How to Make a Family: The Blog

Infertiles Speak Bigger Truths Than They Realize

Melanie Notkin writes about her truth as a woman who wants to be in a loving partnership before making a baby, and about how that truth is keeping her from that baby. She calls is "circumstantial infertility," a term that once applied to me. I like it a lot, that term. 

Most importantly, Melanie is writing about how life's circumstances are requiring her to re-write her personal story.

That's pretty much all our lives are -- stories we tell ourselves. Even documentable events can be spun and twisted to match our comfort level. The Infertility Chapter for most of us is one that we'd rather skip over. But here we are. And so we share it in hopes of "getting over" it. How selfish of us, no? Blathering on and on about our misery...

Here's the upside: I think it's possible, given how public conversations can be broadly influential over time, that all this infertility talk out in the open might actually benefit far more than just those who are struggling to get pregnant.

In a follow-up piece about being invisible, Melanie refers to the incredible viral nature of that first blogpost and to the many insensitive responses she received from readers. 

She hit a nerve.

I think it's possible that our discussions about parenthood and biological drives and obstacles in the mix might promote talk within the larger society about really tough ideas, concepts that are bigger in a way than just "who 'gets to' have a baby".

My own infertility struggle brought me face-to-face with myself, or at least the person I thought I was. I've seen countless others echo that experience. Many of us believed without even thinking the thoughts out loud in our heads that parenthood was It, The Pinnacle, The Reason We Are Here (both as individuals and as a species). We still find a lot of reasons to hang on to that notion.

But maybe all this talk about struggling to do something (get pregnant/have a baby) deemed by everyone from "Society" to our own tortured psyches to be the raison d'être to such an extent that we believe if we cannot clear those hurdles, we are doomed... maybe the conversation will finally take us beyond that singular drive.

I don't mean to minimize the emotions. I believe wholeheartedly in the impact of biological drives on virtually everything we think, feel, and do. But I think I'm hearing the winds of change, or maybe I should call it a breeze at this point, in online conversations as people start to think more deeply beyond the initial "OMG I can't have a baby! What do I do now?!"

Most people are not so lucky as to have life present them with opportunities to truly delve into their motivations. Infertility -- if used well -- will make you wonder why you want kids in the first place. And not just in that off-hand, silly way that haggard parents wonder ("What was I thinking?!" the mom said as the children climbed the walls.) But in a way that, for me and some others, required dredging the depths of my soul, murky and smelly, and bringing that muck and mire up to the surface to show it some light. And of course, as those of us who've done it know, once you see that stuff more clearly, it's easier to move on, whether that means keepin' on that TTC path or choosing a different truth about yourself.
I don't think the "infertiles" of the world should keep that life-changing exercise to themselves. 

For a second, just ponder what a world would be like if everyone of us clearly understood this drive to parent -- not as a species, but as individuals. And then imagine if that same world offered no societal bias about whether or not individuals became parents, so that each person could truly make that personal choice without fear of being judged or ostracized. Now, think about the children who might be created in such a world. 

It's a tough thing to do, re-writing our stories. Some of us find ourselves in circumstances that make those revisions essential to our existence here. Bringing it up out there in "the Fertile World" is our way of offering what we've learned, not about infertility, but about living life. 

Peeling the Baby-Making Onion Ring

So far, I'm still mostly unshocked. Call me an irritating devil's advocate, but my position has always been and will remain that if regulations, even just trace amounts, are nowhere to be found and there's money to be made, money will be made. Ethics and morals be damned. The most surprising thing of all to me in the whole thing is that an attorney with such a prominent reputation would risk her career and color the rest of life for herself and her family... for what? But shocked that "such a thing" has occurred? No way. 

Here's my dire prediction in black-and-white: Virtually any horrendous activity that you can imagine might happen within the reproductive medicine arena has happened (with or without everyone's knowledge) or will eventually, at least once. Life is long, folks.

You can call me cynical. I'm used to it.
But there's a point that I think is missing in some of the telling of this most recent Repro Med Gone Awry story. 

I'm reading the LA Times' account that unfolds details of the surrogates' points of view in the baby-ring scam headed by Theresa Erickson. 

[The prospective surrogate] found a couple nearby, but two attempts to get pregnant failed. That made her even more determined as she searched surrogacy want ads.

"I was responding to anything and everything," she said. "That's how desperate I was."

First, here's my bias, for those who don't already know: I'm on the kids' side. That's not to imply that every case of baby-making can be or even should be viewed as though it's a triangular and adversarial arrangement. But my professional experience with families tells me it's likely some percentage of family-building activities entailing third-party A.R.T. involves folks whose motivations are skewed toward uber-self-centeredness under the guise of self-sacrifice. 

