TOMORROW’S children, like today’s, will not be perfect. But the conception,
pregnancy, childbirth and infertility that the women of tomorrow will experience
will not be the same as that of our mothers.

The authors identify three main types of book that deal with the new
reproductive technology – those that inform us what the new techniques are
and how wonderful they are; those that examine the ethical questions raised
by the techniques; and those by feminists. All but a noteworthy few of this
last group condemn the development of many of these techniques and call
for them to be banned.

This book, on the other hand, is by feminists who are not writing to
arouse a fear that science and medicine are using technology to take control
of reproduction from women or to create perfect children for tomorrow’s
society, even if they find much to question.

They inform us what the new technology involves, not merely to praise
its wonders, but to examine the ethical issues as these are relevant to
women. They also outline the kind of principles and policies that they think
women should promote so that this technology can be most beneficial to women
individually and socially.

The handbook section, describing infertility and its treatment, and
genetic disease and screening, assumes quite a lot of knowledge, but it
does have something to teach about presenting information on medical treatments.
It explains what can go wrong as well as what can go right, yet does not
overstress the disadvantages and risks of the techniques to put women off
them. The authors do not assume that a reader who has infertility problems,
or who is considering prenatal screening will or will not, should or should
not, choose a particular treatment.

Some of the most interesting issues aired by this book are to do with
the changing definitions of choice in reproduction and of what a family
is, that arise from new developments in treatment. The authors show clearly
how certain choices are cut off by new options. For example, there is no
longer any pressure on men to marry women who get pregnant by them outside
marriage, because safe abortion is available. So those who defend all new
techniques, saying that they always widen the scope of available choices,
are mistaken. They have picked up on the language, but not the understanding,
of the women’s reproductive rights movement, and are using it in a false
way.

Unlike conservatives in government and religion, these authors welcome
the broadened definition of families that the split between genetic and
social parenthood creates, a split which widespread divorce had already
begun to create. With such views, they address conservative fears other
than those of feminists, fears that tend to dominate much of the policy
debate in the political arena. On the other hand, the authors tend to underestimate
the importance to most people of having children who come from their own
bodies whenever possible.

They deal with the increasing use of prenatal screening and the way
in which it will make more and more pregnancies tentative ones until test
results are received. While the difference this makes for women cannot be
stressed enough, the authors are sidetracked into replying to the accusation
that science wants to create perfect babies with prenatal screening. Because
medicine is now saving the lives of babies who would have died without treatment,
it is inevitable that we want to know in advance if something is wrong with
them to decide whether to bring them into the world or not.

While ‘perfect’ babies may mistakenly become a goal of the future, we
are at a stage where we are trying to have healthy babies. Prenatal screening
is a means to that end, though not the only one. I would like to see more
discussion about this, rather than about possible future scenarios. We still
have no consensus about what ‘healthy’ means, let alone the best way to
achieve it, for ourselves or for our children.

The conclusion makes this book most worthy reading, with its principles
and recommendations for policy. Among these is the principle that an embryo
is only potentially a human being once it is implanted in a woman’s womb,
and that an embryo or fetus inside a woman’s body is part of her, and not
independent.

Enabling people to carry out their reproductive choices, for example,
should be an important aim of public policy. Twenty-three years after the
passage of the 1967 Abortion Act, National Health Service abortions are
still not available to more than 50 per cent of women who have abortions,
while NHS provision for family planning and maternity care are being slashed
from all sides. This is a shameful record indeed, which is being reflected
again in uneven access to infertility treatment. It makes this recommendation
by the authors highly relevant.

They urge that all women should have access to reproductive technologies
on the same terms. I would amend this to say that all women should have
access to reproductive health services on the same terms, since technology
is only part of health care. In fact, I would like to see the word ‘technology’
disappear from the discussion of these issues. It is a dehumanising and
limiting word to apply to reproductive health care. It is clear that even
the words we use to describe this treatment as a whole – whether we call
it assisted reproduction, artificial reproduction or new reproductive technology
– depends entirely on how we view it.

