifically, “Beating the Clock” memorializes my infertility journey. It acts as a
material artifact documenting my choice to pursue a Ph.D. rather than face the
numerous decisions I must still confront if I want to have a child of my own. To be frank,
it documents the years I have spent not dealing or wanting to make fertility-related
decisions. Now, with this dissertation written and graduation upon me, I am a bit
overwhelmed by new beginnings. This project has allowed me to not only develop a
research agenda that is personally fulfilling, but this project has allowed me to come to
terms and acceptance with my own infertility. I share this personal story as it makes
visible how research evolves – not just the actual written publication – but as one
researches, the researcher frequently evolves.
This chapter serves a moment to document the evolution of this project. As a
dissertation project that I have personal stakes with, as a project that works with other
infertile individuals to represent and tell their stories, as well as a project that theorizes
the building of a community arts and infertility organization, this dissertation has had to
grapple with moments of doing real advocacy work – in the discipline and in the real
world. Trying to figure out what that looks like and moments in which I could have done
better. It is a public, living project. In coming to terms with the variety of stakeholders
involved in this project, I have been forced to contemplate moments of methodological
messiness that appeared because of the various bodies that this project represents as
well as speaks to.

6

As you read on I invite you to note that when it may seem that I am not talking to
rhetoric and composition, it is because I am not. Some of this is for the discipline and
some of this is for the infertility community. The goal of this project is to begin building
models in which rhetorical research can be valued in both spaces. This dissertation
then, is not a “how to” but rather a larger research story documenting how I have
attempted to build a community project out of my rhetorical training to better support a
community in need, a community that wants to share their story, a community that
wants to invite others into the realities of living with infertility. With that, I invite you to
read on so as to learn more about infertility and the rhetorical realities infertile
individuals face because of this disease.
***
Infertility, defined as a disease of the reproductive system, affects 7.5 million
people in the United States. This figure represents 12% of women of childbearing age,
or 1 in 8 couples.1 For a couple attempting to conceive, infertility is commonly
diagnosed after one year of unprotected, well-timed intercourse without achieving and
maintaining a pregnancy, or if the woman has suffered multiple miscarriages. If the
woman is under 35 years of age, time to diagnosis is reduced to 6 months of
unprotected, well-timed intercourse without achieving and maintaining a pregnancy. 2

																																																								
1
This is a 2016 statistic reported by the Center for Disease Control (CDC). For more
information, please visit: https://www.cdc.gov/nchs/fastats/infertility.htm
2
This definition of infertility is supported by the Center for Disease Control (CDC),
RESOLVE: The National Infertility Association and the American Society for
Reproductive Medicine (ASRM). For more information, please see:
https://www.cdc.gov/reproductivehealth/infertility/; http://www.resolve.org/aboutinfertility/what-is-infertility/; https://www.asrm.org/Booklet_Infertility_An_Overview/
7

A variety of factors and conditions are frequently cited as reasons for infertility.
Men and women may experience factors or conditions impairing their fertility. Upon
diagnosis, a series of treatments may be suggested. These range from the use of
hormone-induced therapy (like Clomid), to intrauterine insemination (IUI), to the most
common associated fertility treatment, in vitro fertilization (IVF). These treatments,
however, are frequently not covered by individual insurance plans, resulting in high outof-pocket costs for fertility treatment. Notably, other family-building options exist such as
adoption, foster care, surrogacy or the decision to live childfree. Nonetheless, the reality
remains building a family when infertile is challenging. High out-of-pocket costs attached
to fertility treatment, state regulatory laws limiting surrogacy, imperfect financing for
adoption, in addition to a range of challenges and stigmas attached to, what is
frequently described as “alternative” options such a foster care or choosing to live
childfree make navigating experiences of infertility arduous.
I begin this chapter, and dissertation, then with this overview on infertility so as to
capture “the many faces of infertility” (Sandelowski & de Lacey, 2002, p. 43). Infertility
does not discriminate. It impacts men and women, the young and the old, of all
nationalities and ethnicities. In fact, I am one of the 7.5 million affected by infertility. I am
infertile.
I claim my infertility in this dissertation for two purposes. One, as a feminist
cultural rhetorician, I embrace what Rich (1989) calls “a politics of location” that
“reconnect[s] our thinking and speaking with the body” (p. 31). My infertile body orients
me to my research, my participants and my claims. To remove my body from this
dissertation is to remove the personal exigency for this work. I argue that personal

8

exigency for our scholarship should not be dismissed, despite patriarchal values
omitting subjectivity and embracing objective scholarship. Haraway (1988) explains how
objectivity occurs through the disembodied “conquering gaze from nowhere” serving to
achieve an illusion, “a god trick”, removing personal subjectivities from our scholarship
(p. 581). My claim to infertility aims to disrupt this scholarly preference for a presumptive
objective researcher.
Second, I claim my infertility to call attention to the overarching silencing of
infertility, which exists not only in the world3 but also very much in higher education,
including rhetoric and composition. As a discipline, rhetoric and composition has a
tradition of countering hegemonic language practices, marginalizing students and
instructors from their home languages and practices. Explicit commitments to language
diversity4 and the promotion of access to enhance conditions for learning and teaching5
have called the discipline to be more attentive and responsive. These disciplinary
position statements to diversify and call attention to practices that normalize at the
expense of marginalizing others has resulted in more culturally responsive pedagogies
and scholarship. Yet, I argue more must be done in regards to the gendered institutional
structure of higher education. Further, it is because of rhetoric and composition’s
commitment to intervening in social injustices within the academy that this is a discipline

																																																								
3
Allison (2011) addresses a global cultural silence around infertility, explaining
“sustains the myth of fertility as a universal experience, suppressing contrary
experiences in an ideology of motherhood and symbolic ideal of family” (p. 17).
4
See the following statements made by Conference on College Composition and
Communication: http://www.ncte.org/cccc/language-power-action;
http://www.ncte.org/cccc/resources/positions/srtolsummary
5
See the following statement made by Conference on College Composition and
Communication: http://www.ncte.org/cccc/resources/positions/disabilitypolicy		
9

that could begin to initiate wider support to revise policies of institutional labor that fail to
support those who are infertile in the academy.
I claim my infertility in this dissertation to recognize the many other women – and
men – in the discipline who have had to silently contend with their infertility.6 While
explicit support systems exist in the rhetoric and composition field for those raising
children, such as maternal/paternal leave policies and the newly formed SIG “Academic
Mothering in Rhetoric and Composition,” little recognition and rhetorical grappling with
how experiences of infertility shape graduate student and faculty life has happened. I
claim my infertility then to call attention to what Konrad (2016) calls “access fatigue.”
Konrad’s term aims to make visible frequently unrecognized issues related to
accessibility, such as making conference proceedings accessible to those who are
visually impaired. I draw on Konrad to elaborate on how disciplinary and cultural
silencing related to infertility additionally fatigues the infertile body.
I am fatigued by how my infertility discursively becomes positioned as a
perceived privilege in the discipline. I am tired of being told how my infertility allows me
to be more flexible, to write more articles, to be more ambitious in my scholarship, to
mentor students as if this aids my maternal desire. I am tired of a discipline that has
adopted and circulates maternal metaphors such as rhetorical and institutional laboring,
metaphorical use of “mother” and the over-presumed assumption of the inherent value
of a “nurturing” pedagogy particularly in our first-year classrooms. These maternal
metaphors continue to link rhetoric and composition’s practices as a potential alternative
																																																								
6
I honor the numerous men and women whom I have met after presenting on this work.
Many have come up and thanked me for discussing this topic and making it visible. This
dissertation then is just as much for them as it is for me and the millions of others who
have felt silenced by infertility.
10

space for those who cannot have their own children. Further, the continued use of such
metaphors perpetuates the silencing of infertility and its prevalence across academia.
Therefore, while the discipline has done much to push against the social injustices of
disability and language, I ask the discipline to ponder how well its practices recognize
and address the larger institutional silencing of infertility.
With the exigency established for claiming my infertility in this dissertation, I turn
to the focus of this chapter to locate lived experiences7 of infertility as a topic of study in
rhetoric and composition. Specifically, I point to scholarship that has previously attended
to infertility from a rhetorical lens. My intention in doing so is to call attention to rhetoric
as a framework to analyze and unpack the discursive construction of infertility, what I
call a “rhetorics of infertility” frame. Such a framework, I argue, is important to
underlining the fluidity of infertility. Meaning, whom infertility impacts as well as what is
implicated by its discursive construction shifts with how infertility is defined. However, I
draw upon my own personal experiences with infertility as well my collaboration with an
infertility arts organization to suggest a new rhetorical understanding of infertility, what I
call “infertility as rhetoric”. Specifically, I address how my attention to the lived
experience of infertility serves to unearth the various and continual rhetorical decisions
infertile individuals must confront as a result of its fluid construction. This emphasis on

																																																								
7
I root my definition of “lived experience” in Max Van Manen’s work Researching Lived
Experience. He claims “lived experience is the starting point and end point of
phenomenological research” (p. 36). “The starting point of phenomenological research
is largely a matter of identity what it is that deeply interest you or me and of identifying
this interest as a true phenomenon, i.e. as some experience that human beings live
through” (Van Manen, 1990, p. 40). My lived experience with infertility serves as the
starting point thus for understanding how others have lived through experiences of
infertility.
11

lived experience, which focuses my examination of infertility as rhetoric rather than
rhetorics of infertility, guides the remainder of this dissertation.

Rhetorics of Infertility: A Discursive Framework
Rhetorics of infertility is an interdisciplinary framework, used by feminist theorists
(Sandelowski, 1990; Thompson, 2002), sociologists (Greil, McQuillan & SlausonBlevins, 2011; Mamo, 2013), medical anthropologists (Allison, 2011; Inhorn & Van
Balen, 2002), and rhetoricians (Britt, 2000, 2001; Jensen, 2015, 2016) to identity the
various and multiple hegemonic structures of power that construct what is known as
“infertility.” In this section, I examine rhetorics of infertility from three areas of focus.
First, the rhetorical construction of infertility, analyzing how infertility is defined within
larger ideological value structures and how such a definition creates an infertile subject.
Second, I reference Jensen’s (2015, 2016) historical rhetorical analysis of the evolution
of infertility. I suggest a historical analysis can reveal the discursive fluidity of infertility
and draw on Marsh and Ronner’s (1996) work to further solidify this claim. Third, I point
to Britt’s contemporary work on infertility insurance mandates. Legislative rhetoric
aiming to normalize the infertile body through mandated fertility insurance speaks once
more, I argue, to the ever fluid and in-flux nature of infertility. These three areas of focus
in a “rhetorics of infertility” framework underscore infertility as continually redefined
through discursive initiatives. I elaborate briefly on this, in regards to the World Health
Organization’s revised definition of infertility to include those who are single, yet, desire
a child. Rhetorics of infertility serves as a framework to understand how cultural
discourses construct and define infertility, as well as implicate infertile subjects.

12

Rhetorical Construction of Infertility
Perhaps the most ubiquitous analysis of the rhetorical construction of infertility is
Sandelowski and de Lacey’s (2002) chapter “The Uses of a ‘Disease’: Infertility as a
Rhetorical Vehicle.” In this work, the authors explain how infertility is a discursive
invention as a result of the first successful birth of an IVF baby. They explain:
Arguably, infertility was ‘invented’ with the in vitro conception and birth in
1978 of Baby Louise. That is, in the spirit and language of the
Foucauldian-inspired ‘genealogical method’ (Armstrong, 1990), infertility
was discovered — or more precisely, discursively created (Armstrong,
1986; Arney & Bergen, 1984) — when in-fertility became possible.
(Sandelowski & de Lacey, 2002, p. 34)
Claiming that infertility became invented as a result or byproduct of technological and
biomedical advances fuels the perpetuation of infertility as a diseased subjectivity – an
invented diagnosis that because of reproductive technologies can be ‘cured’. To ‘beat’
or ‘conquer’ infertility often correlates to the notion of successfully building one’s family,
often through the achievement of a pregnancy. Further, Sandelowski (1990) notes how
the construction of infertility as a disease has led to a particular gendering of infertility.
She explains, “infertility has been variously described as…a failure to conform to
cultural prescriptions to reproduce, and a failure to fulfill the personal desire to beget a
child” (p. 477). Greil (2002) argues that infertile women are forced to address the
correlation between failure and infertility more explicitly than their male partners. He
explains:

13

Regardless of which partner in an infertile couple is ultimately discovered
to have the biological ‘problem,’ it is the woman who is the locus of most
infertility treatment. Even if a woman’s partner has low sperm count, it is
her body that is the locus of artificial insemination or in vitro fertilization
(IVF). It is her basal body temperature and her blood levels that must be
monitored. It is the woman’s body, then, that is most often subjected to the
medical gaze. (Greil, 2002, p. 101)
Greil’s work suggests that the medical gaze becomes reproduced through fertility
treatment, and that because the female body is the treated body, infertility is almost
always constructed from the lens of the female patient. Such a claim is important for
understanding how medicalized discourses, particularly reproductive discourses,
construct subjectivities. Examining rhetorics of infertility allows for a tracing of the
construction of subjects. As explained by Sandelowski and De Lacey to be infertile is to
live as an embodied construct. The framework “rhetoric of infertility” serves as a
methodological inquiry into how ideological discourses produce infertile subjects.

Historical Constructions of Infertility
Jensen’s (2015, 2016) work serves as a historical and discursive tracing of the
definitional evolution of infertility. Noting the discursive turn from describing the
involuntary childless woman as ‘barren’ beginning in the mid seventeenth century, to
‘sterile’ appearing in the early nineteenth century, to the contemporary term ‘infertile,’
her rhetorical analysis reveals how infertility evolved as a mixed-metaphor and argues
that these discursive shifts “corresponded with new rhetorical appeals and promoted

14

new perceptions of married women’s childlessness” (p. 28). Jensen’s attention to the
evolution of infertility, entangled by mixed-metaphors, underscores the fluidity of
infertility. How it is defined, as well as how those definitions connote different cultural
meanings matters to how infertility is culturally situated and experienced.
Marsh and Ronner (1996) elaborate on the discursive differences of experiencing
childlessness from a barren versus sterile identity. They explain that early American
experiences of childlessness in colonial times were frequently understood and
discursively shaped by biblical accounts, invoking frequently the struggles, patience and
faith of biblical figures like Abraham and Sarah. Marsh and Ronner’s sociohistorical
research elaborates on how childlessness, defined in in early America as bareness, was
experienced. Childlessness in early America was frequently not discussed. If the topic
did appear it normally emerged alongside religious discourses, frequently by referencing
The Old Testament emphasizing how Sarah’s faith supported her as she struggled to
conceive with Abraham. Religion became a place to make sense of the struggle to live
without children during this time. Discussions of childlessness thus rarely, if at all,
circulated around medical or biological discourses. As a result, childless couples in early
America were thus encouraged not to seek medical treatment but to discuss the issue
with close friends or family and seek “comfort and aid from her religious faith” (Marsh &
Ronner, 1996, p.10).
This shifted, however, when childlessness began to be defined in terms of
sterility, a much more medicalized definition. Specifically, while bareness was viewed as
a “personal misfortune in colonial America,” sterility addressed larger societal pressures
simultaneously encouraging and creating exigency for medical evaluation and treatment

15

pertaining to childlessness. For example, during the late nineteenth and early twentieth
century public sentiment towards female sterility suggested that their childlessness was
a result of their desired independence and request to vote. Many in fact, linked declining
birth rates to increased female agency (Sandelowski, 1990). Medical address of sterility,
linked to desire and female volition, now required attention not only to physical but
psychological disorders. At this time, treatment of childlessness began to be addressed
from a Freudian psychological theory.
Sterility was now a complex medical condition, involving reproductive
endocrinology, obstetrics and gynecology, and mental health. The linking of
childlessness to such highly specialized medical fields, aimed to remove the personal
blame and stigmatization childless women felt. Sandelowski (1990) explains:
By 1958, the idea that the infertile, particularly women, were in some
measure to blame for their childless state was pervasive enough to cause
more enlightened medical experts to state that the infertile were no more
responsible for their infertility than individuals afflicted with other diseases.
These physicians underscored that there were childless women who really
had done nothing to cause their childless state. (p. 495)
Thus, while physicians worked to contradict the intense levels of guilt and shame
associated with childlessness, the rapid medical developments to treat childlessness
simultaneously led to the development of an ever-increasing protanalist8 society. As a
result, emotional and psychological stress to become pregnant in order to conform to

																																																								
8
Parry (2005) explains pronatalism as an ideological belief that a person’s social value
is linked to procreation.
16

societal values increased. Experiences of childlessness now had to address both
physical limitations as well as mental and psychological distress.
Treating childlessness solely as a female condition also began to shift due to the
work of Samuel Meaker, a Boston gynecologist practicing in the 1930s and 40s.
Meaker’s book Human Sterility argued the need to begin examining reproductive
endocrinology in relation to treating infertility; acknowledged the work of Gerald
Moench’s research on sperm motility and morphology; and perhaps most significantly
drew conclusions that infertility could not be understood as being caused by solely one
factor – that multiple, predisposing factors could contribute (Marsh & Ronner, 1996). His
work suggested that childlessness be understood instead as infertility, which could be
best treated by a multitude of specialists including urologists, gynecologists,
endocrinologists and pathologists. The experience of childlessness was now a more
medicalized condition requiring specialized treatment for both the male and female
partner who desired a child.
These historical, discursive shifts linked to medical advancements reinforce the
fact that experiences of infertility are fluid. They shift and change and are defined in
contention with larger cultural value systems. In what follows, I share more
contemporary rhetorical work on infertility, which examines how legislative issues and
biomedicine are shaping how infertility is being defined as a right to have a child as well
as current definitional debates about who should be considered infertile.

17

Contemporary Rhetoric to Normalize & Stabilize Infertility
Britt’s work addresses larger cultural forces aiming to normalize and stabilize the
fluidity of infertility. Specifically, her work examines a 1987 Massachusetts law
mandating insurance coverage for fertility treatment.9 Britt (2001) argues that state
insurance mandates operate as an extension of normalization, which:
Is not so much about reforming the abnormal (which would eliminate the
need for normalizing power) as it is about distinguishing between the
normal and the abnormal (which would sustain the need for continual
improvement.) To achieve this work, a technology of normalization (such
as the mandate) creates a tension between the categories to be
differentiated. In the case of infertility, the tension occurs not only for the
women who seek medical treatment but also for a culture that has come to
understand this treatment as reasonable and necessary. (p. 144)
The mandating of insurance treatment, works as an extension of normalizing and
stabilizing infertility. Specifically, fertility treatment becomes the path of resolution to
move from infertile to fertile. It acknowledges infertility as a medical condition and
reinforces individual rights to having a biological child. Insurance mandates make more
stable the shifting discursive constructions of infertility by establishing laws that create a
larger cultural norm, as well as a cultural recognition of infertility.
Yet, there remains no federal mandate for fertility-related insurance coverage.
Thus, while Britt’s work demonstrates how state mandates work to normalize
experiences of infertility, infertility continues to be discursively contested and remains in																																																								
9
Only 15 states in the United States have laws mandating forms of insurance
treatment. No federal mandate currently exists.
18

flux. This fluid nature of infertility can be pointed to in a recent initiative by the World
Health Organization (WHO) to revise its current definition of infertility to now include
single individuals.10 Such a definition would expand who is considered an infertile
subject, reaching beyond traditional heterosexual boundaries to now include single
men, single woman, gay men and gay women.11 WHO’s decision to revise the current
definition of infertility, so as to include more individuals, underscores how discourses of
infertility matter. How we define infertility impacts who becomes a subject of infertility.
The historical and cultural evolution of infertility as a definition reinforces the fact that
infertility exists in a fluid state. Infertility is a continually reinvented identity.
Finally, I turn to methodological concerns over scholarship examining discursive
constructions of infertility. Reflecting on the implications of examining discourses of
infertility, Sandelowski and de Lacey acknowledge that understanding infertility as an
ever-evolving constructed cultural identity, influenced by technoscientific advances, has
served to expand whom infertility impacts. Yet, they warn that such scholarship
simultaneously removes consideration and attention to the phenomenological, lived
experiences of being infertile. They explain:
An effect of the invention of infertility has been the many faces of infertility.
This is not surprising given the new status of infertility as a liminal
phenomenon and the multiple identities and selves said to be engendered,
in part, by new reproductive (and other media or medical) technologies
																																																								
10
The revised definition has not yet been published. However, news channels have
reported and confirmed that the revised definition will seek to expand infertility as a
reproductive condition impacting persons beyond the traditional heterosexual
relationship. See:
http://www.nationalreview.com/corner/441392/infertility-definition-changed-world-healthorganization-calls-right-reproduce		
19

(Cussins, 1996; Sharpe, 1995; Timmermans, 1996). Yet the paradox in
these multiple guises of infertility is the virtual disappearance of infertility
as a phenomenological event (Riessman, 1989, p. 749), or an event that
individuals experience uniquely. The ‘deflective power’ (Woliver, 1989) of
reproductive technology has shifted attention not only from how to prevent
infertility and from pursuing nontechnological options for it but also from
infertility and the infertile themselves. (Sandelowski & de Lacey, 2002, p.
43-44)
As an infertile woman, who in the reading of rhetorical scholarship on infertility has felt
frequently erased in the literature, I am emotionally drawn to Sandelowski and de
Lacey’s note of the “virtual disappearance of infertility as a phenomenological event” as
it reminds scholars of infertility that while understanding discursive constructions of
identity are important, it also moves our scholarship away from those who live as a
result of those constructions. Rhetorics of infertility, often, thus allow for a
methodological distancing in which bodies of those constructs are afterthoughts to our
work. As such, I offer in the next section a return to considering the bodies of rhetorical
constructions and offer “infertility as rhetoric” as a renewed location for rhetorical
inquiry.

