I have previously mentioned an excellent and engaging blog called Chez Miscarriage. It's written by a woman - known as getupgrrl - who sublimates her anguish and anger into funny, gut-wrenching accounts of her experiences with physicians and other people.
Recent discussions on her blog have highlighted the fact that couples - or perhaps especially women - who struggle with infertility have insult added to their injury by people - and maybe especially demonstrably fertile women - who give them advice that completely ignores the underlying difficulties the infertile ones experience. For example, getupgrrl tells us, much of what drives her is the passionate need to be pregnant, to feel life growing in her belly, and to give birth.
I can only imagine that many people - and perhaps especially guys - are trying to make rational sense out of this. And failing pretty badly at it.
"Why don't you just adopt?" is one argument I believe Bill Maher came up with, rather less originally than he may have thought. And indeed, when I heard the story of a couple who got donor eggs, donor sperm, and found a surrogate mother to carry the child; only to divorce before the child was born and get into a five-way legal battle over "custody," I also had to wonder whether things had gone too far.
I fancy myself a bit of an economist, and as such I'm interesting in the notion of "utility." For many - though apparently not all - women, the importance of conceiving and/or carrying a baby is of vital importance to their lives. (I have heard several stories of women whose IVF cycles were interrupted by cancer, and were much more concerned about disrupting the reproductive therapy than making the cancer therapy successful.) The utility of fertility is of such value that they willingly accept huge sacrifices in their finance, careers, health, and even marriage.
But while there may not be limits to the sacrifices some are willing to make, their are limits to what reproductive endocrinology can accomplish, even with technologies that are truly dizzying. What is a rational basis for cutting your losses and going to plan B? Or Plan C? Is there a rational basis?
Getupgrrl makes the point that infertile women and couples are all different. For some, the genetic material doesn't matter much; it's the pregnancy that counts. For others, carrying forward one or the other partner's genetic material is paramount. When lesbian couples have children together, one party has to forgo both the pregnancy and the genetic material (although it's technically possible for a woman to have her partner's fertilized ovum implanted). Some couples go quickly to adoption, fulfilling their every desire by accepting a baby that desperately needs them.
Some will say that having children is a selfish and conceited act. What makes us think that our genetic material is good enough to be passed on for future generations, and what makes us so confident that this is a world worthy of the best we can create?
But as far as selfish and conceited acts go, it has to be among the most noble. As a parent, I know firsthand that children don't make my life easier or simpler; it isn't a source of endless amusement; and it certainly gets in the way of your sex life. (I'm writing this waiting for goat milk to cool off so that I can start a yogurt culture for my son, who is on a very special diet. My wife went to bed already).
The rational, economic case to make would be that couples who start experiencing infertility quickly take stock of their preferences: what would be the next best alternative to what they originally had in mind? At what point would they start exploring such alternatives? How would they know when to exhaust those? What would be the last available option? Being childless? Adopting? Divorcing? Without a doubt, there would be a huge range of answers to these questions, but it may be worth considering.
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