Infertility and Moral Luck: The Politics of Women Blaming Themselves for Infertility

Infertility can be an agonizing experience, especially for women. And, much of the agony has to do with luck: with how unlucky one is in being infertile, and in how much luck is involved in determining whether one can weather the storm of infertility and perhaps have a child in the end. We argue that bad luck associated with being infertile isoften bad moral uck for women. The infertile woman often blames herself or is blamed by others for what is happening to her, even when she cannot control or prevent what is happening to her. She has simply had bad luck. We focus on the self-blame of infertile women and show how it stems from pro-natalism that targets women. We also argue that overall for women, regret is a better moral response to infertility than self-blame. bad reproductive experiences, such as unwanted pregnancy and infertility, are partly or wholly the result of luck. Such luck often has bad moral effects, in that people are blamed for it or more generally, lose moral Illi: IN TIKWTIONAI .101 KNAI Ol IKMIMS I AI'I'KOACIIKS TO BIOKTIIICS Vol. 1, No 1 (SPRING 2008) © 2008 This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions CAROLYN MCLEOD AND JULIE PONESSE 127 standing because of it. Moreover, these people are more likely to be women than men: women are more likely to suffer negative moral effects from bad reproductive luck or in other words, to suffer from what we call bad reproductive "moral luck."2 Drawing on psychological literature about infertility, but also on philosophical work on luck, blame, and responsibility, we examine these claims using the test-case of infertility. In so doing, we hope to add important discussion about luck and its moral effects to feminist reproductive ethics, which has hitherto focused almost exclusively on reproductive choice, paying little attention to luck. Feminists have rightly lamented the fact that many women have little control over their reproductive lives; but rarely do feminists mention that the accompanying luck for these women is often bad moral luck, which is worse for women than merely lacking control. One notable exception to the claim that feminists have ignored reproductive moral uck is Donna Dickenson s work on what risks "can women be asked to bear" in reproductive health care, given that the outcomes of risky reproductive decisions can be morally unlucky (2003). But we deal with moral luck more broadly than Dickenson does. For we include moral uck that concerns not the outcomes of people's risky decisions, but the circumstances that people face more generally. An example of such circumstantial luck is the moral uck that accompanies infertility when the infertility itself is not a product of an agent's choices. Generally, with this paper, we hope to initiate an in-depth conversation about the moral effects of reproductive luck on women. More specifically, we want to persuade readers of the fact that women often morally blame themselves for infertility, even though they are rarely a morally relevant cause of the infertility, and moreover, that their self-blame isintimately tied to their oppression as women. When discussing how women blame themselves for infertility, we also refer to how other people blame them. Blame for infertility is an extreme example of reproductive moral uck;3 and to some people, it will seem farfetched that educated women, in particular, experience such blame. We focus on blame for infertility because it is extreme and it shows how serious the issue of reproductive moral luck is for women. The structure of the paper is as follows: first, we describe the luck involved in being infertile; second, we explain why many women experience this luck as moral luck (and more specifically, as blame); and third, we assess whether this moral luck is always bad luck and also when regret about infertility is bad or good. In general, the point of identifying when luck is both moral and bad is to reveal patterns of blame that are unfair and potentially morally damaging. Our This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions 128 J7n£>t**€ad€>*TMZ*i*t/ <7*A*+t+*a/ AW FEMINIST APPROACHES TO <^£w>^L* 1:1 Perhaps, however, a woman would be morally responsible for lifestyle-related infertility if she simply should have known how to modify her behavior to decrease her risk of becoming infertile. Inshort, she simply should have known better. And if that is true, then her infertility would not be just a matter of luck. We usually say that people "should have known better" when they fail to know what is deemed to be common knowledge. (For example, it is common knowledge that leaving young children unattended near water is dangerous; someone who does so should have known better, even if she did not actually know better.) So the question of whether people with lifestyle-related infertility should have known better essentially comes down to whether the lifestyle factors for infertility are common knowledge. We cannot prove that they are not common knowledge verywhere (such a task we leave to feminist sociologists who are interested in women's reproductive moral luck), but we can say this: given