More than a million babies have been born around the world through in vitro fertilisation. Nearly four per cent of all births in Denmark are IVF babies, more than one per cent in the United States. More than half a million embryos live frozen in American IVF clinics.
Welcome to the baby business.
Twenty-seven years ago, the only way infertile parents could create a family was through adoption. But in 1978 when British researchers Patrick Steptoe and Robert Edwards discovered the right mix of care and chemicals to nurture human embryos in a Petri dish, a new industry was born — baby manufacture. In the US alone, it is worth at least US$3 billion a year.
For customers, it hardly seems a business. Whatever it cost them, what they are cuddling is a bundle of joy, the stuff of dreams, their “miracle baby”. This is the image that the industry seeks to promote. The websites of IVF clinics feature glowing mothers being treated by beaming white-coated doctors. They have public relations to die for.
A new book may help to paint a more down-to-earth picture of this highly profitable and under-researched industry. The Baby Business: how money, science and politics drive the commerce of conception gives an account of its development and business dynamics. Its author, Debora L. Spar is a professor at Harvard Business School and a mother of three children herself.
The genesis of this industry actually dates back to the introduction of the contraceptive pill, which broke the link between sex and reproduction. Steptoe and Edwards simply provided a technology which built on a new way of looking at children. Who could have foreseen all the spin-offs from the basic product line? Now we have babies for single women, babies for lesbian and gay couples, babies selected for their sex, babies designed to be free of disease, babies conceived from the sperm of fathers who died years ago, babies with three mothers, babies born to grandmothers. Anyone who wants a child badly enough can have one — if they are prepared to pay for it.
And many people are prepared to pay to the point of exhaustion or bankruptcy. As a business, what makes the fertility industry unique is the combination of supply-side virtuousness and demand-side desperation. The doctors and scientists who run the clinics can do no wrong. The women who want the babies will pay them whatever they charge. “Talk about a big business,” says one industry insider. “It’s carrots hanging out there, because it’s so hard to say when enough is enough.”
What Spar brings to this confluence of dollars and dolours is a steely analytical mind which cuts through the hype and sentimentality:
… the market for babies – the market for children, really – is still a market. How do we know? It’s because there is a deep and persistent demand for reproduction, a demand that often goes far beyond what nature alone can provide. There is supply in this market, too, a wide and steadily increasing supply of ways to produce when procreation fails. There are prices that clearly link supply and demand, and there are businesses that sell their wares in this market, often charging hefty sums along the way.
What she sees, and misty-eyed journalists miss, is the existence of markets. Human reproduction requires raw materials (eggs and sperm) and work (pregnancies). Despite the hype about altruistic “gifts of love”, these are seldom available for free. So markets spring up. In the US, blue-eyed, blonde-haired Ivy League girls can sell their eggs for as much as $50,000. The total price for renting the womb of an American surrogate mother in 2004 ranged between $30,000 and $120,000, with eggs sold separately. There are sperm banks which ship their wares all over the world. (The biggest is Denmark’s Cryos International Sperm Bank.)
There is plenty of room for growth in the market if prices could drop. Only 15 per cent of infertile American women have tried fertility drugs and only 1 per cent have tried IVF. As well, the possibility of genetically engineering healthier, smarter, prettier, faster children could broaden the pool of potential clients to include all fertile couples:
… changing demographics and social mores, combined with exploding technological prospects, suggest that increasing numbers of people will want to exert control over conception. They will want to control when they conceive, how they conceive, and even, increasingly, the characteristics of the children they raise as their own.
However repellant the prospect of commercialising all reproduction may seem to many people, Spar sees nothing inherently wrong in it. The market exists, she says, and repressing it will only send it underground. Already couples who are unable to access certain fertility treatments in the US are going abroad, creating an international fertility tourism industry. Banning a trade in babies will simply lead to exploited and victimised parents and children. This means, she contends, that a regulated market is needed to define property rights and set up basic market rules so that suppliers and customers can have order and safety. Prices will drop; the size of the market will increase; the baby business will make more money; and consumers will be happy.
