| The
birds and the bees, old school: these days you can make a
baby with artificial insemination, fertility drugs, intrauterine insemination,
in-vitro fertilization (IVF), donor eggs or sperm and employment of
gestational surrogates. Full-on cloning, previously attempted in sheep,
recently succeeded in the form of a woman's beloved cat— for
a fifty thousand dollar price tag.
Along with technology comes a slew of complicating factors. Of
the issues cloning raises, philosopher Michael J. Sandel writes:
“When science moves faster than moral understanding, as it
does today, men and women struggle to articulate their unease. In
liberal societies they reach first for the language of autonomy,
fairness, and individual rights. But this part of our moral vocabulary
is ill equipped to address the hardest questions posed by genetic
engineering. The genomic revolution has induced a kind of moral
vertigo.” More than twenty-five years after the fact, the
birth of Louise Brown— the world’s first test-tube baby—
remains emblematic of the debates about how much to intervene in
the making of babies, regardless of what we can do. How does reproductive technology affect our images of and aspirations
about family? On the one hand, technology (of a low-level nature)
has played a significant role in widening the definition of family
from the traditional nuclear model of mother, father, and child
or children to nontraditional configurations. The turkey baster,
popularized in certain circles, set off concerns not so much about
reproductive technology per se than the deliberate lack of a patriarch
in families where a single woman, two women (or less often discussed,
two men) chose to raise children they intended to have.
In the late seventies and early eighties, many questions arose about
how lesbian families would function and feel. As many couples queued
up in Massachusetts to obtain marriage licenses with their children
in tow this past spring, these concerns seem—a generation
later— almost naïve. On the other hand, technology works to assure that the nuclear
family remains a revered, even more perfected aspiration—
a dream, some would argue, that crosses over to entitlement. The
components of IVF can be broken down such that they can be shared
between two or three women (and one or two men). Sperm banks and
sperm donors have long been fixtures in the treatment of infertility
and have been more recently joined by egg donors. Sperm and egg
donors provide the raw goods necessary for conception and generally
remain anonymous. Donors, screened for good health and lack of blood-born
diseases, are scrutinized for other traits deemed desirable. The
contribution males make is less time sensitive and less physically
intensive or involved than their female counterparts. Egg donors
must endure rigorous hormone therapy and undergo surgery in a coordinated
effort with the recipient so that retrieval and implantation of
eggs is synchronized. Ads for egg donors often run in Ivy League
student newspapers in hopes of enticing ambitious and accomplished
young women to offer their eggs.
At times, anonymity can be lifted or even go awry. A recent case
involving the use of the wrong sperm donor resulted in a child support
lawsuit. Another story reported a happy reunion between donor/father
and progeny/daughter after the eighteen-year old successfully sought
contact with this formerly anonymous donor. In a recent New
York Times Magazine story, a lesbian co-parent-egg donor to
their twins-struggled so mightily with her partner about whether
to reveal her biological ties to the children (her partner had carried
the pregnancy) that the relationship crumbled. A bitter custody
battle ensued in California, where an egg donor is not considered
a mother. Joint custody was denied. While adoptions are routinely
becoming more open, sperm and egg donors seem to be, by and large,
mysterious accessories to the process of conception.
Of the technologies
currently available, surrogate parenthood is arguably the most extreme.
By housing a pregnancy throughout gestation, a surrogate can provide
an intended parent or parents a vehicle for biological ties to the
fetus in a few ways. Either a woman’s egg is united (in a
Petrie dish) with her partner or husband’s sperm or her egg
is united with a sperm donor’s sperm. If a woman’s eggs
cannot be used, a third party’s egg is typically substituted.
Some gay men employ surrogates to carry offspring with their sperm
(and a third party’s egg).
Gestational
surrogates and celebrity moms
In great measure, infertility
has remained a private matter, safely out of the limelight, with
a few notable exceptions. Elizabeth Kane (a pseudonym) chronicled
her experiences as the world's first surrogate (in 1980) in her
book, Birth Mother. Kane was herself inseminated with the
intended father's sperm at a doctor’s office. Moved to become
a surrogate because of a keen desire to help an infertile couple,
Kane was wholly unprepared for the grief she’d experience
surrendering this child. A mother of three, who had given up a baby
for adoption previous to her marriage, Kane did not believe that
she’d view this baby as hers. And she did not begin to fathom
the havoc her experience would wreak upon her husband’s career,
her family's social status, and the emotional stability of her children.
Years later upon meeting
Mary Beth Whitehead— the surrogate mother whom unsuccessfully
sued for custody of “Baby M”—Kane became an outspoken
opponent of surrogate motherhood. Kane writes, “Just because
we can do something doesn’t mean that we should... This is
reproductive prostitution... can we really continue to allow women
to rent spaces in their bodies and sell their children for profit?”
