Buying our Children, Selling our Souls

With more and more resources being thrown into having children, has it turned them into just another commodity?

Debora Spar
Autumn 2006

The modern world is full of things to buy. Go into any airport and you can find piles of T-shirts, packets of snacks and glittery souvenirs produced oceans away from the places they depict. You can purchase imported French cheese at most Vermont country stores and African bangles in the streets of Paris. You can buy music online, along with financial reports and assessments of your family
doctor. Lots of things that used to be free—like television, radio and afterschool sports—are now for sale. Things that were once considered luxuries—like pedicures or housemaids—have become the stuff of everyday commerce. We buy so many things, in fact, that we’ve even spawned cottage industries that, for a fee, can advise us on how to stop spending.

Yet even in this age of consumer frenzy, there are some things that we don’t want to buy. We donate kidneys and livers for transplant rather than selling them. We fall in love with our spouses (presumably) rather than acquiring them through contract, and we don’t allow sex (except in the state of Nevada) to be exchanged for money. We also expressly prohibit the purchase or sale of any human being. Across the world, slavery is condemned as a fundamental crime, a sin against both
nature and law.

Specific prohibitions exist against the sale of children, arguably the most vulnerable citizens of the global community. We cannot sell our children as sources of labor and we cannot buy them as objects of value. We define children, in economic terms, as being distinctly inalienable: Those who “own” children have no ability to profit from them. Because who, after all, could put a price on a child? Who could imagine selling one?

And yet every day, around the world, children are being acquired through distinctly commercial channels. Want a better baby? You can buy one—from a fertility clinic that will choose the healthiest
embryos, or a service that enables you to select your child’s gender, or a highly specialized surgeon who can correct certain physical defects while the baby is still in the womb. Can’t conceive the old-fashioned way? Well, the market can fix that too. For a fee, you can select sperm from one source,
eggs from another and a womb from a third. You can hire a broker to find you a very specific sort of egg donor—tall and attractive, most likely, with good grades and interesting hobbies—or a surrogate to undergo nine months of pregnancy. You can hire specialized lawyers to weave the transaction together and specialized doctors to create the embryo that will become your child. Or you could travel an entirely separate route, searching for an already-made baby (or toddler or teenager) from the hundreds whose faces peer out from online adoption postings.

Not surprisingly, most of these transactions avoid the language of commerce. Orphaned children are never “sold”; they’re “matched” with their “forever families.” Sperm and eggs are “donated” even
when they cost tens of thousands of dollars, and surrogate mothers “lend” their wombs to “help infertile couples.” Infertility clinics are generally loath to describe their work in commercial terms, as are nearly all adoption agencies. But the semantics in this area
don’t transform the underlying reality.

When parents purchase eggs or sperm, when they contract with surrogates, when they choose a child to adopt or an embryoto transfer, they are doing business. Intermediaries are making money in all of these transactions, and children are being acquired and exchanged through market mechanisms. As of 2005, the US market for assisted reproduction was worth over $3.3 billion. (Data in this area are very hard to come by. For more complete figures and analysis, see Debora L. Spar, The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception [Boston:
Harvard Business School Press, 2006].) Collectively, American women underwent 112,872 cycles of in vitro fertilization (IVF) treatment in 2003 and produced 48,756 babies as a result. Of these, 14,323 cycles were performed with donor eggs, adding anywhere between $4,500 and $35,000 to the average cost ($12,400) of ivf. Americans also adopted 21,616 children from abroad in 2003, paying fees and expenses of up to $25,000.

People tend to recoil from these numbers. They don’t want to hear that people are buying children and if they have used any of these reproductive channels, they certainly don’t want to hear that
they themselves bought children. Children are so natural, after all, and so pure. Nobody wants to exchange them in a heartless marketplace or put price tags on their priceless little heads. Such sentiments are wholly understandable, but they cloak the reality of what is undeniably commerce. When people choose their sperm online, when they contract with an egg broker or adoption agency, when they pay $18,000 to create a child of a particular gender, they are transacting in what feels
awfully like a market.

Consider what happens when couples conceive using donor eggs. In a typical case, the couple—let’s call them Ward and June—has already tried for several years to create a child. When nature fails, they make a visit to June’s doctor, who prescribes several cycles of treatment with a powerful fertility drug for about $3,000 a cycle. When that doesn’t work, they go to their local fertility clinic, where a team of specialists puts them both through a battery of tests costing between $300 and $1,400 and then advises the couple to try—for about $13,000—a cycle of ivf. Like roughly 75 percent of women, though, June doesn’t get pregnant on that first attempt. And so she and Ward go through two more unsuccessful cycles of ivf, each again costing around $13,000. Finally, exhausted and in despair, they tell the doctor that they want to try something else. Gently reminding them of June’s age (imagine that she’s, say, 41 at this point), he advises them to consider donor eggs—eggs from a
younger woman, which can be impregnated with Ward’s sperm and then transferred to June’s womb. How, the couple wonders, are they to find these eggs? The doctor lays out three possibilities: They can ask a friend or relative to donate them, they can select—for about $5,000—one of the potential donors already connected with this fertility clinic, or they can work with a specialized agency to identify a particular donor to meet their needs.

