by Bryan Caplan
Another diplomatic way to reward fertility is to set up trusts for your grandchildren—and make your children the trustees. The parents will eventually use the trust to pay for expenses like college that otherwise would have come out of their own pockets. You’re effectively giving more to the children who gave more to you. Yet officially, you’re treating your children equally.
Can natalist incentives work too well? No matter how impatient you are for grandchildren, you probably don’t want your kids to drop out of high school or college to have a baby—and you almost certainly wouldn’t want to encourage it. In practice, fortunately, you needn’t worry. The Quebec experiment found little or no effect of baby bonuses on young and unmarried women; it was older and married women who had the extra kids. Young, single women tend to get pregnant by mistake, so modest prizes aren’t enough to change their minds. Older, married women, in contrast, are already interested in kids, so a little money is often all it takes to sway them. If you’re still nervous about bad incentives, make it clear that you only reward parents for responsible pregnancies. If you think it unfair to penalize a grandchild for his parents’ mistakes, take the money you would have given his parents under ideal circumstances and hold it in trust on your grandchild’s behalf.
One last thought: Retirees are often much wealthier than they see themselves. If you own your home outright, you’re semi-rich—and if you think you can’t spend a house, you’re mistaken. Almost any bank will let you cash out some of its value with a home equity loan. Some sell reverse mortgages—you sign your home over to the bank in exchange for a monthly check and free rent. Look before you leap into unfamiliar financial strategies, but keep an open mind. What’s better—the abstract knowledge that you’ve paid off your mortgage or the concrete fact that you have a new grandchild to spoil?
SELFISH SAINTS
Man has almost constant occasion for the help of his brethren, and it is in vain for him to expect it from their benevolence only. He will be more likely to prevail if he can interest their self-love in his favour, and show them that it is for their own advantage to do for him what he requires of them . . . It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest.
—Adam Smith, The Wealth of Nations
We usually picture selfish people as pushy, inconsiderate, loud, mean, and miserly. Want-to-be grandparents who follow my selfish guidelines are none of above. They’re practically saints. How can I begin by condoning selfishness and end by recommending respect, tact, and generosity?
My answer: Pushy, inconsiderate, loud, mean, and miserly people are bad at being selfish. While they’re acting on selfish impulses, they fail to carefully weigh how other people will respond to their behavior. They’re like restaurants with bad food and bad service. Once word gets around, no one wants anything to do with them.
Grandparents’ main problem, though, isn’t that they’re bad at being selfish, but bad at being nice. When grandparents tell their children how to raise their kids, they’re trying to help. Where do they go wrong? By acting on their unselfish impulses, instead of carefully weighing how other people will respond. As a result, they provoke ill will despite their helpful intentions. And for what? The long-run effect of grandparenting has to be even weaker than the long-run effect of parenting.
In the end, Selfish Guidelines for Want-to-Be Grandparents look a lot like Unselfish Guidelines for Want-to-Be Grandparents. The crucial factor is foresight, not intentions. Without foresight, you’ll either be a selfish jerk or an unselfish annoyance. Either way, you’ll antagonize your kids and kids-in-law. With foresight, you will show respect, tact, and generosity even if, deep down, it’s all about you. Playing the in-law from heaven paves the way for your grandchildren to enter the world. When you see the face of your next grandchild, you’ll be glad you did the right thing.
8
LIFE-GIVING SCIENCE: WHAT IT MEANS FOR YOU
My son is now sixteen years old . . . The boy is beyond smart. I’m quite sure he’s way beyond genius. It was never my intention to “cultivate” this particular aspect of his existence—I was happy simply to have my own and only child, however he or she would turn out.
Nor does it particularly matter to me now that he’s in line for valedictorian, has a vast knowledge of computers, technology, international finance, geopolitics, and other subjects he’s grown interested in entirely on his own . . .
Did I do anything wrong or immoral? I don’t think so.