Infertility as Rhetoric: An Embodied Framework
In “Embodiment: Embodying Feminist Rhetorics,” my co-authors and I, put forth a
“more expansive view of embodied rhetorics, one that supports our discipline’s
movement beyond seeing the body in binary terms as either objectified or subjectified”

20

(Johnson, Levy, Manthey & Novotny, 2015, p. 39). Such a shift, we argue is necessary,
given the tradition of rhetoric to limit its understanding of bodies to either “discourses
about bodies” or “ research emphasizing the material body itself” (Johnson et al, 2015,
p. 39). We argue, as feminist cultural rhetoricians, a methodological need to
recontexualize the rhetorical body beyond discourse and research about bodies – to
examining the body as having “its own rhetorical agency” (p. 39). This re-framing of
rhetorical bodies critiques disciplinary tendencies “either to presume one normative
body (white, male, heterosexual, middle-class, abled)…or to recognize an ‘other’ body”
(Johnson et al, 2015, p. 40). Such rhetorical traditions fail to both view as well as
genuinely take up “the complex mechanisms through which some traditions become the
norm and some are assigned to the margins” (Johnson et al, 2015). In the case of
infertility, I raise such concern, as I worry how rhetorical discursive analysis continually
reinforces the binary positioning of the fertile and normal body versus the infertile and
abnormal body. How, instead, may rhetorical scholarship shift towards more complex
understandings of the impact such rhetorical discourse has on the infertile, rhetorical
body, itself? That is, how may we move to an “ethical reading of bodies and recognition
of bodies as people – not objects”? (Johnson et al, 2015, p 40).
Infertility as rhetoric is a framework that addresses such concern and asks
scholars to “rhetorically listen to the negotiations and practices of resistance that exist
within our own bodies” (Johnson et al, 2015, p. 42). It shifts rhetorical inquiry from the
site of discourse to the lived experience of being or embodying infertility. Further, as an
embodied framework, infertility as rhetoric attends to the lived experiences and realities
of embodying the perceived rhetorical construction of infertility. This framework allows

21

me to examine and understand how infertility as an embodied identity requires a series
of various rhetorical navigations related to diagnosis. Much of this can be noted in the
vignettes above that describe infertility as a roller coaster, constantly shocking the
system. To be infertile is to be bombarded by a series of micro and macro decisions.
For example, as an embodied identity infertility must be claimed or the infertile individual
must “come out.” Few, if any, visible markers signify the body as an infertile body. Thus,
when an infertile individual is asked “do you have kids?” the infertile person, in that
moment, must quickly evaluate how to best respond to such a question. The response
may vary depending upon the asker of the question, the scene/location of the asked
question, as well as smaller factors such as the mood of the infertile individual or the
even the fatigue of needing to answer such a question.
There appears then to be a kairotic component to embodying infertility as
rhetoric. Evidence of this can be cited in Arola’s (2011) video essay “Family Christmas
Cards, Rhetoric, and Infertility: A Season of Silence.” Broadly, her essay makes an
argument to critically examine cultural definitions of “family” and how family-friendly
positions, while seemingly positive, can marginalize and ostracize those who are
infertile. On a smaller scale, however, Arola’s piece raises points that support the
karotic nature of infertility. She describes how she arrived at the decision to no longer
send out Christmas cards. This is a result, she argues, of no longer fitting the genre
expectations of the cards. No longer do the cards picture the faces of her family and
friends. These are instead replaced with the images of their children. Looking at these
new faces, Arola realized she does not have such images to share. Instead, she has
years of fertility treatments. The rhetoric of family implies something that Arola is not.

22

The infertile couple is not thought of as a family. I point to Arola’s critique of the family
Christmas card as it demonstrates the kairos of infertility. While she used to participate
in the practice of sending cards, her coming to terms with possibly never having a child
and fitting into this genre, forced her ultimately to make a rhetorical decision to stop
participating in the practice all together. She became in many ways reoriented to other
cultural practices.12 This I argue is a moment in which kairos connects to newly acquired
identities. Coming to terms with a new identity, like infertility, reorients the body to new
scenes of rhetorical meaning-making.
Additionally, Arola’s example suggests a new scene of rhetorical inquiry, focused
on the interconnectedness between lived experience and rhetorical navigation. In many
ways, this dissertation is a project then that embraces Kirsch and Ritchie’s (1995) claim:
And although we believe women’s experiences are an important starting
point for research because they have been ignored and omitted in studies
of many kinds, we also believe that what can be learned from women’s
experiences and from feminist theory has wider implications for
composition research; it can become a location for reconsidering what
counts as knowledge and for revitalizing research in composition. (p. 7-8)
This is a project then that addresses the cultural and disciplinary silencing of
women’s lived experiences, paying homage to the many rhetorical decisions infertile
women encounter as a result of their diagnosis. Further, this is a project that openly
claims value in my own experiences as informing this research. Such a move is
																																																								
12
This idea of being reoriented because of infertility will be taken up again in Chapter 4
when I share moments in which my dissertation participants recall experiences of being
reoriented to cultural practices because of their infertility.
23

important in order to reclaim how colonial knowledge-making practices continually
reinforce patriarchal power positions devaluing lived experience as significant or valid
sites of inquiry.13

Conclusion
Finally, focusing on lived experience of infertility is informed by my fatigue and
felt pressure to study a topic that is so personal to me through a distant and strictly
discursive lens, like rhetorics of infertility. My lived experience with infertility, as well as
my conversations with many other infertile women, suggest multiple other landscapes in
which rhetorical knowledge could be made by studying how one negotiates and makes
sense of their infertility. This project thus takes on Kirsch and Ritchie’s (1995) call to
pursue “the difficulties inherent in a politics of location” as a process that will:
Inevitably lead us to question our accommodation with the status quo in
our discipline, to more seriously question the discipline’s traditional ways
of asking and answering research questions, to examine the internalized
structures, the standard conventions for generating and communicating
knowledge in the discipline, and to reshape our agendas for research and
action in the field. (p. 26)
Claiming that the personal can lead to action frames the site of this dissertation,
which focuses on my relationship with an infertility community-based, participatory arts
project and exhibit, The ART of Infertility. In the chapters that follow then, I advocate for
																																																								
13
Kirsch and Ritchie (1995) elaborate on this point, noting “We have been taught to
devalue our own experiences as researchers and writers, our relationships with
students and other teachers, and our own histories as sources for research and
scholarship” (p. 8).
24

a “research as care” feminist rhetorics methodology for examining lived experiences of
infertility. This chapter responds to the embodied tensions I have with methodologies
that erase the bodies implicated by their scholarship. Drawing attention to such felt
difficulty, I advocate in Chapter 2 for research as care to better address the invisibility of
bodies in rhetorical scholarship, and in particular rhetorics of health and medicine.
Research as care is carried through in Chapter 3 where I elaborate on the site and
methods informing this dissertation. Here, I articulate my own relationality with the site
and participants of this study and discuss how arts-based methods aid the capturing of
lived experiences of infertility. As such, I created an art-i-facts method engaging my
participants in more visual representations and discussions about their infertility. In
Chapters 4 and 5, I share the findings of my research focusing on the intersections of
art, infertility and reorientation. Chapters 4 and 5 demonstrate the various rhetorical
navigations and reorientations with the lived experience of infertility, or, embodying
infertility. In Chapter 6, I discuss takeaways from Chapters 4 and 5 and discuss how
these takeaways influence implications for The ART of Infertility. I reflect on how
rhetoric and composition may contribute to participatory and community-engaged
projects as well as reflect on the particular challenges that come with collaborative and
participatory engagements. The Afterward provides one narrative example of the
challenges faced in doing this dissertation in relation to the larger work of The ART of
Infertility.

25

CHAPTER 2
RESEARCH AS CARE: A FEMINIST REVISION TO STUDYING BODIES IN
RHETORICS OF HEALTH AND MEDICINE

Knowledge does not only emanate from academia; rather, ‘people’ also
create and possess knowledge. This perspective shifts the concept of
research from one in which the community is a laboratory for investigation
to one in which community members not only participate in the inquiry
process but also contribute their own knowledge.
— Karen Hacker, Community-Based Participatory Research, p. 5

Research is a caring act.
— Max Van Manen, Researching Lived Experience, p. 5

In Chapter 1, I provided an overview of how infertility has traditionally been
studied from a rhetorical lens. I made clear that while much scholarship exists on the
discourses constructing infertility, rhetorics of infertility frequently operates as a
framework that fails to consider the lived experiences of being infertile. Instead,
rhetorics of infertility as a methodological framework examines the larger, ideological
discursive structures shaping the construction of infertility. Infertility as rhetoric,
however, offers a new space for rhetorical inquiry on the topic. Exploring the lived
experiences of infertility, including the rhetorical decisions infertile individuals face,
makes infertile bodies, including their voices and perspectives, more visible in rhetorical

26

scholarship. This three-part chapter thus details a methodology to study infertility as
rhetoric.
Part 1 begins as an origin story, detailing how I first became motivated to study
infertility rhetorically. I share this story as it frames my cultural rhetorics orientation to
how I approach studying bodies in rhetorics of health and medicine.14 I argue that
rhetorics of health and medicine tend to draw on more interpretive methods to
understand and advocate for patient bodies, while cultural rhetorics methods depend
upon more narrative methods, which incorporate the voices of these bodies. I raise
unease with how bodies are incorporated and represented in rhetorical scholarship.
Noting this unease leads me to Part II, where I address my “felt difficulty” with
how bodies in rhetorics of health and medicine are frequently represented as subjects of
rhetorical analysis, rather than as human participants. I express concern how
interpretive methods of analysis may place more value in making rhetorical theory than
in advocating for the needs of the bodies their scholarship represents. This leads me to
ask several questions. What if rhetorical scholarship on bodies revised their scholarly
objectives? What if rhetorical scholarship embraced a more public turn? How may
rhetorical scholarship act as an ally to support more patient-centered practices of care?
What may we gain by tending to the lived experiences of patient bodies? To begin
addressing these questions, I suggest how adopting a humanizing research stance
(Paris, 2011; Paris & Winn, 2013) in rhetorical studies on bodies in health and medicine

																																																								
14	My decision to begin by telling a story enacts a cultural rhetorics methodology. That
is, as the Cultural Rhetorics Theory Lab claims “the practice of story is integral to doing
cultural rhetorics” (Act 1, Scene 1). I use stories then now, and throughout this
dissertation, to continue a cultural rhetorics methodological orientation to this project. 	
27

may move objectives of research towards more effective patient-responsive aims,
particularly through relationship building alliances (Kahana & Kahana, 2001).
Thus, in Part III, I offer “research as care” as a feminist methodology that revises
the aims of rhetorical scholarship on bodies in health and medicine. I outline how this
methodology, informed from Tong’s (1998) feminist ethics of care, responds to such felt
unease by tending to community-centered, participatory and relational approaches.
Doing so supports feminist rhetoric calls “for designing research that can enrich the lives
of those whom they study” (Royster & Kirsch, 2012, p. 34). I draw connections to
research as care as an ethical framework that cares for bodies in health and medicine.
Further, a research as care methodology tends to the affective response of “doing”
research, allowing for the researcher to tend to areas they are personally oriented
towards. Research as care, thus, returns rhetoric and composition to a more public turn
and, I ague, because of its commitment to care, a more humanizing approach to
studying bodies in rhetorics of health and medicine. I apply “research as care” to
support my dissertation study on infertility as rhetoric later in chapter 3.

Part I: Origins of Research: Lived Experience, Infertility & Queer Rhetoric
I need to be honest here. When I first decided to “go back to school” and begin a
MA program, most of my motivation was rooted in a need to make my body feel
productive. I needed to feel alive. I was tired of waiting, hoping to get pregnant. So,
when I received a letter of acceptance to enter an MA program in Critical Studies in
Literacy and Pedagogy, I was relieved. Finally, I could do something to keep me
distracted, to stop thinking about infertility. Graduate school would be my escape.

28

Ha! While I was fairly successful at keeping busy, developing new ideas, feeling
productive, infertility still remained a present force. I received my official diagnosis—
unexplained infertility— during my first semester of my MA program. Not knowing who
to talk to or what to think, I continued to distract myself. I decided to not acknowledge
my infertility. It was silenced, hidden from all aspects of my public life.
When I began the second year of my MA degree and needed to make the
decision to either continue graduate school or figure out how to make sense of this
anguish I was struggling to conceal, the decision to go on and receive a doctorate
seemed like the easier task to bear. Thus, when I began to apply to PhD programs in
rhetoric and composition, all of my application materials referenced how I desired to
build off of my MA work and focus on the intersections between critical pedagogy and
whiteness in the first-year writing classroom. None of my application materials
discussed anything related to the topic of infertility. The notion that I would even do
anything related to my personal experiences with infertility in my doctorate studies was
never mentioned.15
Therefore, when I made the decision during my master’s program to go on and
receive my doctoral degree, I knew that I was making a decision that could buy me a
few more years to escape “dealing” with infertility. To be clear, I had no intent to study
infertility as a graduate student or even future academic. This intentional separation
between my personal anguish with infertility and my graduate student identity slowly
																																																								
15
I take the risk of making visible the need to maintain silence around my infertility so as
to call attention to other areas of support in graduate education. While mentoring
graduate students is considered good, ethical and feminist practice, I want to make
clear that supportive mentoring of graduate students, as well as faculty members,
frequently does not consider being infertile as an area of additional, needed support.
29

began to diminish, when I enrolled in a course titled Queer Rhetorics during the last
year of my MA.
I still remember the day and place when my separation between my personal and
professional life eroded. It was Sunday in late September and I sat at my dining room
table skimming the upcoming weekly readings. This week the class was assigned
selections from The Routledge Queer Studies Reader (2013). I scrolled through two of
the assigned readings, Hennessy’s “The Material of Sex” and Cohen’s “Punks,
Bulldaggers, and Welfare Queens.” As I read these two pieces, I recall my body
becoming physically provoked.
In the Hennessy (2013) piece, I underlined:
‘Queer’ is a mark of the instability of identity. It makes visible the ways that
heterosexuality functions as a normative power regime and highlights the
arbitrariness of the neat distinctions it enforces (between masculine and
feminine, straight and gay, for example) in how sexuality and gender — for
some queer theorists race, too — come to be known. (p. 135)
In the margins, I scribbled “infertility.”

Reading “Punks, Bulldaggers, and Welfare Queens,” I was drawn to the Michael
Warner quote that Cohen (2013) cited:
Every person who comes to a queer self-understanding knows in one way
or another that her stigmatization is connected with gender, the family,
notions of individual freedom, the state…reproductive politics…intimate

30

life and social display…and deep cultural norms about the bearing of the
body. (qtd. p. 80)
On this page, I circled the word “family” and wrote once more in the margin “infertility.”
The next few hours I frantically wrote a rather jumbled reading reflection in which
I “came out” to Trixie Smith, the instructor for the course, as infertile and how these two
quotes in particular described not just queer life but infertility. I shared how heterosexual
norms failed to recognize or make visible infertility, referencing Hennessy’s quote. I then
described the deep stigma, silencing and even shame that comes with an infertility
diagnosis. I discussed the ways my body no longer felt like a female body and how
stigmas of infertility reflect “gender, the family, notions of individual freedom, the state,”
connecting it back to the Warner quote. While I did not have third-party documentation
of infertility as stigmatized or invisible, I cited myself. I claimed my infertility and drew on
my lived experiences to begin threading together infertility and rhetoric, anchored by
queer rhetoric.
I share this origin story of how I came to study infertility as it roots my lived
experience as a methodological orientation and also foregrounds how I view infertility as
rhetoric from a feminist rhetorics orientation.16 Only later on in my doctoral program was
it suggested that I tease out connections between infertility and rhetorics of health and
medicine (RHM), “an emerging interdisciplinary subfield” which “seeks to uncover how
symbolic patterns shape thought and action in health and medical texts, discourses,
																																																								
16
Cultural rhetorics signifies an orientation to culture as a plural entity. Meaning, cultural
rhetorics includes indigenous rhetoric, feminist rhetoric, African American rhetoric, as
well as queer rhetoric. This list is not meant to be taken as inclusive, but, serves as a
place to clarify that how a cultural rhetorics orientation includes feminist rhetoric and
queer rhetoric, discussed in this chapter.
31

settings, and materials” (Malkowski, Scott & Keränen, 2016, p. 1). RHM is an appealing
framework for scholars interested in intervening in the stigmatization of infertility. In fact,
in the special issue charting RHM as a subfield, Meloncon and Frost (2015) claim that a
defining feature of RHM is “the potential and possibility of affecting change” (p. 9),
indicating a phronetic aim embedded in RHM scholarship. Malkowski et al (2016)
elaborate stating “while some rhetorical scholarship about health and medicine remains
largely descriptive, analytic, and evaluative, other scholarship explicitly seeks to make
conditions better” (p. 5). To improve health care and medical conditions, many RHM
scholars:
Adopt a discourse-focused, social constructivist ontology in which
language and temporally situated cultural mores are seen as shaping
understandings of particular health conditions, embodied ways of being,
health identities, and medical practices…concerned with the power
dynamics of health care and medical communication. (Malkowski et al,
2016, p. 11-12)
Rhetorics of infertility, I argue, applies a similar discourse-focused analysis,
which examines discursive constructions of infertility and how such reinforces larger
cultural values and systems of power. I express caution, though, in some discoursefocused studies in RHM as it can make space for research that removes bodies
implicated in health and medicine. Take for example, De Hertogh’s (2015) analysis of
artifacts of discursive stories of a natural birth community online; Moeller’s (2015)
analysis of technical medical communication published on breast cancer awareness or
medical advocacy websites; and Owens’ (2015) analysis of online birth plans and birth

32

stories, as well as medical texts and popular advice books, to consider women’s
feminist rhetorical agency in childbirth. Respectively, these studies articulate concepts
of narrative, advocacy, and agency but they do so through interpretation of pre-existing
artifacts found through online publication. Yet, they are analyses of texts that are
removed from the bodies of those who produced them. As researchers, they are
physically removed from the communities in which those bodies reside. While studies
such as these may involve virtual communities or affinity spaces, the researcher enters
those spaces to mine pre-existing online data rather than engage directly with its
participants.
Many other studies in RHM enact a hermeneutic approach from an even more
distanced viewpoint, rhetorically analyzing texts removed from their makers. These texts
range from health and medical documentation (Rundbald, 2007; Hurwitz, 2006) to
pharmaceutical advertisements (Branson, 2012; Landau, 2011) to media coverage of
public health-related events and other medical phenomena (Dubrwiny, 2009; Koerber,
2008), to health and medical objects (Jordan, 2009). These artifacts may be patient
narratives, of particular emphasis in medical humanities, but also in RHM (Berkenkotter,
2008; Segal, 2007). This is not to suggest that the work rhetoricians do as interpreters
of discourse is not valuable. But I caution against how methodologies that remove
bodies from their created objects reinforces a Foucauldian-like gaze over the body.
In The Birth of the Clinic, Foucault describes how medical practice and discourse
create a “medical gaze” separating the patient as body from the patient as a person.
The clinician separating the body, creating the duality of the patient through discourse,
allows for the establishment of contemporary medicine as a disciplinary practice. The

33

gaze establishes medical knowledge in the hands of the clinician rather than the patient
as a person. Foucault (1973, 1994) explains, “if one wishes to know from which he is
suffering, one must subtract the individual, with his particular qualities” (p.15). In this
way, the patient becomes divided into two beings- allowing for the clinician to diagnosis
and treat the patient as a body. Such a practice situates discursive exigency and power
in the hands and language of the clinician.
I argue that when bodies of health and medicine are removed from rhetorical
inquiry and positioned as objects and producers of texts, rather, than engaged with in
scholarly production, scholars risk reinforcing a similar gaze, which places power into
the hands of the researcher to asses, evaluate and make theory abstracted from the
bodies that produced this.
Seymour (2007) echoes such a position, describing how the body of the
researcher and clinician become disguised so as to influence particular communication
practices. In her retrospective article, she reflects on her ethnographic research on
bodies in health and medicine, sharing:
I worked hard to ‘hide’ my disability from the conversations that
developed. It is not hard to discern remnants of professional behavior in
this strategy. In conventional clinical practice, a doctor might display
visible evidence of smoking, overimbibing, or underexercising, yet he or
she might solemnly advise a patient on the dangers of the behavior that
are clearly manifest in his or her own body. In effect, the doctor hides his
or her body so that it will not visually conflict with the health information
that he or she seeks to promote. Was I not, however, engaging in similar

34

behavior?...I minimized my body to focus on the inquiry on their bodies. By
absenting my body, I was unwittingly drawing on earlier professional
experiences that distanced me from the people I sought to understand.
(p.1192-1193)
Seymour’s reflection underscores the fact that “the body [in research] is always present:
it participates, shapes, informs, and is itself influenced by the interactions that take
place” (Seymour, p.1194). Her work asks us to reconsider how rhetoricians, using
ethnographic research methodologies, may simultaneously be engaging in similar
practices of clinicians and qualitative researchers – disguising their visible body. Such a
practice, she argues must be intervened on as “the body is not simply an incidental
variable; the body is a critical issue” (Seymour, 2007, p. 1188).

