The knots of infertility

This morning, I was invited back on to breakfast television to reprise the argument I made on the programme last year regarding the NICE guidelines which recommended that infertile couples should be given 3 cycles of IVF on the NHS.

Since then it transpires that over three quarters of NHS trusts are disregarding the guidance, leading NICE to issue even stronger advice forcing Clinical Commissioning Groups to implement their IVF guidelines, to end the ‘postcode lottery’ system which produces massive inequality in terms of how qualifying couples are treated.

In this instance inequality is not an inappropriate description of the situation. The NHS should provide an equal standard of care across the country – if it has determined that infertile couples should be afforded 3 cycles of IVF treatment then that should apply to you regardless of whether you live within affluent city suburbs, in a remote part of the country or on a run-down council estate.

If IVF is an accepted medical treatment on a par with chemotherapy for example, then it should not be withheld from anyone because their local health trust has decided that they cannot afford it and their priorities lie elsewhere.

The trouble is, of course, that whilst IVF is a medical treatment, opinion is massively and legitimately divided as to whether or not this ought to be funded by the NHS, given that infertility in and of itself is not a fatal, life-threatening or even life-limiting condition, unless one extends the medical definition of life-limiting to encompass quality of life issues.

That’s not to downplay the devastating effects of infertility which can undoubtedly cause emotional ill-health, but simply to note that an inability to conceive won’t actually kill you neither is there any research to prove that it might shorten your lifespan.

This certainly seems to be the view that various CCGs have taken faced with increasing budget constraints and difficult decisions as to where to channel their funds, and its one with which many of us will have sympathy. If the choice is between paying for drugs to extend the lifespan of a cancer patient, a hip operation or heart bypass for an elderly patient and whether or not to fund a form of therapy which could lead to a couple having a much wanted child, then for most right-thinking people, the choice is clear. Our priority should be with assisting the already-living and vulnerable rather than ignoring them in favour of creating their replacements.

As I pointed out last year, NICE guidelines have a habit of becoming quasi-legislation and thus last week former health secretary Andrew Lansley (responsible for the stealthy and undemocratic liberalisation of abortion law) has said that CCGs have a responsibility to obey NICE rules despite the fact that they are not actual pieces of legislation. Spot the inconsistency. In the eyes of Mr Lansley, NICE comes before the letter and spirit of the law.

So slowly but surely, British law has introduced and supported the notion that a child is something that every single person or couple should have a right to and for which the state  should pay. Consider the language of Sarah Norcross, co-chairman of the National Infertility Awareness Campaign who says “it’s high time that patients were allowed to access the treatment that they were entitled to”.

The ethics of entitlement and so-called equality therefore override any other considerations. If you are entitled to medical treatment on the NHS, then you should be given it regardless of other factors. If not being able to have a child is automatically designated as being a medical issue, because it takes clinical measures to achieve one, then it’s some kind of ‘ist’ or phobic to deny the treatment to someone, taking into account their lifestyle or individual circumstances. The needs of the adult are paramount, the needs of the child secondary – all that’s needed is love and the desire to access costly and gruelling treatment is sufficient evidence of suitability and should overcome all other considerations.

Apologies for beating the same allegedly homphobic drum, but recent HFEA stats show that there was a 36% increase in lesbian couples using IVF between 2010 and 2012. No matter how much sympathy one may or may not have for two women deciding to disregard a child’s right to a father, it’s not bigoted to ask whether or not this is really the sort of thing Bevan had in mind when he put in place the founding principles of the NHS? Should a single man or woman have the same right to access this treatment as married opposite gender couple? If resources are scarce, and IVF is going to be an accepted treatment, is it really so heinous to prioritise the married couple in a stable relationship who have been trying to conceive over a number years and have suffered a number of miscarriages over other scenarios? Or does the defining zeitgeist of equality mean that all situations and circumstances have to be treated equally regardless of merit? To say that one person may be more deserving of another, whether that be in the field of IVF or the even more controversial field of welfare and benefits, is today’s unspeakable heresy. In our relativistic world no one set of circumstances must ever be judged as being better or worse than another.