The lasting fallout of
Kane’s surrogate experience is poignant, because her family
paid a high premium for her generous impulse. When one sits back
and considers what Kane did— had a baby for a stranger—
and what the climate was like— gawking and hostile—
the distress surrounding her family is wholly understandable. Her
grief, too, seems inevitable for a host of reasons, including unresolved
feelings about having surrendered a child for adoption. Even though
this was uncharted territory, a blatant lack of compassion or thoughtfulness
was accorded to Kane and her family. A couple’s desire to
have the man’s biological offspring, their doctor’s
ambition to create a money-and-prestige-garnering operation, and
the media’s readiness to maximize the sensational aspects
of the story all trampled concern for Kane.
In the mid-eighties,
when Mary Beth Whitehead decided to keep the baby she gave birth
to, thereby reneging on the contract she and the intended parents—
the Sterns— had signed, the Baby M drama played out in the
courts and in the media. After the Sterns sued for, and received,
temporary custody, Whitehead fled out of state with the baby. Eventually,
she returned to New Jersey in order to file her own custody suit,
which she lost.
Feminists examined and
debated the case widely. For many, Whitehead’s story illuminated
the close link between class and power. Kelly Oliver, in her article
“Marxism and Surrogacy” paid particular attention to
the court’s punitive response toward Mary Beth Whitehead because
she had less financial security (no money for music lessons or private
school education) than the Sterns. Sara Ann Ketchum pointed out
in her article “Selling Babies and Selling Bodies” that
adoptions were not binding until after a baby was born and a period
of time passed to ensure the birth mother certain of her earlier
decision to cede custody. No such protection to a surrogate/birth
mother’s tie was granted. Even before biological ties between
birthing woman and baby were severed, surrogates’ rights were
ignored.
Gestational surrogates
are the first to intentionally assist beyond conception with creation
of babies never— even potentially— for themselves. Does
this constitute reproductive prostitution? Some feminists believe
that a surrogate acts with free agency— she can use her body
as she chooses to— while others think that to conceive a pregnancy
for others willing to pay (an estimated minimum fee of sixty-five
thousand dollars) for the service inevitably involves coercion.
While the lump sum of money received seems large given that the
surrogate isn’t officially working, the hourly wage, especially
if the surrogate undergoes numerous IVF cycles before even becoming
pregnant, might not seem quite so impressive.
The Whitehead case pushed
the burgeoning industry surrounding surrogate arrangements—
agencies and lawyers and doctors-to codify as many aspects of the
process as possible. A profile of those women most apt to choose
to be surrogates and perform the task well emerged: religious, fairly
traditional married women (“stay-at-home moms”) with
moderate incomes who had enjoyed successful pregnancies and believed
they were done bearing their own children. These women were less
enticed by money than a calling to help others. Using a third party’s
donor eggs— the intended mother’s or another’s—
became routine. Along with more rigorous psychological testing of
surrogates, strict contracts were drafted, detailing health behaviors
and the maximum number of fetuses that would be carried. The language
favored those procuring babies: gestational surrogates were not
birth mothers as Kane called herself, nor even surrogate mothers;
instead the current term entirely skirts the word “mother.”
Legislation passed in some key states like California, where a large
percentage of surrogate arrangements occur, that bypasses the birthing
woman’s name ever appearing on the birth certificate, legally
erasing her role. In states where the birthing mother’s name
appears on the original birth certificate, the intended parents
can go to court and receive a second birth certificate with their
names rather than hers.
The image of perfected
motherhood— the sort spread out along glossy magazine pages
depicting every celebrity mom on the planet— encourages entitlement
for privileged women to share biological ties to their babies. Adoption,
perhaps always cast as a second place option to “natural”
parenthood, has fallen even lower because technologies promise “positive”
results. If part of perfectionism is the ability to control a situation
so it goes according to plan, the surrogate arrangement appeals,
given that few details are left to chance.
In their book The
Mommy Myth Susan Douglas and Meredith Michaels point out that
when fifty-two year old television personality Joan Lunden obtained
a surrogate so she and her younger husband could have twins the
only thing larger than her disposable income was her “sense
of entitlement.” Of Lunden's babies they write, “If
you can't have them yourself, you can buy them.”
Celebrities, perhaps
fearful of tabloid innuendo, have come forward with their stories.
In addition to Lunden, soap opera star Deirdre Hall and model Cheryl
Tiegs made public— on People magazine covers—
their surrogate arrangements. According to Meredith Michaels, the
media attempts to assimilate the surrogate arrangement by employing
“the narrative of the miracle” and by “playing
up a fantasy about a sisterhood between the surrogate and this powerful,
privileged celebrity. There is an implication that surrogate and
privileged mom are going to have such a strong bond that they raise
the child or children together, which of course, could not be further
from the truth.”
