A Novel About the Pregnancy Industrial Complex

Aviva Rosner wants a baby. She tries for two years, to no avail. She dreads the start of her monthly cycle. She gets her husband’s fertility tested. She cuts alcohol and sugar out of her diet. In her career as a singer-songwriter, she puts out an album called Womb Service which, in part, is about yearning for motherhood. She processes her feelings about it all with her shrink, the Rabbi. She gets desperate enough to subscribe to the mailing list of a self-proclaimed fertility guru, who sends messages like “Click here for my Fertile Food Five! Click here for my Recipes for Righteous Reproductive Renewal! Click here for my Fabulous Fertility Facts!” 

And when none of that works, Aviva gets angry—at the medical systems that insist she pump herself full of untested drugs that may or may not help her get pregnant. At the influencers who have children and tout them in color-coordinated, aesthetic backgrounds all over the internet. At other people, who give her unsolicited advice. At comments like, “You’re getting older, you know,” or “Your time will come, don’t worry.” At the way that her body is either viewed as something holy because of its ability to create life or a complete failure, depending on whether or not she becomes pregnant.

Elisa Albert, author of novels The Birth of Dahlia, After Birth, and How This Night is Different, brings a wealth of wit, humor, and righteous rage to her latest, Human Blues, in which she reckons with expectations imposed on the bodies of anyone with a uterus, the predatory nature of the wellness industry, and the ways in which people so often moralize fertility and conception. 

Jacqueline Alnes: Human Blues was pitched to me as being about someone wanting to conceive, but it’s about so much more than that. As I was reading, I kept trying to distill themes. It seems to be about what it means to be a woman and an artist in our time, the push to sell yourself via social media or press and the tension that can create between you and your work. It feels like it’s about the way that questions related to motherhood can be so invasive, in that they’re always focused on the body in some way. 

EA: And your worth as a person.

JA: Yeah! I thought it was hilarious when Aviva whips out the “I’m pregnant” card, even though she’s not. No one pays her much attention until she says, “I need my luggage delivered. I’m pregnant.” And then suddenly the world changes for her. People view her as worthy of receiving help and care.

EA: That cracked me up. That first moment when Aviva is at that literary salon and she doesn’t want a glass of wine—because she doesn’t like to drink—and it’s like, “Why aren’t you drinking? What’s wrong with you?” That’s how it started. And then I just thought it would be hilarious to have her somehow validate herself in the eyes of other people. It’s like a fuck off. When she says, “I’m pregnant,” other people go, “Oh, great then. Your womb is occupied? You are A-OK.” And then it just kept unfolding and the opportunities kept presenting themselves. I was cracking myself up, and that’s always a good sign.

JA: What was it like writing about the wellness culture surrounding infertility? The industry seems…predatory?

EA: Totally. A friend of mine had a really beautiful point, and she put it better than I could: while there is this huge, righteous mistrust of the technocratic approach and medical science approach because of all of the violations—ethical, financial, zero regulations, zero long term studies—the other extreme is also problematic, but there is less harm in trying those things. I think for Aviva, she doesn’t trust the wellness guru bullshit, culminating at the end with her mom sending her a book called “Am I The Reason I’m Not Getting Pregnant?” All the psychic stuff, it’s equally problematic, but the profit margins are smaller and the potential negative consequences are smaller. 

It’s like Scylla and Charybdis, trying to navigate and find your way and honor your own intuitive integrity or whatever. But this way feels really violating and wrong and so does the other. How do you empower yourself to inhabit that middle space and refuse either polarity? How do you carve out a space that is authentic and true and safe for oneself without being like, “Ok, I’ll sign up with you.” These are the options we are offered and they are both problematic. The idea that you simply have to decide who you’re going to hand your stuff over to, and then you abdicate and you’re like “Ok, I don’t have to think about anything anymore,” but the truth is that I think we all have to take responsibility for ourselves. That’s a lot of responsibility. It’s easier to hand stuff over to a doctor or nutritionist and close the case. 

JA: And it’s a way to absolve the guilt that is so unfairly placed on someone who is trying to get pregnant or someone who is ill. You see people stuck in these binds and it becomes less about science and the body and a physical thing, and it becomes a moral burden. People look at symptoms and think the person having them is not doing enough to “fix” themself.

