Pregnancy

Secrets of the sperm bank

What do we want from a donor? An expert explains the hidden dynamics of the fertility industry

(Credit: iStockphoto/ignasi_martn/Salon)

Since the economic downturn, a growing number of Americans have begun making money off their bodies. Since the recession began, the number of aspiring sperm and egg donors has surged dramatically in the United States. In 2009, some sperm banks saw a 15 to 20 percent increase in applicants, while, in 2008, egg agencies reported a similar rise — including, at one company, a 40 percent increase in wannabe egg providers. At a time when other industries are collapsing, the sex cell business seems to be doing well for itself. But what is it actually selling?

“Sex Cells,” a new book by Rene Almeling, an assistant professor of sociology at Yale University, pulls back the curtain on the egg and sperm market. She looks at the ways our cultural assumptions about gender roles influence not only the egg and sperm donation industry but also the people within it. As it turns out, egg and sperm donors have remarkably different experiences of the process. “Sex Cells” explains how this unique industry shapes the way we think about gender and parenthood.

Salon spoke to Rene Almeling over the phone about the strange rhetoric of the sex cell industry, which donors are most valued and what this says about the American family.

Egg and sperm donors are essentially providing the same thing, so why are they treated differently by sperm banks and egg agencies?

Egg agencies and sperm banks are both in the business of recruiting sellable donors who will attract recipient clients. But the details of how they go about doing this reveal the importance of gendered stereotypes in their day-to-day operations. For example, drawing on the stereotype of women as nurturing caregivers, egg agencies emphasize the plight of infertile couples so that women will want to “help” people by giving the “gift of life.” In contrast, sperm banks rarely mention recipients, and they encourage men to think of donation like a job.

One cheeky ad calls on them to “Get paid for what you’re already doing!” So the market for sex cells is structured both by traditional economic forces, such as supply and demand, and also by cultural expectations of women and men that are associated with reproduction and the family.

Are there biological explanations for the differences?

For most people, the first thing that comes to mind when I talk about comparing egg and sperm donation are biological sex differences. Women who provide eggs must self-inject fertility medications for several weeks before undergoing outpatient surgery. Sperm donors do not face any such physical risks, to say the least. But many people do not realize that sperm banks require men to donate on a regular basis, usually once a week, for at least a year. It costs a lot of money to screen donors, so sperm banks have to make sure that the tiny fraction of men who are accepted as donors will produce enough samples to make the investment worth it.

All that is to say that there are biological differences between women and men and there are technological differences between egg and sperm donation, but neither biology nor technology explains why producing eggs for money is a “gift” and producing sperm for money is a “job.”

How does the screening process differ between men and women?

Egg agencies and sperm banks require extensive medical evaluations of all donors, including a family health history that goes back three generations, but that is where the similarity ends. Many of the screening standards are driven by social concerns. Sperm banks usually require that men be at least 5 feet 8 inches tall. Egg agencies don’t set height minimums. Most sperm banks require that men be enrolled in college or have a college degree. Egg agencies do not. Most egg agencies require psychological evaluations to assess how women feel about having children out in the world. Sperm banks don’t require that men discuss this possibility with a mental health professional.

But that carries an illogical assumption that the sex of the child will be the same as the sex of the donor. So why might a donor be rejected?

The largest egg agencies in the country receive hundreds of applications every month, so they can afford to be picky. Some differences are driven by medical guidelines to optimize fertility. For example, egg donors must conform to rigorous height and weight ratios, but sperm donors do not. And women over 30 are unlikely to be accepted as donors while sperm donors can donate until they are 40.

Even though most of the egg and sperm donors I interviewed reported that they were motivated by the money they could make, being honest about that would result in a woman’s application being thrown in the trash. Egg agencies prefer women who are motivated by altruism, or at least say they are motivated by altruism, because otherwise they violate the cultural framing of egg donation as a gift from one woman to another. Sperm banks are just the opposite: They expect men to be motivated by the money.

