Leslie Cannold: Writer, Commentator, Ethicist, Researcher
ARTICLES

When more choice means less freedom

IVF advances may make the working lives of women harder, not easier.

EVERY woman knows that children scuttle careers. It starts with pregnancy and the salary rise and promotions that never come. Then on to maternity leave, rarely paid, usually begrudged; that is, if there are no plots to restructure your job out of existence in your absence. The unreliability of nannies (yours had to be the only one who didn’t have chicken pox as a child) and the restricted hours of centre-based care make you inflexible enough to be passed over for interesting and/or career-building assignments due to a lack of ``seriousness‘’ and ``commitment’’.

But wait. Can it be that science has contrived to rid women of the insistent and inflexible demands of their biological clocks? Hang on to your ovarian tissue, girls, because now, at the IVF clinic nearest you, it’s tissue-banking time.

Just pop into your nearest IVF clinic, bank your twentysomething ovarian tissue – brim full with fresh young eggs – and get back to work confident that your fertility is just a regraft away. Now you too can work like the boys. Into the night. Weekends. Get flown overseas with just a moment’s notice. And with no interruptions for childbearing and rearing, and no children to temper your zealous devotion to the job, there’s nothing to stop you maintaining the pace for years.

What did you say? The freezing and regrafting procedure isn’t that easy? Lots of eggs are lost in the removal, freezing, thawing and grafting procedures? Nasty adhesions around the ovaries may prevent natural conception even if the re-grafted tissue works perfectly?

And what’s this about the unknown long-term health risks of the super-ovulation and hormonal stimulation – and the added time it takes to actually get a bub in the hand – should an IVF conception eventually be required? And then problems with mature-age motherhood? Not as easy to gestate the little mites when older what with the gestational diabetes and blood pressure problems that often dog older-age pregnancies. Not to mention the sheer exhaustion experienced by older mothers carting the little ones about, and getting up several times in the night to feed them.

Of course, infertility specialists are likely to overcome some, if not all, of these glitches by the time women now in their 20s are ready to re-embrace their fertility. Ways around operative and re-operative adhesions, extensions to the shelf life of grafts in older women, and even counters to the age-related pregnancy problems and exhaustion experienced by older mothers are all future possibilities.

For women, the real problems with tissue banking may be social, not medical. Problems closely associated with the pervasive assumption that such technologies always give women greater choice and freedom, with those who don’t want to participate free to opt out. In fact, while such technologies expand some women’s choices, they may severely restrict the freedoms of others.

This phenomenon is not new. Writing about his experience in an IVF program, academic Paul Lauritzen describes the mere availability of reproductive technologies as tyrannical and coercive. The existence of multiple treatment options for his retrograde ejaculation turned his infertility from a fact of life for which he was blameless to a choice to be childless for which he was responsible.

Frozen ovarian tissue grafts will expand some women’s reproductive freedom, but at the cost of contracting the freedom of other women to choose. Women who truly want to go full bore at work until they hit menopause, then have children later in life, now have that option. But women who prefer to avoid the invasiveness and uncertainty connected with this new medical procedure, not to mention physical and social stresses associated with older motherhood, may be out of luck.

Stripped of their reproductive inevitabilities, women who leave the workforce to have kids at what their bosses deem inopportune times will be seen to have chosen such timing, and consequently be held responsible for any resulting inconveniences to the company and co-workers.

Women who ``choose’’ to have children while still young may be held solely and fully responsible for any downslide in their work prospects during pregnancy and when they return from maternity leave. After all, they could have chosen to have children at the endpoint, rather than the highpoint, of their careers.

Maternity leave, too, may become a thing of the past. Women who choose to have children while still in the workforce, the argument might run, must take full responsibility for the career and financial costs associated with this choice.

So young lady, get ye to a tissue bank. Or perhaps your union, lawyer’s office or nearest women’s group. Because, if women ever had the freedom, however vague and unvoiced, to conceive children unassisted and when they were young, they may be about to lose it.

In the future, all women may need an as-yet-unwritten clause in their awards or individual employment contracts – a clause that gives them the right to have children naturally, and at the time of their choosing, despite the scientific possibility to do otherwise.

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Email: leslie@cannold.com Mobile: 0417 114 859 Fax: +61 3 9348 2015 - PO Box 1337, St Kilda South VIC 3182 Australia