EA: Which is such a bizarre denial of life. It’s this refusal to accept the limitations of what it means to live in a body that I just find baffling. My first novel was about a girl who was dying of a brain tumor and the whole thing was structured around this self-help book: are you the reason you have cancer?

JA: Oh my god, I have to read this.

EA: It was like, you have to forgive people, you have to let go, and she’s working through it. At the end she dies, but the whole thing is her chapter by chapter letting go. But no! That doesn’t fully work. It is nice to live in a time where there is wisdom everywhere, where trauma medicine is evolved. Like, I don’t want to pray over a gunshot wound or sing a song in place of bone-setting. I don’t want to attempt a home birth with pre-eclampsia. There is a time and a place. We’re all responsible for insisting on some middle place and picking and choosing what’s actually necessary and not letting anyone profit off of ignorance, fear, or brainwashing. 

JA: The noise can feel so loud, that voice that says, “This is how you do it. Come with me. This is how you heal yourself.” It’s so complicated.

EA: It really is. In my work as a doula, over the last dozen years, I’ve learned that you cannot offer people what they don’t want. People have to figure out how to come to some kind of approach themselves. If they seek out support, you can offer it, but you can’t tell somebody who’s been raised on a message that it doesn’t have to be that way. We have familial legacies, cultural legacies, shit held in our psyches that we aren’t even conscious of all the time, directing our feelings. I can’t even count the number of times I’ve heard a prepubescent person say something like, “Oh my god, pregnancy is disgusting.” And it’s like, wow, where did you get that? Do you know? Are you ever going to question that? Or is that going to be what directs your life? 

JA: When Aviva is kind of angry with another person in the book who doesn’t know their own menstrual cycle, part of me was like yeah, that makes sense, but the other part of me was like, wait a second? I also was never taught these things? I think at one point Aviva calls pregnant people “a holy vessel,” sarcastically, and I think imposing that extra layer of morality on people is a lot.

EA: People with uteruses are a huge commodity because we have yet to successfully grow a human being in a laboratory. That is coming. There are lots and lots of people who firmly believe that it will be a really positive step for humanity because we can separate reproduction from the body. Great, then we’re free. I personally think that when we come up with workarounds for human biology, we often create horrific problems for ourselves. Like sure, let’s go colonize Mars, let’s grow babies in labs. I’m on the edge of my seat waiting to see what happens. I don’t see that working out long term? I don’t think we are as smart as we think we are. 

As of now, people with uteruses are the creators of life and if the powers that be want to control us, as they have since time immemorial because we are such a commodity in that regard, the best way to do that is to divorce us from knowledge. If we are ignorant, we are scared. I can’t count the number of menopausal women who have said to me lately, “Oh, I think I’m menopausal. I went to the doctor to have my levels checked.” It’s like, honey, you’re fifty. You wake up soaked in sweat every night and your body is changing. Your doctor doesn’t need to check your levels. It’s so bizarre to me, the need for confirmation from an authority. To what end? Ignorance is endemic, from puberty to death. 

JA: It relates to so much of what’s going on right now with Roe v. Wade being overturned. I mean, part of what infuriates me is that we can talk about creating kids all that we want, but what happens when the kid gets here? There is no universal childcare, no parental support. You’re subject to a whole host of separate legislation that’s making parenthood even harder.  

EA: Back in the day, babies were known in this kind of society as cannon fodder, as in we needed babies to send them off to war. Now I think it’s more apt to say we need capitalist fodder. We need mall fodder. Let’s get more people in so we have more consumers. We need more eyeballs. We need more people going to the mall. It doesn’t have to be this way. It’s not like this in every country. It’s not like this everywhere in the world. There are places where birth is supported and evidence based. There are places where maternity care is humane. There are places with universal healthcare, a lot more green space, dedicated bike lanes, decent education for everybody. But this country is its own special beast. 

JA: I guess that’s why Aviva’s rage felt so right to me the whole book. She looks at every option and just thinks, that fucking sucks, and so does that, and I’m angry all the time about this system that I’m stuck in. And also recognizing that she’s extremely privileged within the system!

EA: Aviva doesn’t want to live in a world where everyone is out for themselves. She’s angry about the acquisitional, consumerist vibe. You’ve got to have it all. It’s brutal.