In many ways, the strange story of Nadya Suleman, the now-infamous “Octomom,” reads like a bad MasterCard commercial. One round of in vitro fertilization: somewhere between $8,000 and $15,000. One Caesarean section: roughly $23,000, plus the additional cost of having 46 doctors and nurses in the room. Eight premature babies: about $165,000 for the cost of a stay in the neonatal intensive care unit, times eight. Food stamps: $132 per child per month. Having fourteen kids to fill an inner void: priceless.
As a nation, this shouldn’t surprise us. Because despite the oddities of the Suleman story—the rumored plastic surgeries, the Angelina Jolie thing, the angry grandmother—its basic outline was completely predictable. Ever since IVF became possible in 1978 with the birth of Louise Brown, the U.S. has been the wild west of assisted reproduction. Americans gave birth to 54,656 IVF babies in 2006 and underwent 16,976 procedures in which the eggs of one woman were fertilized and then transferred to another’s womb. While parenting and assisted reproduction may be the farthest things from the minds of current Barnard and Columbia students, one needs look no further than the classifieds section of this very campus publication to find advertisements offering young women valuable compensation for their healthy eggs. There are 483 fertility clinics in the country and high-profile, highly paid specialists willing to offer just about anything: twins, if you prefer; or a child of your selected gender; or an embryo pre-screened for any of a dozen known genetic illnesses. Most of the doctors who perform these procedures are good, responsible physicians. They treat their patients with kindness and compassion, and have brought immense joy to the hundreds of thousands of people desperate to create a child. Most U.S. fertility specialists adhere to the guidelines set out by the American Society for Reproductive Medicine, the arm of the American Medical Association that oversees reproductive issues, but renegades persist, in this area as anywhere. There are patients who embrace extreme baby-making. And there are doctors who decide to play God.
It doesn’t have to be this way. In most of the world, the business of baby-making is regulated far more heavily than it is in the U.S.; in those countries, clinics operate under state guidelines, in addition to professional ones, and are proscribed from offering certain kinds of treatment. Surrogacy is illegal in most of Europe, for example, as is the common practice (in the U.S.) of paying for another woman’s eggs. In Denmark, the state pays for three rounds of fertility treatment for any woman needing them—but only three rounds, and only if the woman is under the age of 40. In the United Kingdom, doctors are allowed to transfer no more than two embryos to a woman younger than 40; in Sweden, the law dictates that only one embryo be transferred. Had the 33-year-old Suleman gone to a fertility center in London or Stockholm, then, she almost certainly would have been permitted to transfer only one embryo and to have given birth to only two babies (had the single embryo developed into twins).
In the U.S., by contrast, we remain stubbornly resistant to the notion of regulation, particularly in an area as intimate as procreation. We don’t want our Internet regulated, after all, or our banks. We have fought hard, as women, to “keep the government off our bodies” and to preserve the right of reproductive choice. But as reproductive technologies continue to expand, they are bringing us options that push the notion of personal choice to terrifying limits. Do we really want single, unemployed mothers of six (or anyone, really) to produce eight more babies? Do we want parents to have the option of choosing the gender of their child? How about its height, or hair color?
These are admittedly Solomonic decisions, and taking them out of the hands of parents makes us exceedingly nervous, but cases like Suleman’s should force us to look seriously at European models and consider imposing at least a modicum of regulation on the business of assisted reproduction. These regulations need not be Draconian; they need not remove the decisions of patients or the discretion of doctors. Indeed, they could very well start with the guidelines already approved by the ASRP: no more than two embryos transferred to a woman under the age of 35. But giving these guidelines the force of law is important, and further examination is strongly needed. One forum for discussion is this Saturday’s 34th annual Scholar and Feminist Conference, entitled “The Politics of Reproduction: New Technologies of Life,” where academics, artists, activists, and students will consider and discuss the global repercussions of new forms of reproduction.
These issues should concern all of us. Otherwise, people like Suleman will continue to make “priceless” decisions and we, and her children, will pay the cost.
The author is the President of Barnard College. She is the author of The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception.
