Absolute control of women over fertility has been the unparalleled dream of radical feminists for decades. Millions of women now view this aspiration as their sacrosanct right and have, with the advent of anti-fertility and other reproductive technologies, exercised this new right vigorously. This feminist dream, however, is fraught with irony. Many of the very women who have postponed childbearing through devices, hormones, chemicals, and surgery in order to pursue career and lifestyle, later find themselves infertile or sterile, and it is often then that they discover that they want children after all and begin pursuing biological children of their own with the same fervor with which they initially avoided them. For these women, fertility-control technology has ultimately resulted in helplessness and a lack of control over fertility—the opposite effect of what was intended.
Reasons abound for the modern phenomenon of escalating rates of infertility. A principal cause is actual postponement of childbearing, since a woman’s fertility is age-related: it begins a gradual decline in her 20’s, and by the age of 35, it is reduced by 31 percent, declining more rapidly thereafter.
Another irony of the feminist revolution is that some of the very technologies said to liberate women—or sexual practices made possible by those technologies—are at the root of many subsequent infertility problems. The devastation precipitated by the intrauterine device, the Dalkon Shield, was only the tip of the iceberg. Adolescents having abortions, because of their likelihood of experiencing cervical injury during the procedure, have a greater risk of miscarriage in future pregnancies. The thousands of mid- or late-term abortions performed on women every year are far more likely to cause damage to reproductive organs and future fertility than are first-trimester abortions. Fully 15,000 women who were voluntarily sterilized seek to have the procedure reversed every year. The widespread use of nonbarrier methods of contraception—oral contraceptives—fostered the unintended consequence of endemic sexually transmitted diseases, at a rate of at least 12 million new cases in the United States every year. The results for women’s health and fertility have been disastrous.
The enormity of the problem of disease needs to be emphasized. Because the emotive spotlight has been on the HIV virus, the attentive public is not fully cognizant of the scope of this problem and how women have been harmed by this proliferation of disease. Fully one million young women contract Pelvic Inflammatory Disease (PID) every year, and because of the severity of the infections in their reproductive systems a minimum of 10 percent of them become sterile every year. Multiple sexual partners are the single greatest factor in contracting PID. Massive infections are also the principal cause of the startling increase in rates of ectopic or tubal pregnancies, which are often not only a permanent obstacle to fertility but the leading cause of maternal deaths among women today.
Chlamydia has become the disease most frequently contracted by young women, and an astonishing one out of five single women (one out of four in urban areas) has contracted it. Because it can remain in a woman’s body for two years without major symptoms, chlamydia is easily and unknowingly transmitted to males, who rarely manifest symptoms (and who also may become infertile). Chlamydia-induced PID carries a sterility rate of 25 percent with a single episode; with a second subsequent episode, the rate of sterility increases to 50 percent. There are 20 million known cases of incurable herpes; antibiotic-resistant strains of gonorrhea, syphilis, and the human papilloma virus (often followed by cervical cancer) all are on the increase in the United States, and all have wreaked havoc with the bodies and fertility of women and men. The “cures,” which were to liberate women, have gone the way of many other social innovations: they have resulted in new maladies. Forty-five percent of American couples now have difficulty conceiving or are unable to have children.
Enter the brave new (but booming) business of reproductive technology. Infertility has given the practitioners of the new technology an unprecedented window of opportunity. This is a world where, in the cloak of compassion, technologies to enable women to conceive and/or bear biological children of their own have turned childbearing into profitable commercial businesses.
It is widely acknowledged that from the conception of the new reproductive technologies, the experiments exploited unsuspecting women, their bodies, tissues, harvested ovum, and tiny unborn offspring. Experiments by Dr. John Rock in the 1940’s used poor, mostly Catholic women patients at the Free Hospital for Women in Massachusetts. Deliberately scheduling women for surgery at strategic times. Rock harvested eggs and fertilized embryos from surgically removed uteri, ovaries, and fallopian tubes of unknowingly pregnant women. British animal geneticist Robert G. Edwards, credited with the first test-tube human fertilization, also extracted ova from women, inseminated them artificially, and studied and mounted the embryos conceived without the knowledge of the donor-mothers.
