The Ethics of Procreation are Getting Really Complicated

I recently read about two new-to-me innovations related to reproduction. First, Slate has a piece discussing the emergence of at-home prenatal test kits that enable you to determine the gender of a fetus as early as five weeks:

Kaplan’s reporting shows how the abortion option looms behind these tests. The Jains considered abortion but decided against it. Another woman “wanted a girl so badly that she and her husband spent $25,000 on in-vitro fertilization so that doctors could select female embryos to implant in her womb.” The woman took a test at 10 weeks to make sure she wasn’t carrying a male fetus. A third woman who got a bogus result from her test says “there are women out there who experience really big disappointment. They really want to give their husbands the little boy they want, or a little girl, and they will abort based on these results.”

One example of these tests is Baby Gender Mentor (kind of a misuse of ‘mentor’ there, eh?).

The Slate piece is actually about how ordinary it’s becoming to abort a fetus because it’s of the undesired gender (boy, did I struggle over the grammar of that sentence). I’m pro-choice, but I’d prefer if people didn’t use abortion as everyday birth control, particularly when the reason is as trivial as “I wanted a boy”. I don’t have a strong rationale for my feelings, but to do so seems paltry, and flawed at some fundamental biological level.

Your (Surrogate) Mother in India

The second innovation is described in (the awesomely-named) Amelia Gentleman’s article about commercial surrogacy in India:

Reproductive outsourcing is a new but rapidly expanding enterprise in India. Clinics that provide surrogate mothers for foreigners say they have been inundated with requests from the United States and Europe in recent months, as word spreads of India’s combination of skilled medical professionals, relatively liberal laws and low prices.

Westerners pay about US $25,000 to get a (sometimes illiterate) Indian woman to carry their baby to term. Sometimes there’s an egg donor involved as well. The surrogate mother gets about $7500. For comparison, the average accountant in India earns about $5900 a year.

One such clinic is Rotunda – The Center for Human Reproduction, at the non-encouraging URL of www.iwannagetpregnant.com.

The article is imperfect. I think profiling a gay couple needlessly complicates the ethical debate, and there’s no discussion of whether the surrogate mothers suffer any social stigma for their participation. Plus, I was left wondering about the possible physical and psychological risks to the mothers.

Halfway through, the piece gets downright eerie:

In Anand, a city in the eastern state of Gujarat where the practice was pioneered in India, more than 50 surrogate mothers are currently pregnant with the children of couples from the United States, Britain and elsewhere. Fifteen of them are living together in a hostel attached to the clinic there, waiting to give birth.

The phrase that Ms. Gentleman avoids (probably wisely) is “baby farm”. I’m reminded of The Matrix, or Cylon baby farms in Battlestar Galactica.

Who is this service for? Couples who will not or cannot adopt. I gather adoption is more costly and probably more difficult. There’s obviously the ol’ ‘replicate myself’ impulse as well. And, though I have no idea how prevalent this attitude is, parents may want a child that, in terms of race, looks like them.

I’d like to see a little survey of the Westerners who use this service, examining why they chose commercial surrogacy instead of adoption or local surrogacy via a friend or family.

The possibilities and practices of reproduction are changing incredibly fast, and I’m not sure we’re having enough thoughtful debate about these new permutations. Lots of things cloud the debate–parents’ eagerness, commercial interests, taboos, and so forth. I have more questions than answers on these topics, but I think we need to talk about them more out in the open.

17 comments

  1. I think sex determination can create a lot of problems, and that abortion based on gender should be illegal.

    Look at problems due to preference for one sex- things are going to be really screwed up in China due to their preference for boys in a few years.

    (Also, societies are going to have to create a legal system to deal with all the complications that will arise from all this procreation)

    I’m all for adoption, but then I’m admittedly biased because I grew up with an adoptee in my family and don’t have the burning urge to have a child in my likeness.

  2. Pretty interesting, and I can’t help but notice the mix of wealth and ideas about industry and business moving from industrialized nations into other cultures, and how those cultures don’t do the same things with those ideas and wealth as we expect.

    CBC Ideas just ran a 2-part show about how our notions of family are being clouded as test-tube babies grow up and seek out parents as well as half-siblings from the same donor, and begin forming relationships on that basis.

    Where family used to mean the extended group that all lived in the same locality, the idea of what family is is once again changing. Strange days.

  3. Darren,

    Choosing the gender of your child is hardly trivial (… “the reason is as trivial as “I wanted a boy” “). Such a reason might be fraught with moral implications; it might be distasteful to you, and it might have unforeseen consequences on the development of a society that permits, condones, or just fails to stop it.

    But gender choice isn’t a trivial decision, it’s probably the single most important determination that a parent can make about their family’s development. In more general terms, despite what anti-abortion rhetoric would assert, I’d wager that almost no woman ever undergoes abortion as a trivial decision.

    TTFN
    Travis

  4. Adoption locally can be very difficult. It turns out that secondary infertility (difficulty in having a second child) is a bigger problem in terms of numbers than primary (having that first child). This means a lot of people who would adopt can’t adopt locally as they’re either over the “ideal” age, or the birth mother wants her child to be the only child (or at least not the only adopted child) in the family. Then there are other issues. I’ve heard that Jewish couples have problems, since most birth mothers want their child placed with a family of the same nominal religion as them. I’ve heard of problems with placing kids with a family with a different skin colour. Etc. With all that, I can see that surrogacy might be the best of a bunch of bad options for a lot of people.