Who are the most valuable donors for agencies?

There were really interesting differences by gender and race. Egg agencies and sperm banks post “donor catalogs” on their websites, and they strive for diversity of various kinds — racial, ethnic, religious, and even donors’ hobbies — to appeal to a diverse recipient population. In all of the donation programs where I did research, staffers complained about the difficulty they had recruiting African-Americans and Asian-Americans, so these donors were considered particularly “valuable.” In a given sperm bank, all men are paid the same rate, usually around $75 or $100 per deposit. In contrast, some egg agencies will adjust a donor’s compensation based on her personal characteristics, including race. As a result, sometimes African-American and Asian-American egg donors are paid a few thousand dollars more than white donors.

It seems silly that this is referred to as a “donation” when people are getting paid.

Fertility is a multi-billion dollar industry in the United States. However, the idea of selling body parts makes people very uncomfortable, so the euphemistic language of donation suffuses the market for eggs and sperm. Staffers at egg agencies and sperm banks consistently use this rhetoric, even as they make profits on the sale of sex cells. Egg and sperm donors use it, even as they earn thousands of dollars for their genetic material. And recipients of sex cells use it, even as they purchase eggs and sperm in the hopes of conceiving children.

Do male and female donors react differently to their experience?

Framing paid donation as a gift or a job has profound implications for egg and sperm donors. Egg agencies are constantly thanking women for the wonderful difference they are making in the lives of recipients, so egg donors spoke with a great deal of pride about helping people have children. Some egg donors even described the money they received as a “gift” for the gift they had given. Sperm banks treat men more like employees who are expected to clock in on a regular basis, and sperm donors respond by calling the money “income” or “wages.” More importantly, several of the sperm donors said they felt like “assets” or “resources” for the sperm bank, which reveals a sense of self-objectification. I didn’t hear that kind of language from the egg donors, even though they are making much more money than sperm donors. These kinds of differences demonstrate the power that fertility agencies have in shaping donors’ views. Framing donation as a gift or a job is not just a matter of rhetorical flourish. There are actual effects on how women and men experience the exchange of sex cells for money.

How is sex cell donation changing our ideas about family?

Donors are often asked, “How does it feel to have children running around out there?” The truth is that women and men will answer this question in different ways, but not because biology is dictating their responses. Not only are donors responding to how fertility agencies organize the process of selling sex cells, they are also drawing on a longstanding cultural assumption that the male contribution to reproduction is primary. Sperm donors think of their seed as essential to the child, downplaying the role of the recipients in conceiving, gestating, and rearing the baby. Egg donors do just the opposite, de-emphasizing the egg and pointing to the recipient’s nurturance in pregnancy and beyond. So along with all those who rely on reproductive technologies to have children, egg and sperm donors are building on old stereotypes to craft new definitions of motherhood, fatherhood and, ultimately, what it means to be a member of a family.

One of the most interesting aspects of your research is that egg donors do not see themselves as mothers while sperm donors do identify as fathers.

It is interesting because egg and sperm donors each provide half the genetic material needed to create an embryo, so they have the same biological connection to the children who result. Yet sperm donors have a straightforward view of themselves as fathers, while egg donors insist they are not mothers. This is the opposite of what many people would expect, given the greater physical commitment of egg donation and our beliefs about maternal instinct. But it begins to make sense when you take into account the emphasis that egg agencies place on recipients.

Egg donors consider the recipient to be the “real mother,” because she is the one who will carry the pregnancy, give birth and raise the child. Women can make this distinction because, thanks to technology, maternity is more easily separated into different parts than paternity. One woman can provide the egg, another can carry the pregnancy and a third (or more) can raise the child. All of these women can lay claim (or not) to the label of “mother.” Fatherhood is more often reduced to a cultural equation in which sperm equals dad. Sperm donors rely on just this definition of fatherhood, particularly because they are not asked to think much about the people who use their donations to become parents.

