Our bodies, our ignorance

The New York Times today was a bonanza: not one but two stories relating to reproductive science and Crazy Things Americans Do. Especially when they have a) too much privilege and b) too little accurate scientific knowledge.

Exhibit A, page A1: “Born to Run? Little Ones Get Test for Sports Gene,” about a genetic test designed to “determine which sports suit the talents” of a toddler. One parent of a toddler aiming to sign up for the test thought “it’s good to match them with the right activity.” The test analyzes one gene in the 20,000-strong human genome. Supposedly, the reporter tells us on A1, “a 2003 study discovered the link between ACTN3 and those athletic abilities” for speed or endurance. But gentle readers who make it past the jump find that a scientist says the test may actually be “snake oil,” and that the genes merely “have a role in athletic performance.” A role, as in one role among many, as in a link, not the link.

Always keep an eye on the verbs in sensational stories about genetics: there’s nearly always some very flabby words flapping around in there taking up the slack where clarity and rigor ought to be. “Has a role in” and “link” tell you nothing about what causes what or exactly how it does it.

The problem goes deeper than the usual sensationalism necessary to sell newspapers. To think that any complex human trait or behavior could be controlled by a single gene is terrible science (a scientist quoted in the article said that at least 200 genes affect athletic performance) is to have a totally wrongheaded understanding of genetics. Nor do genes alone determine athletic performance or height or weight or … Never mind the broader environment, like, oh, say, how much encouragement to play baseball a child is given; current genetic science suggests that the precise choreography of hormones and growth that happens in the womb is crucial to the expression of any trait.

Which brings me to Exhibit B, cover of the New York Times Magazine: “Her Body, My Baby,” reads the title, next to an astonishing photo of two women. One, very pregnant, is dressed in slightly rumpled khakis and functional shirt that could have come from Wal-Mart or Sears. The other is slim, taut, hair perfectly upswept, black spike heels tall, jewelry exquisitely understated, and black dress little and perfect.

The small smile on the slim author in the little black dress looks smug. How could it look anything but? Iew, iew, iew. I don’t think I can take anymore of these posts from the New York Times’ bubble of privileged women.

Anyway, it turns out that nowadays most surrogacies involve the surrogate woman carrying a baby that is genetically unrelated to her, created through IVF using the sperm and egg of what the article calls “the intended parents.” (Let’s call it like it is: the paying parents.)

This is a strategy to get around the legal implications of the Baby M case and ensure that the surrogate mother’s legal claim to the baby is as weak as possible. Somebody, however, should call a genetic biologist to the stand to talk about the role of the womb in creating a mammal’s essential nature. (For more on this, see for example my review of The Century of the Gene.) The woman whose womb created the baby may not be the “genetic parent” of the child, but she most certainly is biologically related to it.

If I can make it through this article without gagging so hard I rip the magazine, I’ll have more to say…

The amazing, indispensable female body

Happy Mother's Day!

I've just discovered another couple of cool sites relevant to this blog: The Women’s Bioethics Project blog and the Center for Genetics and Society. For all those of you either thinking of keep the wolf at the door at bay by donating eggs or those who might use donated eggs, the CGS tracks the ethics and science of egg donation, among other topics. Bottom line: egg donation is painful and dangerous, much more so than the companies that harvest eggs let on. Apparently the latest industry effort to expand its business is trying to convince women to harvest their eggs and freeze them for procreation later, when they’ve established their careers. Don’t go for it, this site suggests. Stick with the old-fashioned form of impregnation.

Doing away with the need for women’s bodies is a long fantasy of science fiction and indeed of science. But the Women’s Bioethics Project explains, along with lots of other topics, the difficulty of creating an artificial womb. Although we’re often treated to news stories that assume we are the products of genes alone—that we are our genes—more and more scientific research is demonstrating the indispensability of the whole maternal body for creating a baby. Quoting another blogger, the site reports that we’re many decades off from a successful “human uterine replicator” (and that might be optimistic). “Even once we've sorted out the technical aspects of the womb itself, we'll have to deal with what the rest of the mother's body contributes to development.” (Which, by the way, has important implications for surrogacy. Even though, post–Baby M, most surrogates carry babies that are not genetically related to them, the importance of the gestating body to development suggests that the surrogate has to be regarded as biologically related to the baby she carried, and therefore she has some parental rights.)