how many myths and rumors often surround infertility and the lifestyles that purportedly cause it (Weschler 2002, Kaler 2007),8 and also given uncertainty within science about what are the t rue lifestyle factors for infertility (e.g., uncertainty now about whether stress and caffeine consumption are such factors: Homan et al. 2007), we sincerely doubt that these factors are or even could be widely known. Before doing research for this essay, neither of us even understood what most scientists now consider to be the lifestyle factors for infertility, though we study reproductive ethics! One exception was our understanding that delayed childbearing can cause infertility. But anecdotal evidence of pregnancies among 40to 45 -year old women leads us to wonder how much of a delay is problematic. Moreover, we question whether delayed childbearing is even a choice for many women, given that he delay is often financially or professionally necessary. In summary then, we are skeptical that women who are infertile b cause of lifestyle factors can be held morally responsible for their infertility. This discussion of lifestyle factors for infertility reveals that forms of luck other than biological ones can contribute oone's infertility. The bad luck of being infertile because of a certain lifestyle will be not only bad biological luck, but also bad luck in being either stuck with certain lifestyles (unchosen ones) or embedded in societies that do not properly educate people about potential causes of infertility. The bad luck that goes into being infertile ispart of the lived experience of infertility for many people. Consider that anger is a common response to infertility (Greil 1997, 1682; Sherrod 2004, 44), and it is not unreasonable to assume that the anger comes from a sense of unfairness: that one is infertile when so many other This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions CAROLYN MCLEOD AND JULIE PONESSE 131 peoplesome of whom have "risky" lifestylescan conceive when they want, or worse, by accident! Biological luck, along with other forms of luck, is therefore a key aspect of infertility. And as we will see, such luck, insofar as it results in infertility, can be moral, especially for women. Of course, we do not believe that infertility is the only biological condition where the luck of having the condition can be moral uck to some degree, either because people are blamed for the condition or are treated as though they were morally inferior because of it. (Any stigmatized condition would fit his description.) Infertility is one example, though a specifically feminist example, of bad biological luck that often manifests itself as moral uck. Moral luck in being infertile: Women blaming themselves We have claimed that he bad biological luck of being infertile isoften moral luck for women because they take, or are given, moral responsibility for the infertility. They engage in self-blame and experience "other-blame" (blame by others) insofar as they are infertile women. Our argument, which focuses predominantly on self-blame, requires that we clarify the meanings of certain moral terms, namely moral uck, responsibility, and blame. According to Thomas Nagel, "[w]here a significant aspect of what someone does depends on factors beyond his control, yet we continue to treat him in that respect as an object of moral judgment, it can be called moral uck" (1993, 59). In other words, moral uck occurs whenever luck "makes amoral difference": that is, to the moral evaluation of a person s actions or to her status as a good or bad person (Latus 2005). This explanation does not specify to whom the luck does or ought to make a moral difference. We assume that moral uck could make a moral difference only to people of a certain social group or culture, because of how these people have been socialized to think about morality (or about women or fertility). For instance, the luck of being infertile makes a moral difference for many women because of the pro-natalism they face, as we will discuss. But the luck may not make a moral difference for everyone around these women, some of whom (hopefully) will not blame them for the infertility. Still, we call this luck "moral uck." It does make a moral difference, ifonly from some perspectives and for some people.9 We use the term "responsibility" in different senses and the term "blame" in a particular sense. In particular, we distinguish between causal and moral responsibility. People can be causally responsible for certain outcomes without being This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions 132 ^itei+na/to+Kt/ &w;**t**£w FEMINIST APPROACHES TO (&t;*>4>//ii^ 1:1 morally responsible for them. They are causally responsible if through their own action (versus through some involuntary bodily movement or process), they brought about the relevant outcomes (Mackenzie 1992, 138). But they are not morally responsible if there is nothing that is morally salient about these outcomes (e.g., about a door being opened without anyone being harmed as a result) or about their intentions (e.g., they did not desire to hurt someone by opening the door). Moreover, even if the outcomes are morally salient someone was harmed