The Future of Motherhood
Motherhood. Difficult. Complicated. Joyous. Frustrating. Incredible.
Sound familiar? From around one table, this description brings instant agreement from five Californians who have gathered to talk about the future of bearing and raising children.
We review the vertiginous pace of the last quarter-century, when laboratory conception bolted from science-fiction fantasy to everyday event. Astonishingly, the idea of what has mistakenly become known as a test-tube baby--in vitro fertilization usually occurs in a petri dish--has become commonplace in less than two decades. Worldwide, more than 150,000 in vitro babies have been born since Louise Brown paved the way in 1978. Thousands more children owe their existences to a smorgasbord of other procedures, such as ICSI (intracytoplasmic sperm injection), in which weak sperm get a boost via direct insertion into an ovum, or egg donation, the process that enabled a 63-year-old California woman to give birth late last year to become the oldest woman known to have given birth. In addition, the well-established practice of banking frozen sperm continues to enable many women to become mothers without an active male partner. On the other hand, eggs refuse to freeze as willingly, and one member of our panel believes donation of eggs retrieved from healthy young women will continue to be “a very big business.” Surrogacy provides another avenue to childbearing as, of course, does adoption.
After all this, we wonder, just what will a new century and new technological advances bring to motherhood? Will nontraditional approaches to childbearing somehow change our fundamental understanding of what it means to be a mother? Twenty years from now, will droves of adoptive mothers and birth mothers sit beside one another at graduation ceremonies of “their” children? Will our emotional loyalties be torn by the involvement of egg donors--anonymous participants in the conception process whom a child may one day seek to identify?
As it becomes more mechanized, what will happen to our myths about motherhood? Will we rethink our treasured assumption of mom’s being someone who tucks you in and kisses you good night to that of someone who just stopped by to donate a little DNA?
These are among the complexities to be considered by the members of our panel:
Alameda County public health nurse Terry Lopez-Enns, 50, whose specialty is working with children with serious illnesses and disabilities, is a board member of the Independent Adoption Center (a national nonprofit agency that advocates open adoption). She is the stepmother of three girls, Christy, 20, Sandy, 18, and Brittany, 16, and the mother of 4-year-old Troy, adopted at birth.
Marjorie H. Charlop-Christy, 43, is a professor of psychology at Claremont McKenna College who has made an academic specialty of the changing nature of motherhood. Charlop-Christy is also the director of an autism clinic, as well as a psychotherapist, essayist and mother of Kaitlin, 3.
Reproductive biologist Dr. Mitchell Schiewe, 38, spent much of his career fostering progeny among endangered species. Now he works with humans, running the in vitro fertilization lab at California Fertility Associates in Santa Monica. Schiewe has a 2-year-old daughter, Emma Jane.
Belen Salas Eller, 48, is the full-time stay-at-home mother of three daughters: Bobbie, 19, Magen, 17, and Kristie, 13. For 22 years they have lived in the same house in Cypress Park, the neighborhood where Eller was raised. She has always made it a point to be around when her kids come home from school, and she serves as a kind of home-grown Dear Abby to the army of children who congregate in her house.
Nineteen-year-old Bobbie Eller is not yet a mother--an exception, she says, among her friends. But she states without equivocation that she intends one day to have children, and although she won’t be a full-time stay-at-home mom, she will model herself as closely as possible after Belen. In the meantime, she works at Pizza Hut and plans to attend Pasadena City College this summer.
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One of the consequences of the “new biology of motherhood” could be tension between mothers whose only assistance in becoming pregnant is from their husbands and those who turn to techniques that make Bobbie Eller recall “Brave New World.”
Charlop-Christy: I think there’s always going to be rivalry when you have something that comes very easily to some people, and other people have to work hard for it. It’s about misunderstanding. If you’ve conceived easily, it may be hard for you to understand the feelings of the woman who goes through the really complicated, difficult process of fertility treatment.
Looking at it from the other point of view, with fertility treatment, with high-tech reproduction, people have to jump through all these hoops--whereas other mothers just have a child. There’s bound to be some resentment there. There’s going to be a whole group of women who are not going to be able to conceive, even with huge technological breakthroughs--and there may be some tension there.
