Joy Portrays The Birth Of Ivf As Well As Fertility Stigma. Has Much Changed Today?

A tender take on an incredible true story, Netflix's Joy tells the story of the scientists who pioneered the investigation that created the world’s first baby born through in vitro fertilisation (IVF). Their research in the late '60s, early '70s changed the lives of many — since then, over 12 million babies have been born as a result of IVF and other assisted reproductive technologies like it.

Directed by Ben Taylor, Joy is true to life in more ways than one, as the script was not only based on history but was co-written by Jack Thorne and his wife Rachel Mason, inspired by their own fertility struggles and experiences with IVF. Joy follows the lives of embryologist Jean Purdy (Thomasin Mackenzie), surgeon Patrick Steptoe (Bill Nighy), and scientist Robert Edwards (James Norton) as they fight opposition from church, state, and the media towards their work. 

But how much has really changed since then in terms of social stigma and discrimination around fertility and pregnancy?

Joy zones in on harmful social stigma around fertility 

Joy provides a telling snapshot of the ways that societal attitudes hindered the progress of the IVF investigation and establishment of the Bourn Hall Fertility Clinic in Cambridge, and how these views personally impacted not only the team working on it but the women who courageously volunteered to take part — they called themselves the Ovum Club. 

As the leading nurse and embryologist on the project, Jean suffers in her personal life. She is excommunicated by her devoutly religious mother Gladys (Joanna Scanlan) and church community for her work, and is especially criticised for working alongside Steptoe, who was part of a minority of doctors who performed legal abortions at the time, to the outrage of many. We even see Jean grapple with the tension between abortion and her faith, with one poignant scene seeing operating theatre supervisor Muriel "Matron" Harris (Tanya Moodie) reminding her of the overarching importance of providing women with a choice — whether that means giving them a chance to conceive using science or end a pregnancy.

Jean and Robert receive huge amounts of harassment in the film, with Robert heckled on live TV, taunted in the street, and called "Dr Frankenstein" for his efforts, with the words painted on the outer walls of the clinic. The women involved in the experiment (brought to the screen by actors such as Derry Girls star Louisa Harland as Rachel, Bridgerton’s Harriet Cains as Gail, and Carla Harrison-Hodge as Alice) aren’t safe from society’s judgement either, or fertility (and infertility) stigma. Newspapers hound them during their treatment, offering thousands of pounds to the scientists for their names and addresses — all in the service of invading their privacy to shame them for their choice.

The film's examination of infertility is personal for its protagonist; Jean's enduring issues with endometriosis and infertility are a key arc in Joy. Endometriosis — a gynaecological condition that makes it harder to conceive — is under researched to this day, and was even more so in the 1960s and 1970s, generating shame in women who were made to feel it was their fault they couldn’t conceive. Jean expands on this in a heartbreaking scene, explaining that so many women (including herself) feel lost without this ability, whatever the cause. As well as being vilified for seeking out IVF as an alternative, Jean reflects, patriarchal society determines the worth of these women by their ability to become a mother — an attitude that prevails today, arguably, and feeds into pregnancy, fertility and infertility stigma. 

Where does fertility stigma come from? 

Sadly, fertility stigma is as deeply embedded in our history as it is in our modern culture. For instance, noble women in medieval Japan faced judgement within their marriages if they did not produce children, while 19th century France saw doctors accuse women who didn't have children as being promiscuous, of having venereal disease, and having abortions. Even as recently as the mid 20th century — around the time where Joy is set — women were accused of committing “adultery” if they conceived by using artificial insemination by donor sperm. The suffering and vilification of women due to motherhood being viewed as the ultimate marker of femininity, and the traditional methods of conception being prioritised over women’s health and wellness, can be tracked through the centuries. 

The law's impact on our reproductive choices 

We’ve seen a shift in attitudes towards fertility and pregnancy since the era Joy is set. However, we’ve also seen this manifest in different ways, solidifying into law and limiting how women make decisions around their bodies — the most prominent example being the U.S. Supreme Court's overturn of Roe v. Wade in 2022 and subsequent state abortion bans.

In October in the UK, following heavy campaigning, England and Wales passed a law to make mandatory safe access buffer zones at a 150-metre radius around all abortion clinics. This will provide protection for women accessing this healthcare, with activity designed to influence women or which causes harassment, alarm, or distress all banned by law. Reports of harassment continued all the way up to the ban, with British Pregnancy Advisory Service (BPAS) CEO Heidi Stewart reporting women being called "murderers and having leaflets shoved at them falsely claiming abortion causes breast cancer."

Stewart describes the buffer zones as "a crucial step in ensuring that women can access essential healthcare without fear, shame, or intimidation."

But Stewart is clear that there is much further to go to combat fertility and pregnancy stigma, and points to the importance of "remaining vigilant and relentless in the protection of abortion rights for women" — a sentiment shared by the U.S.-based Center for Reproductive Rights.

After all, in the U.S., such stigma remains ever more volatile and threatening, particularly with November's re-election of Donald Trump, who played a key role in overturning Roe v. Wade, causing abortion to be nearly or completely banned in 17 states.

“When issues of reproductive rights are allowed to fester in silence, stigma grows,” Stewart explains. "If the ongoing events in the United States have taught us anything – it’s that remaining silent on reproductive rights is no longer an option."

It's crucial that such attitudes and actions are questioned to quell the spread of stigma on both sides of the Atlantic, so that the choices the team represented in Joy fought for are protected for all women.

How fertility stigma impacts women's experience in the workplace

We also know that this kind of discrimination doesn’t just surround a person’s attempts to become pregnant or their decision to end a pregnancy. Joeli Brearley, CEO and founder of Pregnant Then Screwed (PTS) — a charity dedicated to ending "the motherhood penalty" which encompasses the impacts motherhood has on women's careers — says that their experiences and progression in the workplace are affected too.

“Women are seen as distracted and less committed to their job from the point they get pregnant,” she explains. “So we need managers to be trained in unconscious bias and to understand the business reasons for looking after pregnant employees."

Brearley adds that women have been found to be scared to discuss fertility treatment with their employer for fear of discrimination. "According to our research, one in four women who are undergoing fertility treatment experience unfair treatment as a result," Brearley says. Once women return to work after having a child, the situation doesn’t necessarily improve – according to PTS research, 77 percent of women experience discrimination when they return to work. “It's not a 'mum' problem, it's a societal problem,” she explains.

The pioneering team represented in Joy faced such backlash and treatment, as did the self-described Ovum Club of women who participated in the early IVF tests. Their fertility was dismissed as a serious and impactful health issue back in the '60s, with personal, private choices around pregnancy made fodder for the public to debate. And decades later, we're not out of the woods yet. Much more needs to change for the stigma to truly be lifted, and for women to feel free. 

“When women can make these deeply personal decisions without fear of public judgement or confrontation," Stewart says, "we are affirming their right to choose and reinforcing that fertility and pregnancy choices should be free from stigma."

Joy is now streaming on Netflix.