Clean meat is one of many possible futures of food, so long as we continue to eat meat. We will always have the power to not want it anymore, or to want it much less. That is where the real power lies: in harnessing our desires, rather than in mastering technology. Until we do, we will be even further removed from where our food comes from, and will feel even less responsible for it. We will be perpetuating the kind of thinking that caused the meat mess in the first place.
PART THREE THE FUTURE OF BIRTH
Ectogenesis
CHAPTER NINE The Business of Baby-Carrying
The Pacific Fertility Centre on Los Angeles’ Wilshire Boulevard is the place where the people who have it all make their babies. The waiting room’s walls are upholstered in studded cream leather, the sofas are crushed velvet in shades of mink and ivory, bowls of white orchids rest underneath crystal chandeliers. You’d be forgiven for thinking this was the changing room of a high-end bridal shop, but the images on the flat screen on one of the walls give it away: digital photos of newborns in scratch mittens, thank you notes, posed family Christmas cards, tiny heads cradled in grateful hands. The pictures of the babies scroll upwards and disappear, like bubbles in champagne.
A tall but tiny woman is sitting on my left, dressed in navy leggings and running shoes. She can’t be older than twenty-five. Her cropped sweatshirt reveals tanned skin, an impossibly flat stomach and slim waist; her short, bleached hair, dark lashes and delicate jawline could only belong to a model. Her swan neck is bent over her iPhone, long fingers scrolling through Instagram, long fingernails occasionally tapping on something. On my right, another woman is waiting: ever so slightly older, but just as striking. She wears a straw-coloured beanie and no make up, and her hands are so tiny she needs both of them to hold up her jewel-encrusted iPhone case.
Dr Vicken Sahakian is finally ready to see me. I go down a corridor lined with photo collages in black frames. There’s a newborn in a Santa hat, tucked into a red Christmas stocking. There’s two men with tears in their eyes, each cradling a swaddled twin in his arms.
In the twenty-five years Sahakian has been a fertility specialist he has made families for thousands of the world’s most privileged people. His clients are straight, gay, young and old, and they come to him from across the globe, especially China, the UK and other parts of Europe where surrogacy is either illegal or very tightly regulated. In California surrogates are allowed to make a profit from carrying other people’s children, and the legal system here is renowned for upholding the rights of intended parents over any third parties who might be involved in creating their babies. It’s given the state a reputation as one of the most surrogacy-friendly places in the world.
As diverse as they are, Sahakian’s clients have one thing in common: they can afford him. If you are open to using other people’s eggs, sperm or uteruses and are prepared to pay, he can make anything possible.
‘Money talks. If you have money, you’re going to have a baby,’ he tells me, less than five minutes after I have sat down opposite him at his enormous black desk in his monochrome corner office. Next to his keyboard there is a coaster with the words Babies Are Such a Nice Way to Start People, a plastic uterus and fallopian tubes, and a glass cube paperweight containing a laser-engraved baby.
‘It’s sad, but that’s the case.’ He checks himself. ‘It isn’t sad, actually – it’s pretty happy. When I was in training I was almost going to forfeit this field because it was too sad. We would call nine out of ten patients and tell them, “You’re not pregnant.” Now it’s a 180-degree change, from a technology that was marginally successful when I started out to a technology that is now almost always successful. I believe in this type of science. I believe in family balancing, gender selection, selecting out abnormal embryos, using egg donors, sperm donors. This is what I do. I love what I do. The ultimate goal here is bringing happiness for someone.’
As the range of fertility options open to his clients has diversified, so have their requests. A growing number of women are coming to Sahakian for ‘social surrogacy’: they want to have babies who are genetically their own, but they don’t want to be pregnant and give birth to them. There is no medical reason for them not to carry their own babies, they would just prefer to use a surrogate. They conceive their children using IVF and then hire another woman to do the gestation and delivery part. It is the ultimate in outsourced labour.