Part II: Embodied Unease
When I read rhetorical analyses of bodies, and in particular rhetorical analyses of
infertility (see Haas, 2008; Lee, 2016), I cannot help but feel unease and “felt difficulty”
(Dewey, 1910). I wonder if the participants represented in these articles not only know
but fully understand and consent to research being done on the texts and discursive
discussions produced? I wonder if the researcher/s fully understand the exigency for
such conversations. I wonder if there is any affect or reflexivity occurring in this
research. I ask this, not to say that affect and reflexivity is absent, but to underscore that
it is made invisible.
In other words, when we make bodies in our scholarship invisible, I worry if our
scholarship rhetorically listens (Ratcliffe, 2005) to what it means to be and live in those

35

bodies. For example, what does it mean to be and live with infertility, to navigate the
various and multiple rhetorical constructions of an embodied identity? Asking such a
question positions “understanding as an end of rhetorical listening” (Ratcliffe, 1999, p.
204), rather than a “rhetorics of” disciplinary knowledge-making orientation to our
research objectives.
To encourage a reorientation towards understanding, I adopt Paris’ (2011)
humanizing research methodological stance, which “requires that our inquiries involve
dialogic consciousness-raising and the building of relationships of care and dignity for
both researchers and participants” (p. 139-140). Adopting this stance asks me to
account for my positionality as both researching infertility and living with infertility.
Further, Paris’ humanizing research serves an ethical foundation to tend to the
relationality between my research and the participants that I work with and/or represent.
Paris’s humanizing research stance may find value beyond qualitative research and, I
argue, can be applied to health and medicine practices, which Seymour (2007) argues
continue to reinforce “scientific detachment in the pursuit of objective goals” (p. 1192).
Tending to dialogue and relationship building, in fact, may address Kahana and
Kahana’s (2001) concern over “unresponsive care” in which real-life circumstances
restrict “ethical ideals of advocacy to serve the best interests of their patients” (p. 22).
They advocate for “proactive involvement in health through building alliances” as an
effective strategy to confront contemporary bureaucracies in healthcare “which deliver
unresponsive care” (Kahana & Kahana, 2001, p. 42). In the section that follows, I thus
outline “research as care” which enacts Paris’ humanizing stance to articulate a guiding

36

methodology for studies of bodies in health and medicine, valuing more participatory
and thus patient-centered approaches to such research.

Part III: Research as Care
Research as care is methodological framework derived from feminist ethics and
feminist rhetorics. While “care” has been critiqued by some feminists as reinforcing
gendered “pathological masochism,” “fear of success,” or passivity” (Houston, 1987, p.
240), I draw on Tong’s (1998) feminist virtue ethics of care for healthcare practitioners
as well as Royster and Kirsch’s (2012) rhetorical revision based on an “ethics of care
and hope” (p. 135) to advocate for a research as care methodological approach. This
methodology, I argue, better addresses the embodied tensions and felt difficulty with the
representations of bodies in rhetorics of health and medicine scholarship. To be clear,
how bodies are written about in research matters. It indicates whom our research is for
— disciplinary knowledge-making, evoking public change, advocating for marginalized
peoples, etc. Understanding that how bodies are represented matters, this methodology
enacts an ethical commitment to represent bodies as humans, engaging in research
from a humanizing stance, as Paris advocates for, in our academic scholarship.
To build this methodology, I start with Tong (1998) who calls for healthcare
practitioners to enact a more feminist ethics of care approach, as opposed to a justice
ethics approach, in health and medicine. Drawing differences between the two
approaches, Tong (1998) outlines care ethics in six points: (1) care ethics “takes a
contextual approach”; (2) it “begins with an assumption of human connectedness”; (3) it
“emphasizes communal relationships”; (4) it “works best in the private realm”; (5) it

37

“stresses the role of emotions (or sentiments) in constituting good character; (6) it is
“female/feminine/feminist” (p. 131- 132). Tong contends that healthcare providers may
do more moral good by enacting this ethics of care as it helps “to develop caring
feelings as well as conscientious desires and empathic skills” (p. 151).
This ethical framework, I argue, is applicable not only for healthcare
professionals but for researchers working with patients in health and medicine, such as
rhetoricians of health and medicine. In particular, I find that Tong’s framework reinforces
Paris’ humanizing methodological stance, which stresses a relationship of care in our
research. Further, as an ethical framework emphasizing relationships and conscientious
aims, it creates an exigency to rhetorically listen (Ratcliffe, 1999, 2005) as a guiding
practice to doing research as care. Tong’s feminist ethics of care frames research as
care as a methodological approach demanding dialogue, reflexivity drawing upon
feeling, sentiment and affect as well as stressing relationship building between the
researcher and the bodies being researched or in other words, a participatory approach
informing ethics.
Additionally, I claim that the practice of research as care in rhetorical scholarship
acts as an ally to Royster and Kirsch’s (2012) call for shifting rhetoric and composition
methodological practices towards more feminist rhetorical aims. Royster and Kirsch
(2012) offer four feminist rhetorical practices to aid the shifting of the discipline of
rhetoric and composition towards one that “embraces a set of values and perspectives”
which “honors the particular traditions of the subjects of study, respects their
communities, amplifies their voices, and clarifies their visions” (p. 14). While all four
practices support a disciplinary reorientation for rhetorical inquiry, I view the following

38

three practices as integral to practicing research as care. One, critical imagination, “a
mechanism for seeing the noticed and the unnoticed, rethinking what is there and not
there, and speculating about what could be there instead” (p. 20); two, strategic
contemplation, deliberately taking “the time, space, and resources to think about,
through, and around our work as an important meditative dimension of scholarly
productivity” (p. 21); and three, social circulation, which “invokes connections among the
past, present and future in the sense that the overlapping social circles in which women
travel, live and work are carried on or modified from one generation to the next and can
lead to changed rhetorical practices” (p. 23).
These three practices, coupled with Tong’s ethical framework, builds a research
as care methodology, working to support the following three tenets. First, research as
care makes visible the bodies implicated by our rhetorical scholarship. This tenet
speaks to the ethical exigency that participant bodies in research must be recognized
and must be made visible. Doing so is a practice of caring for the bodies, the
participants in our research. Reflecting on how we make bodies more visible in our
rhetorical research forces researchers to strategically contemplate not only our methods
but the aims of our research. We may be well off to ask, how do we care for the bodies
that we represent in our rhetorical scholarship? How can the caring for bodies bridge
private academic spaces with more public practices?
Two, research as care embraces participatory-centered methods to support the
visibility of our participants. This tenet asks researchers to critically question how
existing methods represent bodies in our research. Doing so may invite moments to
revise, even invite, new methods that invite communities and bodies to participate in our

39

research. Research as care thus allows for a valuing of lived experience as a site of
rhetorical research. This aim invokes Royster and Kirsch’s (2012) critical imagination,
thereby, rethinking the spaces and methods of research scenes and rhetorical inquiries.
For example, how may methods that tact-in to feelings, sentiment and affect make
space for addressing rhetorical embodiment? How may participatory methods and
participant interpretations of their own texts assist in efforts that care for bodies?
Three, research as care accounts for the researcher’s personal experiences and
affect in the doing of this research. This tenet acknowledges the reality that a
researcher lives in a body, with its own experiences and affect. Research as care, thus
demands accounting for researcher motivations, researcher positionality in our work on
bodies. This position adopts Stanley and Wise’s (2002) feminist research stance,
explaining:
The personal is not only the political, it is also the crucial variable which is
absolutely present in each and every attempt to ‘do research’, although it
is frequently invisible in terms of the presentation of this research. It
mustn’t be absent from presentations of feminist research, because this is
to deny the importance of the personal elsewhere. In other words,
academic feminism must take feminist beliefs seriously, by integrating
these within our research. We see the presence of the researcher’s self as
central in all research. (p. 157)
Accounting for researcher bodies in our rhetorical research thus blends critical
imagination, strategic contemplation and social circulation. Taken together, making the
researcher’s body visible allows for tending to our own lived experiences, and how

40

those experiences can be critically imagined as informing our scholarship. As an act of
care, we must contemplate how we may best make our body visible to care for those we
work with in our research as well as how that research may care for us. Finally, it asks
us to make visible and circulate our own motivations for doing such work with our
participants. It requires a social circulation between ourselves as researchers and those
that appear in our research. Making the researcher body more visible to the participants
we work with as well as in our academic scholarship reinforces a more relational and
communal sense of research. Meaning, while we as researchers may care and
advocate for the betterment of our participants, they can also care for us and help us
develop more reflexive research practices.

Conclusion
By enacting these three tenets, research as care practices an ethically informed
methodology to studying and representing bodies in our research. This commitment, I
argue, is necessary to avoid “gaze-like” research, such as research practices removing
the body from disciplinary knowledge-making. Moreover, research as care serves to
account for the embodied, lived experiences that inform both the rhetorical experiences
of our participants as well as how our research impacts ourselves as researchers. Such
an orientation, I argue counters dominate rhetorics of methodological where bodies are
frequently erased. Instead, research as care operates as a methodological approach
understanding how bodies engage in rhetorical decision-making to navigate embodied
experiences. In the chapter the follows, I apply this methodological framework to my

41

collaboration with The ART of Infertility, the site of this dissertation project and the
organization from which I recruited participants for this project.

42

CHAPTER 3
ART-I-FACTS INQUIRY AS A STORYTELLING METHOD

Do we dare imagine that artistic enquiry can not only address questions
and methods of practice in the applied arts professions but perhaps help
other disciplines deal with difficult problems in keeping with the
transformative role of the arts through history?
— Shaun McNiff, Art as Research: Opportunities and Challenges, p. 6

Art is a more universal mode of language than is the speech that exists in
a multitude of mutually unintelligible forms…art speaks.
— John Dewey, Art as Experience, p. 349

I open this chapter with the epigraphs above to address a question that has yet
to be confronted in this dissertation. Why art in a rhetoric and composition dissertation?
Or, to draw on McNiff’s question, how may artistic inquiry extend disciplinary knowledge
in rhetoric and composition? The answer, I argue, can be inferred in Dewey’s response:
art is language-enacted. Thus, if art is itself a form of language, it is clear that rhetoric
and composition, a discipline concerned with the power of language, would do well to
examine art. Further, as Dewey alludes, art is more than a representation of language.
Art is action-oriented. Thus, art performs. Art intervenes. Art connects. Art provokes. Art
does.

43

I build off the statement that art does, and that rhetoric and composition should
pay attention to the doing of art – as an extension of language in practice – to situate
the site and methods of this dissertation. In Chapters 1 and 2, I laid the framework to
examine infertility as rhetoric and how tending to the embodied lived experiences of
infertility supports the stance that research can act as a form of care. In this chapter, I
detail how I used arts-based inquiry methods to understand the challenges and barriers
that come with living with infertility. Desyllas’ (2014) statement differentiating arts-based
methods from other qualitative research methods informs my decision to use a form of
art-i-facts inquiry methods to examine the lived experiences of infertility. She writes:
What distinguishes arts-based research from traditional qualitative
methods are the multiple creative ways of representing experiences and
the different representational forms (medium) of expression that can
effectively enhance the understanding of the human condition and
experience. (p. 478)
Further, my decision to use arts-based methods in this dissertation is reinforced
from my community-engaged work with an arts and infertility organization, The ART of
Infertility. It was through my involvement with this arts-based organization that I began
to trace the connections between art, infertility, lived experience and rhetoric and
composition. In this chapter, I describe these connections through a series of research
stories. My decision to share how I came to this dissertation project, told as a series of
stories, is informed by a cultural rhetorics methodology, reinforcing that “story is integral
to the practice of cultural rhetorics” (Powell et al, Act I, Scene I). Further, my decision to
explain the origins of my relationship with The ART of Infertility is intentional, as it

44

demystifies the “finding” of a community-engaged project. In sum, making visible my
embodied orientations to the sites and motivations of this research models a
methodological practicing of research as care.
That is, when I present on my community-engagement with The ART of Infertility
at academic conferences, I am frequently asked the question: “How did you find this
organization?” To answer this question requires a stepping back and theorizing
engagement as methodology, as Grabill (2010) suggests. In his chapter “On Being
Useful: Rhetoric and the Work of Engagement,” he argues that a methodology of
engagement draws upon the ability “to associate” as a method and strategy for
engaging in public rhetorical work. To do engaged work then requires methods that
associate with communities. Such an orientation to community-engaged work suggests
that the question should not be “where to find a site” but how one works, collaborates,
associates in such sites.
Thus, when I am asked about where I “found” my project, I make clear how my
relationships informed my community-engaged work. This flips the framework of
community-engaged research. Rather than community-engaged work entering scenes
with a pre-established agenda, a relational approach to community-engaged work
collaborates and develops more participatory practices and agenda with that
community. Tacking into relationships serves as a more decolonial approach to
community-engaged public rhetoric work.
In the collaborative article written by my co-authors, “Our Story Starts Here:
Constellating Cultural Rhetorics,” we draw on Tuhiwai Smith’s work to argue that:

45

In the place between resistance and making, we see a location for the
practice of cultural rhetoric — a practice that creates a decolonial space
inside rhetoric studies. It is here, we believe, where we can forge
necessary relations inside and outside of the university. This relationship
allows us to make scholarship — to develop frameworks — reliant on
growth and sustainability, instead of negation and destruction. And
[Tuhiwai] Smith reminds us of something we often forget within academe:
research is about people. It affects people. It can save and destroy lives.
(Powell et al., Act II, Scene I)
Drawing upon relationality as a source for working with communities practices a
cultural rhetorics approach to community-engaged and public rhetoric work. In what
follows then I share the story of how my personal relationship with infertility led me to
“finding” The ART of Infertility. The story of my collaboration with The ART of Infertility
reveals the moments of rhetorical inquiry, which appeared through my participation in
the project. Finally, I turn to how these storied moments influenced the development
and design of this dissertation. Throughout these stories it will be made clear how I
have developed close personal relationships with many of the participants that agreed
to partake in this dissertation. This chapter thus highlights the set of relations,
relationship-building, and relationship-informed practices that guide and have informed
the conception of this dissertation.17
																																																								
17
I stress relationality as I view it as a practice that mobilizes my methodology research
as care. Reflectively and attentively tending to relationality enacts an ethical orientation
to making visible participant bodies, embracing participatory-centered methods, as well
as accounting for researcher lived experiences as well as researcher affect informing
the interpretation, representation and aims of research.	
46

The ART of Infertility
The ART of Infertility18 is an international art, oral history and portraiture traveling
exhibit and was founded in 2014 by Elizabeth Horn-Walker. As an infertile woman who
recently suffered a miscarriage of twins from an IVF cycle, Elizabeth, a professionally
trained photographer, found herself turning to art as a method of self-preservation and
healing. She along with several other infertile individuals she met through her journey
created a series of artwork representative of infertility to be displayed at a local
Michigan museum. The title of this first exhibit was “The ART of IF: Navigating the
Journey of Infertility” and aimed to provide general education to the public about
infertility as a disease.
I did not meet Elizabeth until near the end of this exhibit. In May of 2014, I
traveled to Washington D.C. to attend RESOLVE: The National Infertility Association’s
annual Advocacy Day. The aim of this annual event is to have infertile patients and
representatives lobby Congress on access to care and other issues important to the
infertility community.19 This lack of insurance coverage is what contributes to the
exorbitant out-of-pocket costs associated with fertility treatment, i.e. one-round of IVF
costing in total with medications nearly $25,000. For those diagnosed then with
infertility, many view the lack of fertility coverage as a social justice health issue.
																																																								
18	The name of the project has a double meaning. The artwork, created by women
struggling with infertility, and Assisted Reproductive Technologies (ART), the medical
treatments that help those struggling to become parents. IF also has a double meaning.
IF is the acronym for infertility. It is also a common word that infertility patients use as
they live the limbo that infertility forces them into as their schedules are controlled by
fertility treatments.
19	Important to note is that on a federal-level insurances companies are not mandated to
provide fertility coverage. On a state-level, only 15 states have fertility-related insurance
mandates. 	
47

I, myself, was interested in attending this Advocacy Day for two reasons. One, I
had recently begun a RESOLVE peer-led support group in my local community and
desired a space to connect with other infertile individuals who were also running support
groups. Two, I was in the beginning stages of my PhD. At this time, I knew that I wanted
to study infertility rhetorically, but I did not know exactly where or what my focus should
be on. When I shared my interest to study infertility in a graduate class, Malea Powell,
the course instructor, told me that to figure out what to study I first needed to get
involved in that community. I approached Advocacy Day then as one opportunity to
become involved, as an event where I could listen to the concerns of the infertility
community. Advocacy Day served as an event to connect with the range of individuals,
well-beyond my local community, infertility has impacted.
This is where I met Elizabeth and how I became involved with The ART of
Infertility. As two infertile women from the state of Michigan, Elizabeth and I spent our
day in Washington D.C. together. We shared Congressional meetings, we shared our
infertility stories, we shared our experiences of running peer-led support groups, and
more so, we shared how we both turned to creative outlets — Elizabeth with visual art
and myself with creative writing — to make sense of our lived experience with infertility.
After Advocacy Day, Elizabeth and I continued to stay in touch and met regularly.
At this point the art exhibit was no longer showing in Michigan. But interest and desire
amongst infertile individuals to participate in the project – either by sharing artwork or
contributing their own stories— continued to increase. Elizabeth frequently shared with
me the increasing demand for the exhibit to become a sustainable project. During this
time, I was enrolled in an Oral History Methodology class and saw moments in which

48

oral history methods could be applied to support the storytelling portion of the project.
We worked together that summer to establish an oral history protocol and filed for IRB
status.20 From that summer on, Elizabeth and I worked to establish the project on a
national-level, traveling to several states to host art and writing workshops as well as
exhibitions. Eventually, this led us to begin formalizing into a 501(c)3 organization,
where Elizabeth and I now work as Co-Directors.21

Community-Engaged Practices of Making & Rhetorical Inquiry
I share this story of how I met Elizabeth and my involvement with The ART of
Infertility to highlight how the building of relationships has informed the design of my
dissertation study. That is, as the project grew, so did the connections I began to make
between art as doing, art as intervention and, specifically, the overlaps between art as a
form of multimodal composition and how art as a form of making aided the reflective
processing of being assigned a new identity, like infertility. While these connections
were no doubt influenced by the graduate coursework, I want to stress the importance
of how my involvement with the project and community embeddedness served as the
source for unearthing these connections.
My first memory in which I began piecing together the intricate relationship
between art and infertility was in April of 2015. At this time, The ART of Infertility was in
its very early beginnings of developing community-engaged outreach. Elizabeth was
																																																								
20	Our decision to file for IRB was not to establish the project as a research organization.
Rather, it was to protect the participants we were working with who wanted to contribute
their infertility stories to the project. 	
21
As Co-Directors, Elizabeth is tasked with overseeing community outreach. I am
tasked with establishing the research agenda and aims of the project.
49

invited by some contacts she had made at other infertility events to come to Calabasas,
California and host a small pop-up exhibit and art workshop. As an event needing
volunteers, Elizabeth invited me to travel with her and help her set up the exhibit and
promote the event. I accepted the offer and spent those days in the greater Los Angeles
area collecting oral histories, gathering artwork, gathering art supplies and helping her
set up the pop-up.

Figure 2. A love branch created at the workshop.
Part of the event included an opportunity for participants to partake in a “love
branch” workshop. This workshop invited individuals to select a branch, brought in by
the workshop host, and use a variety of materials to express a story related to infertility.
Participating in this workshop, as well as helping others tie on nests and other small
50

trinkets, I could not help but note the discussions that were happening in this space.
Participants expressed the need for particular colored materials, for particular beads.
For example, some women wanted beads that were shaped as hearts, some wanted a
bead with an initial on it to honor a child that was miscarried. Participants were also very
strategic about where they hung their beads or other materials on the branch. The order
mattered. They were telling a particular story. Image 1, pictured above, depicts a love
branch workshop.
When I participated in the love branch workshop, it became clear how art and
material objects are co-opted to tell particular stories. Further, how the making of art
itself allowed for stories to be told around a table. These stories were painful. Stories of
numerous miscarriages. Stories of failed treatment. Tears were shed and art – as
representing a particular story – was created. Many of these participants noted how
they were going to take these branches home and hang them in their house. Some
noted how one would go in the nursery that was still empty, the branch acting as a type
of offering. Another noted how one would go in the yard, and how she decorated it with
chimes, so that she could hear it and be reminded of a child she miscarried. These love
branches were more than just “arts and crafts,” the love branches became an artifact of
all of the stories and memories these women have carried with them. These love
branches provided a materiality to the grief they embodied.
This scene of community-engaged making informed much of this dissertation. I
wanted to learn more about the stories embedded within the pieces of art that The ART
of Infertility curated. As I observed each participant making pieces of art at this
workshop two takeaways began to emerge. One, infertility art appeared to act like Haas’

51

(2007) discussion of wampum as a cultural artifact, in which meaning and stories are
layered in the actual artifact. Two, art-making seemed to serve as a catalyst for
reflection. This idea mirrors Dolmage’s (2012) discussion of inward learning, in which
composers attend to the corporal materials of composing. Doing so, initiates moments
for critical reflection in making rhetorical decisions about the created image, its colors,
textures as a larger story. These two phenomenons, (1) art as an embedded artifact and
(2) art making as a catalyst for critical reflection, informed the framework for this
dissertation study.