From this ignominious beginning, the commercial business of reproduction has refined its technology and expanded into a huge, largely unregulated industry. Nearly 250 fertility clinics have opened in the last decade, while Americans spend one billion dollars every year in attempts to become pregnant. The number of office visits for fertility services are estimated at over two million visits annually. Women and men subject themselves to an extensive and costly variety of diagnostic tests and therapeutic treatments. It is not unusual for a couple to spend up to $35,000 for a course of therapies.
Artificial insemination using male gametes is one well-known technique that is widely used by the reproductive industry to treat some infertility problems, such as low sperm counts. Sperm banks are consequently becoming more popular, particularly among single women. The New York Times recently reported that thousands of lesbians are using this technique to become pregnant. Not only is. there an absence of screening regulations for potential mothers, but the California Supreme Court and a New Jersey court have both ruled that a child so conceived does not have a “natural father,” that the anonymous donor is not the child’s “father.”
Inducement of super-ovulation through use of fertility drugs, antibiotic therapy, and surgery to correct blocked fallopian tubes are other common treatments. Yet, in spite of the technological advances, 20 percent are diagnosed as infertile for unknown reasons. Some physicians contend that the fertility treatments are a waste of effort and money, since many of the couples would have eventually become pregnant anyway. For example, the New England Journal of Medicine reported findings from a follow-up study of over 1,100 infertile couples: 44 percent of the couples treated for infertility conceived, but 35 percent eventually conceived without treatment. This has led to a debate about the one-year criterion for diagnosing infertility—a criterion that helped create a heightened demand for fertility services.
In vitro fertilization is the reproductive technology that has received the most publicity since the first test-tube-baby was born in 1978. The fertilization in petri dishes of male and female gametes opened up new possibilities for women who could not conceive but were able to bear children. The gametes donated could be from the birth mother and father, a selected donor mother or father, anonymous donor, or various combinations of each. The success rate (meaning a live birth) for in vitro fertilization is a mere 5.6 percent worldwide and only 10 percent in the United States, and the costs are exorbitantly high. Yet, there are about 15,000 in vitro attempts every year by American couples who are willing to do anything to have a baby.
It is this technology that closely resembles manufacturing of commodities—quality control included. Usually, several eggs are harvested and fertilized. The newly developing embryos may be selectively destroyed before implantation, and they are closely watched for “abnormalities.” Multiple embryo implants have been found to increase the success rate of impregnation, but they also may result in multiple pregnancies. New techniques of “embryo reduction” of multiple pregnancies were therefore developed to destroy selectively the “extra” embryos—so as to increase the probability of a favorable outcome for the remaining baby. There are also new techniques of “embryo transfer”—washed out (through lavage) of the body of one woman and implanted into the body of another. Researchers have also developed a means of quick-freezing live embryos for later implantation. These egregious practices have occurred in part because there is no state regulation or accountability over them. Astoundingly, the reproductive technologists are a self-regulating, closed society.
Legislation has focused less on regulating these practices than on beefing them up. A bill proposed by Representative Pat Schroeder would have required insurance infertility coverage for two million federal employees. A failed legislative proposal in Virginia would have required all insurance companies to include infertility treatments in their coverage, as does Massachusetts. At the same time, Virginia successfully amended its informed consent law to require infertility clinics to simply inform patients of the averages of successful treatments. Finally, a law was proposed in Virginia to dispose of embryos should a couple divorce or change their mind—by making the embryos the property of the facility, rather than committed to the custody of the biological parents.
Some couples want a biological child of their own, but the woman either cannot—or is unwilling to—go through nine months of pregnancy: hence surrogate motherhood contracts. Although most Western nations have outlawed this practice, surrogacy contracts have become a thriving business in the United States. Very few states have regulated surrogacy, and only a handful, such asMichigan, have outlawed it. Virginia recently passed a law (with a 1993 enactment date) legitimizing the practice. Nationwide, the absence of laws and the lack of regulation have resulted in a practice where a paid mediator, also known as a baby “broker,” brings a couple together with a woman who agrees to conceive and carry a child for them for a fee or other compensation. No state or federal laws require that the broker be credentialed, although Virginia’s new law uniquely eliminates the broker in the transaction.