Hot, naked and pregnant

How a nude photo shoot at nine months changed the way I see my own body -- and my role as a "mommy"

(Credit: Loskutnikov via Shutterstock)

I’m standing in front of my house in a light rain, in the altogether, eight-and-a-half months pregnant, while a photographer snaps photos. I’m tucked into the hedge, hoping the neighbors don’t have a view from their windows. I’ve never been so happy to be naked.

A year earlier, I had tumbled into a mid-life crisis. I had one child who was nearly three, and my husband and I were planning for a second. This had always been our intention, and I approached this second foray without much anxiety. But when my younger sister called to tell me she and her boyfriend were going to London, something inside my head was knocked loose. “Damn,” I thought. “I’m going to be a MOMMY.”

Yes, I know what you’re thinking: You’ve been a mommy for three years. Get over it.

But it wasn’t the prospect of becoming a parent that freaked me out. I loved my little boy and wanted to add another goofball to the family. What threw me into a tizzy was the prospect of being a mommy and all the cultural baggage that came along with it. With one child, you could be that interesting woman with the cute kid who still retained a modicum of cool. But the second child would define you. This is faulty logic, I know, but I believed it nonetheless: A mommy is invisible. A mommy has bad jeans and a minivan. Twenty-five-year-old boys would never check me out. I would never take off to London on a whim.

Our culture certainly didn’t help these insecurities. “Mommy” is used to denigrate female parents. Professional women planning to have children are on the “Mommy track.” When we write about our experiences, we are “Mommy bloggers.” When we differ about parenting, we engage in “Mommy wars.” When we get into a little erotica, it becomes “Mommy porn.” Once identified as a “mommy,” we’re identified as little else.

No matter that I was never that cool or adventurous in the first place. I was the high school valedictorian, the Goody Two-Shoes. I’d had two boyfriends and married one of them. I always win “I’ve Never” because, really, I’ve never. But now I had no chance to be cool. Any possibility was off the table. I considered getting a tattoo or tarting up my wardrobe, but then I realized that doing these things to avoid being a mommy cliché was a cliché in and of itself.

Eventually, I realized I needed to get over myself. The demands of parenting a small child did not leave time to wallow, and at lucid moments I recognized that I would not have young kids forever. I would be able to go to London someday, and I didn’t have to drive a minivan. But my mommy fears still nagged.

A year later — pregnant as can be and irreversibly a mommy — I learned that a favorite local photographer was looking for models for a project on pregnant women. It was an appealing proposition, but there was a catch: She wanted nudes. I dismissed the idea; I couldn’t do a nude photo shoot. But I also realized I did not want to be the type of person who would say no to this.

This is how I found myself in my yard in the nude. I had spent an hour posing with my clothes on — the black bike shorts and black tank that had become my uniform in those sweltering final weeks. The photographer, Ellen, posed shots of me contemplating my belly on the back deck, family portraits in front of a nearby dilapidated barn, and shots of my boy and me frolicking in the neighboring cemetery. We chatted while she clicked away: about pregnancy, our kids, our town, and her work, and I tried not to think about where this was leading.

Eventually it started to rain and we ducked into the front yard, sheltered by a tall hedge. I ignored my misgivings, summoned a little confidence, and shed my clothes.

All along, I hadn’t been sure I could strip. I may not be the person so neurotic she changes in the bathroom at the gym, but I’m also not the woman who wanders around the locker room stark naked. I’ve often struggled with my weight, and I fight the urge to hide my body: too much belly, too much breast, flab and curves where I don’t want them.

But pregnancy gave me a freedom with my body that I didn’t have before and haven’t had since. At nearly nine months, my body was supposed to look like this. I was supposed to have an enormous belly, giant breasts, and a little something extra in the back. I could have done without the tree-trunk thighs, but I could live with those, too. Much to my surprise, revealing this body felt fine. So did the rain on my skin — it was awfully hot being pregnant in June.