Drawing on Relationships to Design the Study
As I continued my collaborative partnership with The ART of Infertility, I shared
with Elizabeth the connections that I began to make between art, infertility and
multimodality.22 She frequently participated in these conversations, as we would reflect
on a new piece of art donated to the project or a recent art workshop that we had
facilitated. Engaging in these reflective practices influenced the development and
objectives of The ART of Infertility. As such, the project took on a two-part objective: (1)
community-outreach facilitating support and awareness; (2) and an embedded research
approach to examining the linkages between art, infertility and story. This two-part
objective naturally emerged and took particular shape as I began my dissertation
design.
The ART of Infertility served then as the site for this dissertation project. I chose
this site to inform my research as I hoped for it to provide moments to understand the
																																																								
22
These connections will be further elaborated on in Chapter 6, my implications
chapter.
52

rhetorical strategies infertile individuals engaged in as a method to navigate barriers to
infertility care.23 I wanted to understand why The ART of Infertility participants created
pieces of art representing their infertility. I wanted to explore how, if at all, art served as
an extension of translation. This idea of art as translation refers back to Dewey’s notion
that art speaks, art does, art is language-enacted. As such, I designed the dissertation
around the central question: How does multimodality24 function as a rhetorical
translation of the embodied experience of infertility?
To answer this question then I needed to recruit participants. As a study attached
to The ART of Infertility, I consulted Elizabeth about whom she thought would be willing
participants. Reflecting back on prior relationships with these artists, Elizabeth and I
identified several individuals whom we thought would be wiling to participate. In the end,
I ended up contacting three individuals: Adi, Sara and Meg. 25 My rationale in asking
these women to participate was based upon the prior relationships that I had with them
as well as their artwork. Sara and Meg I had previously met and had established a
relationship with them. They knew my personal story with infertility and I already knew
much of their story. Additionally, I was personally moved by Sara and Meg’s artwork.
Their pieces were provocative and emotionally grabbing. I must disclose that I did not
																																																								
23
By infertility care, I am referring to both fertility-treatment and related healthcare as
well as larger cultural situations requiring navigation, such as an unsupportive family
member.
24
I use multimodality here to reference the study’s relationship to rhetoric and
composition. More specifically, I am referring to multimodality as including arts-based
making practices. This claims is informed by Selfe and Takayoshi’s (2007) definition of
multimodal composition, which claims that multimodal pieces “exceed the alphabetic
and may include still and moving images, animations, color, words, music and sound”
(p. 1).
25	You will learn more about their individual stories in chapter 4. All three of these
women had made pieces of art representing their infertility and later donated these
pieces to The ART of Infertility for exhibition.
53

have a personal relationship with Adi. When she first donated pieces of art to The ART
of Infertility, I was not yet involved in the project. However, I admired many of the pieces
that she created. I was also interested in learning more of Adi’s perspective as she
identifies as Israeli. My intention was to capture a more global, yet still Western,
perspectives of living with infertility. Identifying these three women as potential
participants, I emailed them explaining the project and inquiring if they would be
interested. Each of them agreed.

Art-i-Facts Method
After I recruited my participants, I arranged individual online, audio interviews
with each of the three participants. Prior to the interview, which took about 1-2 hours, I
asked each participant to review and sign the interview consent form. I also asked for
each participant to identity 2-5 pieces of artwork that they created and donated to the
project.26 These pieces of art served then to facilitate what I call an “art-i-facts”
method.27

																																																								
26
While I was interested in work that was already part of The ART of Infertility exhibit,
some participants did bring work that had not yet been donated. Given the personal
significance and stories that these pieces held, some of these pieces appear in this
dissertation.		
27
. This art-i-facts method is play in meaning on multiple levels. First, it is in reference to
Halbritter and Lindquist’s operationalization of artifacts to solicit stories typically
unavailable to traditional ethnographic research. But art-i-facts is also a play on the
meaning behind the art our participants brought to their interviews. The art-i-facts
represent, at least partially, their experiences with ART (assisted reproductive
technology). Additionally, art-i-facts is also a play on what Mantas (2016) has called
“notions of fact (i.e. scientific facts) and fiction (i.e., artfully crafted forms), especially as
they relate to telling and retelling, remembering, and memory” (p. 118). Mantas’
explanation suggests various layers of storying embedded within artifacts.
	
54

This method is informed by Halbritter and Lindquist’s (2012) four-phase, videobased, interview methodology, which engages in inquiry around scenes of literacy
sponsorship. Central to their narrative inquiry is that this methodology does more than
ask students to tell stories of literacy, instead it invites both the participant and research
“to go find these stories” (Halbritter & Lindquist, 2012, p. 173). This narrative
methodology then is what Halbritter and Lindquist (2012) claim as “a story of
researchers learning to learn — not only from the research, but also through it” (p. 173).
While their methodology invites participants to research their lived literacy experiences
through a series of structured scenes, I drew on Halbritter and Lindquist’s first phase: a
personal history interview, which centered around participant-selected artifacts.
As such, during the online interview, I asked my three participants a series of
open-ended questions, inviting them to analyze and narrate the artwork brought to the
interview. Questions that did this are reminiscent of: Can you tell me why you opted to
create an oil painting? Why use oil paints? Did that medium allow you to express
something in particular about your infertility experience? Or, can you tell me a bit more
about the choice to use a deep red in this piece? What is that communicating about
your infertility?
The decision to ask my participants to narrate their infertility through their art was
intentional and for several reason. First, experiences associated with infertility, such as
miscarriage or physically invasive treatments, are traumatic. To reduce trauma, I
wanted my participants to be able to talk about their experiences through a piece of art.
Second, this decision also helped focus much of the interview on the relationship
between art s multimodality and infertility. My fear in applying oral history methods to

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the topic of infertility was that participants would talk about their infertility stories without
connecting them to the pieces of art that they created.

Participant Input After Interview
Once the interview was conducted, I informed my participants that I would be
sending out the interview to a transcription service. Once I received the transcribed
interview, I reviewed the transcription and sent it out to my participants to review, edit
and comment. I received edits and comments from Adi and Meg. I did not receive any
edits or comments from Sara. This decision for participants to review their interviews
was to support my feminist methodology – research as care. I wanted my participants to
feel as if they had ownership over their stories and that the transcription was not only
mine but theirs as well. I also invited all three participants to write their own bio for how
they wanted their story with infertility represented in the dissertation. These bios inform
how participants are described in Chapter 4.
Once I received the edited transcripts and participant bios, I began to
thematically code each interview using feminist critical discourse analysis, which takes
“a political perspective on gender” and is “concerned with demystifying the
interrelationships of gender, power, and ideology” (Lazar, 2005, p. 5). This method
allowed me to attend to any dominant gendered themes that appeared across each
participant’s experience. Infertility researchers have remarked on the gendered
disparities of infertility, noting that:
In general, women consistently report higher levels of infertility stress
when compared with men (Greil, 1997). Because women experience

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greater levels of distress, they often report using coping strategies more
frequently than men. (Peterson, Newton, Rosen & Skaggs, 2006, p. 2443)
Given the impact of gender on experiences of infertility, I used feminist critical
discourse analysis to trace how my participants represented gendered experiences of
infertility in their art or how those experiences emerged during our interview. I used
analytical memos to organize and trace themes that emerged in each participant story.
Emerging from these coded memos were three major stories that pertained to the
following themes: (1) a need to navigate, or reorient, themselves to what it meant to live
with infertility as an embodied identity; (2) a desire to circulate their infertility stories;28
(3) art served as a central method to reflect on their reorientations, represent their
reorientations and ultimately be used as an appeal for others to consider the challenges
of living with infertility.

Conclusion
I drew upon these three emerging themes and found that there was an
embedded process to these themes. First, all of my participants noted a need to
process their infertility as a newly acquired identity. They needed to grapple with what it
meant to them personally and culturally to be diagnosed with infertility. In Chapter 4, we
will learn how the making of art actually helped assist the reflective processing of
identifying as infertile. Part of processing infertility meant developing an awareness of
how cultural discourses assign meaning to infertility as an identity. Chapter 4 focuses on
moments in which my three participants remark on how infertility has forced them to
																																																								
28	Stories can refer to written narratives, oral histories, visual art or creative writing.		
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reorient. Art becomes a method to grapple with and represent the cultural challenges of
being labeled infertile. By enabling reflection, art allows one to make reorientations
more visible to themselves. I draw on Ahmed’s (2006) theorization of orientation in this
chapter to call attention to art making as a reorienting, self-reflective processing
technique allowing for one to make sense of their infertility. In Chapter 5, I examine then
how these artists desire their art to be interpreted by others. While Chapter 4 adopts a
more inward, reflective approach Chapter 5 discusses how art is a method of selfadvocacy for these participants. Art allows them to tell their individual stories of
reorientation to others. Doing so, they remark how they hope others may see infertility
better. Art serves as a appeal to others to understand what it is like to live with infertility
by using materials to give infertility a materiality. Nonetheless, these appeals are varied.
There is no “one” approach to infertility advocacy. Rather, I use the word “appeal”
purposefully as it responds to the specific embodied orientation each participant has to
their infertility experience. At the heart of these findings then is the reality that art does
more than represent, art tells stories, art affects the heart, art does.

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CHAPTER 4
ART AS A RHETORICAL REPRESENTATION OF INFERTILTY’S REORIENTATION

The medicalization of infertility builds on the flawed social identity of
infertile women. The very process of medical intervention further
stigmatizes women and devalues them for any accomplishments outside
of reproduction…The result is that once a woman enters into the medical
intervention process to treat infertility there is a great pressure placed on
her to continue treatments until there is either a ‘successful’ outcome, or
all the options have been exhausted. Until U.S. dominant cultural norms
value women equally for their productive and reproductive roles, flawed
social identities for infertile women will remain.
— Linda M. Whiteford and Lois Gonzalez, “Stigma: The Hidden Burden of
Infertility,” p. 36

I begin this chapter with the epigraph above to situate the stigma attached to an
infertility diagnosis, and in particular, how cultural norms impact a woman’s infertility
identity.29 To be clear, receiving an infertility diagnosis – particularly in Western culture –
is often traumatic (Schwerdtfeger & Shreffler, 2009). Social scientists report an
immediate sense of grief accompanying diagnosis, particularly for women. Much of this
																																																								
29
While Whiteford and Gonzalez’ scholarship on stigma and infertility is relatively dated,
other scholars (see Allison’s (2011) examination of silenced experiences of infertility in
Ireland; Barnes (2014) exploration of stigma and male infertility; and Sternke et al’s
(2015) study on stigmatizing experiences of infertility as a disability) have continued to
note a cultural continuation of the silencing and stigma that is attached to experiences
of infertility.
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is a result of Western culture’s embrace of pronatalist ideologies, which link a person’s
social value to procreation (Parry, 2005). For example, Galhardo, Pinto-Gouveia,
Cunha, & Matos (2011) explain how young women become taught through cultural
messaging to desire motherhood and associate being a mother with being female,
stating:
During childhood and adolescence, social messages about the importance
of parenthood are constantly disseminated and especially for women,
being a mother is something often central to identity. Thus, a sense of loss
of identity and feelings of defectiveness and incompetence are quite often
experienced. (p. 2409)
Thus, when women receive an infertility diagnosis, the experience is frequently
described as:
A major disruption in one’s projected life course, a failure to live up to
normative notions about what it means to be an adult woman in American
society, and a challenge to the stability and quality of social relationships.
(Greil, 2002, p. 101)
These examples highlight how prontalist cultural messages continually reinforce a
particular orientation that values female identity with motherhood.
I draw on Ahmed’s (2006) Queer Phenomenology to explain how orientations
and reorientations operate. She states:
A path is made by the repetition of the event of the ground ‘being trodden’
upon. We can see the path as a trace of past journeys. The path is made
out of footprints — traces of feet that ‘tread’ and that in ‘treading’ create a

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line on the ground. When people stop treading that path may disappear.
And when we see the line of the path before us, we tend to walk upon it,
as a path ‘clears’ the way. So we walk on the path as it is before us, but it
only before us as an effect of being walked upon…Lines are both created
by being followed and are followed by being created. (p. 16)
Orientations, according to Ahmed, are paths made visible through repetition. In this
way, the desire to become a mother can be understood as a visible path continually
perpetuated by discourses and pronatalist beliefs that “promotes motherhood as the
most important role for women” (Ulrich & Weatherall, 2000, p. 334). To want children, to
want to become a mother, is to follow a path continually made visible and valued by
cultural practices.
But what happens when one discovers they may not be able to attain
motherhood? These paths are not as visible. Infertility thus forces the female body to
reorient oneself to new conceptions, new pathways, for the female body to walk. To
reorient oneself, first, requires self-reflection. One first develops self-awareness of how
they do or do not conform to a particular path. Upon doing so, they may choose to try
and align themselves to a visible path. This may occur through the attempt to become
pregnant through fertility treatments or through attempts to become a parent through
adoption or foster care. The infertile woman may also choose to reorient themselves to
a path that is not yet as visible. This reorientation may occur by creating an alternative
path that contests pronatalist values, such as choosing to live childfree. Despite these
various paths, at the heart of each reorientation is reflective navigation. Infertile

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individuals are forced to navigate scenes and experiences that often are not visible to
those who follow and align with more dominant paths.
In this chapter, I introduce my three participants and share their stories of
reorientation. These stories were told to me when the participants narrated exigency for
their pieces of artwork, connecting them to their infertility journey. In the next chapter, I
turn outward, sharing how my participants view their pieces of art as appeals for
advocacy. These pieces of art make visible their reorientations and begin to trace paths
that are often not seen to those whose bodies align with pronatalist practices. Before I
do so, though, I begin with each woman’s infertility reflection and connect those
reflections to moments in which they speak of being reoriented to a culture that often
ignores experiences of reproductive loss and grief.

Meet Sara
When I interviewed Sara for this dissertation, in January of 2016, she was just
beginning to prepare for her second in vitro fertilization (IVF) cycle in Colorado. She had
recently undergone her first IVF cycle, which did not take. This failed IVF cycle resulted
in the creation of a piece of art titled “Failed IVF#1,” pictured below.

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Figure 3. “Failed IVF #1”
As we began the interview, I asked Sara to share the story of when she received
her infertility diagnosis and to describe the experience of learning she could probably
not naturally conceive. Thinking back to when she was diagnosed in 2014, she explains
to me:
It's been kind of a whirlwind. I've been on this infertility path I'd say about a
year and a half now. I had originally gone to my OB/GYN and said, "Hey,
I'm considering having a family," and she said, "Great, see you in a year." I
came back and I was like, "Okay, do I have a green light to try and to have
a family?" I asked her that because I had been trying to lose weight. That
was really where it all started. I tried for about two years to lose weight
and didn't get anywhere. I kept cutting foods out of my diet. I keep adding

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in exercises and cutting out more foods, adding in more exercises. I was
just getting to the point where I was insanely frustrated. I went to a general
practitioner and she said, "Well, you're now pre-diabetic," and she yelled
at me about my weight and sent me to a crazy nutritionist. It was like this
huge roller coaster. The doctor sent me to this nutritionist and this
nutritionist wasted my time telling me that my diet was not sustainable.
The nutritionist put me on a different diet but it was ridiculous ... I ended
up firing that doctor and found a new one. After I found a new one, and
still wasn’t getting pregnant, the new doctor started saying, "Well, maybe
you have polycystic ovarian syndrome." With the PCOS diagnosis, nobody
seems to be able to confirm that I have it. I'm actually personally very
frustrated with PCOS as a diagnosis for me. I don't feel it fits. Of the
symptoms of PCOS, I only have three and they are the thin hair, difficulty
with weight loss and elevated testosterone levels when I'm not on
Metformin. Now, I'm on my third doctor. I don't want people thinking I’m a
doctor hopper. It's not that. If somebody isn't going to hear me as
somebody who gets my own body and knows myself very well, then I'm
going to leave and find somebody who will listen to me.
Still not pregnant, it was recommended that Sara undergo a dye test to
determine if her fallopian tubes were blocked. During this procedure it was discovered
that she has a T-shaped uterus and that her tubes are at least partially blocked. One of
her doctors believe she was exposed to a particular drug by her mother when she was
in utero, though the timeline for this does not add up. She explains:

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My uterus is T-shaped and my tubes are either not completely formed or
clogged. Nobody has been able to answer that question for me just yet.
Because of the shape of my uterus, I was also diagnosed with exposure to
diethylstilbestrol. This was a drug that was given in the 1950s. By 1971
doctors were told to stop giving that drug to expectant mothers because
they found that it caused infants to be born with a T-shaped uterus and
causes frequent miscarriages or ectopic pregnancies. The problem is that
I was not conceived until 1975’ish because I was born in 1976. So the
math doesn’t add up. I do know that my mom was given an injection to
keep her from miscarrying me, but the records are gone and the doctor
has passed away, so I will never know what drug I was exposed to.
Given the variety of factors possibly impairing Sara’s fertility, her T-shaped
uterus, her possible PCOS diagnosis, her weight, it was recommended that if Sara
wanted to become pregnant she should undergo an IVF treatment. I asked her how she
reacted to being told she needed to do treatment. She tells me:
I am one of the lucky ones, my husband is employed by a state that has
mandated fertility coverage. In my particular case, I get three IVF tries. It's
kind of a three strikes you’re out policy, but it's amazing coverage and I'm
so thankful to have it, because if we didn’t, I don't know if I would have
been able to afford it. And the reality that my first IVF treatment failed is
scary. If I did not have coverage, I probably would not have been able to
afford another treatment cycle. Failing my first treatment was already
devastating. I can’t imagine if that was my only chance at having a baby.

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Elaborating, she shares how she never realized that fertility treatments were not always
covered by insurance. The shear cost of treatment, and how that impacts the ability to
build one’s family, is part of the reasons why she wanted to create “Failed IVF #1,”
stating:
I am very frustrated that insurances don't cover this. That's one of the
reasons I wanted to do the art piece and that's one of the reasons I
wanted to talk with you. People need a name to go with these things.
Infertility doesn't have a face or a name. It’s like it is lost in a void. When it
suddenly happens to someone you know or someone who's near you,
then suddenly it has real impact. The statistic that infertility impacts one in
eight people is fucking high! And not everyone has insurance coverage. I
just don't understand why it's not covered.
Through these series of reflections, where she discusses the motivations for her art
piece, Sara reveals a reorientation to the ways in which healthcare practices often
ignore women’s health issues, such as infertility. She explains:
I feel like in our society women's health is not as paramount as men’s
health, and I don't know why. The male is considered “normal” in most
scientific studies and the female is considered “abnormal.“ I guess I just
am very angry because I think that is what contributes to infertility not
being covered. I think the other reason that it's not covered is because of
how much money pharmaceutical companies make on fertility drugs. For
infertility to be covered, I think there would be a lot of money that lost and
there is no incentive to make this process cheaper at this point in time.

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These conversations with Sara, who discusses the medical factors and
healthcare costs with infertility, reveal a more critical reorientation to infertility as a
healthcare issue. Her reflections reveal how cultural practices are simply not oriented
nor taught to recognize and validate infertility as a medical experience. This is evident
from her statement:
People need a name to go with these things. Infertility doesn't have a face
or a name. It’s like it is lost in a void. When it suddenly happens to
someone you know or someone who's near you, then suddenly it has real
impact.
Much of Sara’s reorientation to viewing infertility as a medical condition is rooted
in her failed treatment and the difficulty she has experienced in trying to figure out what
is the cause of her infertility. Later, in Chapter 5, Sara will share more about the need to
make infertility as medicine more visible or as she hopes for others to see “all those
needles, all that medicine” going into a fertility treatment. For Sara, who is relatively new
to living with infertility is reorienting, is becoming more critically aware, of the intense
medical treatment and the costs associated with it – all in an attempt to become
pregnant. Experiencing a failed IVF treatment also is reorienting her to the reality that
medicine, despite how promising it may seem, is not always the simple solution. Getting
pregnant can be hard, really hard and for those who can get pregnant easily they simply
do not realize all that is involved when one tries to build a family and experiences
challenges.