The surrogate mother is usually, but not always, artificially inseminated so that the adopting father will be the biological father. However, there are also cases where the surrogate is impregnated using in vitro fertilization techniques, so that the adopting mother will be the biological mother. Under terms of the contract, the surrogate mother is paid to surrender completely the child at birth. But as in the infamous case of Mary Beth Whitehead, many surrogate mothers have found that they developed a strong maternal bond and do not want to surrender the baby. Diane Rothberg, a surrogate mother from Massachusetts, testified of her grief after being forced to surrender the child:
The pain that comes from these moments is not the same pain that comes with the loss of a vision or a right, but the loss of a real human being . . . the loss of a mother to a child, and a child to a mother. As I go through the everyday paces of parenthood, the pain of the loss does not ease. I realize what I am missing and the loss I suffer.
An increasing number of surrogate mothers have gone to court—where judges are expected to make Solomonic decisions—to gain custody of their child or even visiting rights. One recent case involved the birth of fraternal twins who were separated because the adopting parents already had boys and did not want another one, and a celebrated divorce case in California involved the surrogate, the biological father, and the adoptive mother all vying for custody.
Other tragedies have occurred. Pat Mounce, a Virginian, had a daughter who was a surrogate under a commercial contract. Both the daughter and the baby she carried died. As Pat testified before a Virginia legislative committee:
She had been ill and very tired most of the eight months she carried the baby, whom she named Jackie. And by the way, she bought baby clothes; Denise was changing her mind. She called her obstetrician’s office several times in September of 1987. She was six and one-half months pregnant. She was complaining of chest pains and her racing heartbeat. The records show she was in an absolute panic. And the only treatment Denise received was from a nurse who told her to take slow, deep breaths. Six weeks later she died of acute heart failure.
Although infertility is the primary reason given for commercial childbearing, singles, homosexual couples, and those who are not infertile also participate. Opponents of commercial surrogacy charge that the practice is not in the best interest of the child, and exploits women and the poor. Andrew Kimbrell, an attorney with the Foundation on Economic Trends, describes a typical contract: “The very first provision says that the woman agrees not to perform a parental bond with the child that she bears—by contract, for ten thousand dollars. The other provisions include forced amniocentesis (forced genetic testing) and then abortion on demand of the customer.”
Kimbrell adds that it is not the wealthy who become paid surrogate mothers: “Women who are often economically disenfranchised or who are in adverse emotional states are being victimized by these businessmen [the brokers], and who are being enticed by the ten thousand dollar fee or by some personal circumstance.” Pat Mounce adds that one never sees, for example, “a Beverly Hills socialite carrying a child for a New Jersey garbage collector.” Kimbrell concludes, “What we really risk here is forming—and I put this in quotations—a ‘breeder class’ of women who, for a fee, will act in this role.”
The search for the perfect and planned child now extends to planning the perfect sex of the child. The practice of sex-selection abortions—those performed when the unborn child is not the “preferred” gender—is no longer the exclusive domain of foreign countries, such as India and China. Reports indicate that the practice is spreading throughout the United States.
When prenatal genetic testing began, sex-determination was made through amniocentesis performed between 15 and 18 weeks of pregnancy. Abortions resulting from such testing were performed in the second or third trimester. But with the increased use of a new procedure, chorionic villi sampling (CVS), sex-determination can be made as early in the pregnancy as seven to nine weeks. A woman can now choose an abortion in the first trimester when it is emotionally less difficult to abort—before she feels movement or bonds with the child. According to Dr. Wayne Miller, director of the prenatal diagnostic laboratory of Massachusetts General Hospital School of Medicine, the chorionic biopsies can be performed before “any identification of pregnancy in the mother’s mind or the minds of her friends and family. The urge to use it for fetal sex determination is going to be much higher.”