those who caused the harm still might not be morally responsible for it, because they might not have known, and were not in a position to have known, about the potential harm. Unlike causal responsibility, moral responsibility requires that people's actions (obviously) have a moral dimension to them and that they were aware or should have been aware of this dimension when performing the action. In addition, we briefly mention different senses of moral responsibility, including what Claudia Card calls the "credit sense of responsibility owning up to having been the (morally) relevant cause of something's happening or not happening, taking the credit (blame) for it" and what she labels the "administrative or managerial sense of responsibilityundertaking to size up and organize possibilities comprehensively, deciding which should be realized and how" (1996, 28). The first sense of responsibility, the credit sense, is "backward-looking": it looks back to who was the cause of something's happening and who was to blame for it. By contrast, the second sense is "forward-looking": it looks forward to who will manage a situation that needs managing. Each of the above forms of responsibility causal responsibility, moral responsibility in the credit sense, and moral responsibility in the managerial sense figure in our discussion of the moral luck that women face because of being infertile. The blame associated with the credit sense of responsibility is moral blame, which is also the kind of blame we focus on. Blame may not always be moral in kind; for example, I might blame myself for forgetting to put a carton of milk back in the refrigerator if the milk goes bad, but I do not experience this blame as a moral reprimand. Blame of a moral kind usually prompts negative moral feelings, such as guilt, shame, or feeling that one has let people down. By contrast, blame for letting the milk go bad would normally only generate disappointment or perhaps frustration, either of which are necessarily moral feelings. In referring to blame below (e.g., to whether women genuinely blame themselves for infertility), we mean moral blame. Women could take responsibility for their infertility in any of the above senses: they could simply assume that they are causally responsible for it, they This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions CAROLYN MCLEOD AND JULIE PONESSE 133 could blame themselves for it, or they could take responsibility for managing it. Often women, as opposed to men, take responsibility in the managerial sense for infertility. For example, they are more likely than men to "seek out information about infertility" and to "initiate treatment" for it (Greil 1997). What probably explains why many women become managers of infertility is their desire to have children, which tends to be stronger than men's, or influence of a sexist and pro-natalist culture that as much delivers the message that women are responsible for overcoming infertility as it does that women are to blame for it. Notice that women can assume managerial responsibility for infertility without taking causal or credit responsibility for it (just as anyone can work to solve a problem that s/he did not cause, in a morally relevant sense or not). Heterosexual women probably manage their infertility more than their male partners do even when the women recognize that they are not to blame for the infertility. Our argument, however, focuses on how, or more importantly whether, women take responsibility for infertility in the credit sense: that is, whether they blame themselves for it. Our aim is to show that self-blame among women for infertility is common, although we discuss reasons why other-blame iscommon as well. In showing that women blame themselves, we also reveal why they blame themselves, where the "why" is connected with the oppression of women.10 It intuitively makes sense to us that many women would blame themselves for infertility and in so doing, point to any number of possible causes for it: not timing intercourse properly, being too "stressed out," having a bad diet, having a past abortion, having engaged in risky sexual behavior, and so on. These may not be true causes of a woman's infertility, however, or if they are, the woman may not (and could not easily) have known that they would compromise her fertility, in which case, while she may be causally responsible for the infertility, she could not legitimately be blamed for it. As suggested above, most, if not all, women who blame themselves for infertility are either merely causally responsible for it or are not causally responsible for it at all. The only clear exception would be a woman who autonomously chose to be sterilized, but then changed her mind about wanting to get pregnant. She could rightfully blame herself or being infertile, since she knowingly and freely undermined her chances of getting pregnant. Most women ought not to blame themselves for infertility, however; yet they do it anyway. But one could legitimately ask, "Do women truly blame themselves for infertility, or do they just say that they are responsible for it, from which it could follow that they are only causally responsible for it?" For three reasons, we