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Meet Adi
Adi’s story reflects similar reorientations. For Adi, she is still in the process of
trying to conceive, trying to figure out what treatments may help her become pregnant.
However, Adi has been invested longer than Sara in her journey to become pregnant.
She has had to navigate more moments of failure than Sara. She has had to undergo
more treatments than Sara. She has had to grapple with the reality that despite all of
this, she may never become pregnant. She has also had to find ways to distract her
from thinking and dwelling about infertility. Her story supports how infertility is a process
that continually reorients oneself as time passes and no pregnancy occurs.
At the time that I interviewed Adi, an Israeli woman, she was 32-years old. She
explained to me over an email exchange that when she and her husband made the
decision to begin building a family, the two of them were living in California. They had
moved to the United States for her husband’s job, but after months of trying to conceive
with no luck, she and her husband began consulting a fertility specialist in the Californiaarea they were residing. The fertility specialist recommended Adi and her husband
undergo several medical procedures in an attempt to pinpoint the cause of their
infertility. Adi, thus, underwent three painful hysterosalpingograms (HSGs) and her
husband submitted several semen samples for semen analyses, which would examine
sperm motility and sperm morphology. The results of those tests were inconclusive,
leaving the fertility specialist to rule Adi’s inability to conceive as “unexplained.”
Not knowing the direct cause of their infertility, it was recommended by the
specialist for Adi and her husband to begin treating their fertility through interuterine
insemination (IUI). Adi and her husband agreed to the treatment and Adi underwent a

68

total of 5 unsuccessful IUIs. With no success, it was recommended that Adi and her
husband move on to in vitro fertilization (IVF). Adi and her husband once again agreed
to the treatment. However, the IVF procedure did not succeed. In total, Adi and her
husband spent nearly $25,000 in fertility-related treatments. Wanting to still build a
family, they made the decision to leave California and return to Israel where fertility
treatment is common and less costly than the United States.
During our interview in February of 2016, Adi noted how they were continuing
some treatments in Israel, though her husband and herself were taking some breaks
and enjoying life rather than only focusing on trying to get pregnant. She shared with
me:
I feel like because of infertility a lot of stuff in life is complicated. You want
to have kids and you think about your life with kids. But then, again,
sometimes you don’t. Sometimes you want to just have fun. Like the ski
vacation we went on, it was fun. Going to Italy was fun. Lately, I’ve been
enjoying life more.
Adi tells me that she and her husband remain interested in becoming parents,
though at this point in their infertility journey, Adi has lived for several years with
infertility. Telling me a bit about her experiences, she reflects on how innocent she once
was about getting pregnant. These reflections emerge when she tells me about the
piece she created below.

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Figure 4. “Innocence”
She explains the watercolor above:
This is the first painting that I did about trying to get pregnant. It was about
the second or third month we began trying to conceive, before we knew
that we were infertile. Here, you can see that there is a penis and some
boobs and an ice cream cone. I think I had an ice cream cone the same
day that I got my period. Looking at this piece now, I think it is cute. I think
it shows that I had a lot of hopes. Almost like I was kind of living in a
movie. I was very innocent about getting pregnant. Very Innocent.
For Adi, this image represents a reorientation to cultural assumptions that getting
pregnant would be relatively easy. Adi’s journey to get pregnant, however, is anything
but easy. Adi has spent thousands of dollars, moved countries and undergone

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numerous medical procedures all in the hope of simply getting pregnant. Adi’s story
about her previous innocence marks a new orientation to the very real difficulties of
conceiving.
As she moves on to a different piece, this idea of innocence re-emerges.
Showing me the piece below, Adi tells me about the meaning behind it, explaining:
This is a three-dimension image of a pregnant woman. I made this to
represent what I was feeling about myself when my friend told me that she
was pregnant. I don’t really like this piece. It feel like it is something that
should be in a hospital and it doesn’t represent my art. But it does
represent myself in a way. Sometimes I can be really black or white. It’s
something that I don’t like about myself. This is a piece that is black and
white – a piece talking about feeling not whole. Feeling like fucked up.
That you’re not, that I can’t be pregnant.

Figure 5. “Mixed Media”

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This piece renders connotations of innocence. Announcing a pregnancy was,
from the perspective of Adi’s friend, presumed to be an innocent act. Yet, for Adi, the
announcement of a pregnancy is triggering and reminds Adi of how “fucked up” she
feels because she cannot get pregnant. For Adi this piece of art serves as a
representation of her reorientation to cultural innocence embedded within
understandings of pregnancy. For someone not infertile, the announcement of a
pregnancy may be met with congratulations or joy. Yet, for the infertile woman, a
pregnancy announcement serves as yet another reminder of one’s inability to conceive,
an inability to be fully a woman.
These two pieces of art represent much of Adi’s current state in which she feels
“fucked up.” Living through years of infertility has reoriented her to more critical
understandings of gender expectations. That is, for Adi, she no longer identifies with
assumptions that getting pregnant will be easy. For her, that is simply not a reality.
Further, she also understands her body differently. Her body does not function as a
natural female body. Instead, placing her parts around a test tube reveals how she is in
need of medical assistance to conceive and carry a child. Such a piece contradicts
more pronatalist cultural expectations of gender. Later, in Chapter 5, Adi shares two
other pieces of art that make visible her reorientation to infertility. At the center of this
reorientation is the reality that to be infertile is painful – physically and emotionally.

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Meet Meg
I end this chapter by focusing on Meg’s story, who has lived the longest with
infertility compared to both Sara and Adi. Meg’s story underscores how infertility
continually reorients until one either becomes pregnant or one needs to choose an
alternative path. For Meg, she never became pregnant. Exhausting all of the options
she and her husband felt comfortable exploring, Meg’s story tells how reorientation with
infertility sometimes requires creating a new path, one that is not always visible or seen
as a valid option even to the infertility community. This will become clear reading further.
Meg and her husband's infertility story began in 2010 with her husband's infertility
diagnosis. Meg's own infertility diagnosis followed in 2012 as they embarked on fertility
treatments. Meg shares how she and her husband established a set to guidelines to
approaching infertility. She explains:
Before we even started fertility treatments, the two of us came to a few
agreements on what we wanted out of this experience. One is that we
both wanted genetic link to a child. That meant that we were definitely not
going to look at any donor. Obviously the easiest thing we could have
done was just do donor sperm from the beginning. Keep it easy, we’d
have had probably a 5 year old by now, but it’s not what we wanted. Third
party reproduction was out, so no donor sperm, egg, or embryo. The other
thing, we decided was that we didn't want to adopt or foster adopt.
Establishing these guidelines helped us from the beginning know the limits
of what we were going to take on. I think these also contributed to how
long we actually stayed committed to treatment. It was really hard once we

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began realizing this probably isn't going to work out for us because we had
set a limit already. We did obviously revisit those decisions, but we kept
coming back to how those other options didn’t feel right for us. It’s not
what we wanted.
Yet, after discovering male factor as the primary cause of their infertility and undergoing
three surgeries between the two of them, seven non-successful IUIs and nine failed IVF
cycles, Meg reflects on how she and her husband slowly began to realize they may
never become pregnant. She states:
Last year all of this slowly started revealing itself. It was a slow unfolding
of like, oh fuck, we’re getting to that end point that we said if it wasn’t
going to work out for us, we were going to be happy just the two of us, but
it's really hard to let go of. When you've been struggling for a really long
time, that's where your life is. That’s what you do. It becomes your whole
Identity and all of your financial resources, everything so to let that go is …
Our whole relationship has been revolved around how we’re going to have
kids.
Meg’s realization that she may never have children is further reflected in some of her
pieces of artwork. Take her piece titled “Bloodlines,” pictured below. She explains the
meaning of the image by reciting to me her artist statement.

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Figure 6. “Bloodlines”

She reads from the label she wrote:30

																																																								
30
This label was written for an exhibit hosted by The ART of Infertility. This label hung
next to the piece “Bloodlines.” Meg is the author of the label and the piece of art.
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Artist Label:
In Bloodlines I express the complexity of one’s relationship to ancestry when
infertility wipes out your descendants. I was also exploring the symbolism of
bloodletting in human reproduction: the monthly offering of menstrual blood. This
bloodletting is initially seen as a signal of health and fecundity, but quickly becomes
a trigger of despair the longer you are unable to conceive. As I embarked on
intensive fertility treatments, many more rites of blood offerings followed. While
more clinical, they are no less sacred rites of the body:
•
•
•
•
•

The almost daily blood draws to monitor hormone levels and follicular
growth.
The Beta test to find out if HcG, the pregnancy hormone, coursed
through my veins.
The track marks left on my belly, hips, and butt from injections.
The blood red sharp containers filled to the brim with discarded syringes.
My vaginal wall punctured by needle during each egg retrieval.

I gladly offered up my blood -- vials and vials of blood. Each time I did so with a
prayer that my own warm, pulsing life blood may hold the answer. Unfortunately,
sometimes no matter how beautiful and well-intentioned the rite, the answer
remains no. In making Bloodlines, I used charcoal and water soluble pastels to
make markings and scratches across the surface. Some markings were of vein-like
lines, others were intuitive scratches depicting complex emotions. The markings
were then covered with layers of paint applied with scrapers and brushes. Lastly, I
made paint batches the same consistency of fresh blood to explore how blood
flows, pools, and coagulates across the surface.
Figure 7. Label for “Bloodlines”.
Upon reciting the label during our interview, she elaborates further on her interpretation
of the piece, stating:
It's a little unPC, but it is how I feel. It's a base. It’s a primal need. My
desire to have a child has always been very primal. I want to feel
pregnant. I want to give birth and there’s something about bloodlines in
there and I can't get around it. I'm smart enough to have researched
epigenetics, but it was just not cutting it for me. It wasn't enough and I do
think there’s a part around how dysfunctional my family of origin is, and

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really wanting to change that patterning and I think that that plays into it,
the desire that there has to be a genetic link so I can fix the family
somehow. It's not logical. I don't necessarily think it's the healthiest, but I
know that that's part of it. I don’t know if that makes any sense.
In “Bloodlines,” Meg reflects on the reality that she will never be able to become
pregnant. For her, these reflections are rooted in the years of failed treatment, which
have ultimately caused her to reorient to a new path, one that is childfree.
Her other piece “My Consent” also serves as a reflective artifact, which allowed
Meg to document “how far” she was willing to go just to “beat” infertility and get
pregnant.

Figure 8. “My Consent”

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Figure 9. Lines of poetry emerging from “My Consent”.
She begins, first, by reciting the piece of blackout poetry. She reads what the piece
says:
I perform. Observe. Authorize certain risks. I will be disposed of. Used for
research. No right or entitlement. My consent. Not an exact science. No
guarantee. All inclusive.
Immediately after reciting the piece, she shares with me:
What was surprising to me was that it’s a very legalese form. It’s very,
very legal. It’s not like, there are some consent forms that are more about,
what are you going to do with the embryos? This is all just like, it literally

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says you could die during this procedure. Are you okay with it? In
legalese.
I was very surprised that what came out was very poignant about how
much we’re willing to put on the line for this possibility. To me it was pretty
powerful and I really like that, because I’m so verbal. It’s really nice. I get
to have the words and the image. It also brings up questions of how far
will you go to get pregnant? How are you willing to do that? I’ll do
anything. I’ll eat crazy smoothies every day. I won’t touch my art supplies.
I’ll do all these things...just to get pregnant.
“My Consent” is one such example of this embodied learning in which Meg becomes
more aware of the multiple risks and the extent she has willed herself in order to
become pregnant. This piece serves as an artifact in Meg’s infertility story of when she
was willing to do anything to become pregnant, to reorient herself to more dominate
cultural norms. No longer is that the case however, as I learned in my interview
Today Meg’s story critiques narratives that one must “beat” infertility. Meg’s story,
instead, reorients even the infertile community to the realities that medicine and fertility
treatment is limited. She states:
I think most of us are so disconnected from our bodies that we don’t even
know. That’s part of the shock always. It’s like “What? We couldn’t
overcome this with the best medicine in the world or whatever?” Yeah.
Not all can “beat” fertility. Other paths must be available. For Meg, this path is one that
views living without children as a valid choice. Meg’s story then reorients infertility

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success towards a reorientation that views failing to have a child as simply a valid reality
not often seen or discussed in the infertility world, let alone, the fertile world. This is
made clear when she shares with me how she feels:
I felt like I have my experience hasn’t belonged or hasn’t been validated…I
think the hardest thing is hearing people say in different ways that I don't
want it enough, because if I wanted it enough, I would be adopting or I
would be trying donor eggs or something else. That’s really hard to hear
and that's from the infertility community…There’s a lot of policing of
woman’s choice happening right now. This is my whole … we could have
that whole conversation about result, but I feel like there's a lot of policing.
Just a lot of women policing other women right now…There's a lot of that.
I have really, really struggled with it. It’s tough. Like I said, even within the
infertility community, I feel like my experiences diminished a lot.
In the next chapter, more pieces of Meg’s artwork will be shared and elaborate
on how Meg creates pieces as a strategy to make visible moments of failure that are
often policed, silenced.

Conclusion
There are multiple moments in which infertility causes reorientation. The stories
of Sara, Adi and Meg trace reorientation along a length of time. That is, for someone
like Meg who has lived for several years with infertility and has undergone multiple
failed treatments, she has reached a point in which she can no longer try to orient
towards a path of pregnancy. For Meg, she has tried every path that she has felt

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comfortable pursing. Her reorientation is now one that embraces a path less visible, one
that embraces living childfree as a valid choice. 	
Sara’s reorientation, on the other hand, reflects the opposite spectrum of time. As
someone relatively new to an infertility diagnosis, many of her reflections reveal
moments in which Sara finds herself more critically attuned to cultural systems failing to
support and recognize infertility. Sara’s story is one which documents moments in which
infertile individuals begin to see themselves as “othered” in a culture the takes fertility
and pregnancy for granted.
Adi’s story echoes similar themes referenced by Sara. Adi still is in pursuit of
becoming pregnant. Yet, there is an element of fatigue in Adi’s story. Reorientation is
laboring. It wears on a body. For Adi, it is clear from her stories how reorientation is
fatiguing. She is fatigued by feeling as if her body cannot conform to gender norms. She
is fatigued by reminders of how she once thought getting pregnant would be easy.
Needing to escape such fatigue, Adi discusses how she enjoys escapes her infertility.
Vacations become a needed distraction. Yet, she is not fully ready to give up on trying
to realign her body to a normative path. She still is trying to become pregnant.
Nonetheless, her fatigue cannot be denied.
In the chapter that follows, I discuss how art makes visible these reorientations.
In a sense, art acts as a rhetorical appeal – making visible previously unseen
experiences to others. Making experiences of infertility visible works as an appeal for
advocacy. Making visible these reorientations in public displays asks others to reorient,
even for just a minute, to the realities of living with infertility.

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CHAPTER 5
ART AS A RHETORICAL APPEAL TO ORIENT VIEWERS TO INFERTILITY

I just wanted some way for people to see how much medicine goes into
this.
— Sara, The ART of Infertility participant

I feel words are not for me. Sometimes words cannot be deep or
complicated ... you cannot explain stuff with words the way you can in art.
— Adi, The ART of Infertility participant

I think that art holds power and energy. It’s like, especially if we make
something with intention, it keeps that. If I hang up on my wall a whole
bunch of stuff about how I wasn’t able to have kids or how angry I am
about it, I would be seeing that every day and I’m going to be stuck in that
place emotionally. I don’t want to be, but I also feel like it has value. It’s
not the thing where I’m just going to throw it away at some point. I feel like
my point of view is important and other people could connect to it.
— Meg, The ART of Infertility participant

As stated in Chapter 3, art does. In Chapter 4, I elaborated on this statement,
exploring what art does for the maker of art - the artist. I argued that the making of art
allows the artist to engage in a process of self-reflection. Art serves, in that chapter, as

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an artifact narrating each participant’s reorientation to particular practices and beliefs.
Now, in Chapter 5, I turn outward, exploring how art, representative of participant
reorientations, may invite outside viewers of the art to reorient as well.
Much of this chapter is informed from studies in art education, advocating for the
inclusion of visual culture as a method to invite critical inquiry into what is (and is not)
made visible in cultures. Tending to the intersections of the visual and of culture invites
individuals to “look critically at surface appearances and begin to reflect on the
importance of the visual arts in shaping culture, society, and even individual identity”
(Freedman, 2003, p. xi). As such, while art may serve as a representation, or “physical
manifestation of an artist’s social, cultural, and individual identity,” art also orients
outward as “it reflects, critiques, and supports the exploration of what it means to be
human for viewers” (Freedman & Schuler, 2002, p. 23). Art, then, as Darts (2004)
argues serves as a “pedagogical strategy” to move others “into spaces of awareness
and resistance” (p. 319).
I draw upon these discussions in art education and visual culture to construct a
framework to examine art as a reflective representation of the artist as well as an
outward invitation up for interpretation from the viewer. In this chapter then, I share my
participant’s motivations for creating pieces of artwork, focusing on moments when they
discuss how they intend others to view their pieces of art. Reoriented by living with
infertility, my three participants all use art to invite more critical awareness from viewers
about the topic of infertility. For Sara, she uses art to make more visible the impact of
fertility treatment upon the body. She desires the outside viewer to see infertility as a
medicalized identity. For Adi, she uses art to make more visible the various moments of

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pain that she endures because of infertility. She wants viewers to validate her
experiences, which are often painful. Moreover, she wants others to see her. Art is a
medium for individuals to begin seeing her. For Meg, she uses art to make visible
moments when infertility cannot be “beaten” by treatments. Art becomes a method for
Meg to trace a new path and invite others to reorient to new conceptions that to beat
infertility may mean redefining infertility success. Meg’s art thus serves as an invitation
for the infertile community to redefine how and whom gets to claim infertility success,
suggesting the choice to live childfree is just as valid. For each participant, art is an
appeal for advocacy, marking individual moments in which participants felt silenced,
ignored or unseen. Needing to be their own advocates, I discuss how my participants
make visible these experiences through art and how art is an appeal for viewers to
critically reflect and reorient themselves to unrecognized experiences, like living with
infertility.

Sara: Making Visible “All Those Needles, All That Medicine”
In Chapter 4, Sara’s frustration over lack of insurance coverage to assist with the
treatment of infertility is clear. Throughout our conversation, she frames infertility as
medical issue. This is further supported when she starts discussing “Failed IVF #1.”
During our interview, I asked Sara “Why this piece?” “Why a body cast?” Why
needles?” She explained to me a bit about her intention:
I just wanted some way for people to see how much medicine goes into
this. The medications, we can't get from a local drug store. Walgreens
doesn't carry that. You have to get them to the mail from specific

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pharmacies and there aren't very many that deal with these particular
medications. When they come in the mail, they come packaged in ice and
it's a huge box full of medicines, syringes, a sharps container, vials, like all
this stuff. It is overwhelming looking at it thinking, "I am going to put all this
crap in my body. Holy cow." When you fail, it's so hard to take, because
it's like, "I just went through all that and I got nothing." How do you not get
better? I don't think people get how much goes into an IVF.
For Sara, “Failed IVF #1” is intended to make not only medicine visible but to make the
embodied risk of undergoing treatment more visible to others. “Failed IVF#1” is an
appeal to others to witness all that is involved with an IVF treatment. While the
incorporation of the syringes and vials from her failed treatment reveal the physical
invasiveness of fertility treatments, the ultrasound of the uterus also reminds viewers
that despite all of those medications Sara still is not pregnant. Thus, this piece evokes
awareness that to undergo IVF is to accept a certain amount of embodied risk. Viewers
of the piece can see how fertility treatment is risky in two ways. First, fertility treatment
engages in risk simply by injecting the body with additional hormones. Second, there is
real risk in that the treatment may not take; treatment may fail. Sara’s piece makes
visible to viewers how fertility treatment is not guaranteed to succeed.
She continues talking about her decision to make a body cast, as opposed to a
painting or a sculpture. For Sara, a body cast serves as a medium to make visible her
non-normative body. Growing up in California and now residing in Arizona, she shares
with me how she has never fit into “Barbie-like” body standards and how she struggled
to understand unachievable body expectations. She explains:

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Yeah, Barbie was everywhere. I went to school. I went to two colleges
because I have an undergrad and a master's. I went to University of
Arizona and I went to University of Southern California, both of which had
plenty of Barbie running about. That always made me angry and it's
impossible to, as a female, in this society, to not grow up with body
images. Absolutely impossible I think.
Always aware of how her body failed to conform to such an impossible standard led
Sara to creating full body casts of herself. For Sara, documenting the literal size of her
body through plaster bandages is a method in which she talked back to perfected body
standards – both in terms of her size and in terms of her fertility. She tells me:
I've always made casts. I have a cast of my entire right side. Obviously,
I'm not a perfect body and I make people look at my terrible stomach and
thighs, oh my God. I was okay with casting my stomach and thighs.
Maybe I should not show all of this because I am obviously not a size four.
I'll probably never be that size again. I think I was that size in high school. I
decided not to use a model. Instead, I used myself. To look at that piece,
you have to look at me and you have to see what I went through and you
have to see me.
The decision Sara made to cast her infertile body is purposeful. For her, the medium of
a body cast invites a particular type of viewer engagement with her piece of artwork. In
short, it demands that viewers see her, witness what she has gone through and to
contemplate the reality that despite all of that medicine, a cycle can still fail.

