Christine Overall, Human Reproduction: Principles, Practices, Policies. Toronto: Oxford University Press, 1993.
Gwynne Basen, Margrit Eichler, Abby Lippman, eds., Misconceptions: The Social Construction of Choice and the New Reproductive Technologies, Volume One. Hull, Quebec: Voyageur Publishing, 1993.
Do the new reproductive technologies provide women with more choices, more control over our bodies and our destinies? Or are we trapped by them in a cruel and frustrating paradox? Perhaps the more choices we seem to have--embryo freezing, in vitro fertilization (IVF), genetic testing, to name but a few--the more we find ourselves subject to techno/ medical manipulations of our bodies as well as enthralled by an insidious world view Abby Lippman calls "geneticization," which is the attempt to "name things that distinguish one person from another as genetic in origin, to reduce differences between individuals to their DNA codes and to define most disorders, behaviours and physiological variations as at least partly genetic in origin." (40)
Both these volumes of essays provide a feminist critique of new reproductive technologies, but their tones and conclusions are very different. Overall leaves us with the impression that with proper application of feminist ethical principles, some, at least, of the new reproductive technologies might broaden women's choices and enhance women's lives. But the authors collected in Misconceptions leave the reader speculating that the only acceptable feminist ethical alternative is to dismantle them completely and prohibit future tinkering with human reproduction.
Many of the essays in Misconceptions offer an explicit critique of Canada's Royal Commission on Reproductive Technologies (Baird Commission). Margrit Eichler in her detailed analysis, "Frankenstein Meets Kafka: The Royal Commission on New Reproductive Technologies," argues that the commission attempted to manage the discourse on reproductive technology in such a way that most basic questions were not dealt with at all. Both Eichler and many of the anonymous writers who worked for the Royal Commission conclude that research topics and contracts were inappropriately assigned, data was tampered with, and an atmosphere of secrecy and paranoia was created to intimidate researchers. After reading these essays it is impossible to believe that the subject of reproductive technology has been given a fair hearing in Canada. There are too many vested interests involved, drug companies, doctors, private clinics, hospitals, to allow the thorough-going public debate that the subject demands. Instead, we get, as Gwynne Basen puts it, "discussion that excludes any consideration of risks, consequences or ethics." (29)
Although Ms. Overall's essays consider a number of issues, including: contract motherhood, embryo cryopreservation, access to in vitro fertilization, selective termination in multiple pregnancy, and the sloppy or nonexistence record- keeping with use of IVF and artificial insemination, they fall into the trap of debating technology management rather that interrogating the technologies and their proponents. For example, in order to determine who should have decision-making power in the case of a dispute over preserved embryos, Ms. Overall takes a critical look at the Davis vs. Davis case, in which Mary Sue Davis wished to have frozen embryos, "conceived" while she was married to Junior Davis, implanted after their divorce, over her former husband's objection. Ms. Overall notes the way that Junior Davis coopted the feminist rhetoric of rights, in this instance, the right not to reproduce. However, she argues that decision-making power should go to the woman in disputed cases, since she would otherwise have to undergo IVF again.
In her chapter arguing against the hiring of women to gestate foetuses for infertile couples, Overall rightly rejects the term "surrogate motherhood," an inaccurate and obfuscating name if ever there was one. Instead she uses the term "contract motherhood" to describe the relationship between the inevitably rich couple and a poor or working class woman. She notes the potential for exploitation of women of colour by whites, using the technique of embryo transfer.
Along with most other feminists, Overall sees contract motherhood as "a type of slave trade in infants" and, for women, "a modern form of indentured servitude." (29) She advocates that it neither be legalized nor criminalized, but thinks such contracts should be rendered unenforceable and agencies that act as go-betweens should be liable to prosecution.
However, Ms. Overall parts company with American feminists like Gena Corea and Janice Raymond, as well as with the authors collected in Misconceptions, in her limited support of IVF and equality of access to it. She observes that "it is surely inappropriate for feminists to claim to understand better than infertile women themselves the origins and significance of their desire for children." (148) Feminists have long condemned male experts for defining women's experience; we should not be guilty of the same thing by claiming the desire for a child is a kind of false consciousness: "The demand for an end to all use of IVF is an expression of a kind of feminist maternalism that seeks to protect the best interests of the women affected by IVF." (149) (To be consistent, Overall might have made the same argument about contract motherhood, where she seems more willing to engage in "feminist maternalism.")
