The Varieties of Reproductive Experience

"First comes love, then comes marriage, then comes a baby in a baby carriage." Or so goes the old childhood saying. But in recent decades the traditions and culturally accepted mores surrounding the bearing of children have given way to new realities. As a result of scientific advances, the creation of human life has become increasingly rooted in the laboratory, as more and more children are being born to older women and in contexts that deviate from the traditional nuclear family. Over the years a number of Atlantic articles have offered commentary on these changes—addressing everything from the science behind them to their practical and ethical implications to the experience of taking part in them first-hand.

In "On Living in a Biological Revolution" (February 1969), Harvard historian Donald Fleming reviewed some of the dramatic scientific advances—from the discovery of DNA to the development of a contraceptive pill—that had taken place in the preceding fifteen years. Many of these changes, he asserted, especially recent advances in the study of genetics and embryology, would dramatically transform the way society thinks about the creation of human life. The new ideal of the contemporary biologist, he wrote, is "the manufacture of man."

In a manufacturing process ... quality-control is maintained by checking the output and replacing defective parts...

This is the program of the new biologists—control of numbers by foolproof contraception; gene manipulation and substitution; surgical and biochemical intervention in the embryonic and neonatal phases; organ transplants or replacements at will.

While he conceded that some might object to such a dispassionately technical view of human genesis, he speculated that the rewards of embracing such an outlook would ultimately win over skeptics.

Abstract theological speculations about genetic tailoring would be totally lost upon a woman who could be sure in advance that her baby would not be born mentally retarded or physically handicapped. The private anxieties of individuals are likely to diminish rather than increase any effective resistance to the broader consequences of the Biological Revolution...

The new form of spiritual sloth will be not to want to be bodily perfect and genetically improved. The new avarice will be to cherish our miserable hoard of genes and favor the children that resemble us.

Two years later, in "The Obsolescent Mother" (May 1971), Edward Grossman suggested that given the recent advances in the science of human development, the day might not be far distant when a woman's womb would no longer be necessary for the gestation of a human fetus. Already a physiologist named Daniele Petrucci at the University of Bologna had claimed in 1961 to have sustained a fertilized embryo for twenty-nine days inside a fluid-filled silicone container. Reactions to this claim had been decidedly mixed. While the Catholic Church had decried the experiment as "monstrous," the Communist party in China had hailed it enthusiastically. Grossman quoted an editorial from a Chinese Communist newspaper:

Nine months of pregnancy is no light or easy burden and such diseases as poisoning due to pregnancy are detrimental to health. If children can be had without being borne, working mothers need not be affected by childbirth. This is happy news for women.

Most serious scientists, Grossman explained, had dismissed Petrucci's claims as fraudulent. But he pointed out that great strides were being made by legitimate scientists in the science of extracting eggs from human females, fertilizing them in the lab, and eventually, it was hoped, implanting them back in the uterus for gestation to full term. If in vitro fertilization was so close to becoming a reality, he suggested, artificial wombs might not be far behind. After all, he wrote, "it might be said that for the United States, there is no technological project that is not assured of success provided the decision is made to invest whatever talent and money are necessary." And the artificial womb, he argued, would benefit everyone—especially women.

[The mother] will find that society does not expect her to have a special relation to her offspring that takes up years of her life, and also she will not expect it of herself. Too, a society that can grow fetuses in a laboratory will be more disposed to have meaningful day- and night-care centers and communal nurseries on a large scale, for the state, being a third parent, will wish to provide for the maintenance and upbringing of its children. Natural pregnancy may become an anachronism.

In a companion article in the same issue, the renowned scientist James D. Watson addressed the possibility that advances in the study of genetics and embryology might soon lead to human reproduction by cloning. "A human being born of clonal reproduction most likely will appear on the earth within the next twenty to fifty years," he wrote, "and even sooner, if some nation should actively promote the venture."

Given that science seemed to be progressing so quickly in that direction, Watson urged that the practical and ethical implications of such a development should be thought through as soon as possible.

This is a matter far too important to be left solely in the hands of the scientific and medical communities. The belief that surrogate mothers and clonal babies are inevitable because science always moves forward ... represents a form of laissez-faire nonsense...

If we do not think about it now, the possibility of our having a free choice will one day suddenly be gone.

In the ensuing years, reproductive technology did continue to make dramatic advances. But as Gina Maranto warned more than twenty years later in "Delayed Childbearing" (June 1995), reproductive science had not in fact progressed as far as some had been led to believe. In the 1970s, she explained, the field had become a mecca for the best and most creative scientists who, in her words, had "assumed the status of latter-day fertility gods." The rapid pace of discovery and the intensity of the media hype surrounding it at the time had "conveyed the impression that the vagaries of reproduction had been brought under technological control."

As a result, she explained, women had come to believe that, thanks to the wonders of science, they could now be assured of having children whenever they chose. Sadly, she reported, many of those who had waited until their thirties or forties to attempt to become mothers were now finding that they had waited too long and could not conceive. For many of these women, this discovery was devastating. Fertility clinics do hold out some hope for the desperate, Maranto noted, but in her view that option is far from ideal:

This path is generally costly (patients must pay tens of thousands of dollars out of their own pockets), as well as unpleasant (women undergo painful daily injections of fertility drugs, frequent blood tests, general anesthesia, and invasive surgery). Medically mediated conception is also time-consuming and encourages a kind of obsessiveness...