‘I don’t have any issues with it,’ he tells me plainly, sitting back in his grey surgical scrubs embroidered with his name, his hair slicked back and greying at the temples. ‘You’re a twenty-eight-year-old model or actress, you get pregnant, you’re going to lose your job – you will. If you want to use a surrogate, I’ll help you.’ It costs $150,000 to have this sort of help, and more women than ever are prepared to pay for it. ‘Five years ago I would have seen a handful a year. Now, probably twenty a year. And if I’m seeing that, there are so many reproductive endocrinologists in the area who are very competent fertility specialists, I’m sure they are seeing the same.’
‘Do you think more women would be doing social surrogacy if they could afford it?’ I ask.
‘Absolutely. There’s an advantage of being pregnant, the bonding, I understand that, but as a man I can’t understand what it is. From experience, I can say that most women love to be pregnant. But a lot of women don’t want to be pregnant and lose a year of their careers.’
Sahakian doesn’t have a typical client. ‘I work with everybody.’ But there are Hollywood stars, household names he is too discreet to tell me: ‘You won’t hear it from me but of course you would have heard of them.’ The women who come to him for social surrogacy aren’t the big stars, he says; if you have real heft in Hollywood you have the leverage to call the shots when it comes to schedules, and you can be confident that your job will still be waiting for you if you have a career break to have a baby. The typical candidates are ascending in the entertainment industry but haven’t yet made their names.
‘They tell me point blank, “If I get pregnant, I will lose my part.” “I work, I don’t have time because of work.” “I model, I act, I look good like this and I don’t want to disfigure my body.”’
I wince. ‘Do you disfigure your body when you get pregnant?’
‘I’ve never been pregnant,’ he shoots back with a sparkling grin, and I might be imagining it, but I swear he takes a quick glance at my torso, as if to gauge whether a former pregnant person has asked the question. ‘You are definitely disfiguring your body while you’re pregnant, for that duration, and then if you don’t do the necessary exercises it’s going to take you a while to get back to normal. There’s definitely some truth about pregnancy changing your body. Your pelvic bone opens up, you accumulate fat, you accumulate discoloration that doesn’t go away. Things change. I’m not saying that’s a reason to use a surrogate, but it is for some people.’
He shifts in his big leather swivel chair and tries another approach. ‘I make the analogy of plastic surgery. If you criticize somebody who’s had a breast augmentation then you are certainly going to criticize somebody who wants to do social surrogacy. One is saying, “I don’t feel comfortable with my body, it’s psychologically an issue for me and I want to fix it.” The other is saying, “I don’t want to disfigure myself.”’
Not all of his social surrogacy clients are models and actresses; some just have demanding careers that would be very inconvenienced by pregnancy. ‘I have many clients who say, “I can’t, I have to travel, I don’t want to wait any longer, I am getting older and my career in the next two or three years is critical, I travel all the time.” It’s an honest argument.’
‘Do women generally do it for aesthetic or professional reasons?’
‘Professional, I would say. “I don’t have time because of work” is common, followed by physical appearance.’
Men get to be parents without it disrupting their lives very much, no matter how high profile or demanding their jobs. They often don’t
even need to consider the impact having a baby will have on their careers, even at the most critical times: former Lib Dem leader Charles Kennedy’s son, Donald, was born during the 2005 general election campaign. Mo Farrah’s wife, Tania Nell, gave birth to twins three weeks after he won two gold medals at the 2012 Olympics.
‘What do the partners of the women who come in for social surrogacy think?’
It’s clearly the first time Sahakian has ever considered this question. ‘You know, I never bring that up! I never ask that question.’
‘But do they come in with their partners?’
‘Yeah, yeah, of course.’
Sahakian tells me that his years of working in the fertility field have turned him into a feminist. ‘I am such a feminist, because every day I see how prejudiced this society is, how male chauvinistic it is. You women are judged. I am very proactive when it comes to women and I believe there is a double standard.’
‘Do you mean that men get to have babies and keep their careers while women often can’t?’