Another unpalatable fact that no-one seems to want to discuss when discussing the ethics of IVF on the NHS is the ethics of IVF itself. So when I attempted to point out that for every live birth that comes about due to IVF, another 30 embryos are created and that of the 4 million embryos created since 1991, only a tiny proportion have made it through to birth – this point was brushed aside. The discussion has to centre around the ethics of the treatment being made available for free, regardless of whether the treatment is in itself ethical.

I don’t know what is more frustrating, the entitlement culture, the disregard for the welfare of children or the wilful short-sightedness. Any other expensive treatment costing around £3.5K to £5K a time which had a less than 25% chance of success would not see NICE attempting to impose it upon CCGs as a matter of routine, especially when the treatment itself is so physically and emotionally demanding. It would instead be allocated according to individual circumstances.

As I said on the programme, it seems that we’ve got ourselves in something of a pickle with regards to fertility. On the one hand there’s couples crying out for IVF and the opportunity for a biological child of their own, on the other almost 200,000 abortions take place in the UK every year. Added to which abortion rates amongst women in their ‘30s and ‘40s are rising as women believe that they are no longer fertile.

It’s time for some joined-up social policy thinking on this issue. We know that with a little bit of training women can be trained to monitor and track their monthly cycles and pinpoint with a high degree of accuracy the fertile periods every month.

Women are given so many mixed messages and conflicting signals about their own fertility it’s not surprising that so many of us fail to navigate successfully through the reproductive minefield. Instead of teaching young women how to avoid pregnancy and that sex can be devoid of consequences how about teaching girls (and boys for that matter) the specifics of how to track female fertility. Instead of teaching them that fertility is an obstacle which must be suppressed via chemical hormones and abortion a useful and necessary back-up, why not help them to empower themselves in terms of learning the ebbs and flows of their own unique monthly cycle.

Armed with that information, they can then make the decisions which they feel are most appropriate, especially during the window of peak fertility. Tracking monthly cycles has another advantage in that it enables abnormal cycles or potential issues and barriers to conception to be identified and treated.

If the NHS is serious about wanting to tackle infertility, then instead of chucking money at what is a not very effective sticking plaster, a more pragmatic and cost-effective solution is to enable both women and medical practitioners to become specialists in natural female fertility instead of attempting to artificially suppress it until such time as it might be needed and then attempting to employ a costly treatment with a 75% chance of failure.

Even more radical, instead of teaching young girls that pregnancy is to be avoided until an indeterminate date in the distant future, how about education that focuses their minds on real family planning and the pros and cons of early versus late motherhood? How about going a step further and implementing far better childcare and maternity solutions and options for university students. While we’re at it why not chuck in cheap starter homes for young couples and measures to make life more attractive and conducive for young families?

Unfortunately the genie is out of the bottle when it comes to IVF and it would take a heart of stone not to sympathise with women like Jessica Hepburn who was interviewed alongside me earlier. What I wouldn’t do to be able to wave a wand and give her a baby and find a method that was successful, devoid of harmful physical side-effects and didn’t involve the destruction of life. Disagreeing with the use of technology does not extend to blaming or shaming those who want to avail themselves of it.

Heartbreaking, unexplained and untreatable cases of infertility cannot be completely eliminated, but with a bit more joined up thinking, the need for both IVF and at the other end of the spectrum abortion, could be drastically reduced.

Catholics reading this might be aware that today marks the start of a novena to Mary, Undoer of Knots. Dedicating it to couples facing the pain of infertility seems a good place to start.

 

Some fascist objections

I don’t want to spend too much time on this, but in the light of the Question Time online Twitter storm and bullying that came my way, it was suggested that I find a way of logging all the incidents/abuse that come my way as a result of defending the prospect that marriage is the union of one man and one woman for life.

