In her ethnography, Embodying Culture: Pregnancy in Japan and Israel, Tsipy Ivry uses her own experiences with pregnancy and her research on the topic to compare and contrast two widely different medical systems. Both Japan and Israel are non-Western, highly industrialized societies that provide medical facilities and insurance subsidized by the government (Ivry 20). Their differing religious and historical backgrounds heightened Ivry’s interest in the matter and helped her understand that “there is much more to pregnancy than merely the transitory stage to birth and motherhood” (Ivry 1). She discusses the importance of understanding pregnancy as much more than just reproduction and uses Japanese and Israeli beliefs to do so.
One of the most polarizing characteristics between Japanese and Israeli doctors is their perceptions of the health of the patient and what constitutes as “good” or “bad” during pregnancy. Israel’s pro-natalist state provides national health insurance to their citizens, which cover most costs of gestation. As a result, Israel has the highest rate in the world of IVF clinics and has more lenient abortion laws (Ivry 38). Among the many services covered by health insurance are diagnostic tests that can detect abnormalities in the fetus. Having access to such tests has lead to a heightened awareness and resulting paranoia about knowing the health status of their baby. Ivry mentions that “the word ‘hysteria’ is often used, by doctors, male partners, and relatives, and sometimes even by women themselves, to signify an anxiety about possible abnormalities in the fetus” (Ivry 47). The women become dependent on the doctors to constantly reassure them that their baby is fine and are depicted as an external bystander of their own pregnancies. The doctors’ main concern is that the women fully understand all aspects of their own health, and the health of their fetus, and are thus recommending procedures that are in the best interest of their patients, making them less tolerant of patient’s personal decisions (Ivry 76). Contrarily, Japanese prenatal care is focused much more on the natural changes during pregnancy and how they can affect the health of the baby. The health progression of the baby is connected with the woman’s “conduct of her daily life” (Ivry 92). Japanese doctors stress the importance of keeping the “maternal environment” as safe and healthy as possible and as a result, the fetus will grow with little complications. The patients are not as enthusiastic about prenatal diagnostic testing because they are not as threatened by statistics on fetal abnormalities. Women spend much of their pregnancy monitoring all aspects of their lives including diet, work and travel in order to ensure that no harm will be inflicted upon the fetus.
Furthermore, the way that women experience their pregnancies are significantly distinct. Japanese women and society stress the importance of bonding with the fetus while it is in the womb. The mother will often take time off of work beginning at about month five of gestation so that she can spend time with the fetus. She will talk to it, sing to it and touch her belly often in order to ensure that her baby knows that he/she is safe and wanted. The doctors also participate in this bonding by personifying the fetuses during check-ups and ultrasounds. As Ivry mentions in her work, such theories of prenatal bonding “designates women as the primary creators of the children: with every breath they take, every move they make, women make their children” (Ivry 165). Unlike Japan where the pregnant women are virtually hidden, in Israel pregnant women are “highly visible” (Ivry 187). They do not take nearly as much time off of work and are not worried about their diet or weight gain during pregnancy. Israeli state is also more inclusive of men in gestation by providing pregnancy classes for both the mother and father and allowing the father to attend routine check-ups. Israeli society often separates the woman and the fetus, which allows them to continue on in their “normal lives” without disruption from the pregnancy.
Ivry effectively describes the pregnancy in Japan and Israel and highlights gestation as a cultural category in need of more social analysis. After reading her work, I was shocked by the wide variation of views on gestation were and how such a common natural event can be treated with such unique/varied procedures. I also wonder if Western societies, who are so stringent about prevention of diseases, would relate more with Israeli medicine or Japanese? We discussed in class last week that biotechnology is not culture-neutral and ideas about risk vary from setting to setting, which can be seen Ivry’s descriptions on Japan and Israel. Pregnancy is a universal event and is much more than just the physical changes that occur. All aspects of gestation can be understood in matters of cultural values and societal perceptions of humanity.