Once Ellen began shooting, I adopted a strategy of “don’t look down.” It was best to ignore the absurdity of standing in our tiny front yard, separated from the sidewalk and street by only a hedge. As the shoot progressed, I felt an amazement that I could do this, that I was doing this. I can still see it in the small, pleased smile I’m wearing in the photos. It is equal parts relief, surprise and satisfaction.

Looking at the photos now, years later, I feel a bittersweet pang for those last few days when we were just three, before we became something new. I’m gobsmacked not only by the size of my belly and breasts but also by my nerve.

Later that day, after Ellen left and I had dressed, my husband observed, “Now you’ll never have to get a tattoo.” I’m grateful for that. And I’m grateful that the postman didn’t choose that moment to deliver the mail.

 

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Megan Rubiner Zinn lives in Western Massachusetts with her husband and two sons. Her work has appeared in Jezebel, the Daily Hampshire Gazette (Northampton, MA), VisualThesauraus, and her blog, life in the little city.

Hell-bent on natural pregnancy

I wanted to solve my fertility issues without hormones or high-tech meds. I had no idea how unnatural this would be

I’m not exactly the woo-woo type. I eat meat, shave my armpits, and Birkenstocks don’t fit my feet. But the year I turned 35, I went a little nuts in the New Age department. My husband, Ron, and I had crossed the three-year mark of trying to conceive. So far, our fertility journey had amounted to one miscarriage and countless trips to the doctor. Tests all showed the same thing: Ron had Super Sperm; I had a luteal phase defect. Every month, my period started too early and lasted too long. It’s difficult for a fertilized egg to implant in a uterus that’s constantly shedding its lining.

Attempts to fix my cycle didn’t work. Over time, my bleeding worsened. That’s when my fertility specialist recommended in vitro fertilization. IVF, he said, would allow him to “toy around” with my hormones. As he explained how many types of drugs he planned to inject in my body, I nodded politely while screaming no way inside my head. I was skeptical of high-tech baby-making measures. All that medication didn’t appeal, for one thing. Neither did the odds: I’d seen friends go through multiple failed rounds of IVF (chances are about one in three). From what I could tell, the stress of IVF wreaked havoc on relationships. Couples pillaged their savings and retirement accounts (the procedure is $15,000 a pop). I figured if traditional medicine wasn’t for me, perhaps I could cure my infertility a more traditional way, by changing what I ate and how I lived.

I had no idea that going natural would be so unnatural.

It started off simply. I weaned myself off coffee, kept the wine bottles corked, and threw away my Cocoa Puffs (caffeine might disrupt hormonal balance, alcohol might impair ovulation, and sugar is just plain bad for you, according to my fertility nutritionist). I put the kibosh on two of Ron’s favorite weekend activities: cycling, which could potentially damage his Super Sperm, and grilling out. I was being crazy, I knew, but I promised him it would only last a few months — just until I got pregnant.

Instead of hamburgers, dinner now consisted of daikon seaweed soup, a recipe I got from Julia Indichova, author of the book “Inconceivable” (Indichova conceived naturally after changing her diet and lifestyle, and I clung to her book like a map in the wilderness). I began eating more fruits and vegetables, except for peas, which, according to Indichova, contain a natural contraceptive.

A friend had gotten pregnant with the help of acupuncture. Some studies have found it can boost the chances of IVF success. Though I was skipping the IVF part, I began visiting a practitioner weekly; he poked me with needles to awaken my Qi, which, according to Chinese medicine, is the body’s vital life energy. After listening to my pulse, checking the coating on my tongue, and listening to me spill the details of my life’s struggles in a therapy-like session, he told me that my reproductive area was weak and that the acupuncture would move my Qi to help regulate my menstrual flow. Then he stuck a needle in the external part of my ear, and I yelped in pain. I began to suspect acupuncture wasn’t for me.

