Tuesday, October 29, 2013
in lieu of creative writing, which my brain is Not Up To right now, I'm clearing out my files; discarding things that are no longer any good, or never were.
and there are a few things that just never found a home. I am chucking most, but I kind of liked this one. it's seven years old now. it has gaps in it that I meant to fill in, but they're minor. engage ctrl+V:
and there are a few things that just never found a home. I am chucking most, but I kind of liked this one. it's seven years old now. it has gaps in it that I meant to fill in, but they're minor. engage ctrl+V:
note: points requiring checks or footnotes are marked by an asterisk and ended by a question mark, ie, *check this?
A story about babies, prostitution, and Kerry Packer’s helicopter pilot’s kidney.
Some people have all the luck.
Me, I’m infertile. These days that’s not always as bad as it used to be: we went to IVF and had a healthy baby boy. Thank you very much, medical people.
And then I got cancer – a year after the birth, to the day, a diagnosis of early but serious breast cancer. More, but different, medical people rode in on their white horses and helped me out with that one.
Now I’m three years in remission and facing my third Big Medical Issue in five years: what to do about the embryos. There are eight of them, stored in a cold *temp? dark vat in a hospital a few kilometres from my home.
The Issue is: should I be able to pay to have them turned into babies? And it’s not
really a question of medicine. It’s a question of what money should be able to buy.
IVF and cancer. I mention these things not to shock or gain sympathy – I well understand how unreal they are to the non-afflicted, and how merely commonplace they are to the rest of us – but to stake my claim to some authority when it comes to discussing the contested site also known as the female body.
Let’s see what being female has brought me: I’ve had ttc (trying to conceive) sex, I’ve had painful spurts of dye forced (unsuccessfully) through my Fallopian tubes, I’ve had countless ultrasounds (internal and external), shots of hormones that brought back my raging adolescence; I’ve had long needles poked through my uterine wall into my ovaries; I’ve had a mastectomy, failed reconstructions, radiation burns, menopause before the age of 40, worn a wig over a bald head, and I still have scarred and stained veins in my left arm from the chemotherapy.
I’ve also had the brief and transcending experience of feeling life quicken inside me; known the maternal power of breastfeeding and of knowing that, until he was five months old, my son was completely composed of my material self, every cell in his body drawn from, or fed by, mine.
I’ve had plenty of time, too, to think about motherhood: what it is and what it’s worth, with short, dread-filled glances at the “motherless child” – any child, anywhere, but most of all mine, whom I love no more than any mother does, but with perhaps a greater consciousness of my double good luck: first in having him at all, and second in being here to love him.
When I think about surrogacy, about one woman carrying a baby in her womb on behalf of others, I do so not as an ethicist or medical expert, but as the most keenly interested kind of amateur: the potential “intended parent” (known as an IP). But I’m also an IP who knows a little too much.
Three years into remission, nearly four years post-diagnosis, as my son approaches his fifth birthday, I’m still getting the question, from people who know I had cancer and people who don’t even know my name: Are you going to have another child?
My usual response is to say “it’s not always that easy,” then to hope they drop the topic. Because my particular history has thrown up questions that make IVF look like a walk in the park.
As the mother of a small child, going off my medication to carry a pregnancy myself is not an option. My oncologist tells me that every year I stay on the drugs decreases the risk of a recurrence, and I need every percentage point I can get. And there’s a niggling concern that pregnancy might itself be a trigger – no one can tell me for sure.
But I very much want a second child, for myself and for my family.
Friends say “you just need someone to have the baby for you,” and they’re always surprised and a little angry to hear that it’s effectively illegal in Victoria, where I live
Many couples who need a surrogate go overseas or interstate to undertake an IVF cycle in a more surrogacy-friendly jurisdiction. But I can’t do IVF now – the drugs again – so those eight embryos are it for us, and they have been hostages to the political process for three years.
Moving the embryos interstate or overseas to achieve a surrogate pregnancy is technically not allowed under the current laws – if a procedure is not permitted in Victoria, hopeful parents can't transport embryos to somewhere it is permitted, at least not with intent. We could of course move to Canberra or Sydney, take our embryos with us in an incidental fashion, and then begin the surrogacy process there – if we didn't have jobs, studies, friends, family and a home in Victoria, and if our son wasn't happily settled in his kindergarten.
Yet to find a surrogate under the existing Victorian law is more than difficult, it's a conundrum worthy of Catch-22's Joseph Heller. The law requires that not only the surrogate, but their partner, if they have one, be infertile. It's a hard enough thing to ask of any woman - to carry a child for you and then hand it over - let alone a woman who is infertile herself. The Victorian Law Reform Commission has called this inconsistent *footnote? and said the requirement should be removed if surrogacy is to be allowed at all. The Victorian Government has promised new laws: we’re still waiting.