think This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions 134 ,j£*aW#«/i»#*«^r^#**W'rOF EMINIST APPROACHES TO(£tw//itns 1:1 £7 that the women do in fact blame themselves; that something enuinely evaluative is going on. The first reason is this: other people often blame women for infertility, and self-blame and other-blame tend to go hand in hand. (In other words, women blame themselves because other people blame them.) In some societies, blame by others for infertility, which is both rampant and overt, is directed primarily at women. These societies are ones in which divorce, abandonment, social ostracism, and abuse are highly correlated with infertility for women (Dyer et al. 2005; Guntupalli and Chenchelgudem 2004).11 The majority of peopleor at least the majority of dominant societal membersmust support these practices for them to continue, which means that the majority must blame women for infertility. (Why else would they endorse such treatment of women?) Blame by others need not be so overt or severe, however. For example, the pervasive belief that stress causes infertility is a source of blame for women that is certainly palpable, but not severe. Telling a woman that she should "just relax" or "should stop working so hard" implies that the problem is hers to begin with. Such advice, which can be wellmeaning, has negative implications for its receiver. The message is essentially one of blame: "if you relaxed more and were not so preoccupied with other things, then you would be pregnant. Moreover, relaxing more and working less are surely within your control." Such other-blame easily can be converted to self-blame. A second reason for thinking that women who say, "I'm responsible for the infertility," genuinely blame themselves for it is that the thought coheres with psychological studies about women who are infertile. In fact, studies dealing with self-blame overwhelmingly conclude that women who experience infertility blame themselves for it: they do so more often than men and even when the cause of the infertility is unknown (Greil 1997; Schneider and Forthofer 2005; Peterson et al. 2006).12 They also blame themselves more, in comparison with other women, if their culture is especially pro-natalist toward women (van Rooij et al. 2007). This research, although important to our project, is problematic because it often fails to distinguish carefully between blameworthiness and causal responsibility.13 Women say that they are responsible for the infertility, and researchers a sume that they therefore blame themselves, when in fact, they could merely be accepting that they caused the infertility (blamelessly). So the research does not obviously corroborate our thesis about self-blame. But if we explore the research findings in more detail, we will see that the best interpretation of them does support our thesis. This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions CAROLYN MCLEOD AND JULIE PONESSE 135 Consider first the finding that women whose culture is especially pro-natalist blame themselves for infertility more than other women. This result suggests that pro-natalism has something to do with the "self-blame." According to pro-natalist norms, childbearing is a woman's ocial role and if a woman does not bear children, then she does not "count" (i.e., have value) in society, or she counts less than other women. If an infertile woman or people around her believe that childbearing is her social role, then she's likely genuinely to blame herself or be blamed for the infertility. Consider that with social roles come social responsibilities and that the relevant responsibility here is to bear children: for one's own sake, for that of one's spouse, for one's parents, for one's spouse's parents, or for one's existing children. If women have internalized such pro-natalismwhich they can do without endorsing it (Calhoun 1995)then in all likelihood, they will feel that they have let people down if they cannot get pregnant; for that is how people commonly feel when they cannot fulfill their social role, for whatever eason. Believing that one has let people down indicates that one blames one's self. Consider second the finding that women who experience unexplained infertility tend to assume that they are the cause of the infertility and take responsibility for it. Now, why would women do that? We think the answer is similar to the answer to why self-blame isgreatest among women who face severe pro-natalism: to some degree, the women have internalized the view that their social role as women is to reproduce. And if that is their role, then as women, they should be able to reproduce.14 If they cannot do it, then there must be something wrong with them. Furthermore, if they cannot do it, then they let other people down. Thus, they attribute he cause of the unexplained infertility to themselves and also blame themselves for it. The previous explanation is our preferred xplanation for why women take responsibility for unexplained infertility; and the explanation suggests that the responsibility hey take is moral, not causal. But there is at least one other possible explanation that we ought to consider, one that suggests that the relevant