Choosy Moms Choose ART?

Feminist Perspectives

ofAssisted Reproductive Technologies

by Samantha Stephenson, M.A.

Freedom. Reproductive choice. Procreative liberty. The women’s liberation movement reached a tipping point in the United States in the 1970s. In addition to a growing push for women’s equality in the workplace, feminists fought for control over their own reproductive choices. Legal access to contraceptives was granted to married women in 1965, and to all women in 1970.  The movement pursued freedom beyond preventing pregnancies: the freedom to end them.  Since the infamous 1973 Roe v. Wade Supreme Court case, feminists have aligned themselves in favor of the freedom its ruling grants women to decide what happens to their own bodies, and whether to become mothers.  Although some radical feminists believed motherhood to be a source of oppression from which they were now liberated, more recently the movement has identified motherhood as a key aspect of women’s identities.  It is because women take this identity so seriously that they ought to have the freedom to claim or reject it.

More recent developments in reproductive technology have opened still further choices for women.  Now, women are free not only to avoid pregnancy and motherhood; options for achieving pregnancy have increased.  Thanks to assisted reproductive technology (ART), women can choose how and when to become pregnant with greater degrees of freedom than ever before.  These ARTs encompass a host of fertility procedures that expand the circle of reproductive agents.  Beyond a man and woman, ARTs entail a combination of doctors, donors, and surrogates in the procreative process.  Within heterosexual relationships, third parties in addition to the doctor often become involved as donors or surrogates in cases of infertility of the intended parents. Single persons and homosexual couples who wish to make use of these services must always contract outside parties to contribute their genetic material or bodily services.  The oldest of these ARTs is intrauterine insemination (IUI), a process by which sperm are inserted directly into a woman’s womb.

Sperm is often that of a woman’s husband, but it is not uncommon for couples to use a donor. This procedure is also used by single women and lesbian couples who make use of donor sperm that has been purchased for a low price by sperm banks. Those seeking sperm are able to choose from online catalogues to ensure that the product they receive is desirable.  A more invasive procedure, developed in the 1970s, is in vitro fertilization (IVF). In this procedure, an egg previously extracted from a woman is fertilized in a laboratory setting and then placed in a woman’s womb.  The gametes may belong biologically to the couple, or they may be from donors, or some combination of the two. The woman who gestates the fertilized embryo may be the intended mother, or she may be a surrogate hired to carry the child to term before surrendering it to the woman who will raise it as the social mother. In traditional surrogacy, the surrogate is impregnated using IUI, and so donates both egg and gestation. As IVF increases in popularity and success rate (it is now at 25%), it is becoming more common for surrogates to gestate biologically unrelated fetuses. Moving reproduction from the bedroom to the science lab and exam room makes procreation a choice available to any individual willing and able to pay the high price.

Given that procreative liberty, the ability to choose when one has children, has been central priority of the feminist movement, the widespread feminist objection to ARTs might be surprising.  While there are some feminists who defend women’s unlimited liberty to choose anything they wish, including purportedly exploitative practices like prostitution and pornography, most denounce oppressive practices in the name of liberation.  In spite of the vast increase in procreative liberty that ARTs offer, feminists are joining with other special interest groups in voicing strong ethical objections to the practices.

Each of these groups sheds light on particular ethical concerns.  Disability rights advocates point to the eugenic nature of procedures that allow parents to select the genetic characteristics of their children as well as to prevent children with chromosomal defects from being born.  Faith communities urge caution with regard to the growing control humans exercise over their own creation and the dismantling of the traditional family.  Pro-life advocates point to apparent disrespect for embryos in IVF.  What will become of “leftover” frozen embryos?  How is “selective reduction” (i.e. selective abortion), intended to make multiple pregnancies safer for the remaining embryos, compatible with loving parenthood?  What troubles feminists is unique from these concerns.  Feminism is not unconcerned with these issues; it simply asks different kinds of questions.  Regarding ART, feminism voices its loudest concerns in three areas: the coercive nature of ART, the commodification of human beings inherent to ART, and the resultant dismembering of motherhood.  In this paper, I explore the feminist treatments of these concerns to evaluate the use of ART. 