Incidents of sex-selection abortions are not just isolated cases. The Fort Worth Star Telegram (March 12, 1989) reports: “Dr. Michael Roth, a Detroit obstetrician, says he will do an abortion for the purpose of sex selection. ‘You have a million abortions done every year. The majority are healthy. The reason they are terminated is because the woman has a reason and in most cases it is not because of the baby’s health—so why shouldn’t a . . . woman who . . . wants an abortion for fetal sexing have that option?'” The Lancaster Sunday News (January 22, 1989) quoted the administrator of Harrisburg Reproductive Health Services of Pennsylvania as saying of sex-selection abortions: “It’s okay with us. We are not here to judge their reasons.” The New York Times (May 30, 1985) carried a story stating: “A mother with two girls had amniocentesis and found out she was carrying another girl. She had her aborted.” The feminist Sojourner: The Woman’s Forum (December 1988) reported: “A woman who had tried all methods she knew to conceive a female child found out from chorionic villus sampling that she was carrying a boy. ‘I aborted him,’ she said.”
Since most states do not require reasons for abortions in their reporting requirements, no one knows just how many sex-selection abortions are performed annually in the United States. However, the number of inquiries for CVS, and the actual number of CVS procedures performed, gives some indication of the demand for sex-determination and subsequent abortions, particularly when the tests are performed on healthy mothers and babies. While a number of obstetricians recommend routine ultrasound tests during pregnancy, and in the process determine the sex of the child, ultrasound does not place the mother or child at risk, as do the genetics tests. Therefore, requests for the early trimester prenatal genetics procedures suggest some other motive than merely wanting to paint the baby’s room blue or pink. Massachusetts General, for example, has received over one hundred inquiries in a single year for CVS tests. The Fort Worth Star Telegram says that “Eugene Pergament, MD, a Chicago geneticist who does prenatal diagnoses, says he knows of about four women who have had abortions for sex selection from his clinic alone.” The Free Lance Star reports “Dr. Laird Jackson of Philadelphia says that about 10 of the mothers visiting his prenatal diagnostic clinic at Jefferson Medical College between 1984 and 1987 went on to have sex-selection abortions.” The Washington Times (February 13, 1987) carried a story in which Dr. Joseph D. Schulman, director of the Genetics and In-Vitro Fertilization Institute in Fairfax, Virginia, said he has performed the CVS procedure on about 1,400 women in the past two years: “Dr. Schulman and leaders of other government-sponsored premarket studies of CVS acknowledged that they’ve also had cases in which the women have had the diagnostic test solely to find out the sex of their baby and, if it was not to their liking, have aborted.”
Medical professionals such as Dr. Thomas McCormick of the University of Washington School of Medicine contend that CVS and other prenatal and diagnostic tests should not be used for the purpose of gender-selection abortions. Dr. McCormick says that medical science should be used for disease treatment, and “gender is not a disease.” Because the vast preponderance of sex-selection abortions are performed on unborn females, some feminists decry the irony that their “right” to abortion is now being used as the ultimate, most violent form of sex discrimination. “So sure are some scientists that sex selection of children will soon be widespread that they are worrying with psychologists and sociologists about how it will affect the world. Almost everyone agrees that most parents will opt for boys, at least at first,” writes Joan Beck in the AMA News (November 22, 1976). Affected, she says, will be family patterns and developmental characteristics derived from birth order, and a disproportion in the male-female population balance. In addition, it is morally repugnant to obstetricians who will be called upon to perform sex-selection abortions for what they consider to be a frivolous reason.
The practice is legal in nearly every state. Proscription of sex-selection abortions was one component of a pro-life law enacted in Pennsylvania, but legislation to outlaw the practice in Virginia was scorned by pro-choice legislators. In the absence of prohibitive laws, the trend is projected to continue and become a widely accepted practice. Andrew Kimbrell argues that the time to stop the practice is now, while demand for them is low, before people assume that fetal sexing is a right, and before the testing becomes an important source of revenue to prenatal diagnostic facilities.
This, then, is the state of the feminist dream of absolute control over reproduction. The abysmal track record is illustrated in the unforeseen damage done to women’s health and fertility, unregulated commercialization of conception and childbearing, the exploitation of desperate and poor women and their unborn offspring, and the rates of technological failure. In Nineteen Eighty-Four, Utopian leaders claimed that “Freedom is Slavery.” In a supreme twist of irony, the Utopian promise of “reproductive freedom” is delivering this very fate to millions of American women.
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