To gear up for her second
round of family (she has three grown daughters) Lunden launched
a media blitz. In deference to sisterhood, she posed on the cover
of People with arms encircling her very pregnant salt-of-the-earth
surrogate. Lunden’s much younger husband had never had children
before. Sharing her story to “help others,” for all
of her openness, Lunden refused-and continues to refuse— during
an interview in Ladies Home Journal that featured her and
her year-old twins— to reveal whether her own eggs or those
of a donor were used. “I do that for all the other people
who are calling and writing me now, wanting to do this. I don’t
want them to feel they can’t achieve what we have if they
can’t produce their own eggs. I want everybody to understand
that however they make their families doesn’t make any difference.
It’s about parenting. It’s about having these children.
If they can use their own egg and sperm, fantastic. And if one of
them isn’t viable, then get a donor. I don’t want anyone
to feel their way isn’t right.” Given Lunden’s
smugness, it’s abundantly clear that if she’d used her
own eggs, she would share this as further proof of her unique youthfulness
compared to other women her age. Also over fifty, Tiegs was questioned
heavily by the media when she claimed that her eggs were used because
so many doctors have disputed this as likely.
Despite the fact that
Kane and Whitehead did not help celebrities, the number of people
able to afford surrogates remains small. Few people will come face
to face with this issue. Yet, images of celebrities with their surrogate-born
babies (and miraculously old eggs) confirm for all women dealing
with infertility that a means to have one's “own” baby should somehow exist.
No
cut and dried answers
This glossy image offered
up by the “celebrity mom” feeds into American society’s
current baby making obsession. A recent issue of Good Housekeeping flouted actress Courtney Cox on its cover with a story inside about
celebrities who overcame infertility. Many of those actresses kept
their struggles private until they triumphed with a “precious
miracle.” Never mentioned were actresses who continue to confront
infertility. Michaels believes that Lunden represents the most egregious
end of this spectrum. “‘Why should I be denied?’
people are asking, as if having a biological baby is a basic, inchoate
right. Globally, to put so many resources and so much effort into
a single child makes no sense.”
“While there was a knee-jerk response among feminists that
reproductive technologies were bad for women,” Michaels recalls,
“that was too simplistic.” Reproductive technologies
run a wide gambit. Activists have long worried that singling out
later abortions would compromise the right for all abortions. Similarly,
feminists feared that to question surrogacy might compromise other,
more simple interventions. Some feminists are among those reaching
for help from technology in their personal struggles with infertility,
making it even harder to raise pointed questions about its ramifications.
Michaels says, “There’s this faux feminist argument
about choice that you are expanding women’s choices, but this
notion doesn’t take into account the perversion of some of
these choices. If left untended, these so-called choices make pregnancy
and family into commodities.” Marlene Fried, activist, professor
and co-author (with Loretta Ross, Jael Silliman and Elena R. Gutierrez)
of the book Undivided Rights: Women of Color Organizing for
Reproductive Justice also warns against overly simplistic responses
to these complex questions. “Who would you find to regulate
these technologies?”
The increasing precariousness of abortion access over the past
quarter century has squelched feminists’ abilities to examine
other reproductive health matters freely. Fried says, “Given
abortion rights’ minimal security, it’s hard to look
at reproductive technology without potentially jeopardizing those
tenuous rights.” Yet, to keep abortion entirely out of the
infertility equation is impossible. Infertility drugs and IVF elevate
the risk of multiple pregnancy. Medical reduction, a euphemistic
term for abortion, is a doctor-sanctioned procedure involving dissolution
of one or more fetuses from a multiple pregnancy. These reductions
occur for a range of reasons, from birth defects in one fetus to
the fact that carrying three or more fetuses greatly increases the
risk of premature delivery and sometimes compromises the health
of the pregnant woman.
It cannot be disputed that extreme reproductive technologies raise
the risk of devastating losses surrounding pregnancy and that the
costs-in terms of dollars, emotional and physical health-are potentially
enormous. A very short list includes a sharp rise in complications
for premature babies, a direct result of the exponential rise in
multiple pregnancies and the enormous toll infertility treatments
takes upon women and their partners, sometimes regardless of whether
they end up with a child or children or not. The myriad ways that
others can now be involved in the creation of children opens the
door for potentially complicated connections between strangers never
before imagined. There are countless happy stories of the ways reproductive
technologies have created families or assisted people in having
healthier children. No cut and dried answer exists now that what’s
possible and what might be possible in the future has rendered simple
answers obsolete. Technology, moving at warp speeds, cannot be slowed,
so we need to slow ourselves down in order to disentangle our questions
and concerns from the enticing momentum of “progress.”
What seems clear
in the meantime: a woman’s right not to have a baby is intricately
linked to her right to try to have a baby or to help someone else
to have a baby. To lose the right of one side of this equation is
to threaten the loss of the other side. Sometimes, this might create
uneasy alliances. At this juncture uneasiness may be called for—
even welcome.
mmo : february 2005
Sarah
Werthan Buttenwieser is a former reproductive rights organizer
turned writer, attempting to raise three fair-minded children in Northampton,
Massachusetts. |