           

THE ILLUSION OF CHOICE: ART AS COERCIVE

The first objection to ART is that the choices offered by these procedures are not genuinely free choices.  The introduction of ART has intensified the societal pressure that women face with regard to choosing motherhood.  There are two main arguments for the coercive nature of ART.  First, societal structures stifle women’s autonomy.  Second, even if women do have the necessary freedom to make autonomous choices, the very existence of artificial options leads inevitably to their use.  Historically, we see that options in reproductive medicine tend to become the normal standard of care.   As their use becomes commonplace, ARTs too will become the reproductive standard and women will be unable to refuse them.

Feminists Gena Corea and Barbara Katz Rothman take up the first argument for limited choice in their respective works “What the King Can Not See” and The Tentative Pregnancy.  Each woman argues, to varying degrees, that society conditions women’s choices such that they are not free. Corea represents the most radical of feminists on the subject, spelling out in her essay the steps towards the systematic conditioning of choices that society imposes on women. She insists that the physician-scientist engaged in reproductive technology exerts social control through medicine, or what she calls pharmacracy.[1]  While Corea acknowledges that women and men share common motives for wanted children, she claims that the male-centered pharmacracy is unable to see the coercive forces that condition a woman’s will to be a mother. Considering this, the pharmacracy perspective of an infertile woman is limited; it sees only a desperate will to be a mother, which must be fulfilled at all costs. This point of view further imprisons infertile women: “If a doctor thinks it is reasonable for a woman to go to any lengths to bear a child, women will be confirmed in their suspicion that motherhood is a goal to be pursued at all costs” (Corea 80).  Corea argues that society structures a woman’s will to be a mother by fixing her function as reproductive and sexual, manipulating her motivations, withholding vital information about motherhood’s challenges, devaluing women’s labor and intelligence, and encouraging complacency about violence towards women through rape, pornography, and the like. Under these conditions, women are coerced into motherhood, which serves as a power-base that offers status and protection (Corea 81).

Barbara Katz Rothman believes in a less sinister, more inevitable conditioning of choices. She argues that there is no such thing as absolute individual choice within social structures; her very definition of society is the structuring of choices. She uses abortion and contraception to demonstrate Ruth Hubbard’s argument that “. . . as ‘choices’ become available, they all too rapidly become compulsions to choose the socially endorsed alternative” (The Tentative Pregnancy 12).  As society comes to rely on these options to limit the births of children to the economically disadvantaged, and to limit family size in general, it perpetuates structures that fail to support families in raising their children. As a result, children are treated like private property, the care of which falls solely upon their parents. Under these conditions, children become luxuries that many parents cannot afford. The very existence of certain reproductive “choices” leads to a kind of society that limits the alternatives. Rothman considers ARTs within the scope of such choices: “. . . embryo transplants, surrogate motherhood, and other new reproductive technologies are all being used to give the illusion of choice” (15). 

Paul Lauritzen shares Rothman’s belief in the illusory nature of the “increased” reproductive choices offered by ART, and elaborates on the coercive nature of these illusions in his article “What Price Parenthood?”  After detailing his experiences with ART as recourse to infertility experienced within his own marriage, Lauritzen entertains the feminist arguments against ART.  His article begins by comparing his experience with IUI to an excerpt from Margaret Atwood’s dystopian novel The Handmaid’s Tale, in which a husband, wife, and a coital surrogate lie together in a reproductive ritual. Lauritzen’s descriptions of alienation he has experienced from his wife, and pressure he has felt to prove his virility, offer evidence that it may not be women alone who suffer from the ill effects of ART.  Of the pressure ART exerts by its very existence, Lauritzen writes: “once an individual is presented with a treatment option, not to pursue it is, in effect, to choose childlessness and accept responsibility for it” (Lauritzen 41).  To be faced with these options is to be left with no option at all.  He agrees with Rothman and Corea that society conditions women to make use of ART: “...in a culture that so thoroughly defines a woman’s identity in terms of motherhood, the fact that women choose to participate in IVF programs does not mean they are truly free not to participate,” (Lauritzen 40). 

