There’s more to parenting than egg production

Speaking both politically and personally, I am a big fan of family planning. Women’s ability to use modern contraception to prevent ourselves from becoming pregnant when we don’t want to be, and to access abortion services when we do become pregnant when we don’t want to be, has given us a range of public opportunities and personal freedoms. It is good to choose how many children we want, and when we want them – children are wanted, rather than acquired; and parenthood is sought after, rather than foisted upon us.

But listening to the debates that go on within policy and medical circles, I sometimes wonder whether ‘family planning’ has changed its meaning entirely. Family planning is supposed to be something that women, and their partners, do in order to shape their childbearing choices around their lives. The way the concept is promoted today often implies that the planning should be done for us, or despite us, according to an abstract set of rules; and that we adults should be shaping our childbearing choices around the babies we do not yet have.

A recent conference organised by Parenting Culture Studies (1) discussed the phenomenon of ‘extending pregnancy backwards’ – in other words, promoting the behaviours and anxieties associated with pregnancy to all women, on the grounds that they may become pregnant someday. Rebecca Kukla, author of the excellent book Mass Hysteria: Medicine, Culture and Mothers’ Bodies, described the growing trend towards ‘preconception care’. This policy idea promotes the notion that the way to ensure the birth of healthy babies is to ensure that all women of childbearing years are treated by doctors, not as individual women, but as potential mothers. This makes them subject to all manner of lifestyle modification advice and lends itself to a situation where women are given medical treatment determined on the basis of what might have the least adverse outcome for a potential foetus, rather than what will work best for the woman herself, right now.

The practical consequences of treating all women as mothers-in-waiting for the healthcare they are given are pretty disturbing. But the broader cultural effect of such ‘preconception planning’ are, if anything, even more disturbing. The notion of women as incubators was supposed to have gone out with the Ark – yet now the new language of health is used to promote the idea that women really matter most in terms of the mothers they may become. Or as Kukla put it: ‘Women’s healthcare is increasingly co-opted by reproductive management – whether or not a child is involved.’

The optimal health of the putative child is brought in to justify controlling more and more aspects of women’s behaviour, and to encourage them to see themselves, not as individuals with needs and ambitions of their own, but as ready receptacles for the someday child. In this sense, notions of ‘family planning’ become a life sentence of health conformity, not chosen by women to make themselves freer, but imposed upon them by officials to keep their behaviour in line and their attitudes suitably compliant.

Hot on the heels of the Parenting Culture Studies conference, I attended an event at University College London (UCL) examining the debate about older mothers and fertility treatment (2). One of the key debating points was the idea, promoted by such medical authorities as the Royal College of Obstetricians and Gynaecologists (RCOG), that the trend for an increasing number of women to have children beyond the age of 35 represents a problem both for their ability to conceive, their own health and that of their babies, and that women should somehow be made aware of the dangers of leaving procreation too late (3).

Scientific and medical evidence presented at the ‘Motherhood in the 21st Century’ conference at UCL confirmed the fact that women’s fertility does indeed start to fall beyond the age of 35, and this has led to a situation where women are both more likely to seek fertility treatments such as IVF and those treatments are less likely to work. Some critical points were well made by speakers, including fertility guru Lord Robert Winston, who argued that it should not be the business of the medical profession to determine when women should have their children, and Professor Anna Smajdor of the University of East Anglia, who drew out the problematic ethical consequences of fixating on an optimal window of time in which women should be encouraged to become pregnant.

But while the sympathy and flexibility of IVF clinicians for women who want to become ‘older mothers’ was reassuring, the extent to which this debate always focuses on ‘the woman’ is intriguing. It is almost as if women decide to start a family completely on their own, and make such decisions by balancing the rise of their careers against the fall in their egg production. The recognition that starting a family – with or without fertility treatment – generally involves a man, and that women’s reproductive choices might also be shaped by the desire to have a relationship with a man with whom she wants a baby – and the time it might take her to form such a relationship – is remarkably little discussed.

When it comes to contraception and abortion, it is absolutely right that reproductive decision-making is presented as the woman’s choice. It is the woman who has to carry an unintended pregnancy and care for a child whose arrival might have a negative impact on her life. Even here, though, many women make such decisions in discussion with, and with the support of, their partners, who consider the impact of an unplanned child on their lives as a couple.

When it comes to choosing actively to have a child there are obviously some women who go it alone – but most people start families as a result of a decision made with their partner about their future lives together. They don’t count down from the age of 35 in order to diarise their first, second, third pregnancies, and set about finding a man to fit in with this timescale. They start by the search for another adult with whom they want to share their lives, according to much less scientific criteria such as love, companionship, and shared personal goals. Which is how it should be, surely. And if this search takes a bit too long for the biology, it can only be a good thing that new assisted reproductive technologies provide the possibility of assistance.

From the assumptions behind ‘preconception care’ to the handwringing over ‘older mothers’, there is a disturbing prejudice that parenthood is an abstract decision, made by individual women in accordance with what medical advice and the current parenting orthodoxy suggests is the optimal pregnant-person-to-be. This ignores the messy, human aspects of real life and relationships, and reduces women to the status of farmyard hens whose mission in life is the production of decent eggs. You could be tempted to tell these bossy officials to cluck off.

Jennie Bristow edits the website Parents With Attitude, and is co-author of Licensed to Hug (Civitas, 2008). Her new book, Standing Up To Supernanny, is published by Societas. (Buy this book from Amazon(UK).) Jennie will be speaking on these issues at the London Battle of Ideas festival in London, 31 October – 1 November 2009. You can email Jennie {encode=”jennie@bristow.com” title=”here”}.

Read on:

A guide to subversive parenting

(1) See Parenting Culture Studies.

(2) See ‘Motherhood in the 21st Century’ conference

(3) Concerns over older mother trend, BBC News, 12 June 2009