Eventually, the couple decides to proceed with the last option. After all, June reasons, they have already spent nearly $50,000 in pursuit of a child. Why not go after precisely what they want? So
they contact the broker with an explicit list of desired traits: They want a college-educated donor, of course, since both Ward and June value education; they want a tall donor, since their families are on the tallish side; and they’d like someone with June’s wavy auburn hair and Ward’s blue-green eyes. The broker trawls through her list of “exceptional” donors and places a few additional ads. Before long, she comes up with a perfect match. For $35,000, Ward and June can have precisely what they want: Donor 1026 is a young graduate student, majoring in philosophy and with a complexion that is oddly like June’s. She is 5’10”, and plays the cello to boot. Ward and June are delighted. They sign a contract with the donor in which she relinquishes any parental connection to the child who may come of her genes, pay for the costs of retrieving her eggs, and then return to the clinic for a final round of IVF, this time transferring the tiny embryos created from a genetic mixture of Ward and donor 1026. The process works, and nine months later the proud parents blissfully carry their baby home. The baby is priceless, of course, but also cost about $95,000.

It’s hard to argue that this isn’t commerce. The deeper question is whether this economic intrusion is necessarily bad. Is there something innately wrong with spending $95,000 in pursuit of a child? Does the intervention of money—along with doctors, brokers and third-party genes—contaminate what should be a wholly natural, purely nonfinancial production? It is very easy to answer that it does and that babies, like kidneys or truth, should be forced entirely out of the market. This is the intuitive response for most observers of the baby trade, as well as for esteemed scholars such as Margaret Jane Radin, who has argued passionately that “conceiving of any child in market rhetoric wrongs personhood.” (Margaret Jane Radin, Contested Commodities: The Trouble with Trade in Sex,
Children, Body Parts, and Other Things
 [Cambridge: Harvard University Press, 1996], p. 139. See also Michael Sandel, “The Baby Bazaar,” New Republic, October 20, 1997, p. 25.) Yet the question
demands further scrutiny.

If we assume that children are inherently good, and if we argue, as most Americans would, that markets can produce positive outcomes, then it’s not obvious why producing children through markets is necessarily bad. It may be naturally risky; it may be the kind of market— like health care or education—that governments want either to regulate or to subsidize. That’s different from arguing that the market itself is bad. There is also a difference between asserting that commodification exists and proving that it exploits any parties to the transaction. When parents like Ward and June pay for eggs, or IVF, or adoption fees, do they demean the children who join their family as a result? Do the contributors to this process—the egg donors or surrogate carriers or birth mothers—lose dignity in some way that they themselves can’t identify? Empirically, we have no way of determining whether expensively procured children feel any less cherished than those created for free. We don’t know whether their parents, or other parents, were degraded by the market forces that contributed to their birth. How can we claim exploitation on their behalf?

The business of assisted reproduction has been around only since the 1978 birth of Louise Brown, the world’s first “test tube baby.” Since then, the science has improved dramatically, pushed in large part by the deep-seated demands of people like Ward and June, people desperate to conceive a child at any price and unconcerned about any opposition to their mode of conception. As the science of reproduction continues to advance, and as changing social mores bring more and more customers (same-sex couples, older women) into the baby trade, the market for reproduction is going to grow. As a society, we have yet to grapple with the changes that this market has wrought. We haven’t acknowledged, first of all, that this is a market, and we haven’t asked seriously where in this market we might want to draw some lines. We haven’t considered how, as a nation, we might want to support some elements of high-tech babymaking and regulate others. We haven’t defined as clearly as we should what differentiates the sale of a child from the purchase of those services necessary to
conceive or adopt one.

Already, childhood in the United States has become fraught with all kinds of payments. We pay for our children to ride buses in the morning and to play soccer after school. We pay for them to be
educated outside the public school system and then to be tutored as well. We pay for outrageous birthday parties to excite them and for Ritalin to calm them down. According to one recent estimate, the total cost of raising a child in the United States now hovers between $139,000 and $279,000, and that’s before college. We can choose to stand on the sides of our well-manicured soccer fields and bemoan the commodification of parenting. We can decry the imposition of science into the pleasures of baby-making and the intrusion of commerce into it all. But we cannot deny the reality of these events, or the likelihood that they will expand over time. Instead, like Solomon, we need to wrestle with the dilemmas that modern desire has created, considering how we can shape and secure our children without destroying ourselves.

Debora Spar is the Spangler Family professor of business administration at the Harvard Business School and the author of The Baby Business (Harvard Business School Press, 2006).

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