Clearly, there is consensus among feminists that, contrary to the cultural myth, women in the developed world do not have a great degree of freedom when it comes to their reproductive choices. Is this the coercive nature of ART enough to condemn its use on ethical grounds?  Perhaps not, but there is compelling evidence that the coercion surrounding ARTs leads to the exploitation of women. In her documentary films Eggsploitation (2010) and Breeders: A Subclass of Women? (2014), Jennifer Lahl details the personal stories of women affected by egg donation and gestational surrogacy. Her films note that these practices are advertised by the fertility industry as benevolent choices in which altruistic women give the gift of life.  By characterizing ART services in this manner, the industry manipulates women to participate willingly in exploitative practices. Unlike the overtly demeaning sexual exploitation of prostitution and pornography, reproductive exploitation entices women because it appeals to their preconditioned sensibilities.  When economically disadvantaged women are conditioned to conform to a female norm of altruism, women may even be happy to submit to reproductive exploitation. Still, these feelings do not outweigh the real danger these practices pose to women.

The $6.5 billion-per-year egg industry centers around college-aged women who tend not to weigh the possible risks to themselves in light of the compensation they receive (Lahl 2010). The procedure of egg retrieval involves an intense regimen of drugs and synthetic hormones that harnesses the woman’s menstrual cycle and increases her production of eggs by up to 400%.  By the time doctors perform the laparoscopic procedure to retrieve the eggs, the donor has experienced intense emotional and physical tolls.  After “superovulation” is medically induced, a doctor will retrieve up to forty eggs (as opposed to the average one to two eggs produced naturally each month).  These inconveniences also come with the risks standard to laparoscopy as well as the risk of ovarian hyperstimulation syndrome, which can result in ovarian torsion, infertility, stroke, and death.  And these are just the documented risks.  In over thirty years of egg donation, no longitudinal studies have ever been performed to assess the long-term health risks of this procedure.  Anecdotally, doctors and patients have reported early and frequent occurrences of colon and breast cancer (Lahl 2010).  Due to the anonymity of donors, we may never know the risks egg donation poses to these young and economically disadvantaged women.  This ignorance certainly serves the best interests of the industry and the beneficiaries of this naïve altruism, but how can it be equitable to ask one group of women to sacrifice for the personal fulfillment of another?

The ethical risks posed by coercion are clear.  When it comes to the pressure to “donate” (read: sell) eggs or serve as surrogate gestators (read: human incubators), it is not simply societal constructs that manipulate women.  The industry intentionally preys on women by capitalizing on their social conditions and economic disadvantages, ensnaring them with deception. In failing to investigate health risks, the industry remains conveniently unable to provide possible donors with information that would empower them to make fully autonomous decisions. Fenced in by imaginary walls built of expectations, hens surrender their eggs to be sold and experimented on, placated by the feed provided in their free-range prison. Even those on whom the chains of expectations have no hold need not be fenced in, if leaving means uncertainty regarding their next meal.

The exploitation of the ART industry is even more pronounced in the third world, where monetarily, less is so much more.  Despite being paid a tenth of their U.S. counterparts, Indian surrogates can afford to buy cars and houses with their earnings (“Wombs for Rent”).  The vision of “baby farms” is more fully realized in Indian surrogacy; female incubators are enclosed with one another in an agency facility, their diet and activities closely monitored throughout pregnancy.  Surrogates are not permitted to leave the premises without an agency representative.  Contact with family members is limited and intercourse with their husbands is prohibited.  Because the ability to carry a child to term is a prerequisite for surrogacy, this also means that women’s contact with their own children is strictly limited.  In a culture that defines women in terms of their procreative prowess, where the money earned from surrogacy can empower a family’s financial independence, how can a woman say no to any number of nine month stints to offer others the honor of a child?