The policy wheels are turning towards change, but slowly – they’ve been creaking away since before I was diagnosed in 2004. Still if I could find an infertile woman, whose husband was also infertile, who was willing to carry my child for me, it would be possible. If I lived in Queensland, it would be impossible, anywhere, anytime if I wanted to stay there – Queensland’s laws forbid Queenslanders to go through the surrogacy process in or out of the state. (This is currently under review). *recheck? If I was in Tasmania, it would be illegal for a medical professional to help me try to achieve a surrogate pregnancy. *recheck.
Counsellors have suggested I try to go interstate anyway; but for all my desire for another child, I am daunted by the massive administrative and emotional task of finding the right person, then fighting the battle to take the embryos to them, let alone the upheaval it would cause my family. And I fear what losing the battle would do to me.
It’s too much, a voice tells me: you’ve had enough medical and emotional grief. And it gets more complicated; even if we could get around the infertility rule, say by moving wholesale to Canberra, or waiting for the Victorian laws to change, we certainly couldn’t use any surrogate anywhere in Australia unless she was an “altruistic” surrogate – policy-speak for unpaid.
We live in a mobile world. Medical tourism is already with us, from the benign if ridiculous plane trip to be worked on by the best plastic surgeon in New York, Sydney or LA, to the dubious partial-bodysnatching of travelling to a third-world country for a kidney that may have been bought for a few hundred dollars, taken from a corpse without permission or perhaps – who can tell in these cases – a corpse that has been created for the purpose.
I don’t know about those things. I don’t need a kidney to live. And no, I don’t need another baby to live. But if the “journey” (a word I despise) of IVF and cancer has taught me anything, it’s that comparing or rating pains does no one any good. I don’t know if I could, or should, buy a body part to save my life – the *furore earlier this year over a Sydney surgeon suggesting it should at least be considered suggests that I’d be frowned on if I did. But I do know what it’s like to have a doctor, one I trust completely, suggest that if I can’t move the embryos, I could go to America and use an egg donor. In America, this means buying eggs, and paying the surrogate *tens of thousands of dollars.?
I hadn’t thought of that, I said, and the idea of having a second baby within a year, not in four years or, more probably, never, flashed on my mind.
People do it. *rechecks on these two A gay Victorian couple who took a filmmaker along to document their “journey” did it (and have gone back for a second child.) A federal minister and his wife went from Victoria to NSW to do it. People do it all the time: people with money, that is.
In Australia, our excellent public health system (no, it’s not perfect, but bear with me) has insulated us from this fact: not all infertile couples are equal.
In the US, houses are sold, literal fortunes are spent, to pay for IVF treatment. Here, Medicare makes it widely available: it still costs, particularly for private treatment, but it costs more on the level of giving up holidays and a second car than going homeless to get a kid. Most – not all – of us can afford it if we need it.
(And here I must give a nod and apology to the singles and the gays who don’t qualify for government help or even access to assisted reproductive technology in many states. Their fight is an even more bewildering mix of financial, legal and moral-judgement issues that I don’t have the space or understanding to go into here.)
So until I found myself in need of a surrogate, I was on a level with most infertile women. Considering surrogacy, though, brings money back into the equation. Pregnancies are expensive. You need doctors, extra food, time off work. Pregnancies are hard work, and the intending parents who go to the US to use surrogates usually pay well for the surrogate’s time and physical labor. Pregnancies are risky. Pregnant women die.
And here are the horns of my dilemma: money and risk. Well-meaning law reformers seek, rightly, to protect women. From the 2007 report on Assisted Reproductive Technology and Adoption by the Victorian Law Reform Commission: “any reimbursement of expenses should only apply to an actual loss incurred.” * footnote? This would at least be an improvement on the current Victorian law, which could send me to jail for two years for giving money to a surrogate. The LRC has recommended a two-month cap on lost earnings payments, plus “reasonable” medical and legal expenses.
We could extend the mortgage right now, go to American and pay a healthy young woman to have a baby for us. People do it.
And the risks would be the same. A “volunteer” in Australia could be permanently injured – become diabetic, suffer injuries during the birth – yet I wouldn’t be allowed to pay for so much as a cleaner for her house while she was pregnant.
Because of the risks to a surrogate’s own fertility, (and the vexed question of her changing her mind and keeping the baby) it’s considered advisable in Australia for the surrogate to have completed her own family – so to use a surrogate, I’d be risking not just her life, but that of her children’s mother. And I already think about motherless children, far, far, too much.
I’ve been saying “use” a surrogate. That is deliberate, because when I look at this, I don’t want to shrink from the fact that ultimately, this is the use of another person’s reproductive capacity for my benefit. The key word in the Victorian LRC report about this is “exploit”. We may use another, but not exploit them.
