Men Women and the Family - Artificial Reproduction

In the late 1980s and early 1990s, when an estimated four thousand women became surrogate mothers by being artificially inseminated with sperm from men whose wives were infertile, many people were concerned that surrogate motherhood might threaten family stability. Who would be considered the child's mother? Also, some surrogate mothers refused to relinquish the child after delivery, resulting in long, bitter fights for custody of the child.

Rapid advances in fertility technology made such family matters even more complicated. The use of donor sperm and/or eggs could mean a child might have three or four parents—the donor or donors, the mother who carried the transplanted embryo in her uterus, and her spouse. While federal funding for human embryo research was banned during the administration of President Ronald Reagan, private fertility enterprises continued to be unregulated, and each fertility clinic operated under its own guidelines. Critics feared that fertility patients as well as donors might fall victim to unscrupulous clinics and doctors who did not have to answer to scientific and ethical review boards. To further complicate the issues, initial successes with cloning of sheep led to rumors about the cloning of humans.

Monitoring Fertility Technology

Because of the expense of in vitro fertility treatments (about $8,000 for each attempt), couples wanted to ensure a successful pregnancy. In most cases the procedure had

FIGURE 2.2

to be repeated several times. Through ultrasound imaging, doctors could keep track of the number of maturing eggs. If too many eggs had matured, the doctor typically advised against continuing the treatment. Once sperm had been introduced, in cases in which it could be determined that a higher-order multiple birth was likely to occur, many doctors considered destroying some of the embryos in order to improve viability of the remaining embryos. Generally, this was not done without the permission of the parents. Some parents considered this act an abortion and refused to permit it, a stance that often led to a much higher level of multiple births. In the National Vital Statistics Report dated February 12, 2002, the Centers for Disease Control and Prevention (CDC) reported that from 1980 to 2000 the rate of twin births rose 55% from a rate of 18.9 per 1,000 total births to 29.3. From 1980 to 1998 the rate of higher order births (triplets or greater) surged from

TABLE 2.1

Fertility indicators for women 15–44 years old by cohabitation status, June 2002
(Numbers in thousands)
				Women who had a child in the last year
Cohibitation status	Number of woman	Mean age in years	Percent children	Number with a birth	Birth per 1000 women	First birth per 1000 women	Children ever born per 1,000 women
1Includes women of any marital status who were living with an opposite sex unmarried partner at the time of the survey.
2Includes women of any marital status who were not living with an opposite sex partner at the time of the survey.
SOURCE: Barbara Downs, "Table 4. Fertility Indicators for Women 15–44 Years Old by Cohabitation Status, June 2002," in Fertility of American Women, June 2002, Current Population Reports, P20-548, U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau, October 2003, http://www.census.gov/prod/2003pubs/p20-548.pdf (accessed July 19, 2004)
Total	61,361	30.0	43.5	3,766	61.4	23.1	1,211
Married, spouse in household	27,828	34.5	18.5	2,382	85.6	29.6	1,784
Unmarried partner in household1	3,531	29.2	45.0	307	87.0	42.8	1,124
No partner in household2	30,001	26.0	66.5	1,077	35.9	14.6	689

37.0 per 1,000 total births to 193.5. In 1999 and 2000 the rate of higher order births dropped to 180.5.