In the early stages of this blog, I wrote a post about in vitro fertilization. I essentially wondered out loud why people would attempt IVF given the fact that there are babies "out there" in needs of homes. I basically asked, "Why don't you just adopt?" In the years since I first asked the question, I've realized that the answer isn't nearly as easy or obvious as I once thought. My friend Ellen Painter Dollar has helped to complicate the issue for me through her writing about reproductive ethics. I'm grateful that Ellen was willing to offer an answer to my question here today (and I'm excited to read a draft of her forthcoming book, No Easy Choice: A Story of Disability, Parenthood, and Faith in an Age of Advanced Reproduction (Westminster John Knox, January 2012)) :
Nine years ago, my husband and I went through an emotional, expensive, ethically fraught attempt to conceive a child via preimplantation genetic diagnosis (PGD, which is IVF with the added step of genetic screening of fertilized eggs). We wanted a biological child who would not inherit my genetic bone disorder, osteogenesis imperfecta (OI). Our first child inherited OI, which causes frequent broken bones, and we hoped for a healthy second child. Our IVF/PGD cycle failed and we went on to conceive two more children naturally, neither of whom inherited the disorder. The ethical, theological, and emotional conundrums of reproductive technology have since taken center stage in my writing work.
I read every account I come across of people who have used or considered assisted reproductive technology to have a child. Inevitably, a number of readers point out that the world is full of needy children who could thrive in a loving family. Given the fact of such children's existence, and the expense, moral quandaries, and risks involved in assisted reproduction, readers ask, "Why don't you just adopt?"
In some ways, it's a reasonable question, especially given the more and more frequent stories of people going to questionable lengths to have children via assisted reproduction—a grandmother serving as gestational surrogate for her own IVF-conceived grandson, Western couples hiring low-income Indian women to gestate their babies.
But ultimately, "Why don't you just adopt?" is not a useful question. Besides making people feel defensive for experiencing the fundamentally human urge to conceive and bear a child (and defensiveness stifles helpful conversation), the question "Why don't you just adopt?" glosses over some important truths about adoption.
Adoption is not simple. As with assisted reproduction, adoption can be a complex and emotionally fraught process. In both cases, prospective parents confront questions and assumptions—about why they want children and how they will raise them—that those who conceive naturally do not. No one responds to a couple's pregnancy announcement by asking, "Why didn't you just adopt?" No one did a home study of me and my husband before we brought our firstborn home from the hospital. And while all parents must ultimately accept the heart-stopping uncertainties of raising children, adoptive parents have to confront much uncertainty up front, as they agree to abide by others' timing and enter high-stakes relationships with birth parents, foster parents, and various agencies.
Adoption can be expensive. A relative shortage of U.S. babies available for adoption has fueled two trends: (1) the increasing use of assisted reproduction, and (2) a higher number of international adoptions. International adoptions, as well as private domestic adoptions, can cost tens of thousands of dollars, the equivalent of several IVF cycles. Although adopting through state agencies can be less expensive, the pool of healthy infants is small. Some parents-to-be are eager to adopt an older child or one with special needs, but some are not. (And I've noticed that adoptive parents whose kids have special needs are often the first to say that parents should only take this step if, after careful consideration, they are certain it's the right one for them.)
Needy children are not the same as adoptable children. Read a newspaper on any given day, and it is obvious that there is no shortage of needy children. But that does not automatically translate into an abundance of adoptable children. Some adoption experts, for example, discouraged the altruistic desire of some Americans to adopt orphaned Haitian children after the 2011 earthquake, arguing that these traumatized children most needed to receive aid within the communities they knew, in the care of extended families whom they loved, and vice versa.
Wealth and poverty complicate adoption. In his book Pursuing Parenthood, theologian Paul Lauritzen identifies a "myth of unwanted children," writing that "even to talk about 'unwanted children' may be misleading in situations where a woman is relinquishing a child not because she is unwilling to care for her child, but because she is unable to do so. . . . To speak about 'unwanted children' is to fail to take seriously what is perhaps the most compelling reason women relinquish children, namely, poverty." The blurry line between "I don't want my child" and "I can't care for my child" raises some moral questions. There is potential for exploitation when desperate parents relinquish their children and better-off parents are looking for children to adopt. This is not to say that adoption is necessarily exploitative, but neither is adoption always a clear win-win solution for needy children and people who long to become parents.
Adoption is one way to become a parent, not an act of selfless heroism. Those who dismiss the desire for biological children as selfish (particularly if assisted reproduction is necessary), while holding up adoption as selfless, diminish the powerful forces—biology, emotions, circumstances, vocation—that influence people's decisions about whether and how to create a family. One friend, the mother of two sons through adoption, admits that it bothers her when people say her boys are "lucky" or that she and her husband are "heroes" for adopting them. From her perspective, "All we did was create a family!" People pursue parenthood for many reasons, conscious and unconscious, selfish and noble. Good parenting requires a large dose of selflessness, whether one's children are adopted or biological. And for Christians, parenthood as a vocation means that decisions about how to build a family are considered in light of our faith. My friend who adopted two boys did so not because she was infertile, but because she and her husband sensed that God was leading them toward adoption.
Adoption involves loss. Paul Lauritzen put it succinctly: "We must face the fact...that every adoption involves loss." More and more often and openly, adoptive parents are addressing the painful losses their children experience—loss of family history and identity, loss of early relationships. Children adopted from other countries, for example, often spend their early lives with foster parents who are the only mothers and fathers these children know before they are taken by adoptive parents to an entirely new place and culture.
In the end, my husband and I were lucky. While my genetic baggage gave us plenty of difficult childbearing decisions to make, we had no trouble conceiving. If we had, could we have overcome our deep desire to have biological children? Probably. Eventually. But we would have had to reach that point in our own way, allowing time to grieve the experience of bearing biological children and adjusting our vision of how our life with children would come about. We would not have been convinced to take a completely different route toward parenthood by someone asking the overly simple question: "Why don't you just adopt?"
*This blog post is adapted from my forthcoming book, No Easy Choice: A Story of Disability, Parenthood, and Faith in an Age of Advanced Reproduction (Westminster John Knox, January 2012).