This book by Liza Mundy is a fascinating look at infertility treatment and artificial reproduction today. It gives a very thorough look at all the different ways people can have babies today: IVF, ICSI, IUI, surrogacy, donor eggs, donor sperm, adopting embryos, etc. I thought I understood what was available fairly well before reading this book, but I was wrong. There’s a whole lot in the infertility world I had no idea about.
Mundy does a good job of juxtaposing scientific explanations of the treatments with stories about real couples who are going through treatment. It makes the technical become personal and makes for a good read. She also talks about the history of how these techniques have developed and evolved.
She does less of a good job in exploring the ethics surrounding these issues. She seems to want to be neutral and just tell the stories without making judgments. However, she clearly is writing from a pro-choice position and portrays those who are pro-life as being on the fringes of society. So for example, the chapter on “selective reduction” deals with when it’s ok to “reduce” an embryo. For gender? For genetic diseases? 3 down to 2? 2 down to 1? But she comes at it with the assumption that “selective reduction” itself is ethically fine.
Mundy does point out that different groups within the pro-choice and women’s rights communities are at odds over infertility treatment and ethics. Some want to emphasize choice above all, no restrictions ever on reproductive rights. Ever. At all. Get your hands off my uterus. But Mundy points out this brings up questions like can a woman choose to have as many embryos as she wants implanted at once, despite the risk to the babies? Do children born from egg donation or sperm donation have the right to know about the details of their conception? To have the opportunity to meet the donor? As Mundy says, “What happens when the rights of the child conflict with the rights of the parent? Whose reproductive freedom is it?”
As someone who is pro-life I come at the issues from a different perspective than Mundy. I have always had some real concerns with fertility treatments. I believe in medicine and science and I believe God gives us medicine as a gift. I don’t have a problem with medicine or science helping with infertility. I don’t see it as “playing God”. However, I do think the infertility industry (and it is a huge commercial industry) has been allowed to develop in a culture where there are no limits. Or at least very few. The prevailing ethic seems to be that of choice above all other considerations. Mundy sums up the problem like this:
There were moments when it seemed to me that two modern ways of thinking about parenthood – an absolute commitment to reproductive liberty under all circumstances, and a trend toward compulsive micromanagement of every aspect of our children’s lives- sometimes persuade would-be parents that they are entitled to pursue any avenue of reproductive technology and to determine every aspect of the outcome.
And the ironic thing is- for me, this was a key revelation- determining the outcome is exactly what can not be done. Assisted reproduction is, often, the least controlled form of reproduction imaginable. That’s what we should be taking away. Situations never turn out the way patients expect them to.
Mundy does a good job of pointing out that this ethic of choice above all is problematic, to say the least.
The ethical issues in this book aren’t easy and aren’t black and white. But they are here to stay. If you are interested in bioethics I would definitely recommend it. Even if you aren’t that interested, I’d recommend it. A warning though, if you are pro-life and very sensitive this is NOT the book for you. There are some graphic descriptions of certain procedures that may upset you. ( Mom, that means you, do NOT read this book.)
I was acutely aware while reading this book while nursing my third child who is not yet three months that I really have no idea what the women and couples in this book have gone through. I’ve never experienced infertility and I can only imagine the pain and heartache that goes along with it. It’s easy for me to think in my head where I might draw the line ethically if I was in their shoes, but the reality is I have never been nor ever will be in their shoes. That was a good lesson for me and in itself worth the time spent.