The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception

[lightreads]

The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception by Debora L. Spar

My rating: 4 of 5 stars


There was a sign in the waiting room of a fertility clinic I was in a while ago that said, "One of our babies is born every X hours." I don't actually remember what the X was, but I remember sitting there, trying to stay calm, multiplying it out in my head and coming up with thousands and thousands of babies a year, and being just stunned.

When I first heard that about 1% of American babies born these days are the product of IVF conceptions, I thought that was extraordinarily high. Oh, those naive days. Now that I know so much more about infertility – how one in six heterosexual couples will meet the clinical definition, to say nothing of the hundreds of thousands of queer and single people who will have to participate in the fertility market out of practicality, not medical need. Yeah, now that I know a lot more, that 1% is shockingly low. It says to me that many people find noncommercial ways to acquire the children they want, even when banging a heterosexual partner won't get the job done. But more to the point, the 1% says millions and millions of people simply can't afford to play at all.

I get pretty angry about that. How making a baby for some people takes a bottle of wine and some jazz. And for others it takes $120,000 and years of anguish and depression and loss. And obviously there's a lot of selection bias, and obviously worthiness has nothing to do with it, but sometimes I swear there's a direct correlation between how awesome someone is and what a great parent they will be, and just how tortuously difficult it will be for them to get there. And let's not even start on the way access to the fertility market is stratified by class and race and sexuality.

Anyway. This book is ostensibly about babymaking economics: IVF, gamete donation, PGD and genetic screening, surrogacy, adoption, cloning. How supply and demand interact with the political and social and legal milieu to create functional – or not functional – markets. It's pretty interesting, but the book is already outdated in less than a decade, and I object to many of her premises. For example, she leans heavily on this notion that demand for certain fertility services is nearly limitless, because enough people will spend past the point of rationality to get what they want. Which is just flatly incorrect – there are people like that, but if you spend as much time in infertility communities as I have, you'll discover that the first thing everyone talks about is, obviously, infertility. But the second thing is money, and just how many chances the money will buy, and how once X dollars are spent, that's it, game over.

She also dwells more on moral alarmists and scare stories than I felt was necessary. The surrogacy chapter was particularly egregious on this front. And I blinked a lot at all the times she talked about "wrenching moral dilemmas for society" where I was like, "eh, no, I have no problem with that reproductive choice, what's your damage?" E.g. apparently people think that reproductive cloning will mean the end of humanity? Because, like, reproducing a new human without a genetic partner is so fundamentally different that it will rewrite our species identity, and we should not let anyone do it ever? And I'm like yeah, it's a big deal, and there will be abuses (the Bujoldian force-grown clones for medical cannibalism, for example) and it will be the playground of the uber wealthy, but come on. Get some fucking perspective, and also, your sciencephobia is showing.

Anyway. I have a much longer list of intellectual quibbles with this book, but it was interesting and well put together and really very useful to me. But I think that's partly because we're not TTC right now, and it's been months since I had to deal with fertility industry bullshit, or asinine government regulations. If I read this when we're back in the trenches, my reaction to this somewhat judgey outsider perspective might be different. So there's that.




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