With technology making it possible for much older women to have babies, you may also have some tension around a kind of generation gap with the mothers, where the older mothers and the younger mothers will feel like they don’t have a lot in common.
Bobbie Eller: I don’t think it will be a problem at all. I think that if somebody uses this new technology, it will just show that they really wanted to have a baby, that they wanted to have a healthy baby. I don’t think it’s going to make a difference. I don’t think anyone will judge anybody else.
Lopez-Enns: It’s hard when someone is trying to have a baby, when they want to become pregnant and it’s not working, with or without technology. Of course there’s tension, and the changes in technology may increase that tension--temporarily. After the baby comes home, I don’t think many people care how it got there. You see that now with adoption.
Charlop-Christy: Two things may happen to relax tensions in the future. One, the process [of reproductive technology] may become much easier. Two, it will be much more commonplace. If we do see tension, it will disappear when the baby comes. That’s the grand equalizer. The baby humbles us all, no matter how we have had it.
If you look back historically--this is not based on science, this is just me talking--the women’s movement of the 1970s united women. It sort of came around as a sociological current, a wave. I think we are going to have a fertility movement, much like the socio- and political movements of the past. As we know, fertility advances are going to be made even more rapidly, and as all of this becomes a larger part of society, as these options become more and more available to more and more women, I think women are going to come together around this.
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Mehren: In theory, building a family should be a pleasurable event. But assisted reproduction is a cumbersome process, fraught with expectations--and often cursed by disappointment. Will the increased stress of new technology add to an aspiring mother’s sense of defensiveness about the “artificiality” of the process?
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Schiewe: Some patients do have a concern about leaving things as natural as possible, but in most cases that I see, that option doesn’t really exist. More than anything, what you hear is that they want a baby at all costs. You give them all the facts, show them what’s involved--that you’re not really playing God, just kind of assisting things.
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Mehren: In the next century, the dimensions of such assistance will only expand.
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Schiewe: Some of the most exciting work we are doing involves detailed, single-cell analysis of an embryo. We are looking more at being able to identify anomalies in the embryonic stage. The implication of this work is that we will be able to diagnose--and perhaps alter--the genetic state of that embryo prior to transferring it [into a woman who hopes to carry it to a full-term pregnancy]. We’re looking at a number of genetically traceable conditions. We’re not sure we could cure them, but that is certainly a possibility.
Bobbie Eller: Finding birth defects and things like that, that’s the good part of it. But at some point, how much do you want to know about the baby? Imagine if you find out that the baby has brown eyes and you want a blue-eyed baby. Do you keep changing it until you get it the way you want it? Are you going to choose the kind of personality you want for your baby? I worry sometimes that we’ll start to know too much for our own good.
Belen Eller: Taking your egg out, taking out the chromosomes that are bad, putting in better ones, I don’t even know if it will be your child by the time you’re done. I just hope we’re not looking for some kind of master race.
Schiewe: Well, that’s a reasonable opinion. But if you were the person carrying the [genetically abnormal] condition, you would want this kind of repair work for sure. I don’t think anyone would want to bring an unhealthy baby into the world if you have a chance to make it healthy.
Lopez-Enns: I work with a lot of kids that are so terribly disabled, [and] if they would repair some of those things before the child was born, or change their genes, that would be marvelous. What’s scary is, are they doing the right thing, repairing the right one? If the child is going to come out altered, is there the possibility that we might make it worse? That’s why I think we need limits. Just because technology is moving forward, let’s look at all the aspects--not just, hey, it works, so yeah, let’s do it.
Schiewe: Maybe in 25 years we will not only be able to diagnose these conditions, we may be able to cure them as well. I think that’s an example of how technology can help mothers to have more choices. It’s offering women the choice of having a healthy child.
Lopez-Enns: That’s what every mother wants, of course. That’s what every mother dreams of.
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Mehren: Or for that matter, every father. Looking into our postmillennial crystal ball, we toy with the speculation that the mother of 2020 may actually be a father.
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Schiewe: It’s not likely. I don’t see it anywhere on the scope. But who knew 20 years ago that we’d be doing egg donations? I didn’t.