The columnist who arguably was responsible for drawing a lot of heat my way is one Benjamin Cohen who according to his biography was  formerly of Channel 4 news and is now the founder of Pink News, a columnist for the Evening Standard and Gay Times. So it’s fair to note that in terms of impact and and influence, in engaging with me he is punching well below his weight. He has almost 17,000 Twitter followers and platforms in the national media. I have 2,000 followers or thereabouts and am not a regular contributor to mainstream media, aside from when I am invited on at the request of a producer or editor to explain a Catholic or socially conservative position. I don’t know whether or not my weekly Universe column counts.

In any event he has decided that I am worthy of his attention and began to follow me on Twitter following the Question Time affair. On several occasions yesterday he did that passive aggressive trick of using a full stop before my Twitter handle, before going on to misrepresent my position.

My crime – being friends with a transgender woman. Actually his ire is mainly directed onto her, for being friends with such a hateful person such as myself and because she takes a pro-life position, her view being shaped by the fact that she was adopted. Furthermore she disagrees with the concepts of surrogacy and IVF, not on religious grounds, but accepting the science that human life begins at conception. Worst still she believes that surrogacy exploits women and that every child deserves the chance of a loving mother and father.

So at time of blogging, I’ve had another non-stop 18 hours of unsolicited and unprovoked online aggression from the gay Twitterati and their supporters. Benjamin Cohen went from attacking a woman for her friendship with me, to inexplicably claiming to all his followers that I think that his lovely niece should not exist, after randomly attacking my position on IVF. He’s then gone on to justify his position that my gay friends should shun me because no one should be friends with someone who wants to deny them their rights; he would not be friends with anyone who would deny him his rights as a gay man or indeed as a Jew.

There’s a lot to unpick here, but I’ll try to address the points briefly.

1) – It is bigoted to try to undermine or dictate friendships of which you do not approve. It is more than possible to be friends with someone who takes an entirely opposite ideological point of view to yourself, accepting that they do so in good faith. I am friends with many LGBT Christians and progressive Anglicans who believe entirely different things to me on the subject of marriage and ordination of women to the priesthood, but that does not hinder our friendship or closeness.

2) Godwin’s law time. Believing that marriage should be defined as a union between a man and a woman does not equate to facism or Nazism. Marriage is not a universal human right. If it were then brothers and sisters could get married or any two people who declared a love between each other, regardless of blood ties or age. The only ostracism or turning one group into ‘untouchables’ or second-class citizens is coming from the LGBT lobby and their supporters who wish to take to the internet to undermine friendships and defend their proposition that no-one should be friends with me, or indeed anyone who takes a similar position. We must be isolated, ostracised and hated. Which is why Benjamin Cohen has repeatedly ridiculed and misrepresented my position to all his followers, to ensure that they turn their hatred and derision on me. He’s already posted a video of Lynette Burrows comparing me to her, after he debated her at the Oxford Union, saying that my language is similar to hers. This is disingenuous in that Lynette not only used sexually inappropriate language she also made some wild and unsubstantiated and provocative claims. My language and tone has been infinitely more measured. If you look at my online activity I do not go about soliciting attacks on LGBT advocates or inciting my followers to have a go at gay marriage supporters. The aggression here has been solely one-sided. I’ve had 18 hours of being compared to Nazis and specious arguments.