 

THE BABY MARKET: COMMODIFICATION OF WOMEN AND CHILDREN

 In discussing the coercive nature of ARTs, it becomes painstakingly clear that commodification is not a slight possibility, but the dangerous and intrinsic reality of ART.  Aside from dehumanizing market rhetoric that refers to women as gestational carriers, human incubators, and breeders, the compensation exchanged for goods and services (gametes and surrogacy) cannot be seen as anything but market practices.  As Lauritzen points out, “If women are paying for embryos or being paid for eggs, the embryos and the eggs cannot but be understood as products,” (Lauritzen 1990, 43). While the money exchanged for gamete donation and surrogacy is ostensibly reimbursement for inconveniences incurred by the procedures involved, the fact remains that a child is not out of reach for anyone willing and able to meet the right price point. It is possible to purchase the raw materials to create a child. It is possible to rent a woman who will labor unceasingly for nine months, contributing literal blood and sweat, to bring that product to life. Those in favor of unlimited procreative liberty, such as John Robertson, believe individuals have rights to these types of goods and services.

 

Robertson argues that because married couples have traditionally exercised a constitutional right to reproduce coitally, noncoital reproduction through ART is simply an extension of that same right (“Procreative Liberty, Embryos, and Collaborative Reproduction: A Legal Perspective”).  Married couples ought to be able to achieve the end of procreation through any means they choose, including purchase of bodily tissues and services.  For Robertson, a law that permits treating persons as objects is more acceptable than a law that denies infertile couples access to biological procreation.  Because access to these means is access to a fundamental good, it cannot be denied.  We must permit surrogacy and the sale of embryos so as not to limit procreative liberty.   Robertson argues that there is little ground for moral objection to override access to ART: “Unless sale is connected with tangible harm to other persons, the moral offense that some people might have in such transactions is not a sound basis for restricting procreative liberty by banning sale of embryos” (188).  Unless feminists can prove that tangible harm results from commodification, they have no grounds from which to argue that it be legally prohibited.

Robertson’s argument fails to consider a few relevant points. First, he fails to recognize the significant differences between coital and noncoital reproduction.  The right of procreation protected by the U.S. Constitution assumes only the traditional means of procreation by virtue of the fact that up until very recently, no other means has ever existed.  The existence of a new means of procreation means that we must evaluate it on its own merits.  In fact, the precedent of child rearing law in our country does not support unlimited liberty or rights that entitle parents to children; if this were the case, any parents who expressed desire to adopt would be entitled to receiving children.  Current practices do not reflect that anyone possesses a right to obtain children.  The absurdity of this claim sharpens when one focuses on the fact that the respect of our rights imposes duties on others.  If there were in fact a right to obtain children, this would impose a corresponding duty.  Society would be responsible for providing access to ART.  Perhaps every fertile man and women should be required to donate bits of themselves along with filing a yearly tax return. 

Mara Ryan critiques the commodification implied in Robertson’s arguments: “[A right to procreate] could not be understood as unlimited, as extending as far as the acquisition of a human being” (“The Argument for Unlimited Procreative Liberty: A Feminist Critique” 7). The absurdity of Robertson’s argument advocating the sale of embryos sharpens considering our ban on the sale of organs.  If our own rights to life and health do not permit us to obtain life-sustaining organs by purchasing them from others, how can Robertson maintain that we have a right to acquire not simply a part of another, but his entire existence?  The moral objection to purchasing children is similar to the objection against slavery: human beings are not the kinds of things that ought to be bought and sold.

The slavery analogy resonates with several different women featured in Lahl’s Breeders (2014).  Tanya, a former traditional surrogate (the term for women who gestate their own biological children), and Laura, a product of surrogacy, draw connections between surrogacy and slavery.  Regretful of her decision, Tanya wonders what effect it will have on her daughter to grow up knowing that the foundation of her existence is money.  Of her own existence, Laura says, “It’s hard not to be aware that there is a price tag. There is an awareness that, in essence, you were bought.”  Even when children are raised with an explanation of surrogacy as an expression of how deeply wanted those children were, there is no escaping the reality of the commercial exchange that led to their existence. And there is no way to predict the potential psychological effects without using an entire generation of unwitting children as subjects in this reproductive experiment.