‘Oh, more than that. If you are a sixty-two-year-old man and you come here with a thirty-eight-year-old woman, no one asks you why you’re having a kid at sixty-two. If you come here as a fifty-five-year-old woman trying to have a kid, they’d tell you you’re old, you’re a grandma, you’re crazy. Larry King was, what, seventy-five when he had kids?’ King was actually sixty-five, but Sahakian’s got a point. He himself is fifty-six, with a wife who is twenty years younger and two children under six, who look down on us with perfect smiles from the frames on his wall.
The American Society of Reproductive Medicine has guidelines that say that gestational carriers – surrogates who carry babies conceived through IVF, with eggs that aren’t their own – should only be used when there is a medical need. But Sahakian doesn’t have concerns about going against those guidelines.
‘You can define medical reasons broadly,’ he says, casually. ‘And also I understand that it’s controversial – you wouldn’t be here otherwise. It’s borderline unethical for some people, but so what? So what. Put yourself in the shoes of a twenty-six-year-old model who is making her living by modelling swimsuits. Tell me something – is it that unethical to say, “Let’s not destroy this woman’s career”?’
‘Couldn’t she wait until she’s older to have a baby?’
‘Yes. But what if you want to have a child now, and you don’t want to be maybe forty when you have a kid? I don’t think I’m doing anything unethical by helping those couples. In this field, in Los Angeles, you can’t judge those clients. This is the Wild West. Twenty years ago helping a gay couple was taboo – it still is, in Arkansas. We are so in the infancy of all this here.’
‘You don’t have any ethical qualms at all about doing this?’
‘You’re talking to the wrong person,’ he chuckles. ‘I walk the edge, you know.’
And yes, I do know. Sahakian has a reputation for pushing boundaries that he clearly relishes; it’s given him a degree of notoriety that drives his business. In 2001, he helped Jeanine Salomone get pregnant with a donor egg and give birth at sixty-two. She is the oldest French woman on record to have a baby. A scandal erupted in France, where giving fertility treatment to post-menopausal women is illegal, after it emerged that the biological father of the baby she gave birth to was actually her own brother, Robert. He may have had limited capacity to consent to his sperm being used to conceive a child; he was living with a brain injury he sustained after shooting himself in the chin in a failed suicide attempt a few years previously. French journalists suggested that their son, Benoit-David, might have been conceived to secure an inheritance from Jeanine and Robert’s wealthy mother. The press descended on Sahakian, who said the siblings had presented themselves in his consulting room as a married couple, and Jeanine had lied about her age.
I knew all this before I arrived in Los Angeles, but Sahakian brings it up before I can. In fact, he brings it up when I ask him why clients come to him.
‘I got the oldest woman on record in France to carry a baby and have a baby at sixty-two. You can Google that story and find out the details. Basically, there was a social stigma surrounding that story.’
‘They were brother and sister.’
He nods. ‘They were brother and sister. So I was put on the map – the message from that was, “Hey, this guy can get a sixty-two-year-old woman pregnant.” So I had everybody over fifty calling me in the 2000s.’
Then, in 2006, Sahakian became responsible for the oldest woman in the world to give birth. Maria del Carmen Bousada, a retired sales assistant from Spain, had her twin boys, Christian and Pau, the week before her sixty-seventh birthday. Bousada was diagnosed with cancer less than a year later, and died in 2009, leaving her sons orphaned at only two and a half.
‘That woman from Barcelona is in the Guinness Book as the oldest woman on record to give birth, actually,’ he says with a pride that feels grotesque.
‘Do you like having a reputation for pushing boundaries?’ I ask.
‘I didn’t push the boundaries with the Spanish woman. She lied about her age, she said she was fifty-seven. She was sixty-seven. She forged documents, she forged her medical records. With the French people, they came in as husband and wife with the same last name – we had their passports. We don’t ask for a marriage certificate, we don’t ask for birth certificates. Which doctor asks for a birth certificate?’
‘That sixty-seven-year-old woman died and left her kids without a mother,’ I say. ‘What about them?’