Next, I worked with an herbalist who gave me a combination of 15 plant extracts mixed and bottled into a tonic to drink daily. The herbal concoction looked like brown goop and tasted so disgusting I had to hold my breath to swallow the stuff.

When I described my new regimen to my fertility doc, he was open-minded about acupuncture but cautious about the herbs: “Herbs aren’t regulated by the FDA,” he warned. Still, I liked the idea of using plants as medicine; it seemed better than drugs designed to coax my ovaries to pop out 10 eggs at a time instead of one. There was no evidence that the herbs would be effective; other women who had my problem only turned to alternative medicine as a last resort, after IVF had failed. I held out hope that if I tried alternative medicine first, I could avoid IVF altogether.

But even with plenty of sex, followed by Viparita Karani (a yoga pose where I elevated my legs up the headboard to help the sperm along), goji berries (reputed to be an aphrodisiac), and week after week of acupuncture sessions, I didn’t conceive. In fact, I could barely tolerate acupuncture. The needles left me feeling anxious, not relaxed, so I stopped. Instead, I turned back to Indichova’s book to see what additional strategies she suggested to boost fertility: yoga for stress reduction (I practiced regularly), colonics to clean out my intestines (no way), and visualization techniques to bring about physiological changes in the body. That sounded safe enough. A stretch maybe, but much less painful than sticking a hose up my butt.

Indichova cited Gerald Epstein, a physician in New York City, as the go-to guy. So I called him at the American Institute for Mental Imagery and arranged to see him.

Epstein faxed me a visualization exercise to do before my appointment, one that he called the Egyptian Healing. Once a day, for seven days after I ovulated, I was to picture a larger-than-life me taking a journey up my cervix and into my uterus. Maxi-me had five eyeballs —one on the end of each finger of my left hand. I also had five small hands on the end of each fingertip of my right hand. If that wasn’t strange enough, I had to envision using these hands to gather yellow rays from the sun and vanilla beans from a field before climbing into my uterus to take a look around (with five eyeballs, I could see well in there). I cleaned away my hostile uterine lining with a golden brush, planted vanilla beans, and watched orchid petals unfold along my uterine wall. Gold, Epstein said, represented transformation; vanilla was a purifying aroma; and orchids represented strength. I tried to take the imagery exercise seriously, but it was hard not to giggle, which made me feel bad. That’s one of the problems I kept running into with alternative medicine. If I wasn’t diligent and earnest enough, I feared I wasn’t doing it “right.”

When I met Epstein in person I liked him right away. He wasn’t a quack. The more I listened to him, the more I felt what he said had merit. He believes that the mind is a powerful force. “It can both create and destroy health,” he said. To demonstrate how the mind exerts influence on the body he had me hold my arm in place, parallel to the ground, while he pressed down on it. I had an easier time resisting his push when I thought of things I loved (like my husband), but my arm sank when I thought of things I hated (like acupuncture). I was surprised; Epstein wasn’t. “People try to separate the mind and body, but they’re one,” he said.

Along with my fertility nutritionist and my ex-acupuncturist, Dr. Epstein wanted to “investigate my inner conflicts.” Especially those surrounding parenthood. Like most women, I was worried about whether I could successfully juggle my career and motherhood. I hated to admit it, but I was dreading the pregnancy weight gain, and I could easily work myself into a panic when I thought about the logistics of pushing out an 8-pound baby. We also talked about the fact that my extra-long periods began the same month I’d learned Ron and I had to leave California for Washington, D.C., a move I was less than thrilled about. Could my unhappiness about our relocation be causing my period problems? Epstein thought so. He told me about a cluster of cells in the mid-area of the brain known as the locus coeruleus, or blue nucleus, which typically sends neurochemicals to other parts of the brain to help the body function optimally. But in times of anxiety, the adrenal gland secretes stress hormones that deactivate the blue nucleus. To get it functioning again, Epstein suggested that I try reducing my stress hormones with visual imagery and by taking long, slow exhalations.