Even if we are willing to allow women to sell themselves in what Corea calls the reproductive brothel, can we really agree with Robertson that there is no harm done to the children traded as marketplace goods?  Even if products of IVF are gestated and raised by their biological parents, can we deny that their creation was not a loving familial union, but a contracted medical procedure, the fruit of labor bought and paid for?  While Robertson would object to the identification of embryos as children, he would not be able to deny that if there are psychological consequences to being bought, they will be suffered by children.  After all, these parents wish to procreate.  Their desires are not to obtain embryos, but children. Ryan worries about the consequences of promoting a system in which children are created to fulfill parental needs and desires.  Wonders whether this might overlook the good of the children, she writes: “...if a child comes into the world primarily to fulfill parental need, are there limits to what a parent may do to ensure that the child will continue to meet the specified expectations?” (Ryan 8). A high price paid in exchange for a child reinforces the belief that the child is owed to them.  A priori, this objectively devalues the child.  Rather than existing for their own sakes, children become malleable goods.  If Robertson cannot agree that harm exists in the sale of the embryos themselves, perhaps he can recognize the limited self-determination and autonomy that characterize the reality into which these embryos are born.

  

Reflecting on his own use of ART, Lauritzen agrees with Ryan that once procreation is separated from sexual intercourse, it becomes about production: “once one has begun the process that inevitably treats procreation as the production of a product, the methods of production can only be evaluated by the end result” (Lauritzen 1990, 43). In this context, the products of conception must be evaluated in terms of how well they approximate the desired standard. Children become specimens.  Rothman highlights the dangers of this thinking in citing “wrongful life” suits—product liability lawsuits in which parents sue their fertility doctors on behalf of their children for bringing said children into existence.  In these lawsuits, parents file claims on behalf of their “defective” children, asserting that the children in question would have been better off had they never existed.  When children become private property, they cannot be gifts to be accepted and loved unconditionally; “...it inevitably it follows that they will be sold and carry different price tags based on social desirability. And some will be rejects, not salable at any price: too damaged, or the wrong color, or too old, too long on the shelf,” (Rothman 10).  When children become commodities, they lose the freedom to be who they are, rather than what we wish them to be.  Granted, some of these parental attitudes exist towards naturally conceived biological children as well, and are not unique to ART.  However, the fact that some parents have lamentable attitudes towards their children, subjecting them to less than ideal circumstance, does not justify the creation of a market and industry in which such attitudes are the foundation of an entire parenting generation.

 

WHAT IS IN A MOTHER? ARE YOU MY MOTHER? MOTHERHOOD DISSECTED

The creation of children in laboratories troubles feminists for yet another reason. Feminists are especially concerned by technology that transfers what was once a woman’s domain into a realm governed by men.  In doing so, procreation no longer belongs to women, and cannot remain a part of motherhood.  Motherhood is further segmented when biological, gestational, and social motherhood are intentionally separated to fulfill the desires of infertile persons.  While we must certainly have compassion for those who experience infertility, we must also consider what we ask others to contribute in solving this problem.  Is dissecting motherhood good for women?  Is it in the best interest of the children involved?  If the answers are“no,” what does it say about the motherhood of women willing to sacrifice the best interests of their potential children in order to become mothers?

Lauritzen comments that ARTs “...alienate women from procreation and thus rob them of one of the most significant sources of power and identity,” (Lauritzen 42).  This may seem an odd statement considered alongside feminist desire to resist coercion into motherhood, but that should not be the case.  Both issues spring from a single feminist value: women’s ability to maintain control and freedom to define their own identities.  Just as women do not wish to be coerced into claiming motherhood, they do not wish to lose the inherent power they have over procreation. Maintaining control over both sides of reproductive choice is necessary for authentic choice.  Until recently, it seemed that for all the societal power men had, they would never be able to harness the procreative power of women to bring life into the world. Nature had given procreation to women, a power that men could never claim for themselves.  For some feminists, ARTs represent the loss of women’s final domain of power:

Now men are far beyond the stage at which they expressed their envy of
women’s procreative power through couvade, transvestism, or subincision.
They are beyond merely giving spiritual birth in their baptismal-font wombs,
beyond giving birth with their electronic fetal monitors, their forceps, their knives.
Now they have laboratories.  (Corea, The Mother Machine 314)
 

The commodification and objectification of women’s bodies diminish the meaning of motherhood so much so that future generations of women will not feel competent to harness their own reproductive power.  The normalization of the technological process of procreation is taking place as we speak.  As Corea points out, women born today will never know a world without ARTs.  Today, women’s contributions to procreation are valued in terms of labor supervised by men.  Future women will devalue their own contributions as simply the building materials that men use to create children.  Corea imagines their perspective as they reach maturity: “‘Reproduction is a complicated intellectual and technical feat performed by teams of highly skilled men who use, as raw material for their achievements, the body parts of a variety of interchangeable females’” (“What the King Can Not See” 90).  As the role of medicine in procreation increases, it also serves to amputate procreation from motherhood.

Finally, ART causes us to ask a question we have never had to ask about motherhood before: whose child is this?  The separation of biological, gestational, and social motherhood leads to crises of identity for children and the mothers who bear them.  While we do accept this separation in cases of adoption, no one advocates this as the ideal.  Rather, adoption is the best solution to an already imperfect situation.  With ARTs, we are considering bringing children into a world where motherhood is fragmented from the start.  Some may question whether such a start in life harms children, but it is clear that harming mothers harms children, and fragmenting motherhood harms mothers. 

One needs only to glance at the conflicts that have arisen as a result of ART to see that realm harm is occurring as a result of this practice.  A 1998 IVF error in New York resulted in a conflict between biological mother Deborah Rogers and gestational mother Donna Fasano (“The Ethics of Reproductive Technologies”).  Having carried her child to term, Donna felt that baby Joseph was her own child, and wanted to raise him as her own.  Were it not for the difference in race between Donna and the child to whom she gave birth, no one would have known that Joseph was actually Deborah’s biological child.  The courts ruled in favor of returning Joseph to his biological parents.  This heart-wrenching story shows the potential dissection of motherhood in IVF, but most troubling for this dissection is the practice of surrogacy.

           

As previously explained, there are two types of surrogacy, one in which a mother donates her own egg and so gestates her biological child to be surrendered at birth, and one in which the embryo implanted is not related to the woman in any other way. While the former practice has more potential to cause psychological harm due to the added biological claim the child has on the mother, both practices harm women who bond emotionally with the children they nurture in their wombs.  This toll is acknowledged even by strong advocates for surrogacy, such as the producers of the documentary film Two: The Story of Roman and Nyro (2013).  In this film, director Heather Winters follows the sons of a gay couple whose close friend served as their surrogate carrier.  The film generally champions the couple and the family they have designed, but its tone shifts dramatically during scenes that depict Angela’s pregnancy.  In spite of the fact that she knows she will be the only mother figure these children ever know, Angela struggles to remain detached.  In describing her experience, uses phrases like “performing a service” and “just an incubator” to aid in her detachment.  She reminds herself repeatedly, “These are not my children. I shouldn’t be feeling this way.”  She describes herself as sobbing uncontrollably at the thought of having to surrender the children, as well as at the thought of disappointing her dear friends by reneging on her promise.  After bringing these two children into the world for her friends, Angela discovered that she would be unable to have children of her own.  The children from which she struggled so hard to detach will be the only children she will ever carry.

 

Despite the emotional anguish Angela described during her pregnancy, the situation ended in a fairly positive way, with mother and children being able to continue their relationship. Surrogacy was not so kind to the gestational mothers interviewed in Lahls’ Breeders.  The four women featured in this film entered into a variety of surrogate relationships, serving as carriers for friends, brothers, and complete strangers. Each woman expressed a change in her perspective as pregnancy developed.  No longer were they content with the original agreements made to surrender the children.  Something about the nature of nurturing these children in their wombs created relationships that these women were unwilling to discontinue.  Two of the women fought for and received partial custody.