3) Objection to IVF does not mean that I wish babies who have been brought into this world out of existence. Furthermore my objections to it are across the board – regardless of sexuality. I object to IVF on a number of ethical grounds. The amount of sheer wastage of embryos involved in the process, as Lord Alton has noted, is on an industrial scale. I also believe that it is inefficient as a treatment. The success rates are shockingly low for a process which is emotionally and physically costly. Clinics exploit the desperation and misery of women as Professor Sir Robert Winston, one of the original pioneers agrees. I also have some scientific concern about the process, which seems to be born out by health outcomes. Children born from IVF have a greater risk of health complications and treatment cycles can prove harmful, for example it doubles the rate of non-fatal ovarian cancer in women. I don’t have a problem with the children who are conceived, rather the way in which people have gone about conceiving them. IVF is a sticking plaster, a gruelling way of circumnavigating infertility without addressing the underlying causes and in common with all issues concerning human life, a technique developed out of compassion has been exploited and distorted as being a human right.

From a Catholic point of view, I object because children have the right to be conceived from the natural embrace of their mother and father; to use IVF separates the unitive and procreative elements of sexual intercourse, which is contrary to Catholic teaching. IVF turns the child into a commodity to be made in a laboratory and makes doctors, technicians and even the sales and finance staff in the clinic, part of the conception process.

4) Surrogacy. As above, the surrogacy process once agains treats children as a commodity. The surrogacy industry exploits women as being nothing more than wombs for rent and disregards the importance of the gestational link between mother and child, which a recent study demonstrates, could be even more important than splitting the genetic link as provided by donor eggs and sperm. Basically studies are beginning to confirm the psychosomatic upset caused to mother and child alike when a child is cut off from the emotional and physical bond built up between them and their mother. We know that when a woman is subjected to high levels of stress in her pregnancy that this can have an adverse affect on the health of her unborn child. We also know that there is already a bond between an unborn child and their gestational mother, one that is not merely imaginary but assisted by hormone production. Any mother of a newborn will rave about the effects of Oxytocin, the happiness hormone, which is produced in pregnancy but also designed to be reinforced post birth, by eye-gazing, skin to skin contact and breast-feeding. As the mother of four, it’s something I have experienced repeatedly, all of my children would instantly be quietened by the simple act of my picking them up as babies, while my husband would look on in bewildered awe. I remember placing my babies next to me in my hospital bed lifting them out of fish tank provided; just lying next to me would comfort and silence a bout of crying.

As this link points out:

this oxytocin link not only facilitates key physiological processes in the baby’s development, but also helps the mother to recover after delivery. It promotes bonding patterns between the mother and neonate and creates desire for further contact. In fact, the powerful imprinting for mother and baby from the oxytocin release during breastfeeding occurs chiefly “so that mother and baby will be able to find and recognize each other in the hours and days after birth.”[1] Most importantly, studies show “the resulting high or low level of oxytocin will control the permanent organization of the stress-handling portion of the baby’s brain—promoting lasting ‘securely attached’ or ‘insecure’ characteristics in the adolescent and the adult.”[2]

All of this essential maternal-child melding and mother-to-baby recognition is proactively disrupted when the surrogate mother hands her baby over to its sociological parents. We can only guess how long the resulting love-vacuum is felt, consciously by the surrogate mother and subconsciously by the baby. Nor can we know when failure to experience this gestational link might morph into a panoply of insecure behavior on the part of the surrogate child/adolescent/adult: anti-socialism, aggression, difficulty forming lasting bonds with a mate, mental illness, and poor handling of stress.[3]

According to a study conducted by Dr Susan Golombok of Cambridge University  published in the Journal of Child Psychology and Psychiatry in 2013, children born with the help of a surrogate may have more adjustment problems – at least by the age of 7 – than those born to their mother via donated eggs and sperm. [4]

Second, this study showed that, if the sociological mother exhibited maternal distress when the surrogate child was 3 years old (particularly over whether to tell the child about his surrogate birth), this distress was predictive of adjustment problems for the 7-year-olds who, after being told of their surrogate birth, “conceivably…felt less secure when faced with their mother’s emotional problems.”

Another Golombok study [5] in 2011 revealed that the absence of a 7-year-old child’s genetic or gestational link to his sociological mother caused the mother’s interaction with her surrogate child (and vice versa) to be less warm and less mutually responsive and cooperative.

