324

Baier, Annette. 1985. Postures ofthe Mind: Essays on Mind and Morals. Mi
of Minnesota Press. ,\
Callahan, Sidney. 1987. "A Pro-life Feminist Makes Her Case." Utne R,i Section B:
10 4-1 4. Procreative Technology and Procreative Freedom
CARALIHalifax. 1990. Telling Our Stories: Abortion Stories from Nova Sco·
Halifax (Canadian Abortion Rights Action League).
Diamond, Irene, and Lee Quinby. 1988. "American Feminism and the Lang
Feminism & Foucault: Reflections on Resistance. Edited by Irene Diamon
Boston: Northeastern University Press. .
Eisenstein, Zillah R. 1988. The Female Body and the Law. Berkeley: Univ,
Press.
Hoagland, Sara Lucia. 1988. Lesbian Ethics: Toward New Value. Palo Alto, C
The Meanings of Choice
bian Studies.
Lange, Lynda. 1983. "Woman is Not a Rational Animal: On Aristotle's Biol~, in Reproductive Technology
tion." In Discovering Reality: Feminist Perspectives on Epistemology, Metap
ogy, and Philosophy of Science. Edited by Sandra Harding and Merill B.
drecht, Holland: D. Reidel. Barbara Katz Rothman
Lerner, Gerda. 1986. The Creation of Patriarchy. New York: Oxford.
Luker, Kristin. 1984. Abortion and the Politics ofMotherhood. Berkeley: Univer:
Press.
MacKinnon, Catherine. 1989. Toward a Feminist Theory ofthe State. Cambrid
University Press.
McDonnell, Kathleen. 1984. Not an Easy Choice: A Feminist Re-examines ice and information have served as the cornerstones of the women's health and
The Women's Press.
roductive rights movements. We are, above all, pro-choice. We support the
Morgan, Kathryn Pauly. 1987. "Women and Moral Madness." In Science, Mo
Theory. Edited by Marsha Hanen and Kai Nielsen. Canadian Journal ofP of the individual woman to choose, to choose pregnancy or abortion, to
mentary Volume 13: 201-26. alternative medical treatments or none at all. And choice, we claim, rests
Murphy, Julien S. 1989. "Should Pregnancies Be Sustained in Brain-dead on information: to choose treatment for breast cancer, for example, requires
sophical Discussion of Postmortem Pregnancy." In Healing Technology. ation on the full range of medical treatments, their side effects, and their
tives. Edited by Kathryn Srother Ratcliff et al. Ann Arbor: The University ility of success. .
Overall, Christine. 1987. Ethics and Human Reproduction: A Feminist An
MA: Allen & Unwin. emphasis on choice and information all sounded very logical at the time,
Petchesky, Rosalind Pollack. 1980. "Reproductive Freedom: Beyond ed like women were going to get more and more control as first their access to
Choose.''' In Women: Sex and Sexuality. Edited by Catharine R. StimpsoJ} ation and then their choices expanded.
Person. Chicago: University of Chicago Press. '0 beginning to have second thoughts.
Sumner, L. W. 1981. Abortion and Moral Theory. Princeton: Princeton Univ,
ology is also about information, and about choice. More information on
Thomson, Judith Jarvis. 1971. "A Defense of Abortion." Philosophy and Publ;
Tooley, Michael. 1972. "Abortion and Infanticide." Philosophy and Public Affi ·ngs work seems to give us more choices, new and better ways of doing things.
65· true of the technology of transportation, which brings us cars and jets, and of
Van Wagner, Vicki, and Bob Lee. 1989. "Principles into Practice: An Activist' chnology of reproduction, which brings us the Pill, amniocentesis and fetal
Reproductive Health Care." In The Future of Human Reproduction. E ors.
Overall. Toronto: The Women's Press. [
while technology opens up some choices, it closes down others. The new
Warren, Mary Anne. 1973. "On the Moral and Legal Status of Abortion." The
_ _ _ .1989· "The Moral Significance of Birth." Hypatia, 4, 2 (Summer): 4 is often greeted with such fanfare that the silent closing of the door on the old
\'\Thitbeck, Carolyn. 1973. "Theories of Sex Difference." The Philosophi goes unheeded. For example, is there any meaningful way one could now
(Fall/Winter 1973-74): 54-80. e horses over cars as a means of transportation? The new choice of a 'horseless
ge' eventually left us 'no choice' but to live with the pollution and dangers (as
s the conveniences and speed, of course) of a car-bas'ed fransportation system.
roductive technology is heralded for its choice-giving capaCity. For those who
ord it, the enormous growth of information about reproduction does make
newly possible: the pregnant can choose whether or not to continue the preg-

325
326. Procreative Technology and Procreative
nancy, can even learn more about the fetus and then choose whether or not
tinue; the infertile can choose new ways of attempting pregnancy; birthing
can choose alternative ways of managing their labors and births. Choices ab
want to look a bit at the negative side, though, look to see what, if any, cho
being lost to us, going the way of the horse.