It’s no use being coy about the baby market or cloaking it in fairy-tale prose. We are making babies now, for better or worse, in a very high-tech way. We are procuring these babies from a wide array of sources, and we are pushing deeper into the components of their birth. We can moralise about these developments if we desire, ruing the gods who pushed nature aside. We can decry the fate of our manipulated offspring, closing our eyes and trying to make them fade back in time. Or we can plunge into the market that desire has created, imagining how we can shape our children and secure our children without destroying ourselves.
But while Spar has done a great service in unmasking the mean commercialism of IVF, her solution involves turning human beings into products. Basically her argument is a libertarian one: that the law should permit people to do whatever they like, so long as they do not harm anyone else. The same mantra is chanted for legalising prostitution, pornography, euthanasia and the sale of hard drugs. If it is banned, it goes underground and becomes unsafe; if it is legalised, it is transparent, safe and controlled.
In addition to the deep philosophical flaws in this approach, libertarian reproduction raises a number of practical questions. It makes far-reaching assumptions about the nature of children: that they are property, that their genetic heritage is unimportant, and that they have no inherent right to a natural mother and father. It privileges the desire of an adult for a child above a child’s need for a family. It ignores evidence which shows that the best environment in which to raise a child is a natural family.
And, like most libertarians, Spar neglects the downstream effects of individual freedoms upon society. Statutory regulation will give entrepreneurs legal and economic security they need to corporatise procreation. Just as brothels are now listed on stock exchanges in some countries, it will become possible to set up a market for babies, whose broad outline will be indistinguishable from the market for African slaves.
It is important to bear in mind that the revolution in reproduction has only just begun. The next great leap forward will be the manufacture of sperm and eggs in the laboratory when the technique for therapeutic cloning is mastered. Overnight, sperm and egg donors will disappear because gametes can be made to order. The very concept of mother and father will fade into that of a mere genetic progenitor. It will also be possible to meddle with children’s genetic make-up. Social commentator Francis Fukuyama has warned that this could give rise to a world populated by two sub-species: the GenRich and the GenPoor. So more important than tidying up market irregularities is foreseeing future consequences of a new paradigm of reproduction.
Libertarians like Spur typically contest the notion of a natural order and a fixed human nature. But historical experience suggests that tinkering with human reproduction is a risky business. A notorious example is the increasingly skewed sex ratios in India and China after decades of aborting (or murdering) girls. No one knows what will happen when scores of millions of young men are unable to find wives. But it is sure to result in major social dislocation.
A novel documentary
There is no need to go as far afield as India or China to see how reproductive technology creates a new way of looking at human beings. Try Los Angeles, an Infertilistan where one sperm bank is the sixth largest user of FedEx. This crazy world where the deepest of human longings is processed and sold for hard cash is described in a stunning recent documentary, Frozen Angels, directed by the Berlin-based team of Frauke Sandig and Erik Black.
The film features several colourful characters, each more disturbing than the last. There is Bill Handel, the loud-mouthed host of LA’s highest rated morning radio program, who also has been running the world’s biggest surrogacy business for more than 20 years. There is a serviceman’s wife, a mother of two, who earns $15,000 as a surrogate mother for a nerdy couple in their late 40s. There is a young blonde, a single mother of two, who is asked to donate her eggs to a lesbian couple in their mid-40s. There are Shelley Smith’s egg-donor “angels” being photographed for her website. When a “trophy donor” appears, she says, clients go into a feeding frenzy. There is the head of an IVF clinic who describes the masturbatorium in which young men make their donations.
And saddest of all, there is Doron Blake, who was conceived with the help of a sperm bank of Nobel Prize winners. Doron is a nice young man with a wistful look, a wispy goatee, long hair and earrings who sort of hangs around and goes for walks on the beach. He has an IQ of 180 and lives at home with mom. She breeds dogs, too. So much for genetic engineering.
Frozen Angels is an excellent response to the heavy-handed libertarian ideology in The Baby Business. In the words of Frauke Sandig:
… we see a minimally informed public, little critical media coverage and only a small window of time remaining for informed democratic discussion before it is slammed shut by the ever increasing weight and interest of the biotech industry who would like to have us believe the transition was inevitable.
Michael Cook is Editor of MercatorNet