George Monbiot
The
British approach to gynaecology was encapsulated in the furious whisper I once
heard in the pub, from a man arguing bitterly with his girlfriend: "I don’t
want to talk about menstruation. Period." We might be obsessed by sex, but
our distaste for its biology would be comical, were it not so deadly.
A
reluctance to engage scientifically with women’s bodies ensured that, until the
beginning of last century, childbirth was one of the foremost causes of female
mortality. While the rest of the human body was mapped centuries ago, the
anatomy of the clitoris was accurately recorded only in the 1990s. Advances in
women’s medicine number among the great success stories of the past 100 years,
but I can’t help feeling that an underlying revulsion still informs the debate
about the ethics of reproduction.
The
Daily Mail marked the news that 56 year-old Lynne Bezant is to give birth to
twins by interviewing Liz Buttle, the 63 year-old who, also as a result of in
vitro fertilisation (IVF), gave birth to a boy in 1997. Joe Buttle is plainly a
healthy, happy child, but his mother, the article suggested, is wholly
unsuitable. "Mrs Buttle is a scruffy, careworn figure. Her body is in
reasonable shape, but the lines on her face leave you in no doubt she is in her
sixties".
The
message could scarcely be plainer. Though Liz Buttle is fitter and more active
than most women half her age, though she is clearly a strong, reliable, caring
person, she didn’t deserve to become pregnant, for she is no longer attractive
to men. While elderly fathers are admired for their prowess, elderly mothers are
an offence against nature.
Nature,
of course, is the theme to which critics of the implantation of older women keep
returning. Late pregnancies, according to the Mail’s Mary Kenny, are
"starkly contrary to what nature intended". The director of the
Adoption Forum was quoted in the Guardian as suggesting that these developments
were "straying over nature’s line".
Yet
when we do leave sex to nature, the Daily Mail and children’s rights
organisations such as the Adoption Forum are among the first to complain. If
"nature" means the conditions prevailing while human beings were still
subject to natural selection, then Liz Buttle would certainly not have given
birth at 60. She would have died years before. But there would have been ample
opportunities for 12-year olds to become pregnant. Women would have given birth
to a clutch of babies, of whom only one or two might survive. Nuclear families
would have been outcompeted by sprawling clans in which both men and women had
multiple partners. There would have been no Caesarian sections, no epidurals, no
doctors, no hospitals. At least one in every hundred women would have died while
giving birth. But this is plainly "what nature intended".
In
Monday’s Guardian, Sally Weale suggested that Mrs Bezant’s late pregnancy
offends the rights of her unborn children, for when they are 20, she will be 75.
But what about the rights of children whose parents are too immature to respond
to their needs? Is there any mother or father who would not have brought up
their children differently, with the benefit of hindsight? Surely children whose
parents have gone to enormous trouble to conceive are more likely to be loved
than the accidents of a carefree fecundity?
There’s
no doubt that IVF raises some major ethical questions. It is readily available
only to the rich. It raises expectations which are unlikely to be fulfilled: the
current success rate is only 17%. It generates a surplus of embryos, whose
disposal, as we have seen this week, is a matter of great controversy. It
increases the likelihood of multiple births. It allows doctors to screen the
embryos available for implantation, eliminating those predisposed towards
disability and, possibly, selecting those with desirable genes. Some people
believe that fertility treatment might increase the risk of ovarian cancer.
But
these problems surely apply to all IVF, and not just the implantation of older
women. There is a real danger that the publicity surrounding late pregnancies
will encourage women to forget that fertility declines steeply after the age of
35, and to wait too long before they try to have children. But this doesn’t mean
that we can’t congratulate older mothers on their good fortune.
To
suggest that late births are unethical, we have first to say whom they have
wronged. Otherwise our complaints boil down to this: No blood please, we’re
British.