responsibility is causal and therefore, that women do not truly blame themselves when the cause of infertility is unknown. Women might take responsibility for unexplained infertilitypublicly, if not privatelybecause they want to protect their male partners from the shame or embarrassment of thinking that they themselves are infertile. And if that is their purpose, then they need not take moral responsibility for the infertility, because assuming causal responsibility is enough to save their partners' male egos. Unfortunately, this explanation does not jive with recent research on self-blame among This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions 136 ej£rfWW&*#W^«***«/OF FEMINIST APPROACHES TO6Si^^^ 1:1 infertile women in the West (Peronace t al. 2007). This literature veals that hese women, in general, will not publicly accept blame for male-factor infertility, though one would assume that they would if they were concerned about protecting their partner from embarrassment. Therefore, they probably would not take responsibility for unexplained infertility either. This same literature also concludes that men tend not to find male-factor infertility to be particularly distressing, compared to female-factor or unexplained infertility.15 Women who are partnered with these men may be well aware that virility is not a major source of self-esteem for them. If so, then these women would not assume that by attributing the cause of unexplained infertility to themselves, they would be saving their partners from serious psychic injury. Of course, some women might assume as much, and for good reason, because they inhabit cultures in which virility is clearly important for men. Where it is important, the previous explanation for self-attribution among women for the causes of infertility is certainly plausible. But we think that our explanationthat women attribute the cause of unexplained infertility to themselves because of pro-natalist social norms that encourage women to blame themselves rather than just take causal responsibility-coheres best with all of the empirical literature and arguably with different cultural backgrounds of infertile women and men, including backgrounds that are not especially pro-natalist. Even in societies where women who do not reproduce or bear children also have value, cultural messages marking reproduction as the domain of women are strong. There is one final reason why we think it is false to assume that when women say they are responsible for their infertility, they mean causally responsible. When people believe themselves responsible for a dire outcome, it is unusual for them just to accept causal responsibility for it. They blame themselves. For example, if I make what turns out to be a poor financial decision, one that puts me in financial ruin, then I will probably blame myself for making a poor decision, even if I could not have known that it would turn out to be poor (or that Iwould). The alternative of believing that horrible vents, such as financial ruin, occur by chance alonethat I have no control over whether they do occur is too hard to accept. Hence, I blame myself and assume that things turned out badly because I failed to exert the control I do have over whether things go well or badly. Similarly with infertility: thinking that the world is just unfair or that their bodies have betrayed them may not be an option, especially for women who find infertility to be devastating and who want to believe that they can overcome it by making different choices than ones they made in the This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions CAROLYN MCLEOD AND JULIE PONESSE 137 past. Here, self-blame isa coping mechanism for women, especially perhaps for those who have internalized the pro-natalist message that infertility is a disaster for women. If persuasive, the previous discussion shows that the responsibility many women attribute othemselves for infertility is responsibility in the credit sense "taking the credit (blame) for it" (Card 1996, 28)rather than the causal sense. And therefore, bad biological luck of being infertile for these women is moral uck. (It would be mere luck if the responsibility hey took were causal, and thus, nonmoral.) To be clear, the idea is not that infertile men never face moral uck of this sort, but that whatever amount of it they do experience is significantly less than what women experience. Analyzing self-blame and regret for infertility There is some question as to whether the self-blame of many infertile women could be helpful to them, rather than harmful, especially when it serves as a coping mechanism. If it is helpful, then the moral uck it represents could be good luck, not bad. We would like to pursue this question and also consider whether regret, instead of blame, would be an appropriate r sponse by many women to infertility, whether they caused the infertility or not. One might think that the self-blame of infertile women would be helpful to them because, as explained previously, it can allow them to believe that through their own actions, they can overcome their infertility. It could give them hope, in other words, that future strategies they use to get pregnant will