Overall opposes the "commercialization of reproduction and the spread of reproductive entrepreneurialism" (152) and tries to define the necessary conditions for a woman-centred delivery of IVF: "The caring provision of artificial reproduction services requires (a) truly informed choice and consent; (b) equal and fair access; (c) accurate record-keeping, follow-up, and research; and (d) appropriate support systems for all participants." (151)
After reading the essays in Misconceptions, especially Abby Lippman's "Worrying--and Worrying About--the Geneticization of Reproduction and Health" and Louise Vandelac's "The Baird Commission: From 'Access' to 'Reproductive Technologies' to the 'Excesses' of Practitioners or the Art of Diversion and Relentless Pursuit," I find three things in Ms. Overall's position troubling. For one, she seems to assume that IVF is or at least can be made safe for mothers and the children so conceived. This remains to be proven, since, no matter how many "miracle babies" have been produced, the technology is really still in its experimental stages. Second, Overall implies that the technology itself is neutral or even benevolent, or as its proponents would have us believe, the answer to the grief and deprivation experienced by the infertile. However, by tampering so dramatically with reproduction, we leave ourselves open to further genetic manipulation (peddled as "gene therapy") and to basic changes in our thinking about what makes us human. And third, I find it unsettling to think that, at present, social resources might be used to develop and promote these technologies when so many women and children in Canada find themselves increasingly impoverished. We know from report after report that childhood poverty is a growth area, and I would like to see this addressed in more than token ways before focussing on in vitro fertilization.
As we know, the drugs used to stimulate ovulation, and the implanting of multiple embryos have caused another problem, large multiple pregnancies and the apparent "need" for selective termination, a chilling phrase that recalls Varda Burstyn's comparisons of reproductive technologies with Nazi medical "experimentation" in her article, "Breeding Discontent." As Ms. Overall notes, this is a perfect case of doctors causing a problem, and then offering a very unsatisfactory solution to it. Nonetheless, Ms. Overall supports women's right to selective termination of foetuses as an extension of the right to abortion, not only in cases where it might, arguably, be medically necessary, but even in instances where a woman simply did not want, say, twins or triplets, but preferred to have a singleton. Although I support the right to abortion, I feel that selective termination is about as repugnant as abortion for sex-selection. But I should add, for the sake of fairness, that I have triplets myself, so I may be prejudiced.
Perhaps the problem, as a number of feminists have begun to argue, is with the unproblematic rhetoric of choice that we have used in our discussions of reproduction and abortion. Judy Rebick poses this question in her essay, "Is the Issue Choice?" as does Sunera Thobani in "From Reproduction to Mal[e] Production: Women and Sex Selection Technology": "Can feminists defend selective abortion on the basis of a woman's right to 'choose' when the 'choices' reflect the dominant society's devaluation of certain groups of people, i.e., women, people with disabilities, people of colour?" (148) What we are looking at is a series of "personal choices" subtly moving in the direction of a public policy of eugenics, all the more insidious because it comes from no central authority. As Abby Lippman asks, why is so much attention given to preventing DownÏ€s syndrome babies through promotion of amniocentesis, when more problems are caused by low birth weight--which could be eliminated simply with better prenatal care and nutrition for poor pregnant women?
Ms. Overall is careful to put all her essays into the context of a critique of the medicalization of infertility: "Infertility is seen as a problem that must be solved by acquiring a child of one's own, biologically related to oneself, at almost any emotional, physical, or economic cost." (49) She recommends that more research be done on the causes and means of preventing infertility, rather than depending on heroic treatments. However, in 1987, for example, the Canadian government spent $3.5 million on new reproductive technologies, and $400,000 on research into reproductive disorders. And the Baird Commission did not address workplace related causes of infertility at all.
However, as Gwynne Basen points out in her article, "How Old McDonald Lost the Farm and Doctors Got to 'Make' Babies: A Personal Reflection on the Reproductive Industry," IVF is a growth industry. In the United States in 1986 there were fewer than 50 fertility clinics; in 1990 there were 180. (126) With both animal breeding and human reproduction, "work is fueled by the pursuit of the possible and the profitable and the only limitations are the technical ones." (129) So in the not too distant future, we might see ova retrieved from aborted female foetuses or from cadavers. As Basen warns in another article, "Following Frankenstein: Women, Technology and the Future of Procreation," women "will have little or no connection to the creation of embryos and the embryo will be reduced to the material status of dead matter." (31-2)
Abby Lippman and Louise Vandelac provide the most basic critiques of the new reproductive technologies, both those currently in routine use, like prenatal testing, and those on the horizon, like manipulating genes before embryo implantation. But as Vandelac points out, the Royal Commission refused to consider some of the most necessary issues: "It's as if, appalled by the scope of the questions raised and trapped by the urgent need to react to a series of faits acccomplis, these authorities had overlooked the simplest, most basic and fundamental matters, notably those concerned with experimentation on human subjects -- matters that have been central to contemporary ethical reflections since the Nuremberg trials for crimes against humanity." (268) It is both sad and frightening to think that the chance for a real public policy debate in Canada on reproductive technologies has been wasted, or even snatched away from us. As Varda Burstyn warns: "Either we gain control of their development and deployment in a conscious social fashion, or their proliferation will create de facto changes in reproductive relations and social values, whether we like it or not." (191)