The assumption contained in the Victorian proposals and in the laws that already allow surrogacy elsewhere around the country is that if a surrogate’s paid, then she is doing it for the money. And we don’t do that here – remember the debate about paid organ donation.
From my point of view, as a potential user of a surrogate, not to be allowed to pay for what I know is at least a highly inconveniencing, uncomfortable and painful bit of volunteerism feels even more like exploitation than having them do it for free.
Two months off work isn’t enough. If another woman was willing to “volunteer” to do such a thing for me, I’d want to help her leave work at whatever stage she needed to, go back to work whenever she was good and ready, have cleaners, laundry services, babysitters and thrice-weekly food deliveries laid on. At the very least.
I’ll confess: I’ve gone online and looked. I’ve trawled the information services that list profiles of potential surrogates in the US. The women who advertise on them are not unemployed teenagers looking to make a buck without regard to consequences. They are grown women. They’ve thought about it. They usually, not always, have children, and often say things like: “I love being pregnant” or “having babies is easy for me.” They say they enjoy their own kids so much they want to help others to the same joy; they say they want to give back to the world. And a part of me says: if they want to do it, and potential parents want to give them money to do it, why not? The exchange of cash for labour (dual meaning intended) is not so different to the payment we make to have people do dirty, poisonous, soul-destroying jobs in Australia.
Payment for surrogacy would mean women would be exploited. What else is new? Preventing exploitation of women has also long been used as an argument for denying women freedom of choice.
There are other sites, less wholesome, in India and the Ukraine, and I wonder if it’s better *
The more I think about it, the more my head spins. I try to write it out, like a high-school logic exercise, a twisted syllogism:
You shouldn’t be able to buy this.
You shouldn’t have to do it for free.
This thing should be possible.
It’s easy to find myself contradicting myself. And all the time, as I think, I have to keep a weather eye on the right-to-lifers, the anti-abortionists, the anti-IVFers, the anti-reproductive-technologists, and the leaders of half a dozen churches. As soon as the question is raised, they are there, like a lawyer you’ve asked about a difficult decision, and like a lawyer, their answer is simple and safe: don’t. If in doubt, don’t. They’d say that if I’d never been allowed to create those stored embryos, I wouldn’t have a choice to make now, and so on. Dig deeper in that argument and we get to the lump of God at its centre: let God decide. If it’s not meant to happen, it’s not meant to happen, say some. Some infertile couples even agree (and some have heard this line so many times that when they hear it, they change the topic to the weather).
I don’t buy it. Reproduction is a special area, I’ll grant you. Like dying, the creation of a human life seems to me to have an intrinsic importance that requires us to wear white gloves when we touch it – but we fight nature and God in too many matters already to say: leave reproduction alone, full stop.
I wasn’t mean to have babies, but I did, and he’s beautiful and loved. I was built to die of cancer before the age of 40. I didn’t. Was that wrong of me?
So if it’s possible to get some help with that next baby, I wonder, should I? And if money can make it easier, why shouldn’t I pay?
Perhaps I’ve thought about this too much. My particular circumstances make it more difficult than for most to take up the options that technology and a global medical economy offer. And until now, technology has been my friend: IVF equals baby? Sure! Surgery, chemo, radiotherapy, drugs equal life? What a great deal!
But this is different. This isn’t as easy, in practical terms, and it isn’t just about me and my choices.
I think about Kerry Packer’s helicopter pilot, who donated a kidney to his boss. There was something very Australian about the whole thing: the way Packer could not jump the queue for a donor kidney, and could not or would not go overseas to buy one; the way it was, in the end, a mate’s generosity that gave him a few more good years of life.
When I think about surrogacy, I’m constructing a scenario with an unknown woman at its centre. She might be someone I haven’t met yet. She might be a friend or acquaintance yet to make the offer. Because I know one thing: this, in its altruistic or paid form, isn’t something you ask a woman to do. She must first volunteer. The act of asking would be a form of pressure I couldn’t apply. What I don’t understand is why money isn’t allowed to change hands.
The taboo seems to me to have parallels with what our society forbids – soliciting for the purposes of prostitution, a worse crime on the books than prostitution itself. Why is asking someone to sell their body, or at least the use of it (putting organ sales aside), worse than offering to sell?
Because, the logic seems to run, people are vulnerable to money. Money will induce them to do what they wouldn’t do for free.
Money is what we have chosen as our currency, our means of exchange. In most cases it’s accepted that giving money is a fair way to compensate for wrongs. If my negligence or malice injures another person, the court (as well as jailing me) may order me to pay my victim money. Taken in that order – injury then payment – the exchange of money for the physical person has been normalised. And any shearer, builder’s laborer or overnight-shift taxi driver will yell you that risk and physical wear and tear are the price of money in their jobs.
But we don’t allow payment in order to use the body for particular purposes, and most of all, purposes to do with sexuality or privileging one person’s body over another’s.