work. In blaming themselves, women assume there was something they could have done to prevent their infertility. Women who assume the oppositethere was nothing they could have donecould find it harder to believe that their future choices will have any effect on whether they get pregnant. But the previous analysis of the benefits of self-blame isweak for at least three reasons: (1) Obviously, hope that one's attempts at getting pregnant will succeed can be false hope, which itself can be damaging. A woman who continues to believe that her infertility can be resolved by her own management may be unrealistically optimistic about, and therefore more likely to be devastated by, bad outcomes. (2) The psychological literature reveals overall that self-blame isnot a good coping strategy for infertile womenthe distress they experience as a result of the infertility is usually higher if they blame themselves for being infertile than if they do not (see, e.g., Peterson et al. 2006). (3) The blame can reinforce the pro-natalist and sexist norm that women ought to feel This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions 138 ,J£*^a^/^aW/^«*TM«/0F FEMINIST APPROACHES TO<^&Wrf;^*i 1:1 s7 badly about themselves if they cannot get pregnant. In particular, blame will have this effect if it stems from pro-natalist and sexist social forces, as much of women's elf-blame does, according to the previous section of this paper. For example, self-blame that exists because of other-blame that targets women in general rather than men is clearly linked with these forces, as is the self-blame that women feel because of unexplained infertility. Self-blame that has its roots in pro-natalism and sexism cannot be good for women. For these reasons, we maintain that he reproductive moral uck of self-blame is generally bad for infertile women. In general, these women should not engage in self-blame or be encouraged to do so. There may be some women who legitimately could blame themselves for infertilityas noted previously, using the example of the woman who autonomously chooses to be sterilizedbut again, we assume that such cases are few and far between. Although self-blame by women is normally an inappropriate response to the bad luck of being infertile, one might wonder whether regret is ever an appropriate response, and if so, under what conditions. Women who don't blame themselves for infertility almost certainly will regret it, that is, if they want to get pregnant. But whether regret is appropriate can depend on exactly what the woman is regretting. We consider different possibilities below and do so under the general headings of: regret for past actions (that may have caused one's infertility), regret for one's circumstances (that exist because of the infertility), and regret for one's constitution (as an infertile woman). First, a woman might regret past actions that she assumes contributed to her infertility and regret them without believing that she was a morally relevant cause of the infertility. For example, a woman can regret having engaged in risky sexual behavior, even if she knows that at the time, she did not appreciate the risks and could not have reasonably been expected to do so. Regret of this sort can be inappropriate and would be so if it targeted an action that in all likelihood did not cause the infertility, such as a past abortion that involved no complications. But regretting past actions that could very well have contributed to one's infertility can be appropriate. Aristotle tells us why, in general, one ought to regret actions for which one cannot be blamed but that are normally blameworthy (i.e., because of the nature of the actionsay it was a lieor because of its effects): the regret signals that the action was involuntary (Nicomachean Ethics 1110b 18-20). In certain contexts at least, saying "I regret doing X" suggests that I didn't really want to do X or didn't want what it brought about. Instead, I was coerced into doing it or This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions CAROLYN MCLEOD AND JULIE PONESSE 139 was under some misconception about what its consequences would be. Hence, the action was not fully autonomous (assuming that voluntariness and knowledge about consequences are important for autonomy; see McLeod 2002). What does this reasoning imply for women who regret infertility for which they are causally but not morally responsible? The regret indicates that they are not morally responsible; and hence, the regret is appropriate. Regret for past actions also can signal that one is unhappy with what one has lost, or caused others to lose, because of these actions. So the regret reveals the level of one's commitment toa certain good or the level of one's caring for others who lose something because of what one did (intentionally or not). Thus, a woman might regret the lifestyle she had that contributed to her infertility because she truly wishes that she could be a biological mother or wishes that she could now do her part in fulfilling the goal of biological parenthood that she shares with her partner. Regret of this sort can be appropriate as long as the woman's wishes are authentic, asopposed to being determined by outside