niaw: the politics of baby-making

have you heard, it’s national infertility awareness week! and in honor of it, i have been doing a bunch of posts this week for all of my fertile friends and family to help inform them about infertility and the issues in our community.

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I don’t want this to turn into an abortion debate. I am not naive enough to think that this is some clear cut black-and-white issue that we can all eventually agree on. But I don’t think that I can discuss the legislation impacting our community without going there. So please, just read with an open mind. And if you need to, ignore that part. But please don’t dismiss the real risks to my ability to make a family that current “pro-life” agendas present. I also reserve the right to moderate and delete comments posted here.

I don’t think I have ever met anyone who is so staunchly opposed to abortion that they cannot think of a single situation where they could understand the need for someone to make that decision. Rape. Incest. A woman’s life is at risk. These are the three biggies that seem to be “acceptable” when we are legislating reproductive rights.

But there are many reasons that a woman may decide to terminate a pregnancy. If the fetus has a condition incompatible with life. If parents know that they will witness the short life of their child to be filled with unimaginable pain and suffering. There are diagnoses that guarantee a fetus will die in utero. Should a woman be made to carry a pregnancy, just waiting for the day that the doctor tells her there is no longer a heartbeat? And then be forced to deliver her dead baby?

We don’t like to think about situations like this. They are heartbreaking and uncomfortable. But they exist. If that’s one thing that our struggle with infertility and this community have taught me, all those cases that you think only exist in medical journals and science textbooks, they are real people. I have “met” them, read their stories, sobbed at the choices they have been forced to make. They are real people.

So where do you draw the line? When does life begin – fertilization? implantation? a heartbeat? viability? birth? How do you say what is right for another person’s body, for their life? Is that really a decision that should be made by a politician sitting in Washington, DC, or your state’s capital? Or should it be left to doctors, specialists, and patients? I know there are lines for me, for us, where I believe terminating a pregnancy would be the right choice, and where I don’t think that it would appropriate. But I don’t have the hubris to think that my line is the same as yours. And it doesn’t have to be. Because your line is none of my god damned business. I understand that there are circumstances when you may not think that terminating a pregnancy is appropriate. That’s your choice to make for your body, you pregnancy. Then don’t do it. But don’t force that decision on someone else.

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Between our two IVF cycles, my REs retrieved 32 eggs. Of those 32 eggs, only 26 were mature. These eggs were not people. They did not die.

Of those 26 mature eggs, only 20 fertilized and became embryos. Of those 20 embryos, only 15 demonstrated normal fertilization. Of those 15 “normal” embryos, — stopped dividing and growing in the lab. They were not people. They did not die.
Of those 8 remaining embryos, 3 were frozen and later determined to be of such poor quality that an attempt at a frozen embryo transfer was greatly discouraged. 3 were transferred back into my uterus, but failed to implant into the uterine wall. They were not people. They did not die.
Of those 32 eggs that we started with, of the 20 embryos, one stuck around, and we were blessed with a successful pregnancy and delivery. He is a person.
I have one child. I do not have 19 dead children. Pignut does not have 19 dead siblings. They were not people. They were embryos.

There is a difference, but personhood legislation would ignore that distinction.

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As much as I was heartbroken when we transferred those three other embryos that did not implant and result in a successful pregnancy, or saddened by the 19 embryos that stopped dividing and growing in a lab, they were not my unborn children. They were a cluster of cells. The had potential for life. But they were not people, certainly not people warranting protection via legislation. I was not complicit in neglect or murder. Neither were my doctors or embryologists.

But that’s what personhood legislation says. Especially when they are written so incredibly vaguely. Proponents of personhood amendments often say that they are not trying to criminalize assisted reproductive technologies. But it is a very grey area. The legislation never actually says this though, clearly, in writing, with no opportunity for misunderstanding. Because allowing for exceptions would undermine the goal of banning abortion in this country.

Resolve’s position statement on personhood legislation raises some very interesting, very valid questions:

– If one or more microscopic embryos from an IVF cycle do not develop normally in the lab or fail to result in live births after transfer (all natural events), could the physician, lab, and/or patient be criminally liable?
– Would non-IVF treatments such as simple inseminations be threatened because they carry a risk of miscarriage? Would clinics with high miscarriage rates after inseminations be at risk for criminal liability? Could the miscarrying women be subject to criminal charges?
Would women with fibroids or other uterine abnormalities be forbidden to try to have babies because the problems with their uteruses reduce the chances that an embryo will successfully implant after IVF or an insemination?
Would women who have ectopic (tubal) pregnancies after IVF be able to receive life-saving treatment, or would the embryo’s legal rights have to balanced against hers?
What will be the ramifications for fertilized eggs that have been created in the course of fertility treatment but have not been transferred to a woman’s uterus? Who will have legal responsibility for them?
Not all frozen embryos thaw successfully. Could embryo freezing be prohibited as too risky?
If embryo freezing is prohibited, what will happen to women who experience hyper-stimulation during an IVF cycle and for whom the medical recommendation is to freeze and not transfer the embryos right away? Will they have to transfer the embryos and risk harm to their health?
Will patients be prevented from donating their frozen embryos to research after they complete infertility treatments?

It’s a slippery, dangerous slope if you ask me.

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All that aside though, I do understand the…goal. No body wants abortions to be widespread. But creating legislation outlawing a medical procedure, granting full legal rights to a cluster of cells unable to survive on their own is not the answer.

I hope that, instead, we could have a real debate on sex education and the availability of birth control in our country. How to help women better prevent unwanted pregnancies without imposing someone else’s morality onto their actions.

I hope that I continue to have control over my reproductive choices. That when/if we decide to add to our family again, we continue to have the best medical treatments available to us. That if our family is ever in the position to make a heartbreaking decision, it will continue to be ours to make with guidance from medical professionals and not politicians.

I hope that abortion remains safe and legal, and continues to become more rare.

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