There's nothing wrong with not having children

From a speech by Ruth Deech, the Chair of the Human Fertilisation and Embryology Authority at Guildhall University

When the Pill was invented and brought into widespread use, it seemed to women that power had been granted to them over aspects of their lives that previously had seemed irreconcilable. Now they could avoid having babies when they wished and have them when they did so wish, and thus build reproduction around career progress. Although this belief turned out to be unfounded, it gave confidence to a generation of women to forge ahead and choose their paths as if they were as unencumbered as men. But it has not turned out to be as free and easy as it seemed.

When the Pill was invented and brought into widespread use, it seemed to women that power had been granted to them over aspects of their lives that previously had seemed irreconcilable. Now they could avoid having babies when they wished and have them when they did so wish, and thus build reproduction around career progress. Although this belief turned out to be unfounded, it gave confidence to a generation of women to forge ahead and choose their paths as if they were as unencumbered as men. But it has not turned out to be as free and easy as it seemed.

This evening, I would like to address the theme of women's autonomy in decision-making in the complex and developing field of assisted reproductive technology (ART). Does the demand for and practice of ART and the relevant law embody a belief about a certain way to live and what is normal? Are there hidden agendas and unacknowledged values?

This has to be described in the context of women's desires and place in society. I am using the term "feminism" for this. It is traditional to see the woman as mother and carer. Her right to choose in questions of fertility may be in competition with the husband's, the wider family and the as yet unborn children.

The hallmark of autonomy and the integrity of the self is the right to make decisions about one's own body and regulate one's own fertility. Is woman's autonomy allowed to flourish under the law and practice of ART? I would argue that it is, as long as it is protected by the 1990 Act and the medical law of the country, shortly to be reinforced by the Human Rights law.

Yet I wonder whether woman's autonomy is undermined by popular perceptions of her as a mother, always wanting to be a mother and nothing else. This is often meant kindly, but is reinforced by the press ("my miracle baby"), to the fascination of the warm-hearted public. Women tend to take responsibility for infertility in a couple, regardless of its source. Infertility is increasingly portrayed as a disease for which there is a cure if the woman tries hard enough and spends enough.

This portrayal resembles the description of the exhortation to "fight" cancer, as if it is the victim's fault for succumbing: on this topic, see John Diamond. Is it being assumed that all women are incomplete if they have no children, whether voluntarily or involuntarily? There is a risk that new techniques, which have scarcely been tested as safe or viable, are rushed into use by clinicians in order to be ahead of the field and to be able to advertise themselves as such.

One sees the phenomenon of men and women remortgaging their homes and disposing of their life savings in order to undertake repeated attempts at fertility treatment, sometimes, one suspects, without even a conclusive diagnosis. Is it acceptable for a doctor to encourage a woman to undertake 10 or more treatment cycles, and has he had regard to her feelings about this and the effect on the child, were it ever to be born?

I wonder whether society takes sufficient account of the possibility that women's lives might be considered just as worthwhile and purposive without children as with children. I am concerned that ART should not be pushed so far that men or women are made to feel incomplete unless they can reproduce.

The moderating influence in this scenario of potential conflict is statutory regulation. It requires that doctors and scientists inform patients and subjects, and then abide by the choices that these people have made. Should feminists require any more than that? They should certainly be opposing the unregulated application of new and possibly risky techniques to women. They should be considering the four ethical principles that I have described as the basis of HFEA work: the welfare of the child, safety first, autonomy and control over one's own body, and respect for the embryo.

I hope that this audience, having considered women's status and IVF, can bring their own views to bear on the public and private discussion of these issues. They are bound to increase in the future.