forces, particularly pro-natalist and sexist forces. When a woman truly wants to be a biological parent and to give her partner the experience of being such a parent, it makes sense that she would regret the lifestyle she had that helped to make her infertile. Second, a woman can regret the circumstances inwhich her infertility has placed her and regret them without thinking that any past actions of hers caused the infertility. For example, she simply regrets not being able to get pregnant or not being able to give her spouse a biological child. Such regret can be appropriate for reasons discussed in the previous paragraph: the regret is a way of showing how much the woman values pregnancy, biological motherhood, or the interests of someone close to her. But again, these values can be infected with pro-natalism or sexism; for example, the woman might desire to be a biological mother because she believes that her value as a person is defined by her reproductive capacity. One can legitimately question whether such a desire is authentic as opposed to being a mere product of oppression, and in turn, whether regret for not being able to fulfill this desire is appropriate. Regret in this instance could signal what is important not so much to the woman, but to the culture that oppresses her. Third, an infertile woman might regret her constitution: who she is and who she has become because of being infertile. For example, she regrets that she is filled with angst or self-blame about her infertility, that she feels sorry for herself when so many others uffer from afate worse than infertility, that she is incredibly envious of women who bear children, or that she feels incomplete as a woman because of pro-natalist attitudes that she holds but does not endorse. This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions 140 j£*a£*#*«/i«#*«/^w*#*«/OF FEMINIST APPROACHES TO 6&*<H&&cd;, 1:1 Regretting who one is as an infertile woman can be both appropriate and required even though one's character is not entirely within one's control. As suggested previously, an infertile woman may be who she is, and may feel what she feels, because she has internalized oppressive norms. In that case, oppression has caused moral damage to her character (Tessman 2005; Card 1996).16 Regretting this effect of oppression is appropriate insofar as it encourages one to remake one's self to whatever degree possible. Here, regret has prospective value for an infertile woman because it spurs her on in trying to alleviate damage to her self caused by the oppression she has faced, and to respond virtuously to the bad moral effects of her infertility. Because of the regret (and other factors to be sure, such as encouragement from others), she might even become a better person than she would have been had she not suffered through the infertility. For example, she could become more courageous, more compassionate toward people who experience trials that are similar to infertility, more aware of her personal relationships that are beneficial and those that are harmful, clearer about her desires that are authentic to her, and so on. This is not to suggest that taking responsibility for reconstituting a self that has been somewhat mangled by oppression is easy. Card explains that, on the contrary, this process is normally quite difficult (1996). It requires evering relations with people close to you who reinforce the oppression, forming more positive relationships, and silencing inauthentic yet deeply entrenched desires. For women who regret who they are as infertile women, developing a self that is virtuousthat can respond with integrity or grace17 to the bad luck of being infertilewill be difficult. Nevertheless, they ought to do it, or at least attempt i ; and regretting who they are is an important first step toward developing a better character. In summary, unlike self-blame, regret can be a legitimate moral response to the bad luck of being infertile. Some forms of regret will surely be illegitimate, as indicated previously. But there are many instances of regretting being infertile (and the feelings and anxiety that go along with it for many women) that are appropriate because they communicate concern for others who will grieve over the infertility, for example, or they prompt one to repair a self that is damaged by sexist and pro-natalist forces. Thus, in the context of infertility, regret can be morally good, but self-blame is morally bad, and unfortunately self-blame iscommon among infertile women. Moreover, the blame represents bad reproductive moral luck for women. As we have shown, women are vulnerable to this luck in societies that define women's function in terms of their capacity for biological reproduction. The elimination of This content downloaded from 142.150.190.39 on Fri, 20 Dec 2013 08:46:19 AM All use subject to JSTOR Terms and Conditions CAROLYN MCLEOD AND JULIE PONESSE 141 this bad moral uck for women will require, among other things, that societies remove from themselves vibrant or lingering images of women as breeders. Women must be able to know that they can function well in society without biological children, and that in general, infertility is not a woman's fault.17