"The Baby Business" - Deborah L. Spar

"How Money, Science, And Politics Drive the Commerce of Conception"

I truly believe reproduction is going to be one of the most important political issues of the next century. You only have to look at abortion being discussed back and forth, to realize that women's reproductive rights are far from being a settled issue.

Spar's "The Baby Business" is fascinating stuff even for those, like me, who are severely impaired when it comes to economics. The author is a professor at Harvard, but the book keeps away from pie charts and complicated theories.

There are however, many facts that everyone can understand: 12 thousand dollars per round of IVF (usually amounts to 60-100 thousand dollars before the couple gives birth); 4500 dollars for an egg (on average, since it can go much higher than that); 300 for sperm; and, on average, 25 thousand dollars for an international adoption.

These numbers relate to the american market, and there are some countries who provide assisted reproduction as part of the national health program. Still, it is staggering.

The aim of Spar's book is to show clearly that reproduction is a business, and for many clinics, pharmaceutical companies and adoption agencies it is a very big business. Prospective parents don't of course, view themselves as consumers, anymore than society considers babies a product, and yet, there is no doubt that infertility, or the need for a child, created a market, and a fast growing one, at that.

And where there is demand...

Western society has been consistently looking the other way while the reproduction business regulates itself in the absence of legislation, and the result, for now, is a society where the wealthy can use every kind of technology to have babies (and when that fails, adopt one), while poor women are unable to control their own reproduction.

Spar makes a strong case regarding the economy, and resolutely keeps away from the ethics. What she wants is a political eye and hand involved in this (especially in the U.S.A.) un-regulated market.

But there is much in "The Baby Business" that will have the reader keeping his/her own moral score - it is impossible not to.

I was especially surprised at finding out that in America, black women of modest means, are often employed as surrogates for white couples. The reason? The different ethnicity of the baby, would make it harder for the surrogate to establish her rights in regard to the child in court.

International adoption is an even harder subject to tackle, but one that I suspect will come under harder political scrutiny faster than IVF or other "technological" reproduction techniques. For how can we be sure that the mothers of these babies where not put under pressure to give them up for adoption (in Guatemala (2) the subject has already been raised)? If they are indeed orphans in need of good homes why do the prospective parents pay 25 thousand dollars? Who receives this money? Can we be sure we are not creating a market that will try its hardest to survive, and even thrive?

Are we creating a society where the poor will be reproductive machines for the rich: egg and sperm donors, surrogate wombs, biological parents? Where only the wealthy will be able to benefit from genetic advances that can predict which life-threatening diseases (and even physical traits)a certain embryo possesses?

Debora Spar does not provide answers to these moral questions but does, rightly, insist that we are keeping from looking to closely at "The Baby Business" at our own peril.