Skip to main content

Obligatory Effort [Hishtadlut] as an Explanatory Model: A Critique of Reproductive Choice and Control

Abstract

Studies on reproductive technologies often examine women’s reproductive lives in terms of choice and control. Drawing on 48 accounts of procreative experiences of religiously devout Jewish women in Israel and the US, we examine their attitudes, understandings and experiences of pregnancy, reproductive technologies and prenatal testing. We suggest that the concept of hishtadlut—”obligatory effort”—works as an explanatory model that organizes Haredi women’s reproductive careers and their negotiations of reproductive technologies. As an elastic category with negotiable and dynamic boundaries, hishtadlut gives ultra-orthodox Jewish women room for effort without the assumption of control; it allows them to exercise discretion in relation to medical issues without framing their efforts in terms of individual choice. Haredi women hold themselves responsible for making their obligatory effort and not for pregnancy outcomes. We suggest that an alternative paradigm to autonomous choice and control emerges from cosmological orders where reproductive duties constitute “obligatory choices.”

This is a preview of subscription content, access via your institution.

References

  1. Bharadwaj, Aditya 2006 Sacred Conceptions: Clinical Theodicies, Uncertain Science, and Technologies of Procreation in India. Culture, Medicine and Psychiatry 30(4): 451–465.

    Article  Google Scholar 

  2. Gammeltoft, Tine M 2014 Haunting Images: A Cultural Account of Selective Reproduction in Vietnam. Berkeley, CA: University of California Press.

    Book  Google Scholar 

  3. Gammeltoft, Tine M., and Ayo Wahlberg 2014 Selective Reproductive Technologies. Annu. Rev. Anthropol. 43: 201–16.

    Article  Google Scholar 

  4. Inhorn, Marcia C. 2003 Local Babies, Global Science: Gender, Religion, and in Vitro Fertilization in Egypt. New York and London: Routledge.

    Google Scholar 

  5. Ivry, Tsipy n.d. Divisions of Moral Labor in Reproductive Medicine: Rabbis, Doctors, Patients, and the Potential of Moral Relief.

  6. Ivry, Tsipy 2010a Embodying Culture: Pregnancy in Japan and Israel. New Brunswick, NJ:Rutgers University Press.

  7. Ivry, Tsipy 2010b Kosher Medicine and Medicalized Halacha: An Exploration of Triadic Relations among Israeli Rabbis, Doctors, and Infertility Patients. American Ethnologist 37(4):662–680.

  8. Ivry, Tsipy, Elly Teman, and Ayala Frumkin 2011 God Sent Ordeals and Their Discontents: Haredi Ultra-Orthodox Jewish Women Negotiate Prenatal Testing. Social Science & Medicine 72(9): 1527–1533.

    Article  Google Scholar 

  9. Kahn, Susan 2006 Making Technology Familiar: Orthodox Jews and Infertility Support, Advice, and Inspiration. Cult Med Psychiatry 30: 467–480.

    Article  Google Scholar 

  10. Kelly, Susan E. 2009 Choosing Not to Choose: Reproductive Responses of Parents of Children with Genetic Conditions or Impairments. Sociology of Health & Illness 31(1): 81–97.

    Article  Google Scholar 

  11. Keshet, Yael, and Ido Liberman 2014 Coping with Illness and Threat: Why Non-religious Jews Choose to Consult Rabbis on Healthcare Issues. Journal of Religion and Health 53(4): 1146–1160.

    Article  Google Scholar 

  12. Landsman, Gail 2008 Reconstructing Motherhood and Disability in the Age Of “‘Perfect’” Babies. New York: Routledge.

    Google Scholar 

  13. Lippman, Abby 1999 Choice as a Risk to Women’s Health. Health, Risk & Society 1(3): 281–291.

    Article  Google Scholar 

  14. Lock, Margaret, and Patricia A. Kaufert 1998 Pragmatic Women and Body Politics. New York: Cambridge University Press.

    Google Scholar 

  15. Mittman, Ilana S., Janice V. Bowie, and Suzanne Maman 2007 Exploring the Discourse between Genetic Counselors and Orthodox Jewish Community Members Related to Reproductive Genetic Technology. Patient Education and Counseling 65(2): 230–236.

    Article  Google Scholar 

  16. Prainsack, Barbara, and Gil Siegal 2006 The Rise of Genetic Couplehood? A Comparative View of Premarital Genetic Testing. Biosocieties 1(1): 17–36.

    Article  Google Scholar 

  17. Rapp, Rayna 1999 Testing Women, Testing the Fetus: The Social Impact of Amniocentesis in America. New York: Routledge.

    Google Scholar 

  18. Raz, Aviad 2009 Community Genetics and Genetic Alliances: Eugenics, Carrier Testing, and Networks of Risk. London: Routledge.

    Google Scholar 

  19. Raz, Aviad E., and Yafa Vizner 2008 Carrier Matching and Collective Socialization in Community Genetics: Dor Yeshorim and the Reinforcement of Stigma. Social Science & Medicine 67(9): 1361–1369.