‘That’s why I wouldn’t treat a sixty-seven-year-old woman,’ he replies, without missing a beat. ‘She was a perfectly healthy fifty-seven-year-old. She died from cancer so she didn’t have a pre-existing condition. You can get cancer at twenty-eight.’ He’s now cut his upper age limit down to fifty-five, but he still doesn’t ask his clients for conclusive proof of age.
Sahakian says none of his social surrogacy clients will speak to me. ‘They have nothing to gain.’ They’re doing this to save their careers and have no interest in becoming the poster girls for this new way of having it all. It’s taboo to say you want a baby but are not prepared to carry it, so much so that he’s had a few clients who actually pretended to be pregnant, reassured in the knowledge that their pre-‘pregnancy’ bodies would be there for them as soon as the baby arrived. ‘You can buy artificial, prosthetic bellies, you know. You can buy them in different sizes. There’s a reason why that’s there.’
* * *
Some women want children but don’t want to be pregnant. It’s a rarely spoken but undeniable fact. It’s considered unnatural – heretical, even – to want babies without pregnancy, but that doesn’t stop some women from thinking about it, and even expressing it, under the veil of anonymity. An ‘Am I Being Unreasonable’ thread on the parenting site Mumsnet, entitled ‘If you had money to burn, would you use a surrogate?’, asked users if they would ‘pay for an American surrogate if you simply didn’t want to wait/go through the pregnancy’. At least seven women said they would. ‘Oh god yes. I had horrible HG [hyperemesis gravidum] with both my pregnancies but even putting that aside it’s not an experience I savoured,’ said one. ‘Yes I would. Pregnancy is horrible!’ said another. ‘In a heartbeat,’ said a third.
But most of the responses in the thread were negative and outraged. There’s a tacit acceptance that a woman who wants to raise a child but doesn’t want to give birth to it isn’t fit to be a mother, because if she isn’t willing to undergo the initial sacrifice of giving up her body to a baby, she won’t ever be able to put the child first. This makes superficial sense, until you remember that fathers find a way to put their children first without giving up their bodies to them; they have to do this, by default. The physical sacrifice of bearing a child doesn’t necessarily make you an attentive parent, and to assume it does is to claim that men can never be as devoted to their children as mothers are. And there are plenty of mothers who are more than happy to go through pregnancy and bi
rth, but are unwilling to put the baby first when it arrives.
There are serious reasons why women might not want to go through pregnancy. As much as some of Sahakian’s clients might buy prosthetic bumps and pretend to be pregnant while using a surrogate, a much larger number of women do the opposite: they conceal their pregnancies for as long as they possibly can, in the knowledge that being pregnant is going to cost them dearly. Despite widespread legislation to prevent it, pregnancy discrimination is a reality for women today across the globe. A study by the UK’s Equality and Human Rights Commission found that one in five British mothers have experienced harassment or negative comments after revealing their pregnancy at work, and 54,000 women a year are pushed out of their jobs due to pregnancy or maternity leave. In the US, the National Partnership for Women and Families says nearly 31,000 pregnancy discrimination charges were filed with the Equal Employment Opportunity Commission between 2010 and 2015. Women in all industries, in every US state and from every ethnicity, experienced pregnancy discrimination in the workplace.
Only a tiny minority of women worldwide can afford to hire a surrogate, but many more might have valid reasons for thinking twice about carrying their own children. Some of America’s biggest tech and media companies are already paying for their female members of staff to freeze their eggs so they don’t have to worry about their fertility clock ticking away while they sit at their desks. Is there a future where companies will support mothers looking for someone else to carry their babies so pregnancy doesn’t interrupt their work?
Look closely at the wording on any number of California-based fertility clinics’ websites and you will see that surrogacy for non-medical reasons is on the cards. ‘Couples and individuals who are unable to have a baby on their own either biologically or through intention can still build and grow a family thanks to surrogacy,’ says the website of Growing Generations (with my emphasis). ‘From medical to emotional to logistical and more, the indications for gestational surrogacy can vary significantly,’ says the Los Angeles Reproductive Center’s surrogacy page.
Sex Robots and Vegan Meat Page 17