Fetal monitoring is a good place to start. Fetal monitors, belts to go aro
pregnant belly and electrodes to screw into the fetal head during labor, are a
reproductive technology whose sole stated purpose is to bring more informa
enable more and better choices. By knowing more about the condition of th
during labor, more informed choice was to be possible for the management of
bor. But some strange things happened. We didn't really get all that much rna
formation than we had before-good nursing care always provided considerab
formation about the fetus. It certainly did look like more information though
those long strips of print-out. But more importantly, the information came in
context. Instead of having to approach the woman, to rest your head near he
to smell her skin, to feel her breathing, you could now read the information
fetus from across the room, from down the hall. While still one being on
medical personnel came to see the woman and fetus as separate, as two diffe
tients. And indeed more choices could be made: the fetal heart rate indi
distress-should the mother be sectioned?
When a woman chooses to have a cesarean section because she is informe,
fetal monitor indicates some distress, is she gaining or losing control? In
answer is going to depend on the accuracy of the information. If medical
ners are overly quick to read fetal distress, as they have been, then the loss Q
is clear. The woman is having major surgery, with all of its attendant ris
health and life, making herself sick, weak and dependent as she enters mot
But if the information is correct, and the fetus, her baby, is at risk and th
could ensure its greater health, then she is gaining control over her mothe
she makes this short-term sacrifice for the long-term health of her child.
What happens when the woman and her medical practitioners disagree
either about the accuracy of the information, or about the choice which
made based on the information? What if a pregnant woman does not wan
this sacrifice? Has all this new information expanded her choices? It seems.
icine is once again turning to the state, as it has so many times in the p'
medical choice ahead of women's choices. In several bedside Juvenile Court
with a lawyer appointed to represent the unborn fetus, another represe
pregnant woman, and yet others representing the hospital, women have los
to choose, and have been ordered to submit to cesarean sections, the fe
them claimed by the state as a 'dependent and neglected child'. (Hubbard,
Thus information may expand the opportunity for choices, but it cert
not guarantee whose choices will be honored.
We thought that information would give us power. \"lhat we perhaps ove
that it is power which gives one control over both information and choice:
'eative Technology and Procreative Freedom
327
'he choice of contraception simultaneously closed down some of the choices for
families. North American society is geared to small families, if indeed to any
dren at all. Everything from car and apartment sizes the picture book ideal of
"'es encourages limiting fertility. Without the provision of good medical care,
care, decent housing, children are a luxury item, fine ifyou can afford them. So it
choice all right that contraception gave us, and a choice we may very well experi-
as being under our control, but it may be a somewhat forced choice. In its ex-
e, legislation has been repeatedly introduced to punish 'welfare mothers' by cut-
off payments if they have more children. Sterilization abuse is the flip side of the
rtion battle: the same sorry record....
a there may be choice brought to us by information and technology, the choices
get when we learn how to use contraception and back-up abortion for fertility
trol, but the choices may very well be heavily weighted for, or against, us.
oth the medical monitoring and management aflabor, and the use of contracep-
and abortion, are very well-established aspects of reproductive technologies; it
t the specifics which keep changing, as newer techniques, machinery and chem-
get introduced. The next level of reproductive technology I want to address
lbines fetal monitoring with fertility control to produce something new: 'quality
01: control not just of the number of children we bear, but of the 'quality' or
·tion of those children.
niocentesis and sonography are the technologies which provide the informa-
to make this new set of reproductive choices possible. Sonography, the use of
d waves, allows the visualization of the fetus in utero, and the detection of gross
ornical deformities. Amniocentesis is the withdrawal of a small amount of the
'otic fluid which surrounds the fetus. When done between the sixteenth and
ieth weeks of pregnancy, the fetal cells in the fluid can be cultured and exam-
Other tests can also be performed on the fluid. These techniques allow the di-
:is of many (under a hundred at this writing, but increasing all the time) genetic
es and syndromes. Test results are available by the twenty-fourth week, the le-
it on abortion in the United States. If the fetus is found to have a terminal ill-
ike Tay Sachs disease which invariably kills in eary childhood), a severely inca-
ting condition (a syndrome which leads to such profound retardation that the
,ould be unable to learn to walk or to talk), a moderately disabling condition
'heekhair-bound or unable to walk without assistance), or a socially undesir-
ndition (if, for example, the fetus is found to be of the 'wrong' sex, such as a
If fourth daughter), a woman can use this infof};nation to choose an abortion.
opening up Of choices and control with this te¢hnology is astounding. There
Ufse, still no guarantee of a perfect baby-and even a perfect baby can be
:erribly imperfect in accident or illness after birth-but one no longer need
'Wn syndrome, spina bifida or a host of other diseases and unwanted condi-
is of course begs the basic question of what makes any particular condition
disabling or undesirable. Why Down syndrome, why daughters, why
air-bound? But information is available, and information makes choice pos-
328 Procreative Technology and Procrl
sible. And it is the woman's choice. There may be pressure, subtle or p
genetic counselors, doctors, family members, but it is still the woman
to abort or not to abort. Or is it?