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When Sara talks about her “Failed IVF #1” it is clear that she is trying to make
visible her experiences as an infertility patient. She uses art as an appeal for selfadvocating her experience. She makes visible her failed treatment so as to invite
viewers to see her, to validate her experience. Sara’s art acts as an appeal to make
infertility as a healthcare injustice visible. She explains:	
The thing about that piece is you can't look at it without going, "Whoa." It's
whoa. All those needles, all that medicine ... People do this six or seven
times, sometimes more. That's a big thing and not to be covered by
insurance, it's just insane.
Sara’s creation of “Failed IVF #1” not only acts as a static object for viewers to develop
more critical understandings of what goes into a fertility treatment, but Sara also shares
with me how her piece helped her advocate for herself during a healthcare exchange
with one of her doctors. During our interview, she tells me that she showed a picture of
“Failed IVF #1” to her doctor, who was pressuring her to lose even more weight to help
her get pregnant. After showing the doctor the piece, Sara explained to me how the
demeanor between her and the doctor shifted. According to Sara the doctor finally
began to see and understand Sara’s perspective, she tells me:
I saw her and she's like, "Wow. Well, you're down six pounds." I'm like,
"Yeah, and it's intense and the endocrinologist put me on this diet." She's
like, "That's great. What do you think the difference is?" I'm like, "I think I'm
not eating." She's like, "What?" I'm like, "Well, here, let me show ..." I'm
like, "I'm not eating and I'm not on meds right now." She's like, "Why
hadn't he given you any meds?" I was like, "Right, but I had gone through

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IVF." I showed her the photo of the art piece and her demeanor towards
me changed. It went from somebody who thinks that I'm sitting on the
couch eating bonbons to, "Oh my goodness. Okay. My failed treatment
created this." The doctor has been much, much better since then. I was
honest with her. There's nothing left to cut out of my diet.
Sara’s dialogue with her doctor and use of the artwork as a narrative and embodied
expression of the medical and hormonal challenges she faced during her first cycle
allowed for the facilitation of more patient-centered agency within a healthcare context.
Sara, who felt consistently that her doctor was not listening to her, not seeing her, not
trusting her, finally began to connect with her doctor on a more personal level through
the showing of “Failed IVF #1”.
Happy with how her doctor seemed to have a better understanding of the
struggle she had with losing weight and how that was further complicated because of
her failed IVF, she goes on and shares with me how she used “Failed IVF #1” to
connect with her patients who frequently inquire if she has children. Sara elaborates on
the difficulty of navigating such a question, as it requires a quick evaluation of how
much one wants to reveal. She shares with me:
Unfortunately, so many people ask you about kids. My patients ask me all
the time, "Do you have any children?" …You sometimes have to pick your
honesty and you have to pick when and what you're going to be revealing
about yourself. In some of my patients, though, I will talk about it. In fact,
sometimes it helps them understand that I get medicine. They look at me
and they go, "Well, you're young. What do you know?" I'm like, "You want

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to see my syringes?" I promise you, I get it. I have shown the piece with
the needles, that one, to some patients so they could kind of see what it is
that I've been through. I have one very sweet lady who I keep getting as a
reoccurring patient and I absolutely adore her. I showed her the piece and
she's like, "Wow." She's like, "Your next one is going to work." I'm like, "I
hope so, but if not, I'll have another art piece." She's like, "Okay, well,
that's a way to look at." I'm like, "It sure is."		
Sara uses “Failed IVF #1” as an artifact to exert agency over her identity as an
infertile patient and an infertile woman. Showing the physicality of medicine allows Sara
to use her art as an activist expression. Meaning, the question “do you have kids” and
then a response by showing the piece of artwork – asks individuals to have a more
critically informed understanding that not everyone can easily have children. In this
exchange, Sara is attempting to invite others to reorient themselves to more critical
perspectives of infertility. 	
For Sara, art becomes a method to invite political reorientation, she explains:
I think that words on paper only go so far and I think that visual images
can work in a short period of time that holds our attention span better.
With a three-page essay or a five-paragraph essay, somebody has to sit
down and actually read it. They have to have the patience and interest to
read the whole thing. With an art piece, though, you think for a second.
You can’t hide from it when you have to actually interact with it. It's easier
to look at a piece and get the message quickly. I think it appeals to more
people faster and I think it has a greater impact. My viewpoint is: Why

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can't your artwork be the way to be a political activist? I don't see the two
as needing to be separate. That's just my personal opinion.
“Failed IVF #1” is an artifact remediating embodied experiences of medicine that are
often not seen nor recognized at sites that should be examined. Showing others her art,
she believes is important to supporting the injustices she has been reoriented towards.
It makes visible the reality that medicine does not always work and uses a medium as
well as physical artifacts (a syringe, vials and an ultrasound photo) to invite others to
view her experience with a failed IVF cycle. “Failed IVF #1” is constructed then not only
as a personal memento but as a plea for others to witness her experience.

Adi: Vulnerability & Making Visible the Pain of Infertility
In the previous chapter, Adi revealed how she has become more critically
reflective of gendered expectations related to getting pregnant and being a woman. Her
two pieces, the mixed-media test tube piece and “boobs and the ice cream cone”
watercolor, serve as reflective artifacts marking moments in which Adi no longer
identifies. Her previous assumptions about the ease that one becomes pregnant along
with cultural conflations that being female means being fertile no longer align. Adi is
reoriented.
Important though is that, during our interview, Adi makes clear that reorientation
is not a neutral process. To reorient is painful. Adi shares with me two pieces of art that
highlight the pain of living with infertility.

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The first piece is titled “HSG” and discusses the physical pain of that procedure,
which pushes a purple dye up the fallopian tubes to determine if there is any blockage
preventing the sperm from meeting the eggs.

Figure 10. “HSG”
I ask Adi to tell me about the meaning behind this piece, she shares:
It represents something that was very hard for me. But I like this painting.
The story's hard, but I really like this painting because it represents
something that I can release on the page. This painting represents the
three HSGs I had to do. I had to do three HSGs because the first two
times they could not get the dye to successfully push through the tube and
get into my fallopian tubes to see if I had any blockage. I did the first one,
Monday, and that didn’t work. Then I went in on Tuesday and that didn’t

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work again. So when I came in again for the third time I was very stressed
out. So I wrote to my doctor before the third time. And she was amazing
she had a patient and came down and did the procedure herself to make
sure that the HSG would work. I also like this painting because while I felt
very, very weak, I felt like my doctor was really there for me. Because
during the third HSG, my doctor was not down in the room yet. And I
asked the guy "Can you call my doctor? She said that she will come
down." The guy was like, "No." I was like, "Can you please call her?" He
called her and she came down this time. I was happy because I felt like
my doctor was really there for me. But I also had to ask the nurse to call
my husband and let him know what was happening. The procedure was
supposed to take 10 minutes but it has been nearly 40 minutes. It was
very stressful. But finally the procedure was able to happen.
“HSG” remediates the physical pain Adi experienced when she was attempting to first
diagnosis her infertility. It makes visible internal medicine. It serves as a piece
visualizing a medical procedure from the patient’s perspective as opposed to the
medical textbook illustrations. As Adi explains:
It is a way of showing what is what happening there. Yes, so there is blood
there on the side because it wasn’t easy to put it the tube and dye in and
then they had to straighten the tube while it was in my fallopian tubes and
it was very, very painful. So there was some blood when the procedure
was done. That is why there is red and dark purples. So yeah, it looks like
my tubes and the purple dye from the HSG and the blood.

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“HSG” is an artifact making clear to outside viewers the physical pain of attempting to
reorient the infertile body towards a fertile orientation. Reorientation for Adi is painful. It
physically hurts. “Contact” is another piece Adi created that represents painful
reorientations. Yet, this piece speaks more to the emotional pain of infertility and how it
reorients, and at times breaks apart, relationships.

Figure 11. “Contact”
She explains the meaning behind the making of “Contact”:
This painting is about my friend, who went through infertility and now has
a baby. Earlier, she had two miscarriages and we would share our
struggle to have a baby. But after she finally got pregnant and had the
baby it was like she forgot about all of the things we would talk about. As a
mom, she is very attached to her baby like in a way that I don't like. After 9
months, I was like, "I want to meet you without him. I miss you." We kind
of had a fight and stuff. I told her that I feel like she doesn’t see me. It's
hard for me to tell her about my stuff because she not seeing me. And so,

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I made this painting to represent this. The large circle on the upper right is
created from my actual my contact lens. I think this painting is about
infertility but also about life. It’s about how life and relationships can
change because of infertility. I was very sad that we got in a fight and even
more upset that she was annoyed at me because I was upset.
“Contact” thus serves as an appeal to Adi’s friend. It is an attempt to be seen by others
and for Adi’s experiences to be validated by others.
While contact is an appeal to be seen by others, particularly her friend, Adi
remarks throughout our interview how vulnerable she feels when she shares her pieces
of art. She shares:
I feel like art is the way to express myself from the past. It's very hard for
me to give away paintings. In fact, I would say, less than 10 people have
received a piece of art from me. My art feels like it’s my baby. It's very
hard for me to let the art go. For me, doing the infertility art exhibition, it's
starting like, I'm sharing my life with people. Oh my God. Why? And I don't
know them.
She continues to talk about her desire to control the interpretation of her artwork. Adi
views her art as an extension of her own infertility narrative as a story needing to be told
from her vantage point – as needing to be acknowledged, as needing to be circulated.
I talked with my friend last year. I told her that when I make art that I do it
for myself. When I share it with someone else, it's still kind of like for
myself. A lot of times when I share it with people that I don't know, then it's
kind of like, they have my glasses on when they see my art. It’s kind of like

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the glass for my heart. When you see it, you put your glasses. It's kind of
like you get to see me and my perspective. But the problem is that not
everyone puts on my glasses and then they see my art from their heart
and that's the part that I don't like. It's kind of like you are reflecting my ...
you're reflecting your feelings on my feelings. I want to say “Wait, don't
interpret it your way.” That part is hard for me.
For Adi then, her intention with her artwork is to communicate her story, her challenges
to conceive, her reorientation. Adi’s art is an appeal to be recognized, an appeal for her
experiences to be validated. However, the sharing of these personal experiences with
others often leaves Adi feeling vulnerable, at risk of experiencing additional pain. Not
having control over how others interpret her work leaves her feeling anxious and
vulnerable. She tells me a story that elaborates on the anxiety she has when she shares
her work:
If I feel something and I don't want to talk about it, and most of the time I
don't, I send a piece of my art to my friend or my mom. When I do this,
they kind of are like getting some of my feelings. It lets me share my
feelings. And it actually opens up conversations about it. Sometimes I feel
like, okay, I'm done. Sometimes they say it looks frightening. Or they say,
“Wow it's very exciting!” I feel like the people I show my art to, it just make
me feel more close to them, and makes them feel more close to me.
This story underscores the layers of meaning and emotions embedded in each of
Adi’s pieces. Her artwork is anything but neutral, and because of this, the sharing of her
art with others makes her vulnerable. To be vulnerable creates space to experience

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pain. This is important to note as so many of her pieces discuss moments of pain she
has had to endure. Adi thus desires control over the interpretation of her pieces of art.
She wants to control her narrative and for her interpretation of her narrative to be
validated by others. She wants her pain to be seen, even if it is painful for others.
Making pain visible, asking for others to recognize the pain of infertility, is Adi’s appeal
to be recognized. Yet, as Adi’s brief story above notes, not everyone wants to engage in
pain. For some they are frightened, they do not want to feel or recognize the pain that
Adi has had to go through. This is difficult but Adi recognizes that it is important for
others to attempt to reorient themselves to the experiences she has had to endure,
even if they are painful.

Meg: Challenging Dominant Narratives of Infertility Success
In Chapter 4, Meg discusses how despite her efforts to realign with more
dominant norms, the years of failed treatments have left her and her husband forced to
grapple with the reality that she will never be pregnant, never be a mother. She
elaborates on how choosing to end treatment, choosing to stop trying to “beat” her
infertility often leaves her feeling ostracized by others – even those in the infertility
community. For Meg, the choice to stop treatment is interpreted as accepting defeat, as
not wanting “it” enough.31 In this chapter then, Meg elaborates on this, explaining how
she uses art purposefully as a medium to capture the complexities of infertility and
challenge these notions that reorientation without a child is just as valid. She notes that
																																																								
31
“It” encompasses an idea that the experience of infertility denies one so many
experience. Here it is referencing a child, but also the experience of being pregnant, the
chance to be a parent. It is more than just becoming pregnant, it is all of the other
experiences that come with parenting.
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while many want to share success stories, Meg’s story – one that is wrought with a
history of failed treatments and ultimately the decision to stop treatment all together —
is one that is often not told. Art however can be a medium to tell these stories more
easily. She shares:
I found that when you have a hundred points to your infertility story, no
one listens anymore. There’s something about getting away from the
verbal that is good for me. Using art instead helps me focus on what I
want to say. It makes me question, “What’s the one thing I want to put out
there?” Does that make sense? It feels like some people’s infertility stories
are actually pretty succinct, e.g. “We had this issue. We did 3 IVF and now
we have 2 beautiful children.” But when you’ve had failure after failure and
you’ve tried multiple things and you have multiple reasons why things
aren’t working, I think that that makes it a more in-depth story that people
don’t really want to hear. I’m never going to be the person that ABC news
wants on the air when they talk about IVF. They only want the success
stories. They only want the people who are younger and they want the
simple. It’s got to be like you had one diagnosis and you beat it by having
a child. I know I’m an outlier already.
Meg’s reflection suggests that art serves as a reflective processing. Visualizing an
experience or a story forces her to think about its purpose and how it may communicate
that experience to others. Art, is also, a medium that captures the complexities of
narratives. As Meg shares, she believes her story is anything but simple, and art allows
for expressing the multiple challenges and lived experience that a written or oral story

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may not capture. Art, as a form of multimodal composition, allows for complexity to
exist in a narrative. Art acts a medium allowing for counter narratives to exist and be
consumed by others. For Meg, acknowledging and representing the complexity of
infertility is important to depicting more diverse narratives of infertility, especially those
that counter more traditional narratives representing “successful” fertility outcomes.
For Meg then, art allows one to advocate for oneself. Art does not dictate what
story can and cannot be told. Art captures the variety, the contradictions, the
multiplicities of stories. She explains:
We think of traditional advocacy as being around policy changes, but
advocating for yourself is really saying my experience is here and it
mattered. Sometimes that's just as important because there's so much
misconception about infertility in the general population. I think any time
that we’re speaking out outside of closed communities is good when we
can and we feel safe about it.

There’s a way in which I think The ART of Infertility is doing that in a very
powerful way because even people are going to exhibit knowing nothing
about infertility. They don’t necessarily know what's going to involve. I
think that as varied the narratives are, the better. The more you include
stories and artwork of people who don't fit that, like we talked about - the
heteronormative white middle class - the better. That's my personal belief
anyway. That’s one of the things that I liked about the exhibit, The ART of
Infertility exhibit, is that people get to see their experiences reflected back

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at them. I’m like why not have my experience reflected back to someone
else?
Art itself captures complexities and then clustered together, as an exhibit,
enhances the diversity of stories and experiences. For Meg capturing the complexities
of infertility is something that she feels does not happen when one orally shares their
infertility story. Like Chapter 4 noted, Meg frequently feels policed by her choice to live
childfree, especially by the infertility community. Art though, and art exhibition, are
mediums which make visible complex narratives. Art exhibitions allow for a clustering of
multiple, and even contradictory, narratives to exist. Exhibitions act as a curation of
multiple narratives. The multiplicity of narratives is vital to countering more dominant
conceptions of infertility success. Embracing multiplicity is important for Meg who notes
how art is the only medium that allows her voice and perspective to be shared. Art is a
medium that invites others to see moments of fertility failure. For Meg, her art then
becomes a tool to begin offering alternative versions of fertility success. These
alternatives are what situate her art as an appeal for self-advocacy, countering the more
dominant narratives perpetuated by discourses of infertility which perpetuate ideas of
beating infertility through treatments.

Conclusion
This chapter has focused on how Sara, Adi and Meg desire their art to be
interpreted by other viewers. For them, art is a tool to represent their reorientations and
self-advocate for the challenges they have faced because of their experiences with
infertility. Many of these experiences are complex and also frequently not seen by

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others. Unlike other reproductive losses, like miscarriage or stillbirths, infertility lacks a
materiality to that experience. Yet, reproductive grief no doubt exists – as evident from
Sara, Adi and Meg’s stories. Visual art then serves as rhetorical tactic to provide a
materiality to those invisible experiences of infertility.
In next, and final, chapter I reflect upon the findings discussed in Chapters 4 and
5 and grapple with what art and infertility mean for the discipline of rhetoric and
composition. I begin with interdisciplinary implications, focusing on art as an extension
of multimodal composition. I reflect on how my findings make arguments about how our
training can contribute to interdisciplinary sites and projects, like arts-based therapy in
health and medicine. I turn then to pondering community-engaged work in rhetoric and
composition.
Specifically, I reflect on how my collaboration with The ART of Infertility has
forced me to examine what interdisciplinary work in rhetoric and composition means. I
argue that The ART of Infertility is a site redefining understandings of what is public
rhetoric. In particular, I share stories of how my training in rhetoric and composition is
frequently not understood as an asset to an arts and medicine project. However, much
of what the project does is theorize new spaces for narratives. Making visible then new
practices of public rhetoric, like curation, is important to establishing more
interdisciplinary and community-engaged projects in rhetoric and composition.
These implications lead me to end with an afterward where I discuss limitations
of this dissertation. In the Afterward, I offer a reflective story of when my relationship
with a participant in this dissertation broke down. Sharing such a story is important as it
speaks to the challenges of engaging in a research as care methodology.

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CHAPTER 6
TAKEAWAYS, IMPLICATIONS & LIMITATIONS

Bodies rendered infertile through either biological or sociocultural
exclusion from parenting and the loss(es) associated with infertility remain
largely invisible in both artistic practice and academic discourse.
— Melissa McClure, “s/m/othering”, p. 253

This dissertation has, by and large, been a response to McClure’s concern over
the invisibility of infertility in art and in academic discourse. Answering her call for a
more explicit uptake of infertility in art and academia, I began Chapters 1 and 2 setting
up a theoretical and methodological framework to study infertility as rhetoric by focusing
upon the lived experiences of infertility told through pieces of participant art. This
framework, infertility as rhetoric, upholds a methodology that attempts to care for the
participant bodies present in this research. Cultivating and practicing a caring research
methodology supports the central objective of this dissertation project: infertility stories
matter. Often silenced or unrecognized, this dissertation’s objective on a fundamental
level is to tell and theorize the stories of reproductive loss and grief frequently glossed
over or under recognized. In Chapter 3, I contextualized the exigency of this project by
disclosing my collaboration with The ART of Infertility. Through this partnership, I
became interested in how infertility stories are told through visual art. I then spent time
showcasing art as storytelling in Chapter 4 and elaborated on this claim in Chapter 5 to
demonstrate how art also becomes an appeal for others to understand invisible,

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embodied experiences of infertility. These two chapters share this dissertation’s findings
that art facilitates both a self-reflective practice as well as a tool to invite others into
understanding non-normative and reorienting lived experiences.
Now, writing this final chapter, I find myself reflecting on the numerous
disciplinary conversations this research contributes to: art, infertility, health and
medicine, rhetoric and composition, technical communication, and more broadly,
community-engaged scholarship. These multiple areas of conversations reinforce the
interdisciplinarity of this study. Further, as a dissertation aiming to care and support the
challenges of living with infertility, I believe it is important to extend the takeaways of this
research beyond the discipline of rhetoric and composition. As such, this chapter
weaves together a series of interdisciplinary takeaways emerging from this dissertation.
I then discuss how The ART of Infertility mobilizes these takeaways in community
settings. Doing so, I situate The ART of Infertility as a public rhetoric project facilitating
moments for public pedagogy, and thereby, redefining scenes of community-engaged
work for rhetoric and composition. After articulating the takeaways and implications of
this research, I reflect on some of the limitations of this dissertation and offer future
trajectories to develop this work.

Interdisciplinary Takeaways
To begin, I draw upon the findings of this study and situate the takeaways of
Chapters 4 and 5 to an interdisciplinary audience. The three takeaways discussed
below are informed by the question guiding this dissertation, and paraphrased here:
How does art translate experiences of infertility? Informing this question were

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assumptions that infertility, as an often invisible and silenced experience, needs to be
visible and that art is a form of multimodality making infertility more transparent to
others. At the heart of these takeaways is the stance that scholarship should hold value
in the public world. Community-engaged work, like my collaboration with The ART of
Infertility, mobilizes scholarship beyond academic boundaries and into community
settings. Given this stance, I note in the sub-sections below how these takeaways
inform the practices of The ART of Infertility. I elaborate on this later in my implications
section.