    Article  Google Scholar 

  20. Roberts, Elizabeth F. S. 2012 God’s Laboratory: Assisted Reproduction in the Andes. Berkeley, CA: University of California Press.

    Google Scholar 

  21. Rose, Nikolas 2000 Government and Control. The British Journal of Criminology 40(2): 321–339.

    Article  Google Scholar 

  22. Rothman, Barbara Katz 1986 The Tentative Pregnancy: Prenatal Diagnosis and the Future of Motherhood. New York: Viking.

    Google Scholar 

  23. Seeman, Don 1999 Subjectivity, Culture, Life-World: An Appraisal. Transcultural Psychiatry 36(4): 437–445.

    Article  Google Scholar 

  24. Seeman, Don 2010 Ethnography, Exegesis, and Jewish Ethical Reflection: The New Reproductive Technologies in Israel. In Kin, Gene, Community: Reproductive Technology among Jewish Israelis. Daphna Birenbaum-Carmeli and Yoram Carmeli, eds., pp. 340–360. Oxford, UK: Berghahn Books.

  25. Seeman, Don, Iman Roushdy-Hammady, Annie Hardison-Moody, Winnifred W. Thompson, Laura M. Gaydos, and Carol J. Rowland Hogue 2016 Blessing Unintended Pregnancy: Religion and the Discourse of Women’s Agency in Public Health Medicine Anthropology Theory (in press).

  26. Teman, Elly 2010 Birthing a Mother: The Surrogate Body and the Pregnant Self. Berkeley: University of California Press.

    Book  Google Scholar 

  27. Teman, Elly, and Tsipy Ivry n.d. Pregnancy as a Way of Life Among Ultra-orthodox Jewish Women. Philadelphia. Unpublished manuscript in preparation.

  28. Teman, Elly, Tsipy Ivry, and Barbara A. Bernhardt 2011 Pregnancy as a Proclamation of Faith: Ultra-Orthodox Jewish Women Navigating the Uncertainty of Pregnancy and Prenatal Diagnosis. American Journal of Medical Genetics Part A 155(1): 69–80.

    Article  Google Scholar 

  29. Tsuge, Azumi 2010 How Japanese Women Describe Their Experiences with Prenatal Testing. In Frameworks of Choice: Predictive and Genetic Testing in Asia. Margaret Sleebooom-Faulkner, ed. Pp. 109–123. Amsterdam: Amsterdam University Press.

    Google Scholar 

  30. Whittaker, Andrea 2015 Technology, Biopolitics, Rationalities and Choices: Recent Studies of Reproduction. Medical Anthropology 34(3): 259–273.

    Article  Google Scholar 

  31. Zeiler, Kristin 2004 Reproductive Autonomous Choice—a Cherished Illusion? Reproductive Autonomy Examined in the Context of Preimplantation Genetic Diagnosis. Medicine, Health Care and Philosophy 7(2):175–183.

    Article  Google Scholar 

  32. Zhu, Jianfeng 2013 Projecting Potentiality: Understanding Maternal Serum Screening in Contemporary China. Current Anthropology 54(s7):36–44.

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Don Seeman, Zsuzsa Berend and two anonymous reviewers for their inspiring, supportive and helpful comments on this manuscript.

Funding

The US research sample was funded by a postdoctoral research grant to Elly Teman from the Penn Center for Integration of Genetic Healthcare Technologies at the University of Pennsylvania and by a grant to Elly Teman from the Robert Wood Johnson Health and Society Program at the University of Pennsylvania. The Israeli research sample was partially funded by a research grant to Tsipy Ivry from the Dept. of Sociology and Anthropology at the University of Haifa and partially from a research grant to Elly Teman from the Behavioral Sciences Dept. at Ruppin Academic Center, Israel.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Elly Teman.

Ethics declarations

Compliance with Ethical Standards

This article is based upon two separate research projects. The Israeli sample was reviewed and approved by the Ethics committee of the Faculty of Social Sciences at the University of Haifa, Israel. The US sample was approved by the Institutional Review Board of the University of Pennsylvania.

Conflict of Interest

Elly Teman, Tsipy Ivry, and Heela Goren declare that they have no conflict of interest and that no conflict of interest exists for this research.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all interviewees and all names have been changed to pseudonyms and identifying information has been omitted.

Additional information

This article is our original work and has not been published before or submitted simultaneously to another journal.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Teman, E., Ivry, T. & Goren, H. Obligatory Effort [Hishtadlut] as an Explanatory Model: A Critique of Reproductive Choice and Control. Cult Med Psychiatry 40, 268–288 (2016). https://doi.org/10.1007/s11013-016-9488-5

Download citation

Keywords

  • Ultra orthodox Jewish women
  • Reproductive choice
  • Religion
  • Reproductive technologies
  • Explanatory models
  • Moral dilemmas