My body is no good for the purposes of childbearing. I am not, as the law stands, allowed to pay someone else to use their body as a gestational surrogate for mine. I can pay nannies to look after my child 24/7, but I can’t pay someone to help me have a child.
Along with the prohibition on soliciting, the laws are protective in intent. They position the potentially used person as vulnerable to the lure of cash, in effect suggesting that if the money wasn’t offered, he or she wouldn’t be doing what they do.
And skeptical as I am of paternalistic laws, I can see a point there. I’ve been young and desperate for money, and as a mother I can see how having a hungry child could induce me to take on a surrogacy for payment.
I can also see how simply asking anyone, whether friend or relative, to do this, could put unfair pressure on them. I wonder how many kidney “donations” in Australia have been for reasons other than pure generosity. The guilt associated with being healthy while your sibling is ill, possibly dying, must be immense.
So I don’t want to ask anyone. I don’t want to put anyone in the position of saying “no”. I’ve let one or two friends know of my situation in terms that would allow them to make the offer, and I’ve agreed wholeheartedly when they’ve said “I couldn’t do it” for whatever reason, or for no reason at all.
But I look at those who do it – who travel overseas or make private arrangements here in Australia (self-insemination for traditional surrogacy, where the surrogate provides the egg and the uterus, goes on a lot more often than you’d think) – and I can’t say they’re wrong.
I mistrust myself. I know that the desire for that second child makes me unqualified to judge the issues at the very same time as it makes me alert to each and every question. I read an article about women being trafficked for prostitution and catch myself thinking: paid surrogacy is nothing like as bad as that. I wonder, am I trying to justify my desires by comparing them to worse evils?
But people do it. They travel to America and do it. My choice, and that of most people needing to use a surrogate, isn’t really constrained by the laws in Australia, just by the amount of money we’re prepared to spend. I’d much rather give that money to a woman who offered her help freely, and in the end I think I should be allowed to.
How, then, to safeguard against “prostitution”, against women doing it for the money and only the money? You can’t. The only way would be to ban surrogacy altogether, in every form (and I can hear the anti-s cheering): because if it’s done at all there will be family pressure, social pressure, debts of friendship called in, money offered under the table. And if it’s banned, intending parents will go overseas, to America, India and parts of Europe where they can buy the eggs, the sperm and the womb as well if they need to. I could do it tomorrow.
It’s a complex mix of respect for the law, desire to have my biological child, fear of failure and just plain administrative-medical burnout that keeps me from doing it.
The laws in Victoria may change, eventually. I may still not find a surrogate, or may not be willing to “commission” one without being allowed to pay her; I may, in the end, not be willing to ask her to take the medical risks. I may wait until I’m 44 and out of treatment and risk it myself, or not at all.
But I’d like to be trusted to make the decision.
About 15 years ago, as a weekend-shift reporter for a Sunday paper, I went to cover a protest outside a Melbourne abortion clinic. Margaret Tighe of Right to Life was there, backed by a row of bussed-in protesters waving placards and shouting slogans at the couples scurrying inside. I wrote a brief article, and a few days later one of those couples called me.
I went to see them in their pretty inner-city cottage near a creek, and we talked in the kitchen while their toddler daughter played in her room.
They told me their story: difficulty conceiving, then a diagnosis of abnormalities in the foetus; decisions made not only for themselves, but for their daughter, who would one day be responsible for her brother’s care.
The husband of the couple was in tears as he spoke of “our little boy”. The wife, full of sadness too, had one thing she wanted to be sure I included in the article; her anger that the protesters had shouted in her face: “Think about what you’re doing”.
“I’ve done nothing but think about it,” she said. She wanted them to know that she was between a rock and a hard place, and the while the choice was hers, they should not imagine she did what she did lightly.
And that’s why, though I may not, in the end, pay another woman to take one of my frozen embryos and bring it into the light a squalling, breathing, precious baby, I wish I was allowed to. Laws which make special cases of sexual and reproductive work claim to protect those involved, but I can’t help suspecting that at heart they are just another case of telling us (mostly but not always women) what we may and may not do with our sexuality and reproductive power.
What about the children? How would you feel, to know your life had been bought? That one I can’t answer, except as someone whose life has been extended by technology and money, and who has an IVF baby: life is a good thing, and more so is life in a rich Western nation like Australia when you’re a desperately wanted and loved child. It sure beats not being alive. Enjoy it.
Money to have babies: it makes me uncomfortable too. I can see the abuses, the wrongs that could flow. But not being able to offer money to someone who would give me such a gift: that makes me even more uncomfortable.
That, from my hazy knowledge of Christian theology, is why God gave us free will: so we could make the right choices. That’s why we’re called grownups (men and women both, these days)…and here, as I hear my son wake from his nap and shuffle down the hallway, calling for his mother, is where I have to end.
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