A recent NY Times pair of articles focuses on the human, medical, and social costs of implanting multiple embryos via IVF and IUI, resulting in a spike in both multiple births and a litany of health risks to these babies. The articles, and ensuing barrage of public comments, can be read here: “The Gift of Life, and Its Price,” “Grievous Choice on Risky Path to Parenthood.” In IUI, parents who conceive multiples also face the decision of whether to terminate some fetuses using the procedure termed “selective reduction”. IUI is much cheaper than IVF, and more readily covered by insurance, but the chance of success is lower and ability to control multiples non-existent.

The most startling assertion in the IVF article was an analysis by reproductive health experts and providers explaining the financial and business motivations on providers to disregard medical guidelines by implanting more embryos than may be safe for mom or her babies. Fertility practices want to boost their success rates and attract clientele in a highly competitive and lucrative medical field, and parents apparently think that implanting more, or rejecting selective reduction in IUI, will secure greater chances of a viable pregnancy and satisfy their emotional or religious needs to a degree that makes the risks worth taking. If the underlying reason for the increase in multiple implantations and subsequent births is really a symptom of our profit-based medical system, some suggest we utilize insurance schemes as a way to address this issue. If insurance companies are required to cover IVF, whereas many now only cover IUI, they could regulate the financial incentives by only reimbursing doctors for single implantations. (more…)

I can’t help but recall Jonathan Swift’s “A Modest Proposal” when I read the internet buzz around the recent U.N. data analyzed in a “FEWER EMITTERS, LOWER EMISSIONS, LESS COST,” a report from the London School of Economics. 

The New York Times Science Blog reports that the data suggests:

[T]hat meeting unmet need for family planning would reduce unintended births by 72 per cent, reducing projected world population in 2050 by half a billion to 8.64 billion. Between 2010 and 2050 12 billion fewer “people-years” would be lived – 326 billion against 338 billion under current projections. The 34 gigatons of CO2 saved in this way would cost $220 billion – roughly $7 a ton [metric tons]. However, the same CO2 saving would cost over $1trillion if low-carbon technologies were used.

The blog is entitled “Are Condoms the Ultimate Green Technology” and the author, Andrew Revkin, writes, “I recently raised the question of whether this means we’ll soon see a market in baby-avoidance carbon credits similar to efforts to sell CO2 credits for avoiding deforestation. This is purely a thought experiment, not a proposal.”

Really? Not a proposal? Pardon my skepticism, but why entertain such a “thought experiment” when the forced sterilizations and “contraceptive incentives” (read coercive family planning) that took place in the Global South at the hands of Western trained academics and physicians are well within the institutional and personal memory of many in the international family planning community? Population experts from that time still lament that the Programme of Action that came out of the 1994 Conference on Population and Development in Cairo, Egypt was “hijacked by feminists.” Yes it was, and as a consequence we have an international document adopted by 179 countries stating that, “The empowerment of women and improvement of their status are important ends in themselves and are essential for the achievement of sustainable development,” and that,  “Reproductive rights…rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so…free of discrimination, coercion and violence.”

These statements and the birth of the Reproductive Justice movement may be the most positive consequences ever to come out of a hijacking.  (more…)