Charlop-Christy: I doubt that you’ll ever see a man actually having a baby--although if you did, it would be a pretty interesting sight. But single men are already adopting on their own, and you may see more of them hiring surrogates. If you’re talking about the environmental side of parenting, about providing a warm and loving home for a child, and a ballast for that child, then many fathers are perfectly capable of being good “mothers.” I think men in general can make wonderful caretakers, and the psychological literature supports this. It’s the quality, not the chromosome, that we’re talking about.
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Mehren: There have been reports that scientists are working to create artificial womb environments--off-site housing, in a manner of speaking, for developing fetuses.
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Lopez-Enns: I was well into my 40s when I started trying to become a mother. If that technology had existed, I might have considered it, but you have to look at a lot of things. In our case, there was a baby already available [to adopt]. Having a genetic part of me, having a genetic part of my husband didn’t matter at all.
Belen Eller: It seems strange to think about going outside your own body to do that one thing that ought to be so simple--just to have a baby--but for those who can’t, it’s good that science is making all these other things possible.
Schiewe: I don’t think we’re going to see these artificial wombs, not in the near future. I think that’s going to be a gap that will need more than 25 years to bridge.
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Mehren: Animal research, Schiewe’s former specialty, still provides the basis for much of the work in reproductive technology. The recent appearance in Scotland of Dolly, the laboratory-created sheep, has made it impossible to ignore the possibility that humans might also reproduce via cloning.
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Lopez-Enns: Cloning, that’s scary to me. I certainly would not want an identical reproduction of me, nor of my husband. We’re so lucky we have an adopted child. We couldn’t have done better by copying ourselves.
Belen Eller: I hope we’re not all about to go out and clone Tom Cruise. What a boring human race that would be.
Charlop-Christy: People get very caught up by all this talk about cloning. They forget that what it means is an exact reproduction of yourself. I think it would be weird to see yourself identically repeated. That’s why I don’t see that cloning is going to be something that’s going to be looked on as positive. Now when you have a baby, you kind of make a physical combination of each other--his legs, her eyes and so forth. I think people want a child who is genetically part of them--that’s why people go through fertility treatment instead of automatically adopting.
Bobbie Eller: I don’t care for [cloning] too much. It’s a moral issue. Why would you clone somebody? Anyway, I don’t know if just because you could make a sheep in a laboratory, you could therefore make a human.
Schiewe: If this can be done in a large mammal like the sheep, in most instances there are not such huge differences in humans that they cannot be overcome. The number of chromosomes is different, but the mechanism of fertility is basically the same. But the way that cloning has been talked about in the media is misleading. It’s unlikely for humans, but it’s not out of the question. The only concern, when it happens, is how it will be used. None of us knows that, and hopefully it will be for the right reasons.
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Mehren: Another example of the controversial use of reproductive technology is the harvesting of ova from fetuses, in which, if ova were to be fertilized, a baby might be born to a biological “mother” who never existed. Harvesting eggs from fetuses was sufficiently troubling that scientists in England, where the work was proceeding, chose to halt that line of research.
Schiewe: It’s not being done in this country, so far as I know. But this procedure is [scientifically] possible. It’s not being done here, I think, because of the strong ethical issues. No scientists want to potentially blacklist themselves in a society where the use of human materials for research is not well supported by the government. You’d be going way out on a limb for something that’s not federally condoned, or culturally condoned.
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Mehren: Some aspects of reproductive technology have outpaced society’s ability to fully understand them, often producing ethical confusion.
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Bobbie Eller: I think we have to be more responsible with science. I’m happy that I would have an alternative if I had some problem, if I wanted to have a baby and science could reverse whatever it was that was keeping me from doing that. But I’m worried that we may start discovering things that we shouldn’t have discovered. I think we’re going to need laws to cover this kind of thing.
Schiewe: The truth is that assisted reproduction is pretty low-volume. The number of people who use it is a drop in the bucket compared to the general population. So, in a way, the ethical questions are out of proportion to the numbers. Mostly what I think you’re seeing is a fear of the future, the unknown.
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Mehren: One ethical debate centers on whether the identity of sperm and egg donors should be disclosed.
