Infertility and Assisted Reproduction
Surrogacy and Gestational Care
Making Babies: Ideals, Technology and Politics
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.
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