Individuals, not couples, to be the focus of infertility treatment –
an important distinction, rarely debated intelligently. By treating couples,
we bring in moral judgments and raise questions about who ‘deserves’ infertility
treatment. Why should malfunctioning ovaries be seen as different from a
malfunctioning heart? Unless we agree that someone should control everyone’s
childbearing, which I would fight to the death to oppose, moral judgments
have no place in infertility treatment. We could do with much less rigidity
and fear of social change in the policy and ethical discussions we have
about these issues. The authors try to achieve this, and much of their thinking
deserves a wide audience.

Marge Berer is a writer and edits the newsletter of the Women’s Global
Network for Reproductive Rights.

A PAINTING by Hilaire Degas, ‘Semiramis Con structing Babylon’, showing
the Assyrian queen directing the hundreds of workers building Babylon, appears
on the cover of Patricia Hynes’s book. Queen Semiramis’s achievements –
the invention of canals, causeways and bridges over rivers, the building
of a tunnel under a river, the hanging gardens – were recorded in her time
but barely get a mention in the history of technology. Whatever women have
contributed to science and technology, there has been little recognition
for it. Marie Curie is the only woman scientist I remember learning about
in school and, as author/editor Patricia Hynes points out, she was presented
above all as the wife of Pierre. Hence the title of this book, and the need
for women to reconstruct Babylon.

However, this book is not a celebration of the forgotten and ignored
achievements of women in science and technology. Nor, except for the very
last essay, is it an expose of difficulties put in the way of women scientists,
doctors or engineers when they attempt to participate in science and technology.

This last essay is the history of how Maud S’bongile Matthews, a black
nurse in South Africa, came near to destroying her own health to open a
surgical unit at Madadeni Hospital, train the nursing staff to work in an
operating theatre, and run the entire nursing unit without assistance. The
taxing conditions in which she worked are typical of South Africa’s black
hospitals – under-resourced, understaffed and stretched to breaking point.
The inability of the black director to value her work led to her being dismissed
for criticising white surgeons, who had abandoned a patient with cardiac
arrest during an operation to get some tea. As a result, she decided to
fulfil a dream of her mother’s, to open and run a primary health clinic
in Kwa-Zulu, where she grew up and where there were no local health facilities.
This she did using little more than her own salary, and with no support
from the government.

Most of this book, however, is about what its different authors see
as the relegation of women to the role of victim and object of science and
technology. In the first of two essays, the book’s editor, Patricia Hynes,
shows women and children to be the main victims of lead contamination as
a result of the continued use of lead in household paint, in petrol and
in a range of industries – in spite of what is known about lead as an environmental
toxin.

In her other essay, Hynes slams agribusiness for applying the methods
of industry to agriculture – using animals, plants and soil as raw materials,
turning them into products, exhausting the soil but not replenishing it.
She raises important questions about the risks of biotechnology, which sells
itself on its ability to create new species of plants and animals, while
one natural species after another disappears. She criticises the assumption
that because this technology is possible, it has to be good for us, that
in spite of its risks, its experiments have to take place. The use of genetically
engineered hormones in cows and of herbicides and pesticides among plants
and animals will, she warns, have unlooked-for consequences that may be
out of the control of scientists when they happen. She refers consistently
to Rachel Carson’s The Silent Spring, not as a poetic paean to nature which
scientists might want to read after dinner to relax – but as a guide to
what is both dangerous and appropriate in dealing with nature and agriculture,
and as one of the most important statements in this field ever to be written.

The rest of the book consists of essays on women as object and victim
of reproductive technology, from contraception to in-vitro fertilisation
and surrogate motherhood. Nellie Kanno writes about the failure of Western-inspired
family planning programmes in Lesotho and Nepal to explore social and cultural
factors which prevent women in these places from using contraception.

Several essays each by Janice Raymond and Gena Corea dominate this book.
Both attack and condemn the exploitation of women’s altruism involved in
asking them for the donation of their eggs, wombs and bodies so that other
women can get pregnant. Written during a campaign initiated by these authors
in the US for surrogacy to be banned, they document some appalling abuses
of individual women’s rights and dignity with regard to surrogacy arrangements.
Some of us believe it is possible for there to be donation of eggs and surrogate
pregnancy in which a woman’s rights and dignity are protected, but these
authors reject such a possibility completely.

