Baby hunger. Sylvia Ann Hewlett on why "we should grasp, even celebrate, the reproductive miracles of our age"

Making Babies: is there a right to have children?

Mary Warnock <em>Oxford University Press, 126pp,

Grappling anew with this business of making babies is a central challenge of our times. It has, after all, become so very complicated. Assisted reproductive technology (ART) has opened up options at a dizzying speed. Just this July, a baby was born in the UK who was conceived from one of her mother's own eggs that had been frozen and then thawed. This most recent medical miracle opens up yet another round of choices for women: it allows a 30-year-old woman facing chemotherapy the option of preserving her eggs so that she can bear children once she has recovered from cancer. And it allows a 30-year-old, single, career woman the option of saving her eggs so that she can have a child much later on in life, when circumstances may be more conducive to starting a family.

But if procedures such as egg-freezing and thawing open up new choices - particularly for women - they pose extremely difficult questions for society. For example, do individuals have a right to this new baby-making technology? Do they have the right to state-funded ART?

In Making Babies, Baroness Warnock leads us through this moral and legal thicket. Few people are better qualified. A much-admired philosopher, she chaired the Committee of Inquiry into Human Fertilisation and Embryology, whose report laid the foundation for legislation in the UK. Here, she argues that individuals do not have an absolute right to have a child. The only right they have is the right not to be prevented from trying. In her view, doctors have a duty to provide assistance to infertile couples, but they can occasionally deny assistance, particularly if the welfare of the hoped-for child is compromised. Furthermore, the state does not have a duty to fund ART on demand - in Warnock's view, there are better ways of spending the healthcare pound.

But Warnock moves on to more controversial territory, arguing that there is no overriding reason to deny treatment to those seeking in vitro fertilisation for reasons of convenience. A "busy ballerina" - or any overcommitted career woman, for that matter - should be allowed to freeze eggs or embryos for later implantation. Nor, in her view, should we deny ART to homosexuals because they "do not wish to tangle with the opposite sex". Indeed, Warnock makes a case for allowing sex selection and some forms of human cloning, practices which are currently illegal in Britain.

Her bottom line is that people do not make frivolous decisions when they set about having children, and modern-day families are, in any case, remarkably resilient. So there is not much to worry about. Warnock is "not much enamoured" of arguments that hinge on the existence of a slippery slope. In her view, endorsing a subset of ART options does not mean that we are on the brink of birthing Frankensteinian monsters in the laboratory.

In the end, Making Babies is both exhilarating and frustrating. Warnock is delightfully clear-eyed - no mindless jargon or mind-numbing theory in this elegant book. And I find her take on how and why we should grasp, even celebrate, the reproductive miracles of our age enormously refreshing. Even when she writes of constraints and reining in rights, she manages to be both commonsensical and courageous.

I am, however, disappointed by her limited scope. Perhaps this is a necessary consequence of the length of this book, which is really more of a long essay. Whatever the reason, she fails to embed the moral and legal questions around ART in the larger structural story.

In the year 2002, women are indeed having an extremely difficult time making babies, but the reproductive challenge goes well beyond individual rights to ART. Consider the following facts: in a recent nationwide survey I conducted in the United States, I found that fully 42 per cent of professional women in corporate America were childless at age 40. For most of these women, it was not a preferred outcome: only 14 per cent of them had planned life without children. In the follow-up interviews, I found that these women blamed a variety of factors for their "enforced" childlessness. Prominent among them were long working weeks, rigid career structures, unsympathetic bosses and needy partners - and all this on top of loudly ticking biological clocks. Interestingly enough, age-related infertility - susceptible to ART-type solutions - was just one among many problems they talked about.

The fundamental challenge for modern industrial societies is to create the conditions that allow women to choose both work and family. There are two basic strategies. Governments could underwrite huge programmes of family support (high-quality subsidised childcare, generous paid parenting leave, reduced-hour working weeks, flexitime and telecommuting would be a starter package) so that working women can have their children in a timely fashion. And governments could underwrite the costs of ART, making it free at the point of delivery, so that many more women can rely on having children later in life, when they have more market power and a greater ability to control when, where and how much they work.

Do these strategies sound far-fetched? I think not. Just think of the social costs attached to inaction. The Anglo-American world is characterised by extremely high rates of childlessness among college-educated women (the US, the UK and Australia currently have the highest rates in the world). Why? The long working weeks and weak family support structures that characterise these countries have made career and family singularly incompatible for American, British and Australian women. This is not a social blessing: these nations would actually benefit if more professional women were able to have children, and if more well-qualified mothers were able to stay in their jobs. In other words, there are large opportunity costs on both sides of this difficult divide - for individuals and for nations.

Ignoring this larger structural story not only limits the scope of Making Babies, but causes Warnock to misinterpret the challenges in front of us. For example, her recommendation that we should not use public funds to underwrite ART for career women who want to delay childbearing sits badly with me. In her view, there is nothing wrong with these women, and the state should not fund "lifestyle" babies. However, as we have seen, we are not just talking about "busy ballerinas"; in the Anglo-American world, we are talking about between one-third and a half of all professional women, whose childbearing options have been severely curtailed by forces outside their control. They deserve a more effective right to have children, and state funding of age-related infertility needs to be part of the policy response.

Sylvia Ann Hewlett is the author of Baby Hunger: the new battle for motherhood (Atlantic Books)