A third, Tanya, who donated her egg as well, explains her experience of consequences she did not anticipate.  In donating her egg, Tanya brought her own child into the world to be given away.  Seeing pain in the eyes of her two older daughters as Tanya handed their sister over to her new parents in the delivery room, she realized she had made a mistake.  She describes a heart-wrenching conversation with that same child at five years old, confused by the arrangement: “Mom,” she asks, “We have the same hair. We have the same eyes. Why did you give me away and not [your other kids]?”  As a prerequisite, surrogates must have given birth successfully to their own children.  This means that a new generation of children will be left asking the same question as Tanya’s daughter.  In cases of adoption, the children given up may meet younger siblings raised by their biological mothers after those women became stable enough to care for children.  As painful as this may be, adopted children are usually able to recognize the good will of their biological mother’s choices.  What effect might it have on children of traditional surrogacy to know that their biological/gestational mothers did not bear them out of love, or even by accident, but with the intention of giving them away or selling them?  

The last woman who appears in Breeders is Heather, who describes her first experience with surrogacy as beautiful.  She felt that surrogacy enhanced her own motherhood by providing her with the financial stability to stay at home with her own children.  When she continued with surrogacy, the road was not so easy.  Miscarriage and diagnosis of Down Syndrome were difficult emotional burdens to bear.  It was not until her final experience with surrogacy that Heather understood its full cost.  When the baby she was carrying was diagnosed with missing portions of his brain, the intended parents asked Heather to abort him.  Unable to consent to the procedure, Heather describes the bond she made with the boy she carried: “I became his mother. He had no one else in the world to fight for him.”  While his parents eventually came to terms with the diagnosis and accepted their child, Heather says she lives with his memory, worrying for him every day.

Heather’s is not the only story of conflict regarding abortion of surrogate pregnancies. Many surrogates are faced with pressure to abort in similar situations.  Some surrogates may be forced to choose abortion for economic reasons, as was the case with Selina, a U.S. citizen whose services were contracted by a Spanish couple through a fraudulent agency called Surrogenesis (“Surrogacy: Wombs for Rent?”).  When the company’s owner disappeared and stopped payment of Selina’s temporary insurance, Selina could not afford to continue the pregnancy.  Although the Spanish couple was able to cover Selina’s medical costs to prevent her abortion, for months she felt it would be the only option that would enable her to care for her two children at home.

These stories serve as case studies that demonstrate the toll surrogacy takes on women who serve as human incubators.  If the Kantian maxim never to treat persons solely as means to ends is not enough to condemn this practice as harmful, then these stories ought to motivate us to investigate the short- and long-term consequences of surrogacy.  Without longitudinal psychological studies, there is no data that indicates whether there is a statistical harm associated with this practice.  The very fact that women can and do report harm ought to give us pause.  If it is possible that women are suffering as a consequence of this practice, would it not be prudent to stop surrogacy until we know for certain that we are not putting women in harm’s way?  Why not err on the side of protection?  Surely even those feminists who argue that women should be able to choose any livelihood they wish would agree that until there is full disclosure of the risks involved, autonomous choice is not possible.  By assessments on multiple levels, we see that the dismembering of motherhood harms women in terms of reducing their procreative power, fracturing their identities, and causing them deep psychological pain.

 

CONCLUDING THOUGHTS

To varying degrees, I find the arguments that feminists make against ART compelling.  In many ways, I agree with them.  In some ways, I find myself troubled by certain aspects of their arguments, or pieces that seem to be missing from their methodological framework.  For example, in arguments asserting that ART is coercive, radical feminists speak of women being duped by society, as if feminists are the only women intelligent enough to think critically about the message that is being sold to them.  Often, it seems there is a failure to consider alternative worldviews as legitimate points of view.  Women who do not share the feminist perspective are not necessarily coerced, conditioned, or blinded.  I find it more than a little ironic that a group which purportedly believes in the intelligence and power of women should place so little faith in women who think differently than themselves to make their own free intelligent assessments of the world.  I would like to believe women capable of thinking critically to exercise their freedom to come to whatever conclusions they find most cogent and meaningful.  I remain suspicious of any group that asserts that women are not truly free unless they conform to the ideals of that group.

