Infertility inequalities

Surrogacy as a response to infertility goes back a long way. By my literal reading of biblical stories, both Abraham and Jacob had wives (Sarah and Rachel, respectively) who, after remaining “barren” for years, offered up their handmaidens as surrogates for their husbands’ heirs.

With the recent attention given to surrogacy gone wrong, including custom-created children (purchased eggs and sperm, and a surrogate mother), a quick check on inequality in the rates of infertility and related treatment. It’s not so easy to measure – and, like most fertility measures, is usually calculated for women – but a common assessment is twelve-month failure to become pregnant after not using contraception.

Source: My chart from Bitler and Schmidt (2006).

So the haves have less infertility than the have-nots, which is not surprising considering its causes include poor overall health condition, smoking, obesity, and a history of sexually-transmitted infections. When comparable rates exist, they usually show more infertility in poor countries, too. An analysis in the journal Human Reproduction in 2007 estimated that about 70 million couples worldwide were experiencing 12-month infertility, 85% of them in the world’s poor countries.

The chart also shows the privileging of access to or use of infertility treatment, of which I guess surrogacy is a particular branch (though not included here). White and more-educated women are more likely to have sought infertility treatment.

In a recent paper in Gender and Society, Ann Bell studied the infertility experience of 20 low-income women, noting:

The cultural construction of motherhood represents women of low socioeconomic status (SES) as excessively fertile, placing them outside of the infertility discourse. Previous research on infertility reinforces poor women’s exclusion by focusing on the experiences of women receiving medical treatment, typically women of high SES.

So, we don’t know enough about poor women’s perspectives and experience on this issue.

(By the way, adoption also skews toward upper-income families.)

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One response to “Infertility inequalities

  1. baby funny. triplets is a gift from God


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