Denying that babies need their gestational mothers is damaging for mothers and babies alike. It treats babies as little more than consumer objects and women as commodities for hire. You don’t need to be a religious bigot to condemn the misery and exploitation of women engendered in countries where commercial surrogacy is rife.

5) Sperm Donation. Same with egg donation. Anything that treats another human being as a commodity to be exploited and denies the right of the child to their natural parent is morally abhorrent. Here’s the  testimony of one woman conceived by sperm donation.

All children deserve a loving mother and father. In a world which demands that we have equal numbers of women in the workplace, politics and the media, why then is the prospect that all children deserve the equality of a man and a woman parenting them deemed to be so outré?

Countless studies hold up the model of children being raised in a loving long-term stable relationship between their biological parents as being the gold standard. Every single piece of research which aims to justify surrogacy or same-gendered parents concedes this by attempting to demonstrate equality of outcomes.

Same-sex parenting and surrogacy are still a relatively new modern phenomenon. Every single study  is flawed in its objectivity, methodology and focus. David Benkof, a gay Jew like Benjamin Cohen, analyses the difficulties here. These experiences may not be representative but interviews with children brought up by same sex parents make harrowing reading.

No-one is arguing that sexuality renders you a bad parent, the argument is that children fare best being brought up in relationships with their biological mothers and fathers and that every child has an innate desire or instinct to know their identity, to know who and where they are from. This is innately accepted when children are being placed for adoption. I wonder whether in 30 years time we’ll see a glut of adults actively seeking out not only their biological parents, but also their gestational mothers?

The response from the LGBT community is to attempt to use academia and the language of pseudo-science and equality to justify their desire for children. Studies are trotted out in an attempt to prove that children are not harmed, supported by contentious gender theory which attempts to blur the differences between men and women to qualify the proposition that mothers and fathers are irrelevant. All that is needed is loving, caring ‘parents’. Because they ‘need’ to use surrogacy and sperm donation in order to have children, then to state that the rights of the children come first is deemed ignorant, hateful and worthy of derision. LGBT people have to reclaim their high-ground and narrative as perennial victims, excluded from the specious ‘human right’ of parenting through no fault of their own. They literally have no other choice but to use the body of another. That so much justification is needed, is precisely why I have termed this ‘Jurassic Park’ politics – too busy thinking about whether or not they could, to worry about whether or not they should.  To state the importance of biological parents, to want to nurture and respect the family and above all place value on human life, from the very moment of conception is not born out of any hatred or wish to marginalise. What is more important, the rights of everyone to have a child whenever they want one, or the rights of a child to have their loving mum or dad? Who are we to wilfully deny or deprive a child of that for our own selfish ends and desires?

The term phobia is bandied about a lot and people recognise that a lot of objection is based on fear. While I’m not scared of people’s private decisions regarding their sexuality, actually the notion that children do not need their loving mothers and fathers does terrify me. The notion that a woman’s body can be commoditised or used as a vehicle to provide someone else with a child, does scare me, as does the idea that it’s okay to take children away from their mothers and that the gestational link is unimportant. This profoundly damages women, along with their babies and men too. It treats human beings and human life as nothing more as a consumer product. It does not encourage errant fathers to take responsibility for their offspring for starters. If a child doesn’t really need a mother and a father, then what’s to stop the state from taking children into care to raise according to their norms of child-rearing? If a child doesn’t need it’s mum and dad, then what’s to stop a child being removed from a parent who has the wrong views or ideology and given to a more loving and ‘tolerant’ set of parents?

This might seem rather far-fetched, but I am worried about a world which wants to tell my four girls that they are not automatically the best mothers for any children that they might have. Their job is merely to produce children, but they should not be guaranteed the right to raise them. It would be the same were I to have little boys, I’d worry about their being reduced to mere sperm donors.