The arguments for the coercive nature of ARTs that are most compelling are those that recognize the trend in medical choices: obscure procedures, over time, become standard.  We have already seen this with amniocentesis, and the eugenic push behind this practice has been extended to ARTs through preimplantation genetic diagnosis of embryos as doctors choose the most fit for implantation.  ARTs are intrinsically eugenic.  Donors are specifically selected for desirable genetic characteristics.  As we have seen, the more control we have over the process of reproduction, and the greater the commodification involved, the more pressure there will be to produce perfect children.  As this pressure grows and the success of IVF increases (thanks to growing numbers of high-paying research subjects in the form of infertile women), I too see enforced ARTs as more realistic than dystopian.  If we do get there, I fear it will be have been at the cost of time and funding that could have been directed towards the cause of preventing infertility—another point in the literature that I find compelling.

The commodification and exploitation of women and children that result from the use of ART are the most blatant ethical violations.  So troubling are they that other arguments against their use seem unnecessary.   It seems that the injustice of what is being done to women, or the thought of a world in which children are bought rather than loved into being, ought to suffice as arguments to ban these practices.

In reflecting on the deconstruction of motherhood, I agree with feminist arguments, but I find that the most compelling arguments come from other sources.  The Roman Catholic paradigm, with its focus on the meaning of the family, seems a more fitting context in which to discuss the ethics of procreation.  Interestingly, in none of the sources I read did feminists write about procreation in a family context, nor were they particularly concerned about fathers.  For a group that prides itself on its communal ethics, it seems odd to discuss children outside of the context of a family, leaving their fathers out of the discussion entirely.  None of the egg donors or surrogates in Lahl’s documentaries appeared with or mentioned husbands or partners, despite the fact that all surrogates have had their own children.[2]  “Wombs for Rent” depicted the marital relationship with undertones of control, as an aspect of a primitive male-dominated society.  None of these sources entertained the proper context for children as the family, nor did they consider a sustaining love relationship between man and woman as the foundation of procreation.  While I agree with many of the arguments made against ARTs, I find that feminism works with an anthropological framework that is too thin to be entirely compelling.  It seems to me that feminism pays entirely too much attention to women, to the detriment of a richer understanding of women.  Women do not exist in isolation; they share a common humanity with men.  A more comprehensive account of the meaning of women would take both genders into consideration, evaluating commonalities as well as difference. 

 

Furthermore, to discuss children and procreation in terms of women alone, or women in opposition to men, fails to recognize that, artificial or not, children only come into existence when both women and men are involved.  The fact that feminist literature tends to devalue men and male experience when discussing ART almost certainly leads to a deficiency in thinking.  Privileging women’s experience is one thing; it is another thing entirely to silence or disregard men altogether.  Considering reproduction within the context that makes it a possibility, the relationship between a man and a woman, is essential to understanding its meaning.  Considered outside of this, reproduction is objectified a priori as nothing more than a meeting of gametes, whoever’s gametes, however they come to meet.  While the feminist movement has softened over time in its attitude towards men, authentic communal ethics will only be possible when suspicion and competition are put aside, and true reconciliation and healing take place.  Only then will feminist ethics be able to fully address the ethics of reproduction and motherhood, which, by natural or artificial means, exists only in conjunction with fatherhood.

 

Notes

[1] Interesting to me is Corea’s failure to consider female physicians in her essay, almost as though this staunch defender of women fails to recognize their role in the so-called pharmacracy, or else believes that only men are doctors.

[2] One egg donor mentioned a boyfriend who called for help when she needed medical assistance. No mention was made of his role, if there was any, in the donation decision or process.

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