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Belen Eller: I think somewhere down the road the person who donates her eggs will be looking around and thinking, “Gee, I wonder who I helped create?” And then maybe she’ll want to go looking. I would. Wouldn’t you?
Charlop-Christy: I’m really confused about what to do about laws surrounding the identity of eggs and sperms. I see the utility of a grown child going back to find out where he or she came from--putting the last piece in the puzzle. But if you start attaching too many restrictions, are people going to stop donating eggs and sperms? I think I would be for legislation that protects the sperm or egg donor.
Schiewe: I suppose that in the future we’ll take a much more ethical look at everything we do. I would foresee that we will have laws about donor identification, kind of like the adoption situation. The precedent has been made. I guess I would have to say the individual, the baby, deserves the right at some older or later age to know their [genetic] background.
Lopez-Enns: I do think that what’s happened with adoption might serve as a precedent. With open adoption, kids are getting a better sense of their identity. It doesn’t mean there has to be an ongoing relationship [with a birth family]. But at least the child can see where he or she came from. It lets them know who they are. Kids are kids, they want to know where they came from, and they will seek an answer no matter what. We’re going to have to set some policies.
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Mehren: If the ethics are unsettled, so is the vocabulary. For example, is an egg donor, a healthy young woman who markets or makes a gift of her own genetic material, now entitled to list the position of “mother” on her resume?
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Schiewe: I don’t have an opinion about that. I don’t know what to say.
Lopez-Enns: We talk about “birth mothers” in adoption. Maybe we should be talking about a “gametic mother” in egg donation. I think it could apply. She’s the source of this child’s makeup. I think if I were a donor, I would probably be feeling an emotional connection to that egg, just as a birth mother does.
Charlop-Christy: I don’t think that because you donate an egg that you are a mother. You are donating a biological piece of you to enable someone else to experience motherhood. It’s like giving blood or donating an organ--you don’t become part of that person. You’re donating DNA, not love and attention and nurturing.
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Mehren: Will it unnerve a 21st century child to learn about his or her high-tech origins?
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Charlop-Christy: It will definitely affect your identity, but I don’t know that it will be an adverse effect. It may be positive. You will know that you were wanted and that your parents worked hard to get you. It all depends on how secure the person feels. I can’t imagine that it would undermine your relationship with your mother.
Lopez-Enns: If you’re talking about nurture-versus-nature, I think nature is overrated. It’s the nurturing that counts. It’s the day-to-day experience of 20 or 30 years that defines the relationship.
Bobbie Eller: If my mother were to sit down tonight and tell me that another woman provided the egg that allowed me to be here, it wouldn’t matter at all. I’d still love my mother in the same way. I’d still be glad I’m alive. And it wouldn’t matter because she’d still be my mother, she’d still be the one who loves me.
Lopez-Enns: That’s just it. The day-to-day part of being a mother isn’t going to change, and that’s what matters to a child.
Charlop-Christy: Mothering is a lifelong gig. It’s every single day. It doesn’t matter how you became a mother.
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Mehren: The idea of establishing age limits for fertility treatments also raises ethical eyebrows. Assisted reproduction has been an enormous benefit to women in their 40s, when fertility declines. When the California woman lied abut her age to skirt her clinic’s 55-year age limit, the debate intensified.
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Lopez-Enns: We may be pushing it a little if we allow women in their 60s to have babies. But sometimes that’s the only way we’ll get answers from research--the only way we can find out what’s possible and what’s not.
Schiewe: Even if an age boundary were to be introduced in this country, it’s not like we ask to see your driver’s license when you come into the office. Even in Italy, it doesn’t mean they’re enforcing the age policy. Having some kind of age limit just kind of gives you that guideline. It’s true that men can become fathers at any age, but the man doesn’t have to carry the pregnancy, and there are health concerns about being pregnant at such an old age.
But isn’t maintaining fertility one of the main goals of reproductive technology?
Schiewe: Women have really been denied their biological rights to preserve their reproductive capacity when they are faced with some sterilizing condition--whereas men have been able to bank their own sperm for years. Men can preserve their own genetic legacy if they suffer from testicular disease, or if they travel a lot and are worried that they may die in a plane crash or something. The woman of tomorrow will definitely have the same option. A childless woman who contracts ovarian cancer today can forget about bearing a child. Maintaining reproductive capacity will be one of the most significant things for potential mothers of the future. We’re very close to being able to freeze ovarian tissue and eggs, so that we can preserve it until the woman regains normal health.