“Your mental concerns are reflected in your uterine instability,” he said. Now that’s something I never heard from my mainstream doc.

Maybe a super disciplined person can “imaginate” (as Dr. Epstein termed it) faithfully, practice yoga every day, and resist all urges for peanut butter cups, but I struggled to maintain all the rules of my routine. As I fed beets into my juicer, I felt grateful, I did, but I also felt impatient and frustrated. It’s hard being crunchy.

Two months later, my cycle did begin changing; my luteal phase had lengthened by a day. Was it thoughts of vanilla beans that made the difference? The Bound Supta Baddha Konasana I practiced on my yoga mat? With so many factors in play, it was hard to know for sure. But instead of feeling buoyed by this turn of events, I began to feel like a prisoner of my kinder, gentler routine. Giving up cookies was one thing, but after trying to give up wheat (too inflammatory!), meat (too acidic!) and dairy (too mucus-y!) I felt like a martyr, especially when I’d stare hungrily into my cupboard, bare but for a container of uncooked quinoa. I also felt perpetually paranoid. Would I sabotage my chances of pregnancy if I drank one cup of coffee? I canceled a weekend trip with girlfriends — what if I ovulated while I was away? I spent my free time Googling holistic fertility treatments. Ironically, I was caught up in the fertility obsessiveness I’d wanted to avoid in the first place. And I also couldn’t help thinking that while there may well be power in positive thinking, there is also value in giving voice to truth, even if that truth involves a messy uterus and the sadness of infertility.

Whether I pursued holistic medicine, Western medicine, or took a middle ground, I was beginning to suspect there were things I could control (diet and exercise) and things I couldn’t (whether a blastocyst implanted in my uterus). I’d been frantically running in mad little circles with my yoga practice, baked kale chips, and visualization exercises, hoping that I could create a baby by dint of sheer determination. Meanwhile, I’d ignored the fact that there are things that nobody can bring about by force. No matter how perfectly I tried to follow any routine, there were no guarantees I’d conceive.

A few days later, when Ron brought home a bottle of red wine, I let myself enjoy a glass. I needed to loosen my grip on other areas, too. Because whether or not we eventually ended up with a baby, I wanted to move forward in my life, welcoming whatever lay around the bend.

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Jenny Rough is a writer living in Alexandria, Virginia. Follow her on Twitter @jennyrough.

I’ve got “baby fever”

Could there be real science behind the old cliche of a woman's biological clock? I didn't believe it -- until now

(Credit: erikreis/iStockphoto)

It started with a TV commercial. I can’t remember what was being advertised. All I know is that it showed a father holding a newborn baby, and I started to cry — not out of sadness, but awe. A baby, a beautiful baby!

Look, I’m human, and as such, I’ve always found babies cute — but, suddenly, right around my 28th birthday earlier this year, crossing paths with them caused me to grab the arm of my acquaintance as though I’d seen a celebrity. Reactions formerly reserved for baby animals began to apply to human infants. Noticing this shift, a friend who hadn’t seen me for a while remarked, “Since when are you baby crazy?” The real question is: Since when did I become such a cliché?

It’s not that I’m ready to reproduce — good God, no — but I do want to have a baby eventually, though the possibility seems many years off. Will I be ready — emotionally, professionally, financially, romantically — before my fertility nose-dives? This longing feels physically acute — a twitching in my ovaries, an itching in my arms to cradle. In the past, I’d always written off the cliché of the woman in her late 20s or early 30s with a “ticking biological clock” as a sexist trope. Now I find myself reconsidering and wondering how real it is, and why it is.

While common wisdom has it that this desire grows throughout a woman’s 30s, Anna Rotkirch, the director of the Population Research Institute in Finland, says studies have shown “the urge appears to be strongest in the late 20s.” (Dude, I know.) Some women, however, “say they have felt ‘baby fever’ more or less intensely since their early teenage years,” she says. “Other women feel it for the first time in their late 20s.” (You heard it here first: Not all women are the same.)