When we have this information, when we make these choices for our
we not then accepting responsibility for their condition, responsibility
genuine control? If we choose not to abort a 'defenctive' fetus, and the
lescent it becomes hurls at us, as adolescents so often have, 'I didn't ask
whatever are we going to say now? Will our children be able to sue us fi
life, as they have successfully sued their doctors? The doctors failed to pro
formation which would have given the mothers the choice of abortion.
mother who, given the information, chooses not to abort? Can she be he.
ble for her child's condition, denied state services, insurance payments,
with child abuse?
And if we do choose to abort, is that truly a choice? What of the worn
the fourth floor, walk-up apartment in a city designed without access
abled-is her 'choice' to abort a fetus with spina bifida an exercise in free
of the woman with few economic or family resources who chooses to a'
with Down syndrome because she is fully and truly informed about the st
which will be available to her child after her own death?
It seems that, in gaining the choice to control the quality of our child
be losing the choice notto control the quality, the choice of simply accep
they are.
There are ... genetic conditions ... about which we might be better 0
ing. XYY, the genetic condition which some studies suggested may be Ii
inal behavior, is an example. The studies have been largely discredited,
search shows there are women currently aborting XYY fetuses beca
potential father said, 'It's hard enough to raise a normal kid. Ifhe throw:
across the room will I think he's doing it because he's two, or because he
What will happen as we get even more information, if we can begin to
just retardation, but which fetuses are likely to become children of borde
not just Tay Sachs, but which fetuses are likely to develop juvenile diabe
information may be giving us choice, but is it coming any closer to giving
And finally, briefly, what of the great expansion in the treatment of inti
its choices? .. , All of the technology still leaves many couples, about a
of those treated for infertility, without a pregnancy. At what point is it
their fault, out of their control, inevitable, inexorable fate? At what point
on with their lives? If there is always one more doctor to try, one mor,
around, then the social role of infertility will always be seen in some sens
they chose to give up. Did taking away the sense of inevitability of the'
and substituting the 'choice' of giving up truly increase their choice an
trol?
There are those who are successful with the new technology, those for
drugs and surgery are a success. Surely they have now experienced the cho
'ea tive Technology and Procreative Freedom 329
od, and so their choices have expanded and they have gained control over their
Indeed they have, just as contraception and abortion provide us with the very
and very true experience of controlling our fertility. Choices open and choices
For those whose choices meet the social expectations, for those who want what
'bciety wants them to want, the experience of choice is very real.
rhaps what we should realize is that human beings living in society have pre-
little choice ever. There may really be no such thing as individual choice in a
structure, not in any absolute way. The social structure creates needs-the
for women to be mothers, the needs for small families, the needs for 'perfect'
<iren-and creates the technology which enables people to make the needed
ices. The question is not whether choices are constructed but how they are con-
cted. Society, in its ultimate mean1ng, may be nothing more and nothing less
the structuring of choices.
The question then for feminism is not only to address the individual level of 'a
man's right to choose' but also to examine the social level, where her choices are
ctured. Yes, we will have to continue to fight the good fight for information and
choice, the rights of the individual womap to choose contraception, abortion,
iocentesis, pregnancy by in vitro fertilization, pregnancy by donor insemina-
, labors with and labors without electronic fetal monitoring, to have no children
o have one child or to have many children. We must not get caught into discus-
s of which reproductive technologies are 'politically correct,' which empower
which enslave women. They ALL empower and they ALL enslave, they all can be
by, for, or against us. We will have to lift our eyes from the choices of the indi-
al woman, and focus on the control of the social system which structures her
ices, which rewards some choices and punishes others, which distributes the re-
ds and punishments for reproductive choices along class and race lines.
'here will never be 'free' choice, unstructured reproductive choice. But the struc-
in which choices are made should, and I believe ultimately can, be made fair,
'cal, moral. Individual rights to information and to choice are an absolute neces-
for such a system, but are not alone sufficient to ensure an ethics of reproduc-
e next step in the politics of reproductive control is the politics of social control.
References
ard, Ruth. 1982. 'Some Legal and Policy Implications of Recent Advances in Prenatal Di-
nasis and Fetal Therapy.' Women's Rights Law Reporter, Spring,? (3): 201-18.