Bobbie Eller: That is something I would definitely think about doing if something were to happen to me, like if I were to get cancer.
Schiewe: We might also offer the choice of being able to recover eggs and ovarian tissue for women who want to pursue careers, things of this nature. Then they have an option when they are, say, 35 that will make them better candidates to get pregnant. We’re not doing this now, but it will probably become more common. The studies are just being done now.
Charlop-Christy: In a way this might be the last chapter to the women’s movement. It’s done a lot of good but, in some ways, in urging women to fulfill their potentials in other areas, it kind of forgot about motherhood and parenting. This kind of technology would enable women to do everything they want. It would allow them to have the child that maybe some women thought they had to forgo to get their freedom. I think it’s extremely liberating and extremely comforting. This is really the ultimate in family planning. In a way I would love to have my eggs frozen now and wait a couple of years to have another kid.
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Mehren: Motherhood is steeped in mythology, and on the surface, some of these technological advances threaten to de-romanticize some of our very sacred ideas about being a mother.
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Charlop-Christy: Well, this may mean updating our old romantic notions, losing some of our old mythology. It won’t be “first comes love, then comes marriage, then comes Susie with a baby carriage.” It won’t be this romantic ideal that you just fall in love and get pregnant. I think this will be about modernizing motherhood. Think about it, everything is on the Internet now, everything is technology--and now conceiving is technology. It could be very romantic. It depends on what you’re going to classify as romantic. Why, we could have a whole new notion of romance set around fertility treatment. It could be very romantic to get your medicine and your shots, knowing that you are preparing for this creation of a life.
Bobbie Eller: All that putting your baby into a ruffled carriage, tying little lacy hats on their heads, looking at them and saying, “Oh, that’s so cute,” that’s never going to go away.
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Mehren: So mothers in the future may cling to tradition no matter how much high-tech help they get?
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Charlop-Christy: This learning experience that we’ve gone through is only going to benefit the next generation. From my discussions with my students, most of them are saying they’d like to have children when they’re about 30, 10 years younger than when I gave birth to Kaitlin. That’s what I want for my daughter, too. I want her to be this rocket scientist. But maybe she should have her kids first.
Schiewe: I wouldn’t promote my own daughter into early childbearing, but I would be knowledgeable enough to tell her the concerns about waiting. If I had to continue to provide financial security so that she could go back to school if she had her children early, I would certainly do that.
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Mehren: Teacher, nurturer, heartbeat and human cement: As our panel wraps up, we conclude that these vital elements of the eternal, ephemeral experience called motherhood will never change. No matter what technology the next century brings, the deep, powerful emotions of motherhood will endure. These feelings, our panel agrees, are hard-wired into the daily business of bearing and raising children. Kids may come into the world in new and unforeseen ways a generation or more from now. But mom will always be mom.
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Schiewe: Motherhood in general will be very much the same 25 years from now, just as it was 25 years ago. Certainly we know a lot more now than we did then. But we also know that motherhood is an ongoing dynamic--always changing and evolving, never static--that extends through life. Motherhood is love and nurturing, a developmental bond between mother and child.
Charlop-Christy: A mother is a nurturing entity who puts the needs of the child before the needs of the self, and that’s motherhood. That’s what it is for me, it’s love.
Lopez-Enns: In the next century, it won’t matter how the kids got here. As mothers, we’ll still be vigilant for our children. We’ll still teach them, feed them, empower them and love them.
Belen Eller: In the next century, I think we will still want to be ideal moms. To me an ideal mom is somebody who is nurturing to their children, somebody who is a good role model and who can help instill logic and values in their lives. To me, a mother is like a pulse of a family.
Bobbie Eller: My mother was always there for us, always. Sometimes she drove me crazy because she was always there, even when I didn’t want her to be there, like after school. I’d be thinking about getting in trouble, ditching school or something, and there she was. That’s what I think a mother is. She’s the one who’s always there.