Art-Making Facilitates Moments to Process Identity
The reflective narratives recounted by Sara, Adi and Meg in Chapter 4 reinforce
the centrality of arts-based making to processing, or reorienting themselves to, their
infertility diagnosis. Art as a creative practice allows one to grapple with newly acquired
identities, like receiving a cancer diagnosis, has been adopted by more body-mind
integrated fields, such as art therapy. Drawing upon Lave and Wenger’s (1991) theory
of situated learning, art therapy enables informal learning experiences through creative
expression. Arts-based therapies have been successfully implemented across
populations who have endured traumatic experiences, such as “physical and emotional
abuse, cancer care and incarceration” (Hughes, 2009, p. 28). Yet, in the context of
infertility, the use of art therapy has not yet taken off. Some scholarship, however, has
begun to explore the potential to applying arts-based therapy to infertility. Hughes’
(2009) study on sub-fertile, a Canadian term connoting infertility, writes:

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Art therapy is an inexpensive, insightful, and joyous process that requires
absolutely no technical artistic ability. It provides sub-fertile women with a
powerful avenue for expression, while increasing awareness in
themselves, care-givers and peers, of the grief that they carry. In
visualizing this grief, women are empowered and encouraged to leave it
behind. (p. 35)
In fact, art therapy is described as having a “powerful advantage over verbal and written
communication of visibly showing us how we are thinking and feeling, allowing us to
acknowledge and understand what may be hidden to us and to others” (Hughes, 2009,
p. 28). In the context of infertility, and documented in this dissertation, words cannot
always capture experiences. Thus, art can become a method of self-processing so as to
support moments of verbal communication. Take Adi, who during our interview, shares
with me:
It's kind of like hard for me to put my paintings that into words. That's why
I'm doing that. I'm doing that because when I have something in my heart
and I don't find myself in a way. I feel like I'm sad, I don't know what to do.
I will just start to paint. I would never how do you say it, I would never
know what I will do before. I will just start. It's very intuitive.
Meg also explains to me how she initially relied upon art journaling as a therapeutic
release, stating:
The format was newer in terms of the art, putting in the books and making
it sort of a memory keeping document was a newer form and like you can
see, I did it for a while and then I got …it was a way in which I felt like it

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wasn't that therapeutic. Initially it was. It was great. I got out some stuff,
but then I just was just tapping into how frustrated and sad I was and
sometimes you don't want to keep reworking those emotions, even
creatively.
While Meg admits that there was an ending point to her feeling as if she was
engaging in a type of therapeutic release, there is clearly an initial affective draw to
making art as a method of release. This notion that the making of art acts as a form of
release is important to multimodal composition. It suggests implications that multimodal
composing practices not only exist outside of the composition classroom but hold deep,
personal resonance outside of the classroom.
Sheridan, Ridolfo and Michel (2012) have argued for a public turn to multimodal
composing practices, advocating for how a public turn may assist the
professionalization of our students. They propose that:
Instead of leaving the work of cultural production to graphic designers,
illustrators, photographers, videographers, and other creative specialists,
this work should be consider the proper domain of ordinary people. (xii)
Elaborating on this point, their book, The Available Means of Persuasion: Mapping a
Theory and Pedagogy of Multimodal Public Rhetoric, offers a pedagogical framework
for teaching multimodal public rhetoric in the composition classroom. This dissertation,
however, contextualizes multimodal public rhetoric from another viewpoint – located
very much outside of the classroom and in communities of practice. This dissertation,
and the takeaway that art-making facilitates identity formation, is important to the
composition classroom. For example, art making may serve as an effective assignment

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for students to reflectively explore their learning processes and applying those
reflections to a community of practice, such as the college classroom. It is also
important beyond the discipline, having implications for supporting individuals who have
endured traumatic experiences leaving them feeling disoriented and detached from their
previous identities.
I build later on this takeaway to elaborate how The ART of Infertility broadens
scenes and implications for multimodal composition, or art-based making, through the
hosting of infertility art workshops. These art workshops expand scenes of multimodal
composition in the public sphere and create moments for public pedagogy. I take up this
takeaway later then to model an alternative form of multimodal public rhetoric, situated
more immediately in a community setting for infertility patients.

Art Acts as a Communicative Tool for Patient-Centered Support
While art facilitates moments for self-reflective processing, art can also be used
as a tool communicating infertility experiences to a variety of support networks, such as
fertility professionals, therapists as well as friends and family. For example, in Chapter
5, we learned how Sara and Adi both use their pieces of art to communicate their
infertility experiences with non-fertility experts. Adi discusses, while she has anxiety
sharing her pieces, she has begun to share some of her infertility art with friends and
family. She remarks how “it actually opens up conversations about it” and that she has
found sharing her pieces has “made them feel more close to me.” The sharing of art
with her friends, and in particular, with her mother, facilitates moments to have a
conversation about difficult experiences.

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Sara, too, discloses how she showed “Failed IVF #1” to one of her patients who
had asked if she had any children. Recently suffering from her first failed IVF cycle,
Sara explains how she showed the woman a picture of “Failed IVF #1”. Upon showing
her the photo, Sara noted how the patient’s demeanor towards her changed. Sara and
Adi’s experience suggests that the sharing of infertility art can serve as a catalyst for
more sympathetic and reflective understandings and practices around issues of
infertility.
Additionally, Sara’s experience with showing that piece to her patient is also
important. She discloses that part of her decision to show the patient “Failed IVF #1”
was out of a need to also demonstrate to the patient that Sara “gets medicine.” She
uses “Failed IVF #1” to demonstrate expertise. Fountain’s (2014) work has examined
how technical expertise, particularly in a gross anatomy lab, develops as students learn
through interaction with visual images and physical body parts. Sara’s story suggests
how this form of embodied learning and expertise may also emerge through patient
created artwork.
For example, Chapter 5 also discloses Sara’s story about how she also showed
“Failed IVF #1” to her doctor who was questioning how successful Sara had been at
losing weight in an attempt to get pregnant. After showing her doctor the piece, Sara
disclosed how the doctor’s attitude towards Sara immediately changed and actually
ended up facilitating a better, more patient-centered relationship. In fact, Sara notes
how after showing the doctor her piece that she could finally be honest with her.
Sara’s story demonstrates how art becomes a tool to negotiate power disparities
between physician and patient in health contexts. While research in technical

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communication has done well describing barriers to care (Barton, 2007; Burleson, 2013;
Eggly et al, 2015; Ellingson & Buzzanell, 1999; Segal, 2007; 2012; Wests, 1984), more
scholarship must begin to not only describe problems but build patient-centered models
to intervene in barriers. Wells’ (2010) Our Bodies, Ourselves acts as one example that
has begun to develop participatory and patient-centered approaches to reproductive
healthcare, and I argue, that integration of patient-created artwork in healthcare may
also act as an additional an interventional model to support more equitable
communicative practices between physician and patient. Specifically, the application of
patient created art in healthcare settings indicates moments where agency may be
cultivated through reflective, multimodal composing practices.
Studies have documented the successful application of visual arts in medical
education, finding that “health care students not only gain important clinical skills from
such teaching, but also that arts experiences help develop expressive capacity,
enhance attitudes…[and] challenge clinician’s assumptions about patients” (Kidd et al,
2016, p. e23). The integration of patient-created art, particularly in regards to infertility,
holds importance given concerns over the limitations of current patient-centered models
of care. Cunningham and Cunningham (2013) argue that current patient-centered
models of infertility care fail to fully support patient physical and emotional health given
“the complex every day lives of women living with and through infertility” (p. 3429). To
better revise patient-centered care models, like Dancet et al’s (2011), fertility
practitioners should consider incorporating moments for patients to create infertility art
as a method to facilitate communication between fertility professional and patient.

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Acknowledging how art opens up space for communication between the fertility
patient and the variety of infertility stakeholders fertility patients interact with, including
friends and family, informs the spaces as well as the variety of exhibitions hosted by
The ART of Infertility. I draw upon this takeaway later in this dissertation to discuss how
art exhibitions become a site for public pedagogy, communicating to the public viewer
the various challenges and barriers to infertility care. It is the intention that these
exhibits work similar to what Sara and Adi’s stories demonstrate – opening up space to
talk and show others a glimpse into living with infertility.

Art Makes Infertility Matter
As stressed throughout this dissertation, infertility is frequently characterized as
invisible, silent and thus unrecognized by those who either do not desire children or who
are fertile and encounter no issues conceiving. Silence around infertility operates as a
rhetorical mechanism to maintain normative cultural conceptions of fertility. Specifically,
silence sustains the myth that fertility is a universal experience, and thus, reinforces “an
ideology of motherhood and symbolic ideal of family” (Allison, 2011, p.17). Yet, infertility
inspired art acts a tool to intervene in the silences surrounding infertility. Specifically, art
becomes a mode for materializing infertility.
Sara’s “Failed IVF #1” is evidence of this. She describes how she purposefully
uses artifacts from her fertility treatments, like her syringes and ultrasound image, to
make visible her failed treatment. Adi’s “Contact” is another example that materializes
moments of friendship loss. Additionally, Meg shares with me how in hindsight, she
wished that she had kept all of her negative pregnancy tests. She tells me:

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The one thing I regret is that I didn't keep every single negative pregnancy
test because I really wish I had that pile to do a great installation piece. It
would have consisted of 65 negative tests. For the installation, I would
place all 65 in a pile in an empty room. It would be like a real installation
piece. Viewers would walk into the empty room and there's just this pile of
things that look like sticks. You go up close and you realize that the pile is
all negative pregnancy tests. They’d be piled on top of each other like a
little fire pile. That's how I would have created that piece, that would have
been my installation.
Meg’s desire to create an installation piece using her negative pregnancy tests
reinforces the immateriality of infertility. Despite all of the treatments, vials, syringes
used on her body, as well as on Sara and Adi’s – there is nothing to mark and recognize
all that they have been through. There is no child. Infertility, unlike miscarriages and
stillbirths, lack a material reality. Infertility art thus serves to fulfill a desire to materialize
moments of grief and loss and call the attention of others to these experiences. Art,
thus, acts as a type of Freirean critical consciousness. Desyllas (2014) remarks on how
Freire’s concept of critical consciousness operates within the context of visual art,
especially photography, explaining:
Freire (1970) argues that the visual image is a tool that enables people to
think critically about their communities, and reveals the everyday social
and political realities that influence their lives. The idea of codifying
language and experiences into visual images is seen as a way to
‘stimulate people “submerged” in the culture of silence to “emerge” as

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conscious makers of their own culture’ (Freire, 1970: viii). Within Freire’s
process of community dialogue, ‘codes’ are concrete representations of
community issues that can be used to build awareness and encourage the
construction of knowledge. As a communication tool, photographs can
educate, inspire and influence decisions (Freire, 1970). (p. 479)
Eliciting the work of Freire and understanding how art works as an appeal
reinforces claims in Chapter 3 that art does and findings in Chapter 5 that art functions
as an appeal for self-advocacy. Further, Freire’s work and Desyllas’ interpretation of his
comments indicate that art invokes others to revise previous assumptions. In sum, art
matters. It both represents immaterial experiences of infertility through mediums of
matter. But art also encourages others to see other experiences that matter, but are not
always made visible, like infertility. In this way, “art can teach through challenging readymade perceptions, slipping between cracks in consciousness, assumption and the
‘known’, through making new bodies and creating accompanying ways of knowing”
(Hickey-Moody & Page, 2016, p.19).
This takeaway informs how The ART of Infertility engages in public rhetoric
practices and expands sites for public pedagogy. Hosting art workshops for infertile men
and women, The ART of Infertility provides pedagogical activities for individuals to make
pieces of art demonstrating how infertility matters. As a traveling exhibit, The ART of
Infertility situates exhibitions as spaces to evoke public pedagogy. Meaning, The ART of
Infertility intentionally curates exhibits as an extension of public pedagogy, structuring
exhibits as a critical narrative to evoke viewer consciousness about the issues related to

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infertility. In what follows, I elaborate on how curation and infertility art workshops
mobilize this takeaway into public spaces.

Implications for The ART of Infertility
As indicated earlier in this dissertation, this study was conceived in many ways
out of my collaboration with The ART of Infertility. Therefore, as a dissertation project
rooted in community-engagement, I reflect on the takeaways articulated above to
discuss implications for this research in the context of The ART of Infertility. Specifically,
I claim that The ART of Infertility redefines scenes for engaging in public rhetoric work.
Discussing how The ART of Infertility mobilizes public pedagogy around issues of
infertility, art and curation indicates new, interdisciplinary potential for rhetoric and
composition. As Coogan and Ackerman (2010) write in their introduction to The Public
Work of Rhetoric:
Rhetoricians have already worked as policy analysts, critical
ethnographers, public teachers, rogue historians, advocates, and
community organizers. But rhetoric has not, by and large, positioned these
avocations as vocations for disciplinary renewal in English and in
communication…this collection presents an alternative narrative, a
rhetoric of the ‘lost geographies’ of public life that hold within them the
political and ethical dimensions of real events and social relations that
make our disciplinary identity newly possible. (p. 8)
I offer The ART of Infertility as yet another ‘lost geography’ of public rhetoric work that
the discipline has not yet fully recognized. Making visible how this organization engages

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in forms of public rhetoric and pedagogy may support more interdisciplinary landscapes
for where and how rhetoric and composition make institutional arguments about the
contributions of our scholarship. Williams (2010) argues:
It is important not only that we encourage more research about the writing
taking place off campus but also that we use this moment to engage in
systematic and conscious reconsideration of the practices and, just as
important, of the nature and perceptions of the field. (p. 130)
Williams’ stance for rhetoric and composition to consciously consider how other
disciplines view our participation in more interdisciplinary and community-based
research scenes should not be taken merely as a suggestion. Frequently, I have felt
myself needing to strategically argue how my degree in rhetoric and composition
positions me to contribute not only to an arts project, but especially, a project with a
health and infertility focus. While I understand, and hope to make clear below, how
rhetorical and pedagogical training support the interdisciplinary objectives of The ART of
Infertility, when I travel and talk to medical professionals, other artists, even some in the
infertility community – few know or can make sense of how rhetoric and composition not
only supports the project but qualifies The ART of Infertility as a recognizable research
organization.
Allow me to share one story to better contextualize the tensions I have felt as a
rhetoric and composition scholar sharing this research with infertility professionals and
scholars. In October 2016, Elizabeth Walker and I presented the project to an “Access
to Care” panel at the American Society for Reproductive Medicine (ASRM) Conference.
In our presentation we provided a brief overview of The Art of Infertility and how this

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project — through the telling of stories and artwork as curated exhibits — calls public
attention to the challenges and barriers to infertility-related care. While the presentation
itself went fine, what became clear to me in listening to the other panelists were how
different our methods and professional qualifications were. Elizabeth and I, while we
presented qualitative data, nearly every other panelist presented quantitative or mixed
method data. Further, many of the other panelists were either MDs or medical PhDs. I
was the only individual with a humanities degree. Without doubt, I felt othered in this
space as if my qualifications and data were not rigorous enough to be taken seriously.
I share this brief anecdote to underscore Williams’ claim and Coogan and
Ackerman’s urging to make new geographies for public rhetoric more visible. How may
rhetoric and composition scholars who embrace interdisciplinarity in their research
make arguments and position their work to social science and medical fields? And more
practically, how may we explain our qualifications to the participants who partake in our
community-engaged research? Broadly, how do we make rhetoric and composition
known to the world, beyond the realms of teaching writing? These questions propel me
to make clear how I situate The ART of Infertility as a public rhetoric project facilitating
scenes of public pedagogy.
In what follows, I explain how The ART of Infertility mobilizes the takeaways
listed above through a series of practices, both pedagogical and rhetorical. I begin
overviewing the community art workshops hosted by The ART of Infertility and explain
how these workshops are models of multimodal composition operating in the public
sphere. These workshops are structured as pedagogical activities for adults to engage
in processing their infertility diagnosis. I then switch gears and discuss The ART of

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Infertility exhibitions. I take time defining curation as rhetorical practice constellating
around a series of publics and interdisciplinary issues to evoke infertility awareness. I
end by explaining how curated infertility art exhibits are scenes of public pedagogy.

Community Art Workshops as Multimodal Public Rhetoric
As a project committed to supporting the infertility community, The ART of
Infertility frequently hosts art and creative writing workshops. These workshops are
structured events themed typically around a particular arts-based making activity. Some
previous workshops have included: cigar-box workshops, blackout poetry workshops,
wind-chime workshop and love-branch workshops, as shared previously in Chapter 3.
Important is that these art workshops, while varied by medium, are accessible. Formal
art training is not a prerequisite for participation at these workshops. Rather, these
workshops operate around rhetorical invention. Individuals participate and make, for
example, wind chimes that hold personal meaning to their infertility story. As such, at
these workshops individuals may have support learning how to link a chime to a chain
so as to hang it and allow the chime to function, the objective of these events is not to
make the most appealing or most functional wind-chime. Rather, the objective is to have
individuals engage in a self-processing, of inventing meaning, to the wind chimes. Thus,
more time is spent in these workshops making decisions about what beads or colors –
what story – the wind-chime represents. The decision then to structure these workshops
activities exploring rhetorical invention make visible how art workshops support
accessible forms of multimodal public rhetoric.

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These workshops, then, expand current geographies of multimodal composition.
That is, disciplinary conversations have discussed multimodal public rhetoric as a
method for “nurturing a set of understanding about the social world we live in (or want to
live in) and the kinds of social practices—including rhetorical practices—that sustain it”
(Sheridan et al, 2012, p. 174). Sheridan et al’s (2012) work makes the case that
multimodal composing practices bridge the academic classroom to the greater world
because of how self-reflection appears in multimodal making. The art workshops hosted
by The ART of Infertility expand Sheridan et al’s work to communities beyond the
university. Specifically, The ART of Infertility workshops engage with adults who must
grapple with what it means to be infertile. These workshops move multimodal
composition to community sites and indicate how adults may benefit from multimodal
composing workshops. It allows them to also ponder the moments in which art may
serve as an artifact representing and communicating those experiences to others.
Ultimately, these workshops facilitate moments of life-long learning inviting individuals to
think about what it means to be infertile – expanding whom may benefit from more
public models of multimodal composition.

Curation as a Rhetorical Practice
Community art workshops, I argue, are more recognizable forms of how The
ART of Infertility enacts pedagogical activities to contemplate and critically reflect on an
infertility diagnosis. For example, rhetoric and composition has a history of researching
community writing groups and activities. Evidence of the discipline’s attention to
community writing practices can be found at conferences like the Conference on

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Community Writing and the Community Literacy Journal. While the workshops I
mentioned above are not centered on traditional forms of writing, I reason that given the
discipline’s interest in community writing practices, arguments that arts workshops
extend scenes of multimodal public rhetoric tend to be commonly accepted.
Curation, on the other hand, I believe is less visible and not well understood as a
rhetorical practice that invites moments for public pedagogy. While recent scholarship
examining online collaborative authorship practices, examined in Textual Curation:
Authorship, Agency, and Technology in Wikipedia and Chamber’s Cycloypedia
(Kennedy, 2016), has emerged – no rhetoric and composition scholarship on arts-based
curation as rhetorical practice has taken place. I take time here then to elaborate on the
curation of infertility exhibits as a rhetorical practice intentionally assembling stories and
art to depict a particular infertility narrative and intervene in the cultural silencing around
infertility by evoking more critical awareness about the challenges of infertility.
To be clear, curating The ART of Infertility exhibits involves more than simply
hanging artwork. Rather, curation may be better understood as a series of rhetorical
decisions, which consider:
Exhibition layout, juxtaposition, and museum signage, shape [of] the floor
plan of an exhibition and suggest, if not prescribe, not only visitor itinerary
and movement but also ways of feeling about the cultures from which the
objects on display derive. (Tyburczy, 2016, p. 103)
Curation then is another form of narration. Curators invoke a particular narrative through
the selection of pieces, the arrangement of the exhibit pieces, the direction of bodies
moving through the exhibit and the disclosure of information accompanying the pieces.

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To curate requires both a micro and macro understanding of how the viewer
interprets the exhibition. On a micro level, the curator must attend to the individual
pieces of art and how they may personally resonate with a viewer. On a macro level, the
curator must attend to how the viewer moves through the exhibit and how from this
movement a larger narrative may emerge out of viewers assembling together the
multiple individual narratives they consume through looking at each individual piece of
art. In this way, curation is a public pedagogy practice. It constructs narratives so as to
evoke opportunities for “people to learn about themselves, their culture and society, and
the larger world around them” (Camic & Chatterjee, 2013, p. 67). As such, curated art
exhibitions act as public forms of educational programming and facilitate a public
pedagogy. Doing so, I argue that The ART of Infertility acts as a public rhetoric project
drawing critical attention and intervening in the cultural invisibility of infertility. In sum, it
extends practices – seen in this dissertation – to make visible new paths for orienting to
an infertility diagnosis,
To be clear, these implications concerning The ART of Infertility are in need of
further research. More work must investigate how viewers interpret and leave The ART
of Infertility exhibitions. To be frank, this study did not explicitly attend to how viewers
may or may not have become reoriented to experiences of infertility. In the section that
follows then, I elaborate on the limitations of this dissertation and speak to future
research needed to respond to these limitations.