Rotkirch reported in a paper in the Journal of Evolutionary Psychology that her Finnish interview subjects described the phenomenon in terms of “a painful longing in my whole being” or an “unbelievable aching,” sometimes accompanied by the sensation of having “empty arms” or breasts that “became sensitive and hard.” In a related survey, she found that 58 percent of male respondents and 78 percent of female respondents reported having “experienced a strong desire to have a child of [their] own” — although this seems less a measure of sudden, acute longing than of a general desire to reproduce at some time.

As for why this alleged phenomenon might exist, Rotkirch says we know very little.

“All existing studies use written texts or questionnaires,” she says, which tell us more about how women perceive their “baby lust” rather than the actual origins. Still, Rotkirch has found evidence of a “hormonal underpinning,” she says, with “little influence” of social factors like education or income.

In her paper, she pointed out that, in terms of evolutionary biology, “the ‘default mode’ of the female body is to have experienced both nurturing and pregnancies by the early 20s.” Rotkirch suggested that “longing for a baby can develop as a by-product of hormonal changes that evolved to prepare the woman for motherhood,” she wrote. “Such changes could be induced by falling in love; the ‘nesting behavior’ related to settling down and starting to live with a partner; exposure to infants; and/or by the processes of aging.”

If evolutionary theories are too caveman-y for your taste, there is the undeniable fact that women’s fertility begins to decline in their late 20s, right around the average time that baby panic sets in. She says, “My informed guess is that baby fever is one mechanism for reproductive timing” — or, in other words, a way to urge that “now is a good time to have a baby.” It seems to make intuitive sense, but the science on exactly how this mechanism might work is just not there.

Clearly, though, many women do not ever feel the pull of the ticking clock, or don’t feel it distinctly, and “part of the variation is probably genetic,” she says, “as with most things.” It’s also important to note that men have been found to encounter baby fever too: In an exhaustive study surveying the potential causes of the phenomenon, Gary Brase, an associate professor of psychology at Kansas State University, found that men experience it, just to a lesser degree than women do.

Adding to the lists of “could-bes,” baby fever might just be a “superfluous” feeling arising from “general interest in parenting,” she says. (Although, if a nurturing instinct were the sole explanation, pets would be a far more effective — not to mention cheaper and easier — solution to baby fever.) “At an age were most women in our evolutionary past would have been mothers, or at least surrounded by babies and children, many Western women are not, and this may create a situation where you feel a strong urge to have an outlet and object for your maternal emotions.” Rotkirch points to research on baboons and chimpanzees showing a clear variation in maternal behavior: “Some are very interested in mothering and training to become a mother,” she says, while others are not.

But it’s impossible to ignore the social influence and culture of baby mania — just consider the pregnancy porn in celebrity tabloids and the high-profile exhortations to hurry up and settle down before it’s too late! Then, too, girls are often trained as nurturers from the time they’re in the bassinet. However, Brase, who has studied the issue for nearly a decade, found that beliefs about gender roles — for example, a woman’s conviction that her proper place is in the home — were not strong predictors of baby fever. “Desire for a baby is not strongly connected to people’s gender roles,” he told me.

There is good evidence of a different kind of social influence, though. A Swedish study found that women are more likely to have babies shortly after their co-workers have babies. Is might be a coincidence that my sudden baby ache arrived right around the time that my peers started getting pregnant, or it might not. Within a couple of months of each other, two friends, a family member and a co-worker, all but a handful of years older than me, announced that they had a baby on board. Brase also found that one of the strongest predictors of baby fever was prior positive experiences with babies.