Déjà vu all over again. We’re always hearing that the female body is defective and could be readily improved upon by science. Except whenever it's put to the test, technology falls short of the old-fashioned female body. Remember how formula was supposed be as good and maybe even superior to breast milk? Then scientists began discovering myriad ways that mother’s milk is better than any artificial milk. Same thing, apparently, with gestation. Doesn’t look like us moms will be obsolete any time soon. (In case you were worried.) Happy Mother’s Day—you’re amazing!

A modest proposal on surrogate motherhood

I’m starting to feel alienated from my peeps over at Mothertalkers. In a recent post, Elisa, one of the editors, responding to a recent Newsweek cover story, put in a plug for surrogate motherhood.

“Despite some people denouncing it as exploitive, it made me think the opposite: I would consider becoming a surrogate for my closest family or friends. Also, if I needed the additional income, I could think of many worse ways to make money than give this wonderful gift to another couple.”

A number of readers chimed in to say they’d do it too.

Let’s just look at the economics first. Did anyone notice how little surrogate mothers get paid? According to the Newsweek article, about $20,000—for working 9 months, 24 hours a day, 7 days a week. That’s way less than minimum wage. Considering the major wear and tear on your body a pregnancy and delivery entail—never mind emotional toll and other sentimental nonsense—that is a raw deal. I have a modest proposal: Let’s open up the market in women’s bodies for surrogacy. But women should be paid a fair rate for their 9-months-long, 24-7 labor. Seems to me star athletes’ pay makes a pretty fair guideline, as both are highly physical endeavors that require utter commitment of mind and body, quickly take a lot out of you, and leave you unable to practice the trade for more than a few years. So let’s set a floor of, oh, say, $1 million per pregnancy.

How crass, many will protest. Most of those who commented at Mothertalkers and said they’d be surrogates seemed to be saying they’d do it for something other than the money. Fine. That’s a different matter. Let people make heroic gifts (and I too just might consider being a surrogate for a sister or intimate friend). But then crass contract law should have no part in the matter. A gift is something freely given, and one can change one’s mind about making a gift at any moment. So no court should then turn around and treat such a surrogacy arrangement as binding. Anything different is rank dishonesty, using the traditional glorification of self-sacrifice in women to reinforce the power imbalance created by economic inequality—all in order to enforce contracts for the buying and selling of women’s bodies.

There are lots of creepy oddities of the practice exposed in the Newsweek article. For one, a huge number of surrogates are military wives, and while the article suggests this belies the stereotype of surrogates as ignorant and impoverished, I don't see it that way. The modest $20,000 pay of a surrogate is more than the entire yearly base pay of many of the wives' military husbands; don't tell me these people aren't poor and vulnerable. Another reason military wives make up such a large chunk of surrogates suggests that vulnerability and lack of earning power play a big role:

"Military wives can't sink their teeth into a career because they have to move around so much," says Melissa Brisman of New Jersey, a lawyer who specializes in reproductive and family issues, and heads the largest surrogacy firm on the East Coast. "But they still want to contribute, do something positive. And being a carrier only takes a year—that gives them enough time between postings."

And finally, there's health care. Military wives have generous government-provided health coverage. While they're supposed to tell the insurance companies about their surrogacy arrangements, so their payments can be deducted from coverage, there's no penalty for not telling and no incentive for telling. Efforts to cut off coverage for medical procedures related to surrogacy failed last year, and there are no data on how much the public is paying for this coverage. However much it is, we—you, me, and the rest of America's taxpayers—are subsidizing surrogacy for a well-off few. Next time someone extols surrogacy as a case of free enterprise that shouldn't be repressed, tell them it sounds about as free-market as the Bear Stearns bailout.

I think I might be for a free market if I ever saw one.