"Well, sure," I can hear most readers thinking, "isn't that the point of living -- to meet my own needs, go after what I desire and, well, win?"

I guess. Bottom line, sure. Survival of the fittest and all that. But if there's any place in the repro med arena where The Point really should be centered around the needs of that possible kid at the end of it all, it's third-party ART. 

There was a "type" of foster parent that used to give me goosebumps: The Collectors, we called them. They never seemed to "have enough" children in their home, and often, hackles would raise when they wanted more than their sponsoring agency would allow. The line we social workers had to tread was thin and tenuous with these foster parents, because the need for more housing for more abandoned, neglected, and abused kids was always growing, never shrinking. Weighing the choice of which kid to place in which home was always huge, and The Collectors, with their -- yes, I'll say it -- pathological level of need to nurture children added yet another burden to our decisions.
 
I'll say it again. Pathological level of need to nurture children. And that's a clinically polite way of putting it. These weren't people who were scamming the system and trying to make "a quick buck" through foster care. Most, in fact, were wealthy enough to support as many kids as they could cram into their six-bedroom mansionettes. Their incentive was deep inside their psyches. And they were a good representation of the shadowy difference between love and need, although they were unclear themselves on that nuance.

When I read that this particular surrogate felt "desperate" to carry another person's baby, the word pinged around my brain. I've heard it before, the sense of desperation that (mostly) women feel about getting pregnant. But here we're talking about a woman who has all the children she wants, not a woman who desperately wants to finally be a mother.
 
What IS that desperation? Third-party advocates will tell you it's the very drive that makes a great surrogate. They "love being pregnant." So maybe it's just this woman's word choice in the article that's sticking in my throat. But I don't think so. As I've ranted about plenty in the past, word choice is a big deal, a window into our minds, often revealing what we "really" think even if we're saying what others find soothing to hear.

So here's another bold opinion in writing: Women who feel "desperate" to be a surrogate should be more carefully screened. Not just to avoid the potential "oops she changed her mind" scenario, but because it's the ethical thing to do. Third-party reproductive professionals are putting their own humanity on the scale, in addition to their reputation, if they do anything other than help prospective baby-carriers assess their own psychological base regarding parenting, tease out motivations that may belie deeper issues impacting choices and behavior, and refer some on to appropriate sources of help.
 
Admittedly, I don't wallow in the world of baby-making. I get in there, do my job, and get out to live My Life (which is currently awesome, by the way.) So perhaps I'm too out of touch to know if prospective surrogates are screened and then referred on to help if needed. Maybe this point is, in fact, being taking into consideration and to heart by the people in the business. I hope so. But I bet not so much.

Just A Little Speechless

Today's news about a prominent reproductive medicine attorney's fall from grace is booming through the grapevine. Theresa Erickson, long and widely known as fearless and vocal in her "family formation law" practice, has admitted to committing acts that are generally felt to be heinous. Folks are calling it a "baby-selling ring" -- you can read about it all over the Internet, including here at Courthouse News Service and make your judgement about how to spin what she and a few co-conspirators have done.

On a related note, I stumbled across a video today from a recent appearance on NBC Today of the Ayala sisters. 

How is this case, in which parents of Anissa purposefully conceived a baby (Marissa) who could be a bone marrow donor for her sister, related to the "baby-selling ring"?

Well, it's a loose connection, I'll give you that. But it's also an example of how society and technology interact, inevitably bending morals and ethics. The Ayala's were despised by some when they made a baby 20 years ago to save their older daughter's life. I imagine there are still plenty of folks who find their choice just plain wrong from several angles. But for many of us nowadays, it's merely an interesting and poignant twist in family-making.

Might there be a time eventually when we slip further along the continuum away from the past-perceived horrors of contraception and IVF and surrogacy? Debora Spar, author of The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception, wrote how "Part of the impetus for [the resurrection of surrogacy] came from technology; part from commercial enterprise; and part from shifting moral norms." Spar describes how Noel Keane, the originator of the attorney-broker concept, launched the surrogacy market in the 1970's at the request of distressed, infertile clients who'd heard about artificial insemination. Keane was immediately dismissed as a baby-trading charlatan. Still, a handful of brokers followed him into the murky field.

Once IVF and donor egg technology made gestational surrogacy do-able, the hubbub about women carrying babies for other people quieted a little, or as Spar -- currently President of Barnard College -- puts it, "gestational surrogacy was a godsend" in commercial terms. She predicted in 2006 :

Over the next few decades, a wider trade in wombs is almost certain to emerge. If there is demand in one part of the world (and there is) and lower-priced supply in another (and there is), then the record of both trade in general and reproduction in particular suggests that commerce will proceed. The question is what role governments will play in the regulation of this trade, and how they will approach the potential for exploitation that clearly lurks in surrogacy.