This book suffers from too much diversity. While better editing could
have removed some of the repetition between essays, there are too many subjects
and they do not make for a coherent book. As a reader, I wanted more on
the effects of agribusiness, which I know little about. As a reviewer, I
would have liked to react more to the surrogacy essays, but that would not
have done the whole book credit. Finally, I find the harping about ‘woman
as victim’ tiresome and unacceptably negative on the part of some of these
authors, and wish they could find some good to acknowledge, especially with
regard to issues of reproductive technology.

Marge Berer is a freelance writer on reproductive health and rights.

FEMINISTS have long campaigned for women’s rights to decide whether
and when to have children. Researchers in reproductive medicine and science
are engaged in studying human reproduction and in finding ways and means
that could make this possible. Yet as childbirth and abortion become safer,
contraception and infertility treatment more effective, as the knowledge
of how our bodies work deepens and reproductive medicine grows more sophisticated,
more voices are raised against it, not least those of some feminists.

Professionals in the field who take no account of the women’s health
movement won’t even know about Patricia Spallone’s book: nor about many
others by other feminists. Writing in the same vein as other members of
the Feminist International Network of Resistance to Reproductive and Genetic
Engineering (FINRRAGE), to which she belongs, Spallone’s book condemns research
on in vitro fertilisation (IVF) and also the genetic and embryo research
linked with it as anti-women. Like the majority of writing from FINRRAGE,
it paints an extremely one-sided picture.

Spallone rejects the claim that research on IVF and embryos is to help
those with fertility problems to have babies. In fact, she says, women’s
bodies are being used merely as raw material in a search for knowledge about
human reproduction that has reduced women to hormones, cycles, eggs, tubes
and uteruses and fails to see us as whole human beings.

She asserts that the dominant goal of current research in human reproduction
is to take over pregnancy from women for eugenic purposes, through total
medical management with an increasing variety of invasive interventions,
or through dealing with embryos and fetuses as if they were separate entities
from women. Spallone has read extensively the scientific and medical literature
in this field and she has found more than enough quotes to substantiate
her accusations, even if too many of them come from Robert Edwards.

There is no doubt that some scientists and doctors do not take much
account of women as persons, do not appreciate the consequences and effects
of medical interventions on women’s lives, do mistakenly believe embryos
and fetuses are separate entities, and are convinced that eugenic improvement
of the human race is possible through genetic manipulation. Such views should
be exposed for what they are – not least within the scientific and medical
community.

Neither scientists nor doctors, however, are all cut from the same ideological
cloth. There are many feminists, and progressive and humanitarian professionals
working in this field, whose considerable contribution and influence should
be acknowledged and who are made invisible by Spallone.

There is no doubt that research and technology in human reproduction
is fundamentally altering women’s experience of pregnancy, birth control
and infertility. Not all of it is beneficial to women, or not yet. In the
wrong hands the research and technology can be and is used to control our
pregnancies and to discriminate against us. This is as true of abortion
and contraception as it is of infertility treatment but this does not make
this research and technology less necessary or useful to women.

Feminists like myself, who have fundamental differences with the overwhelmingly
negative analysis by FINRRAGE, believe that women can, and do, benefit from
this research, and welcome medical intervention when it leads to improvements
in our own health and that of our children, and when it helps us to have
the children we want and prevent unwanted pregnancies as safely as possible.

At the same time, the feminist way of dealing with such issues means
that it is crucial to explore with women how the overall experience of childbearing
and birth control is being changed, and not accept every new technique or
intervention as inherently progressive or beneficial. Further, all feminists
share the firm belief that women reserve the right not to make use of the
technology, whether it be IVF, amniocentesis, a Caesarean section, ultrasound
or the pill.

Although I think 91av readers would generally reject both the
thesis and many of the interpretations in this and other books by FINRRAGE
members, they need to be read. First, they are having an influential effect
on feminist thinking, which in turn affects the thinking of others. Second,
while Spallone makes it clear that the FINRRAGE and religious opposition
to reproductive technology come from totally different perspectives, they
share some aims, for example, a stop to current research on embryos, which
is important to know in the political arena. Third, they remind us that
there is a ‘right-wing’ in science and medicine, about which we must never
be complaisant.