—Anonymous mother of a “Nobel sperm bank” baby
THE CLASSIC SOLUTION TO INFERTILITY IS TO FIND SOMEONE ELSE to be fertile with. Since antiquity, inability to sire or bear a child has been a major cause of divorce, adultery, and polygamy. In the Bible, Abraham’s “barren” wife, Sarah, urges him to marry Hagar to continue his family line. Henry VIII changed the religion of England because his wife couldn’t give him a son and the pope wouldn’t give him an annulment.
Despite its pedigree, the classic solution to infertility leaves much to be desired. For the fertile, it is a bad solution. You have to sacrifice your partner to become a parent. For the infertile, it is no solution at all. The breakup leaves you not just childless, but alone. Luckily, there is now a better way. New life-giving technology allows many of us to beat infertility. Millions have children—and millions are alive today—because scientists figured out how to improve on Mother Nature.
When Apple first announced the iPhone, the world was thrilled. My colleague Russ Roberts named it “the most beautiful toy yet” and enthused, “Apple hits a home run. No, a grand slam. Actually, a fiverun homer, the kind you’re not supposed to try to hit.” Two months after the iPhone’s release, however, users were out for blood. Apple’s crime: cutting the price by $200. This is how we normally greet progress—an exciting honeymoon, followed by constant ingratitude.
For reproductive progress, strangely, our reactions reverse: We skip the honeymoon but gradually learn to love it. New advances initially horrify both public and pundits. The public shakes its head; pundits split hairs to prove that the latest technology is an unprecedented affront to human dignity. Governments often answer their repugnance with regulation and bans. Yet before long, entrepreneurs dig a bunch of loopholes, and a new market blossoms. A decade or two later, public and pundits forget they ever objected—yet consumers of the once “repugnant” services feel grateful every time their miracle children blow out the candles on another birthday cake.
Critics often belittle the users of new reproductive technology as narcissistic or selfish. But why is a person who turns to science any more selfish than someone who gets pregnant the old-fashioned way? Still, the critics accidentally make a useful point: Selfishly speaking, reproductive technology makes it easier to get the children we want. Kids who would have been too costly to have in 1950 are often a good deal today. Technological progress is another selfish reason to have more kids.
When I hail these benefits for parents, critics often accuse me of moral blindness. How can I neglect the welfare of the children created by artificial means? But I’m not “neglecting” children’s welfare. I just find it painfully obvious that being alive is good for them. While we can imagine lives so awful that they aren’t worth living, being a miracle baby is hardly hell on earth.
Yes, the child of assisted reproductive technology probably carries a little extra emotional baggage. When single women conceive via artificial insemination, their children often wonder why they don’t have a dad. When children born from donor eggs grow up, some yearn to find their biological mothers. Still, these drawbacks are dwarfed by the gift of life. Who would seriously say, “I was raised by a single mom; I wish I was never born,” or “Unless I find my real dad, my life won’t be worth living”?
In Jurassic Park, Jeff Goldblum’s character protests the resurrection of the dinosaurs. The project is arrogant and reckless: “Your scientists were so preoccupied with whether or not they could, they didn’
t stop to think if they should.” When we hear about new reproductive technology, most of us share his unease. I say that instead of assuming the worst, we should take Goldblum’s advice literally. Let’s find out what science can do for parents, then “stop to think” how we should respond.
USING TECHNOLOGY TO GET MORE KIDS
In the United States, one cycle of in vitro fertilization costs about $12,000—and that’s when the mother uses her own egg and carries her own baby. It sounds expensive, yet it’s infinitely cheaper than it used to be. In 1970, in vitro was beyond the reach of billionaires, for the technology did not exist. The surprising lesson is that innovation reduces the true price of babies by turning what money can’t buy into what money can buy.