The unfortunate bottom line is that infertility specialists cannot help all couples who seek their services. Even leading clinics using the latest procedures offer no guarantees. True, a certain number of couples who don't succeed by high-tech means go on to achieve pregnancies by the old-fashioned method. But many others are left childless, in debt, and anguished over their failed dreams.

Caitlin Flanagan similarly addressed the travails of late-in-life aspiring mothers in her June 2002 book review of Sylvia Ann Hewlett's Creating a Life: Professional Women and the Quest for Children. Flanagan criticized Hewlett for enthusiastically commending the heroism of older women who have braved all manner of costly and painful procedures to bear children against the odds. Given that many of the women Hewlett profiled became pregnant at (in Flanagan's words) "near-biblical ages," Flanagan dismissed the book as "something of [a] freak show." Moreover, it is far from clear, Flanagan argued, that these women's quest to have children is a worthy one.

The most obvious question that such a pursuit prompts—whether it is in a child's best interest to have a mother who will be facing the challenges and travails of old age just as her offspring is entering adolescence—is never mentioned. Why? Because this is a book from the perspective of "high-achieving women," and the main impression we get of the type is that they are going to get exactly what they want, and damn the expense or the human toll.

Though the problem of infertility has yet to be made obsolete, other dramatic scientific developments have continued to transform the process of bringing children into the world. In March 2002, Margaret Talbot discussed new technologies that enable couples to choose the gender of their children. One clinic she reported on used a technique called sperm-sorting, in which sperm with the desired male or female genetic material are selected for. Other clinics, she explained, create embryos in vitro and then screen them for gender before either discarding them or implanting them in the uterus. Talbot vehemently objected to such processes, arguing that they are antithetical to the spirit of unconditional love that parenthood is supposed to represent:

A world in which people (wealthy people, anyway) can custom-design human beings unhampered by law or social sanction is not a dystopian sci-fi fantasy any longer but a realistic scenario...

Without some humility in the face of the unknown and unknowable—without some fundamental willingness to accept and to love whatever child you get—parenthood would be a very different, and a lesser, thing.

Several months later, in "Grade A: The Market for a Yale Woman's Eggs" (December 2002), Yale senior Jessica Cohen described her own experience exploring the possibility of becoming an egg donor for a rich childless couple. The couple had placed a classified ad in the Yale Daily News, asking for "a young woman over five feet five, of Jewish heritage, athletic, with a minimum combined SAT score of 1500, and attractive." Since Cohen fit all the criteria except for the SAT score, and because the couple was offering to pay handsomely ($25,000), she contacted them by e-mail to find out more.

Thus began a bizarre e-mail correspondence in which she essentially "auditioned" to contribute her genes to their family. Cohen found the experience unsettling.

Michelle and David now had my educational data as well as my photos. They were examining my credentials and trying to imagine their child. If I was accepted, a harvest of my eggs would be fertilized ... A few embryos would be implanted; the remaining, if there were any, would be frozen; and then I would be out of the picture forever.

The more Cohen pondered what she was proposing to do, the less comfortable she became with the idea.

Once a couple starts choosing a few characteristics, shooting for perfection is too easy—especially if they can afford it. The money might have changed my life for a while, but it would have led to the creation of a child encumbered with too many expectations.

In the end, Cohen's offer was rejected. The correspondence concluded with a terse email from the husband, who wrote, "'Showed the pictures to [my wife] this AM. Personally, I think you look great. She said ho-hum.'"

Finally, in the September 2005 Atlantic, Lori Gottlieb describes her own experience deciding to have a child by anonymous sperm donor. At age thirty-six, she explains, she came to the conclusion that she didn't want to keep her boyfriend but that she did want to have a child. In short order she ended their relationship and began browsing the online listings at sperm banks.

Selecting a donor from the list of profiles, she found, was a bit like online shopping. In many ways, she comments, it was a less trying experience than attempting to select a lifelong mate.

By bypassing the uncontrollable world of romance, I was able to choose a man to father my child who might be completely out of my league in the real world...

Suddenly it seemed acceptable to rule out guys arbitrarily, based on some perceived flaw. The second you separate mating from dating, it's okay to indulge hubristic fantasies of genetic engineering (must be over six feet tall, with a combined SAT score higher than 1500)...

Once she'd made her choice, she conceived after just two rounds in the fertility clinic's "insemination room," and is now several months pregnant. She explains that while this route to motherhood was hardly her lifelong dream, she has discovered that single motherhood by sperm donor is an increasingly common and accepted phenomenon—and it is one that, in her view, has much to recommend it.

Nowadays it no longer sounds counterintuitive to hear a single woman say that she, like me, broke up with her boyfriend in order to have a baby...

A man in his mid-thirties appreciates getting to know a woman without ulterior motives—one who likes him for his inherent qualities instead of for the children he might help produce. The men I'm dating realize that I already have everything else I want, so now I'm in this purely for a chance at love. Meanwhile, in just a few months I'll meet my new baby. It may not be the traditional fairy tale, but in a very modern sense my life these days feels incredibly romantic.