That people are smugly favouring Ben Cohen’s tweet about not being a second class-citizen due to his sexuality or Judaism, when I did not suggest this reprehensible idea and wishing that ‘people like you did not exist’ because I believe that no-one has a right to deliberately deprive a child of the chance of being brought up by their mum and dad, really frightens me. As does a mainstream media commentator happily describing me as a fascist or comparing my view to anti-semitism and getting his friends (including a BBC London Radio presenter) to agree and endorse that point of view.

I’m also concerned by the bullying of my friend, who is being treated as a traitor to the LGBT cause and threatened with exposés in the gay press, simply because she does not conform to the narrow-minded proscribed ‘rights’ agenda, which dictates that all people must think the same. They are also irritated that she has not only been nominated by several people to win an award for LGBT diversity and engagement, but that she wishes to pursue a political career, which is why they are going after her with such enthusiasm. A trans-woman who accepts the sanctity of life and the rights of children to be brought up by a loving mums and dads in a position of political influence? That must not be allowed.

 A gay man can be a great father, but he cannot be a mother. A lesbian can be a lovely mother, but she can’t be a father. Why is a statement that a baby particularly needs their mother, that all children need both their parents deemed to be  so radical, offensive and deemed to be up there with Nazi policy’s of mass extermination?

We live in a world in which the following statements can be uttered as truths without so much of a hint of irony.

https://twitter.com/jesszkey/status/460556781312565248

https://twitter.com/jesszkey/status/460699509878964224

Even Orwell would have found it fantastical.

This isn’t religious persecution, but illustrates my previous point about Dominic Grieve and fundamentalism. No one is having a go at me because I am Catholic, although they might use my faith to demonstrate alleged irrationality or claim that it’s proof that I want to oppress. Catholicism is an easier target than addressing the very real ethical objections, as is personal attack and smear.

Far easier to attack me as a fundamentalist, a person who wishes to repress minorities and stop them from exercising their spurious rights to children, than to tackle the issue of whether children ought to have a mum and a dad and whether or not life is an exploitable commodity.

Scary times indeed.

Update: Ben Cohen believes that this post falsely accuses him of calling me a Nazi and a fascist. He has requested my address on Twitter to pass on to his solicitor and has given me until midnight to retract.

Ben did not explicitly call me a fascist or Nazi but his tweets which made reference to his Judaism, did in my opinion imply that my views were comparable; one of his friends replied to me asking whether or not I would be friends with a fascist in the context of my friendship with a transgendered woman. Another of his followers compared my stance with racism. Someone else said that I would have been manning a machine gun in the tower at the entrance to a concentration camp in ’40’s Germany.

Combined with the fact that after my Question Time appearance one of his followers wished that I would ‘die soon and hopefully your Nazi family will follow shortly’ I interpreted these references to being compared with fascists and Nazis.

But following his threat of legal action and demands for my address, I am happy to make clear that Benjamin Cohen himself did not explicitly call me a fascist or Nazi.

To reiterate, this whole conversation was begun when Ben interjected into a brief non-related remark I made stating that both social conservatives and progressive LGBT advocates would do well to mix outside of their tribal bubbles and engage with and listen to each other.

People are still rumbling on that it’s my fault for advocating extreme views.

Sometimes the avalanche and seemingly relentless of hate and threats makes me physically shake with fear and retch.

Tonight my husband commented that people want to get me, if they could they would lock me up and throw away the key, showing no mercy. It’s unnerving to say the least.

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[1]  http://www.thebabybond.com/BondingMatters.html (last accessed: 28/4/2014)

[2] Ibid

[3] Ibid

[4]  Golombok, Susan et al, “Children born through reproductive donation: a longitudinal study of psychological adjustment,” Journal of Child Psychology and Psychiatry54:6(2013): 653-660

[5] Golombok, Susan et al, “Families created through surrogacy: Mother-child relationships and children’s psychological adjustment at age 7,” Dev. Psychol.47:6(2011):1579-1588.