The smart response is to check whether the price has fallen far enough to make another kid a good deal for you. For some technologies—like fertility drugs—weighing costs and benefits is simple: Do they improve your chances of conception enough to outweigh the effort and expense? The pros and cons of other technologies, however, are more complex, so let’s take a quick tour of what’s available now—and what’s next. If the help you seek is outside your price range, don’t despair. The world gets better all the time. Most of the products we take for granted—meat, cars, air-conditioning, computers, cell phones, you name it—were once luxuries. In ten years, you too might enjoy the reproductive choices that the rich already take for granted.
ARTIFICIAL INSEMINATION (AI)
Doctors have used AI to overcome male fertility problems for over a century. In 1987, the Office of Technology Assessment estimated that thanks to AI, 65,000 babies—35,000 from their mother’s husband’s sperm, the rest from donor sperm—were born in the United States during the previous twelve months. The government hasn’t collected numbers since, but there are two big reasons to think that so-called baster babies are more common than ever. First, medical norms against selling AI to unmarried women and lesbians are all but dead. Second, the out-of-pocket cost dropped from about $1,000 in 1987 to $400 today. Counting inflation, that’s almost 80 percent less.
The obvious selfish benefit of AI: It helps men overcome biological obstacles to fatherhood. If their sperm is viable but has trouble reaching the egg, AI makes conception much more likely. The subtler selfish benefit: It helps women overcome social obstacles to motherhood. Women married to infertile men don’t have to resort to divorce or adultery. Unmarried women don’t have to find a suitable father. Lesbians don’t have to find a man at all. If any of these conditions were deal breakers for you, AI is a compelling reason to sign your name on the dotted line.
IN VITRO FERTILIZATION (IVF)
Louise Brown, the world’s first test-tube baby, was born in 1978. Since then, this revolutionary solution to male and female infertility has exploded. Specialists know how to create an embryo in a petri dish, freeze it for years, implant it in any functioning uterus, and get a healthy baby. According to the latest report from the Centers for Disease Control, the number of babies born in the United States using IVF and similar techniques rose from about 21,000 in 1996 to almost 55,000 in 2006. During this decade, success rates per cycle steadily rose from 22 percent to 30 percent. For about twice the regular price, some clinics give money-back guarantees—if you don’t get a baby, you don’t pay. Partly thanks to regulations and lawsuits, the price in the First World remains high, but low-cost IVF clinics are springing up in poorer countries. Doctors in Africa—where 10–30 percent of women are infertile—already offer “no-frills” IVF for about $300 a cycle.
Biologically, IVF is much more versatile than AI. It treats both male and female infertility and works for men with low-quality sperm. IVF also allows you to have kids on your own terms. You can reproduce with the person you love—or go solo using donor sperm. If you’re a woman who wants to delay childbearing, you can do the first stages of IVF, freeze the embryos, and implant them years later when you feel ready. With an egg donor, the process allows post-menopausal pregnancy. IVF does not eliminate the trade-offs that parents face, but it does make their trade-offs more flexible.
Another perceived benefit, at least for some women, is the high rate of twins. If you implant more than one embryo, you stand a good chance of completing your family with a single pregnancy. The downside is that multiples are less healthy due to prematurity and low birth weight. “Octomom” Nadya Suleman’s heaviest baby weighed three pounds, one ounce. Her last octuplet to come home spent almost three months in the hospital. And statistically speaking, the Sulemans were lucky. Multiples have much higher infant mortality rates than singletons: Five times higher for twins, ten times higher for triplets, eighteen times higher for quads.
As a father of twins, I feel like I dodged a bullet. Yet the numbers aren’t as bad as they sound. A twin born today is about as safe as the average baby born in 1950. A quadruplet born today is over 50 percent safer than the average baby born in 1900. When Alfred Khoury, a doctor at a high-risk maternity ward, warns, “If Nature thought it was appropriate for homo sapiens to have litters, Nature would not have selected against it,” he lacks historical perspective. Nature now selects against quads less brutally than it used to select against every child born.
