Waiting to have a child, or not. This could be anyone’s story.

There are many reasons one picks up a book. Sometimes, a book picks you. Or that you feel it could tell your story.

Living in Mumbai a decade or so ago, my evening commute home was defined by a certain train, its regularity and very familiarity was reassuring, as was the chatter of women’s conversations (in the women’s carriage). Then I worked myself out of the habit after it came to me that I had become an object of interest, subject to a certain kind of questioning.

This followed from the admission that I had been married for some time, and was still “child-less” or, as it was more quaintly put, “had no issue yet”. What started with open curiosity and some teasing became more accusatory, veiled with thin disguised concern about age and vanishing fertility. So I found myself another train home.

My questioners – and their numbers grew legion as I spent more years being married, not maternal – wanted an answer when I did not have one. To tell them I was waiting was something startling, offensive and strange. Waiting may be deliberate but it is also that most imprecise, vague, of words; it’s a pause, a gap, an in-between stage.

I waited to be more certain of my fledgling career, which followed from a disastrous corporate one. I waited because I worried I’d lose my career for a baby, for I’d have no family support if I had one. I worried about waiting itself, I worried I had no answer for this waiting.

What waiting is

In her book, Belle Boggs does tangentially refer to this kind of waiting. For her, it’s a happy kind of waiting – in her mid-twenties and just married, she describes herself to a young student as being too young to have a child. But a decade later, the waiting becomes something else; it’s more anxiety driven. It’s a waiting to be done in secret, shared among a select few; a waiting suspenseful, then also hopeful.

This book is more about this different waiting – of Boggs’s own and of others too, not merely couples faced with infertility issues but those in same-sex marriages or single parents looking to become parents and keen to have their own babies. It’s about the wider American experience of how this waiting is experienced, its accompanying costs – emotional and financial – and anxiety, and of how this need is medicalised, addressed and treated. Indeed, the industry addressing offers plenty of choice, and, as will be obvious, it has a global reach too.

The anxiety that Boggs experiences a decade after marriage, after she and her partner have been trying unsuccessfully for a baby for three years, comes with shame for one’s body. Experiencing infertility is an “assault on the identity” – the inability to procreate, which, as Boggs says in the early chapters of her book, is a natural function of the body. All around her, nature itself appears programmed this way: There are the singing cicadas and their discarded larval shells, the marmosets and their hierarchic pattern of reproduction – where only one female at a time produces offspring. And then Boggs narrates the story of Jamini, the silverback gorilla at the North Carolina zoo who has been artificially inseminated to induce pregnancy.

Nature’s betrayal

Boggs had always felt it would be natural in her case; it had happened so with her mother, a product of the 1970s, the years of free will, feminism and free love. But four decades and more have passed since then. Though she doesn’t detail what happened following that period of radical feminism, the early 21st century is a cacophony of many voices and diverse opinions, and of changing demographics. There are also the very many who are “child-free”, but interestingly, this appears only in a spare para in a book. A writer who is asked her preference between the two words, “childless” and “childfree”, picks “woman”.

Reproduction in the present day is personal but also political – with conservatism and liturgical pressures as invasive as assisted reproduction techniques playing roles. The former is even more frantic with messages about sustainable population growth (for a certain kind, as it appears in another chapter), and while there are laws for marriage equality, when the US Supreme Court made its historic Obergefell decision in 2015, those for reproductive equality have progressed far more slowly. Laws for surrogacy differ in different US states, and there’s an even greater complexity in the international surrogacy scenario.

Who’s Afraid of Virginia Woolf?

Besides nature, literature itself conspires to hold up the belief that reproduction, procreating, is but inevitable, a natural fact of life. Virginia Woolf’s notes to herself record her fears of being childless, and her resentment of her sister Vanessa on this count. Yet it is her writing that brings Woolf happiness – a fact recounted as well in the Turkish novelist’s Elif Shafak’s memoir of her own writing life, Black Milk: On the Conflicting Demands of Writing, Creativity and Motherhood.

