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ART in America | The Nation

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ART in America

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In the Old Testament, Abraham's wife, Sarah, foremother of a people, was initially unable to conceive a child. Despite harmonious marital relations, she bled every month and her belly failed to swell. Longing for a son, she did what any resourceful wife of her day would have done: she dispatched her husband to her maidservant, Hagar. The plan worked, but Hagar, having succeeded where Sarah had failed, lost respect for her barren mistress. Sarah, in turn, began to treat her harshly, making her fetch extra water and denying her seconds of stew. It was an unpleasant situation for everyone--with the possible exception of Abraham.

About the Author

Rebecca Tuhus-Dubrow
Rebecca Tuhus-Dubrow is a columnist for Next City, an urban affairs website.

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Hagar bore a son, Ishmael, on Sarah's behalf. Fourteen years later, though, God stepped in. He blessed Sarah--by then wizened and post-postmenopausal--with a child by blood, Isaac. "Who would have said to Abraham that Sarah would suckle children!" marveled the triumphal nonagenarian. "Yet I have borne a son in his old age." Eventually she instructed Abraham to cast Hagar and Ishmael out into the desert.

Had Sarah lived in the twenty-first century, she would have had a menu of options to consider before resorting to concubine recruitment. She could have tried fertility drugs, a few rounds of in vitro fertilization (IVF) or a trick called intracytoplasmic sperm injection to escort Abraham's seed to its destination. If all that failed, she could have had eggs extracted from Hagar or taken her pick among strangers with higher SAT scores. There likely would have been no need to wait until her 90s to bear a child--although if she were to give birth at that age, she would have had no shortage of company in the never-ending tabloid contest for World's Oldest Mother.

Couples throughout history have sought to control reproduction, with varying degrees of success. To avert pregnancy, there were always crude contraceptive techniques--withdrawal, proto-condoms--or cold baths. But if your problem was a fertility deficit, there wasn't much you could do besides adopt, enlist a third party or pray. For the most part family planning was the domain of God or nature until, in the twentieth century, technology and feminism joined forces to make childbearing preventable for many women. While lagging in effectiveness, remedies for infertility evolved too. By the late 1930s, hormonal treatments and tubal surgeries had become available, and the 1970s brought the spectacular breakthrough of IVF.

Today, infertility groups consider this array of treatments an extension of "reproductive choice," while flummoxed prochoice groups fear that their terminology has been hijacked. Despite the discord--and the very real differences--the two camps are intimately linked. Both are trying to sort through our increased reliance on technology to shape our lives and solve our problems--problems often created by other technologies. Indeed, in a significant minority of cases the demand for assisted reproductive technology (ART) results more or less directly from old-school reproductive rights: happily, women can take advantage of birth control and abortion to postpone motherhood--but some find that when they're finally ready and willing to get pregnant, they're no longer able to.

Some feminists are suspicious of ART because it allows women to fulfill a traditional role rather than emancipating them from one. Others, feminist or not, squirm at the commercialism: ordering a child, for a considerable price, and in some cases shopping for gametes or leasing a uterus. The availability of these items as consumer products elicits a jumble of reactions: why must we turn to the market to meet all our needs? Isn't there something character-building about accepting limitations and life circumstances? That said, why should only the poor have to accept such limits? Oh and, um, incidentally, what's the going rate for the sperm of a Harvard alum with low blood pressure and silky hair?

Likewise, we may instinctively recoil from the unnaturalness of ART. But this response warrants further scrutiny. "Unnatural" is a smear that can be leveraged against anything from birth control to vaccines. Manipulations of nature can be liberating or oppressive: medical science can be used to prevent pregnancy, to induce it and to provide a cosmetic "mommy job" to erase the residual signs of it. And while we all have opinions about these various technological applications, our judgments are bound to be colored by self-interest. A college sophomore who swears she'll never have kids is going to look at ART very differently from a 40-year-old in her third year of pregnancy attempts. The former could someday become the latter, struck by baby lust she had never anticipated, and distaste for ART could turn to gratitude. In this area, moral disapprobation is a slippery luxury.

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