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Limitations of Study
As a dissertation project informed by feminist research methodologies (Tong,
1998; Royster & Kirsch, 2012), I must reflect on the various limitations of this research.
To do so, I discuss limitations related to demographics of infertility, outside viewer
interpretation of the artwork, infertility as an in-flux identity and art as research.

Demographics of Infertility
I begin by discussing the limitations of the participants of my study, relating these
limitations to demographic issues with discussing infertility. First, the number of
participants limits the implications of this study. As a project designed to be completed
within a year and half of its proposal, I intentionally limited my study to three
participants. I ended up interviewing a total of four women for this project. However,
only Sara, Adi and Meg appear in this dissertation, as the other woman’s interview did
not fully record. When I discovered the technical malfunction, I decided to interview Adi
rather than try to recreate the interview. As such, only three data sets are used in this
dissertation. Additionally, these data sets are from initial interviews.
Second, this dissertation is limited by the scope of infertility experiences
represented. That is, while I desired to collect stories from women who were at different
points in their infertility journey, I did not intentionally set out to interview women who
have yet to become pregnant. The fact that all three women have had failed fertility
treatments and still remain living without children is simply a coincidence that emerged
across all three women. I point to this fact as my examination on infertility focuses on
those who have yet to achieve pregnancy. As such, their stories of infertility are situated

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in a particular context, which often critiques the idea that fertility treatment is a simple
solution to resolving infertility.
Third, all three of these participants are women. This is a limitation of the study,
but also, I believe of The ART of Infertility project as well. That is, artistic expression of
infertility appears to be rather gendered. While The ART of Infertility has received a few
donations of male created artwork, these pieces are few compared to the number of
pieces created by women. Further, infertility itself is a rather stigmatizing experience for
men. While this dissertation has paid some attention to the stigma of infertility in regards
to women, male experiences of infertility are often described by engendered feelings of
inadequacy and emasculation (Throsby & Gill, 2004). To be frank, infertility, while
shattering for both women and men, is heavily gendered experience, of which, outlets
for support as well as research is unevenly focused on women (Culley, Hudson &
Lohan, 2013). Thus, many men do neither share nor talk frequently about infertility.
Recognizing the gendering of infertility is important then to acknowledging the reality
that I simply had access and knew of more female infertility artists than male.
Finally, all three of the women that I included in this dissertation identified as
white women and spoke frequently of their fertility treatments. While they did express
concern over the cost treatment and how that impacted fertility-related decisions, the
fact remains that they all did have access to care for fertility-related services. I
intentionally want to make clear this issue of access to care in my work, as it is a
limitation that has not yet been addressed in this dissertation. Access to care is an
emerging concern across infertility-focused studies. Much concern has been expressed
by researchers noting that while previous studies about infertility experiences have

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provided important information about challenges to fertility-related services, many of
these studies fail to account for the numerous infertile women and men who are
automatically removed from research implications as they do not have access to the
fertility coverage nor fertility-related services, such as even the diagnosing of infertility.
To be infertile then connotes a particular level of class and access. All three women in
my dissertation had access to a variety of infertility services as well as financial support
to pay for at least one fertility-related treatment. As such, this dissertation is
contextualized from a white, middle-class perspective and it limits conversations about
how art may communicate more cultural, social class perspectives about experiences of
infertility. In the future, I hope to mobile my research as care methodology to better
address this tension of access to care in regards to infertility.

Outside Viewer Interpretation of Artwork
While Chapter 5 discusses Sara, Adi and Meg’s intentions for how viewers
should interpret their artwork, the dissertation is limited by the fact that outside viewers
were not interviewed for this dissertation. As a result, while Chapter 5 details how art is
used as an appeal to reorient others to the realities and challenges of being infertile,
how successful or accurate this appeal is to outside viewers is not known. Originally,
when I proposed this project, I intended to interview viewers of the pieces of art.
However, given the time constraints of this dissertation, it was suggested to me that I
think about this dissertation as a two-part study. The first part would focus on the artist’s
intentions and motivations. The second part I could take up at a later point, upon
completing this dissertation project. As such, it is my intention to develop a study to

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elaborate on viewer’s interpretation of the pieces of art displayed at The ART of
Infertility exhibitions.

Infertility as an In-Flux Identity
My decision to study infertility as rhetoric, as an embodied identity, was
intentional and meant to provide an alternative framework for understanding infertility
from a rhetorical lens. As articulated in Chapter 1, infertility as rhetoric examines the
tools and strategies infertile women and men use to rhetorically navigate an infertility
diagnosis. In many ways, infertility as rhetoric explores how rhetorics of infertility
constrain and create structural challenges to resolving ones infertility. While I believe in
the need to understand infertility as a rhetorical embodied identity, I was unprepared to
fully understand the challenge of engaging in identity-related research. Infertility, as
expressed in Chapter 1 and more so in Chapter 4, is a constantly reorienting identity.
New challenges and experiences are constantly forcing one to revise how they identify
as infertile. As Cunningham and Cunningham (2013) state, “infertility is not a single
event but a complex, relational process” (p. 3434-3435). This idea that infertility is an influx identity emerged throughout the doing of research and writing of this dissertation.
Specifically, in the afterward, of this dissertation, Meg’s story and the grappling of
negotiating new interpretations of how one identifies as infertile will be elaborated on.
As such, while I asked all of my participants to read and give feedback on this
dissertation, how they identify as infertile has and will continue to change even after this
dissertation is completed. Therefore, the stories told in Chapter 4 and 5, along with my
interpretation of them, can only be understood as taking place in one particular moment

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of time. As time and other experiences occur, how each woman identifies as infertile
changes and shifts. A lengthier study, in hindsight, may have better addressed as well
as allowed me to trace how infertility identities shift across time and across pieces of
artwork. This limitation thus speaks to additional research that this work may bear.

Art as Research
A fourth area of limitation to this dissertation is simply the challenge of doing artsbased research. Sally Atkins, a Professor Emerita who developed the Graduate
Program in Expressive Arts Therapy at Appalachian State University, reflects upon the
challenges of guiding graduate research on arts-based inquiry. In her article “Where are
the five chapters? Challenges and opportunities in mentoring students with arts-based
dissertation” she (2012) shares “one of my biggest challenges for me in working with
these dissertations has been my own feelings of inadequacy” (p. 63). She openly
documents her challenges to facilitating graduate mentorship over arts-based
dissertations noting tensions because of how such dissertation frequently do not “look
like” traditional dissertations, how to navigate the fostering of creativity – noting the
need to provide one student deadlines while giving the other student more space to fuel
creativity, as well as the integrated role of dissertator’s personal perspective.
I raise Atkins’ honest account of arts-based graduate research as it speaks to
many moments in which I myself felt like I was doing inadequate work. This is further
fueled by the fact that while my dissertation focuses on arts-based making practices, I
myself am in a Rhetoric & Writing program. As such, I felt throughout this dissertation
the need to situate my examination of infertility amongst rhetoric and composition

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conversations. Nonetheless, much of what this dissertation is attempting to document,
is the potential for more interdisciplinary spaces for community-engaged or public
rhetoric projects in rhetoric and composition. This will be elaborated on later in this
chapter when I discuss The ART of Infertility as a public rhetoric and public pedagogy
project. Given then how my collaboration with this project has informed my analysis and
framing of this research, I also wonder how this dissertation format, this medium of
written writing with embedded visual art, limits some of the findings and potential of this
dissertation. Many times I felt as if some of what this project could have benefited from
was an online, digital platform. This platform could serve as a space to digitally
experience the pieces of art, as a curated exhibit. Another option I felt compelled was to
rethink this project as supplementing much of my arguments by creating a physical
exhibition of the work. In sum, what is not shown, what is not made visible in this project
is the shear amount of physical labor involved in arts-based inquiry practices. Making
visible other forms of institutional products – such as art exhibitions – is something that I
believe is not well represented and could be enhanced by envisioning an alternative or
supplemental component to this dissertation.

Conclusion
It feels odd to attempt an end to this dissertation. In many ways, this research
continues to evolve given how entangled I am to this work as a co-director of The ART
of Infertility. This work is not siloed. It travels and is in practice. For example, as I write
this conclusion, I have just returned from a trip to Seattle where The ART of Infertility
curated and installed a month-long art exhibit titled “SEA-ART-HEAL: The ART of

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Infertility in Seattle.” During this month, the project will also be traveling to Boston to
host an educational programming event for employees at EMD Serono, a
pharmaceutical company manufacturing fertility treatment products. The month of April
wraps up with yet another visit to Seattle to both take down the exhibit as well as host a
blackout poetry workshop, inspired from the piece “My Consent” appearing in this
dissertation. Given these events for the month of April, along with a host of other events
scheduled for 2017 and 2018, I have difficulty writing a conclusion for this project.
Instead, I suggest a better metaphor for ending this work may be an ellipsis, as I
plan for this work to continue. This ellipsis reinforces the framework applied throughout
this dissertation: infertility as rhetoric. Infertility as rhetoric tends to the embodied
experiences and rhetorical decisions women and men encounter because of their
infertility. As many of the women and men that I have met throughout this project have
noted: infertility never leaves you, it is always there. Thus, to understand infertility is to
understand it as an identity that constantly encounters a series of rhetorical decisions
and negotiations. Infertility never leaves the body, its experiences and reorientation to a
pronatalist culture remain.
Sometimes though, attempts are made to try and move on from infertility. To
come, as is frequently called in the infertility community, “to a resolution.” That is,
infertility may never leave one but how one chooses to participate in the community may
change given one’s resolution. For example, some who find success and become
pregnant after years of infertility may eventually make the decision to transition to what
the infertility community commonly refers to as “parenting after infertility”. Others may
make the decision to find resolution in embracing childfree living. I share these attempts

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to move on and find resolution as it speaks to one more challenge encountered in the
doing of this dissertation. I invite you then, to read on, just one more time.

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AFTERWARD
Publication, visibility, and telling one’s story — these are acts, a putting of
the private onto the stage of the public, and these acts need careful
negotiation.
— Petra Kuppers, The Scar of Visibility, p. 17
	
I want to take time in this afterward to touch on a methodological concern that
has emerged from the doing of this dissertation. As a project that has articulated and
evoked what I call a methodology of care, an ethical framework making visible the
relationships and including the participation of bodies whose stories and art inform this
work, I feel compelled to acknowledge that there have been times when this
methodology has failed or, at the very least, could have better attended to the realities
of doing community-engaged, participatory research.
To provide some context, I need to acknowledge that when I approached my
participants and asked for their participation in this project, many of them expressed an
openness to participate out of a desire to share their story, to raise infertility awareness.
That is, my participants were not particularly compelled to participate so as to make new
rhetorical theories or have their stories support a new methodological framework. This
dissertation then was engaging in community based-research that aimed to support the
activist agendas of my participants.32 In many ways, they viewed their stories as their
story. Not as data. But as a story they own, as a story they have lived, and as a story
that they control.
																																																								
32
My participants viewed the sharing and circulation of their stories and art as
supporting infertility activism by raising awareness about living with infertility.
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Further, when I asked them why they felt comfortable or compelled to talk to me
about their experiences both Meg and Sara acknowledged how my personal
experiences with infertility positioned me as someone who was trustworthy of knowing
their stories. For example, Meg explained to me:
First of all, when I know that someone else has struggled, it has so many
layers, oh my God. It's not first and second. You’re going to have an
understanding of some of the complexities of the grief and the loss. I know
that. Secondly, I don't have to explain every single term and every single
procedure and every single diagnosis. What you’d have to do with
someone who hasn't gone through it…I went to a gynecologist and she
just didn’t even know the difference between IVF and IUI. I nearly slapped
her. I'm never going back to her again. Anyway, yes. Being able to not
have to explain the medical terminology, which as soon as you do,
distances people. It removes the emotional connection. You have to do a
lot of explaining of the medical. Then I think it's also helpful that I know
your personal story, not just that you identify as infertile, but that I know
that children may not be in your future, because that's even a possibility
makes me feel a whole lot safer.
And Sara told me:
When you don't have knowledge, that you haven't been there, there's a
level of stress that you don't understand. It's all painful. These procedures
hurt. It is not comfortable to be probed. It is not comfortable. There's a
water test that they do and they shove water up you and take pictures. It

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hurts. The dye test hurts. If you haven't been through that, you don't know
the pain. Not knowing if your procedures works is a level of stress that
only someone who's been there can comprehend. When you're dealing
with someone who doesn't know all that, it's kind of like layman versus
not. I would have to explain to you PCOS. I would have to explain to you
the viles and the medicines and the syringes and the fact that there is a
grief and a loss that I think I'm still going through. Somebody who's not
dealt with infertility, has not had to look at their spouse and think, "I may
not be able to give you a kid with your DNA and my DNA combined."
There is such a loss in thinking that. I hope that people who are fertile
won’t have to go there. It’s not something you wish on anybody. I wouldn’t
wish it on my worst enemy.
The anecdotes from Meg and Sara speak to the fact that there was a sense of
feeling comfortable sharing their stories with someone who is also infertile. Making clear
how they understood me less as an explicit researcher, but more as a fellow infertile
woman in this dissertation project, raises implications for activist research practices.
Blythe (2012) tackles the composing of community and activist oriented research,
explaining the relationship between researcher and participant, by stating:
In a reciprocal relationship, researchers must attend to the needs and
agenda of participants. Purposes, questions, methods, and results should
be developed collaboratively, rather than by the researcher alone. Grabill
(2000) goes so far as to argue that researchers should be ‘invited to
participate in local problem solving’ (p. 34; italics added). That is,

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researchers should begin to contribute their expertise only after local
citizens have invited it. (p. 275)
Blythe’s comments underscore the exigency for relationships to inform and guide
activist-oriented research. He tends to the need to negotiate participant defined
outcomes in relation to publication requirements for researchers. Blythe (2012)
demonstrates how several activist researchers tend to these real tensions in research,
indicating that “activist researchers publish article-length works not so much to report
results of research — those improvements or changes that many readers may expect—
but to comment on issues related to research and social problems” (p. 283). Thus,
activist and community-engaged research almost always has two deliverables, one that
is community-oriented and one that is academic-focused.
In retrospect, I question how well I succeeded at offering two deliverables given
my relationships with these women. In many ways, sharing infertility stories, circulating
artwork was meant to be a community-orientated deliverable. Making visible stories of
infertility was in and of itself an aim to support infertility awareness, an aim that all of my
participants noted was important. However, I question moments in which I may have
needed to spend more time explaining the implications and process of academic
research. For one participant, this tension between research that supports communities
of practice and research that speaks to academia was almost always in tension, and still
is. In what follows, I tell story that emerged in the process of doing and writing this
dissertation, to later discussion moments in which participatory, activist and communityengaged research practices have implications in particular for dissertations.

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***
When I began my dissertation project, I knew that I wanted to interview prior ART
of Infertility artists. Sending out an email to past participants explaining my intention to
understand the motivations influencing their desire to create pieces of art representative
of infertility as well as donate those pieces to The ART of Infertility, I settled on three
participants. For this story, I want to focus on one participant, Meg.
I first met Meg in Washington D.C. at another Advocacy Day event. Elizabeth
and I went to Advocacy Day that year with the intention of interviewing more infertile
women about their art for The ART of Infertility. This is how and where we met Meg.
During our interview, she told us about the multiple failed treatments she and her
husband experienced. As well as her coming to the reality that she most likely never will
be pregnant and how she and her husband were wrestling with the decision if they
should try one more time. For them, adoption or a non-biological child was not an
option.
For several reasons, Elizabeth, Meg and I all grew close. Our stories, all of us
wrestling with the idea that we may find infertility resolution by being childfree, bonded
us. And so, when I sent out my email about participating in my dissertation, Meg
agreed. And I should I add, I was happy that she did. Her art and her story were
contrasts to the dominant narratives documented in infertility studies.
We set up a date for our interview in December of 2015. Our interview went well.
We talked for nearly two hours and I thanked her for the time she spent. I shared with
her that I would be sending out the interview for transcription and that I would send her
the transcript so that she could review and clarify any specifics. I would also send her

131

chapters of my dissertation that concerned her story and she again would have the
opportunity to review and change. All in all, I was trying to be a good, reflexive, feminist
researcher.
A few months after I had completed all of my interviews, I received the transcripts
and sent them to Meg. She sent them back with a bit of clarification – mostly language.
A few months later then, as I began to write up my “data” chapters I emailed all of my
participants to ask how they may want their health conditions as well as spouses
represented in the dissertation – if at all.
Immediately, I heard from Meg. She sent me a revision of her bio. She explained
to me that after our interview, she and her husband had underwent additional testing. It
was revealed from those tests that male factors were far more seriously than previously
thought. This, together with her diminished ovarian reserve, made any chance of
conception even more improbable. Noting that, I changed and updated the chapter.
With the chapter drafted, I sent it off to all participants. I heard back again from
Meg who expressed concern that I wasn’t representing their infertility diagnosis well
enough and how it was very important to both her and her spouse that I most accurately
represent them. I wrote her back and told her that I would make these changes once I
had the time to do so. I explained that I was working on a different chapter at this point,
but that I would be sure to adjust and resend to her for review.
A few months past and I am preparing my dossier for the job market. It dawns on
me that my participants may like to see my cover letter as well the sample chapter that I
created – as it frames my research and their stories in rhetoric and composition. I send
these documents and receive another email from Meg who is immediately concerned

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that I am sharing her story in these job materials. I write back and explain how the
consent form covered this and how we talked on the phone prior to her participation to
explain that her story, what would be my “data”, would appear in my dissertation and
then eventually in articles and possibly a book. I explained how we talked about
academic circulation. Upon sending that email, she replied explaining I did not fully
explain these consequences of her participation and that she felt betrayed.
I wrote back frantically explaining how I never meant to betray her. How I
remembered having conversations with her about how she would review chapters and
have consent over her story. I explained how the academic job market worked, how I
needed to share my research to demonstrate trajectory. And I apologized and
apologized – offering that we could still use a pseudonym to protect her identity and that
nothing has been published with her name on it. I also went back and walked her
through the informed consent form that she signed.
After several email exchanges attempting to clear up all confusion, it was made
clear to me in my last email exchange with Meg that she would preferred not to have
participated in this dissertation but that she would now like to use a pseudonym. Her
misunderstanding of how her story would be used in articles beyond the dissertation
placed so much stress on her that she wished she never participated. She ended her
email explaining to me that if we did not have a personal connection, she would have
pulled out. That she didn’t realize how hard it would be for her to see her story
continually discussed in my work and that because of the way her story will “live” in my
research – she expressed difficulty in ever being able to reach resolve with infertility,
resolving that she will be childfree.

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For Meg, participating in this project directly impacted the ways she attempted to
negotiate her infertile identity. When she first began participating in the project, she had
made it clear that they were coming to terms with being childfree. But that she still
wanted to participate and represent being childfree as a valid option in the infertility
community. During our interview, she continually commented on how she felt policed by
others in the IF community, that she was limiting herself from having a child because
she wouldn’t pursue non-biological children. That she was, by herself, creating
additional challenges towards resolution. Meg, though, wanted to use her story to
contest such pressures, to suggest that being childfree is not a failure, that it is a valid
choice. This, however, changed as time went on with Meg and with my dissertation. She
realized that she needed to separate herself from the IF community if she was really
going to be able to move on. She experienced the embodied labor that it took to
continually contest these narratives. She experienced rhetorical fatigue in the need to
use her narrative to contest the dominant stories she faced when talking and advocating
in that community.
But Meg’s rhetorical fatigue also transferred over to my project. She became
fatigued over the need to write her story. She became fatigued over the need to control
and protect her narrative as I circulated it and shared it. She became fatigued I think in
needing to negotiate my need to use her story academically while also needing to
advocate for how she felt most comfortable using that story. And so tensions naturally
emerged.

***

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Meg’s story raises important questions about community-engaged, participatory
activist work in the context of the dissertation and institutional practices, such as the job
talk and the need to demonstrate potential for tenure by discussing dissertation data
and implications. For Meg, she interpreted her participation in a very particular and
controlled scope. My use of her story, outside of the context of this dissertation, clearly
made, and still makes her, uneasy.
I want to return briefly to Blythe’s work in “Composing Activist Research.” His
recommendations suggest that academic use can still be found in theorizing and
offering methodological implications for academic audiences, such as I am doing now.
Grounding this recommendation he cite the work of other scholars negotiating “wicked
problems” and how they contribute to disciplinary-knowledge making. Yet, these
examples do not contend to institutional structures, like the job talk and the reuse of
dissertation data for tenure and promotion that have emerged out of my experiences
with Meg. Such a gap makes me question how activist-oriented research in a
dissertation project requires more time, attention, and methodological support for
negotiating not just the gathering, analyzing and suggested implications of the data –
but for communicating with participants the impact of this work across institutional
settings.
In retrospect, I now think back to when I first recruited participants and suspect
that I could have explained in more detail what their stories would be used for, how their
stories were still their stories. More explicit address of how these stories would be used
as data to demonstrate to institutions my institutional value should have taken place.

135

Moving forward with this work, I now must grapple with how these stories are circulated
in future scholarship.
	

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