In any case, IVF is moving away from octomoms. Parents are responding to higher success rates by implanting fewer embryos. Between 1996 and 2006, the fraction of successful cycles that ended in triplets or more fell from 7 percent to 2 percent. In a decade or two, we will probably remember “litters” of underweight babies only as a symptom of how primitive IVF once was.
SURROGACY
Surrogacy contracts have radically changed during the last two decades. The original idea was for a fertile man and his infertile partner to hire another woman to impregnate using AI. After the baby’s birth, the surrogate would give her biological child to his biological father and partner to raise.
Modern contracts usually cut surrogates out of the genetic loop. Ninety-five percent of surrogates now get pregnant using IVF. Customers prefer a division of labor: The egg donor and the baby carrier are typically two different women. Most women who hire a surrogate prefer to donate the egg themselves, so kids born to surrogates today are often the biological children of both of the parents who rear them.
If you’re lucky, a relative, friend, or random benefactor will agree to carry your baby for free. If you’re not so lucky—or don’t want to impose—you’ll need a commercial surrogate. They’re pretty expensive. In the United States, the all-inclusive cost of a surrogate pregnancy—IVF, the surrogate’s fee, medical expenses, miscellaneous—is about $75,000. If you already plan to use IVF, the upcharge for a surrogate is about $20,000. Sticker shock is understandable, but you don’t have to pay cash. If you were hiring a contractor, you’d probably borrow against your home. You might finance your surrogate pregnancy the same way. Surrogates aren’t for everyone. But it is in your own best interest to weigh the option with an open mind.
After warming up to the idea of surrogacy, one naturally wonders, “Is there a cheaper way?” Yes. It’s called “fertility tourism.” The booming economy of India has quickly become the market leader. Quality is high, and prices are roughly one-third the U.S. level. The all-inclusive surrogacy package that costs $75,000 in the United States runs you about $20,000 in India. As fertility tourism evolves—and more low-income countries enter the market—deals will probably keep getting better.
There are plenty of good reasons not to outsource your pregnancy to India, but don’t let guilt keep you away. By Indian standards, surrogates are very well paid. Your patronage gives them—and their children—a far better life. A profile of a typical surrogate in Delhi: Separated from her husband, she found that her monthly wages of 2,800 rupees, about $69, as a midwife were not enough to raise her 9-year-old son. With the money she earned from the first surrogacy, more than $13,600, she bought a house. She expects to pay for her son’s education with what she earns for the second, about $8,600 . . . “I will save the money for my child’s futu
re,” she said.
Third World poverty is heartbreaking, but use your head: Fertility tourists are part of the solution, not the problem.
Selfishly speaking, surrogacy is more than another fertility treatment. It’s practically magic: Women no longer have to choose between pregnancy and childlessness. And while many women treasure their pregnancies, the experience definitely gets mixed reviews. If you love kids but dread pregnancy, surrogacy is a historic opportunity to painlessly create life.
ARTIFICIAL WOMBS?
Fertility tourism has a bright future for the next couple of decades. But how many surrogates will be on the market after countries like India join the developed world? In fifty years, perhaps our daughters will tell our granddaughters, “Back in my day, we outsourced our pregnancies to India,” and the granddaughters will impatiently reply, “Mom, outsourcing just isn’t affordable anymore.”
Surrogacy is an amazing advance, but it merely redistributes pregnancy. The long-term solution for women who see pregnancy as a burden is the creation—and mass production—of artificial wombs. Science fiction? Imagine people’s skepticism in 1950 if you told them that they would see the day when one woman would give birth to another’s child.
Artificial womb research remains a tiny field, but early experiments are promising. In the late Nineties, Japanese researchers managed to keep premature goat fetuses alive for weeks in an artificial womb. Much more impressive results came a few years later, when Hung-Ching Liu, director of Cornell University’s Reproductive Endocrine Laboratory, successfully implanted human embryos in an artificial womb. Embryos grew for up to ten days; then Liu pulled the plug on the experiment to comply with federal regulations. Next, she switched to mouse embryos—and almost got one to term.