  5. Travis:

    To be clear, I didn’t say that:

    * Choosing the gender of your child was trivial
    * Undertaking an abortion was a trivial decision.

    I said that I believed gender selection was a trivial reason to have an abortion. It suggests an apathy and blase attitude towards what you rightfully characterize as serious.

    Choosing your child’s gender is a powerful determiner. So powerful, in fact, that I think it should be left to nature.

    Ethical issues aside, Alexis rightfully points out the very real social implications of widespread gender selection.

  6. I have a small point to add to the discussion – these tests are not determining the fetus’ gender, they are determining its sex. “Sex” and “gender” are not interchangeable terms (although most people use them as if they are) “Gender” is a social construct (for example, “gender identity” is how one sees themself as “female” or “male” (or another gender, such a “two-spirited) and “gender roles” are the behavioural norms that society expects of females vs. males), whereas “sex” is a biological construct (e.g., females have XX chromosomes, males have XY; females and males have different antaomies/levels of hormones/etc.). So the “Baby Gender Mentor,” which assess DNA to determine the sex of the fetus, is misusing the word “gender” as well as the word “mentor” (and, one could argue, they should be saying “fetus” rather than “baby”)

    Sorry to go all “word police” on you, but I work in the field of sex- and gender-based analysis is health research, so I couldn’t let this one slip by without mentioning it.

  7. I agree with you Darren. The abortion debate needs to be opened up in Canada and debated. In Canada we are just over 100,000 abortions a year. Yet at the same time, we’re looking to other countries to boost our population…. For myself, for a long time I followed the argument that it is about choice, and that choice is the most important criteria. Now that I have a child, I believe that there is something that in most occasions outweighs choice – and that is another being’s life. It could be said that for me, my daughter’s life began when she was born, but for her, her life began at her conception. Who is more vulnerable than a fetus who cannot talk for herself… scary to think that some people want to abort for sex, like it’s a blue toaster you didn’t like and took back to Walmart to get a pink one!

  8. Beth raises a good point. It gets me to thinking, on the small chance that a couple’s child of their “chosen” sex ends up as the other gender (at any point in their lives, but let’s say particularly in youth) or even feels disoriented in their gender, those parents might be facing much greater trauma and disappointment than might a parent whose baby’s sex was chosen by biology. What implications for them, and for the law and society, might come of that prenatal sex manipulation?

    I’m pro-choice as well, though after the loss of a loved fish that got me thinking about the death of a little life, I’m wondering if making this decision in advance is actually reasonable. As far as male/female goes, I think if these people let their high hopes go, they’d find themselves incredibly happy with either. I could be wrong about that, but something about this predetermination just isn’t right. Ethics can be a very personal and therefore undebateable thing…

  9. I’m gonna avoid the abortion topic altogether and just mention my utter disgust that the poor people in developing countries who donate a kidney or have a child for some rich westerner get a very small amount of the money each westerner pays for said organ/baby. It just seems more exploitative that way, that there are people making buckets of money off of this “trade”.

  10. Beth: Good point about ‘sex’ vs. ‘gender’. And the word police are always welcome here.

    I know you’re a grammar fiend, too. You show admirable restraint in not highlighting my all-too-common dangling participles and misplaced modifiers.

    Gillian: I agree that there are a zillion possibilities for exploitation here, but I’m not sure the mother’s payment is one of them.

    Speaking clinically, as an ’employee’, the mother makes about 30% of the payment. I’m no economist, but compared with the average boss/employee relationship and considering the expenses the lab must incur, that seems like a reasonable markup.

    Understand that I’m not advocating commercial surrogacy, just considering the economics of the arrangement.

  11. While technology seems to be on high-speed, many people are still thinking in too traditional ways. In many cultures, male babies are still preferred over females ones. And even today, many mothers are forced to give up their child if it is not the gender desired. Just a thought inspired by this post.

  12. Is this practice of outsourcing gestation to India only for parents who cannot or don’t want to adopt? I can see this being employed for power couples who are simply ‘too busy to be bothered’ with the ‘nuisance of a pregnancy’.

    Beth makes an excellent point. Determining the sex of a fetus doesn’t guarantee that your offspring will behave in the way you hope or expect simply because of chromosome make up. This is a slippery slope we’re on and we’re sliding feet first – like a breech birth – into infants built to order.

    Both of these trends seem to be a by-product of what you were referring to in your subsequent post about living abroad: abundant choices that Westerners have. This Human characteristic of thinking we can alter nature’s course will be, if it already isn’t, our downfall.

  13. Gregg’s point about people being “‘too busy to be bothered’ with the ‘nuisance of a pregnancy'” is actually the first thing I thought of. Celebs are getting induced pregnancies or C-sections just to make sure they can “plan around” the birth. A recent article suggested such-and-such celeb’s baby was going to be born on a specific day, not due around then. Hrmph. Then there’s the whole money-for-baby-pictures thing that’s just disgusting but at least not unethical…?

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