In the play, Who’s Afraid of Virginia Woolf?, Edward Albee, who died recently, writes of George and Martha who make up an imaginary child, bring him up to young adulthood, and live a conflicted life because of this fiction. Lady Macbeth in Shakespeare’s play appears as a scheming, villainous woman, a fact almost synchronous with her having no children of her own.

A decision to go in for In Vitro Fertilisation (IVF) is fraught with stress – with the wait and confusion over the many probable scenarios that could unfold – a state of mind Boggs shares with others on her online support group. It is the only forum where such confidences can be aired with some confidence, in a world otherwise largely indifferent, or too curious.

But IVF is invasive, and undignified (as are other medical procedures, Boggs rationalises) and comes with its own set of health, legal and ethical issues. And Boggs doesn’t detail the other side of the IVF story: of the unregulated practices that surrogates in the developing world, forced to cater to a growing, global market, have to go through, in their IVF cycles.

Adoption has been an option as well, entailing as much waiting, with a daunting regime of regulations to wade through. Adoption options come with uncertainties too – especially in countries where adoption agencies are only loosely regulated, so that the child too may become an unwilling victim, remaining forever unsure of her own story.

The new kind of family

The other side of the waiting story features same sex couples keen to have their own families and yet hemmed in by laws and myriad regulations. But increasingly, Plan B families, (a term coined, as Boggs says, by the sociologist Martha Ertman in her book Love’s Promises), set up the uncommon way, via adoption, ART, family blending, same-sex or single parenting, are a viable option. Some of them, whose stories Boggs narrates, have found a way to work around the system.

Todd and Gabe, who married after the Obergefell decision, opted for gestational surrogacy to have their own baby. With North Carolina’s laws being daunting, they chose an Israeli firm, Tammuz International, which offered a somewhat complicated gestational surrogacy option, factoring in Israel’s own strict laws relating to surrogacy. So it involved egg donations in South Africa, an Indian woman who travelled to Nepal as a surrogate, and medical services in Nepal. It might read as an example of globalisation at its most extreme and it does.

The firm appears in some sections of a documentary on surrogacy titled Google Baby, and it’s clear to Boggs that with surrogacy, “there are no rules and everything is rushed”. As some sections of the documentary reveal, It is clear that at times the women who offer themselves as surrogates are forced to go along, and it is the men who make the decisions.

The shadowy world of surrogacy

The experience in Nepal is well documented in an NPR story, where newborn babies, who also survived the earthquake of April 2015 thanks to efforts of local nurses, were airlifted to safety by Israel with their adoptive parents while little was done to secure the lives of the surrogates – Indian women who survived the quake but were left behind in Kathmandu.

It is this vulnerability that makes the surrogacy scenario so exploitative. It made countries like Thailand, Nepal and, more recently, India, take steps to ban commercial surrogacy. Such measures, especially in the Indian instance, as Gita Aravamudan has detailed, are more reactive than helpful. Rather than ensuring more checks on agencies that provide services and associated ones that thrive on medical tourism, altruistic surrogacy will now be available only to heterosexual couples in India, and those married for five years.

The ART industry is also discriminatory within the US, where treatments and insurance coverage are clearly more easily available to a certain demographic group (white, upper class American) than others. African-Americans, especially the less well off in this group, Boggs narrates, are at times discouraged and often have little recourse but to “folk medicine”.

This goes for same-sex couples too, given that some states have religious liberty laws in place that enable institutions to deny access/service to some. That “medicine indeed serves as a gatekeeper” is a story familiar in the Indian scenario as well, considering that ART appears to be more “easily accessed” by celebrity couples in the film world and in politics.

A short scene in the film Google Baby has an obstetrician coldly asking a weeping woman in a Delhi clinic if she is happy, while some distance away, lies her newborn surrogate baby. As critics of the Indian government’s new proposed law have pointed out, it’s not clear if the law will safeguard the mother’s rights or even the child’s.

ART can be empowering, as it hopes to foil the limitations of the human body. It is also born of the changing notions of marriage, of what families can be, and of parenthood. Such definitions will only change, and laws and regulations – for marriage and parenthood can no longer be simply defined by what is natural – need to be fair too.

The Art of Waiting: On Fertility, Medicine and Motherhood, Belle Boggs, Graywolf Press.