Regardless of whether it stems from our evolutionary roots, there’s no denying that baby fever as a cultural phenomenon or topic of discussion is “a very new and ‘social’ thing,” Rotkirch says. “This is due to the fact that in contemporary developed societies, we grow sexually mature younger but start having babies later than in most other societies through history,” she says. “There is more time to be physiologically mature for a baby without actually having one.”

It’s also the case that women’s greater choices and freedom has resulted in “more ambivalence and decision making,” she says, over whether to have a baby, as well as when and with whom. There are also greater potential barriers related to education and career. Rotkirch found in surveying women that “the longing usually awoke when having a child would theoretically have been possible as the woman was basically healthy and had a satisfying couple relationship,” but “circumstances opposed it, usually the woman’s own life plans, problems in reproductive health, or the attitude of her male partner.”

In an attempt at clarity amid all the hypotheticals, Brase offers, “The short answer is that it is most likely a combination of biology, circumstances and personality.” Does my baby-ache come from a basic, biological imperative? Probably in part. But it’s the tension that results from that urge running up against the constraints of reality that makes it so acute. Without a tension between the two, the ache would simply be an urge put into action.

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Tracy Clark-Flory

Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter.

I’m smoking too much pot

I know I'm going to have to quit once I get pregnant, but I need it for the stress relief

(Credit: Zach Trenholm/Salon)

Dear Cary,

I’m a 25-year-old female, I work two jobs, I’m engaged to a great guy.

Right now, both of our full-time jobs suck. We’re stuck with bosses who don’t appreciate us, even though we are both inherently hard workers. So we are trying to support each other and have jointly decided to move 2,000 miles away to another city where there are more jobs, and where we both have some family.

We like the city we’re going to move to no more than the one we are in, except for more opportunities, cheaper taxes, and great access to the mountains. I have moved cities several times in my life and I enjoy the thrill of the change, and this move does feel right. So, hopefully our job issues will be resolved in a few months in a new setting.

I am very eager to have babies with the man I love. With us now moving, kids are on the back burner because we won’t have health insurance until one of us lands a job with benefits. We had been trying to get pregnant until the decision to move was made because I have decent benefits with my current hateful job. (One of the reasons I haven’t quit, the other main one being that I’m trying to hold this job out till we can move.) I really want kids soon; I have wanted to be a mother since I was 5. But the stress of life and my failing body seem to want other things for me. I had injured my back at work and now am in physiotherapy to heal it, yet I’m still obligated to work my full shifts. Those eight-hour shifts literally drain me. I haven’t had a period in 3.5 months (my doctor insists it’s stress-related). And most recently, my pap test came back with abnormal cells on my cervix. No further tests have been done, but my doctor thinks my back, lack of period and abnormal cells are at least partly because of too much stress. Hard not to be stressed when all these symptoms have made me worry and fret even more about never being able to have children! The more that I worry, the more stressed my body becomes. The more symptoms of the stress I experience, the more I worry. (A huge catch-22.) One of my worst fears is to end up being barren.

On to my other issue. My fiancé and I both smoke marijuana regularly. I will note here that we do not smoke cigarettes at all, nor do we drink alcohol very often. Although I have heard that it can prevent couples from conceiving, I only “slowed it down” when we were trying to get pregnant. My fiancé seems to have his usage under control. He is able to use on a part-time basis and not every evening and every weekend. I am a different story altogether. I use (abuse) marijuana for stress. I rush to get home after work to have the bad memories of the day dissolve into higher thoughts. I am not high at work, but evenings and weekends are full of my usage. It’s the way I’ve taught myself to deal. Although I don’t think marijuana is an “evil drug” that “leads to other drug usage,” I know that I am misusing it. I have never felt the need to try any other drug (besides alcohol and caffeine). But I barely even notice the effects any more. Despite that, I can’t imagine quitting it altogether. I know that if I were pregnant I would not smoke at all, because there is another human being involved who would be affected by it.

But without marijuana, how would I deal with life’s stress? Plus there is some part of me that feels like marijuana is not bad. You ought to know that in my family, a few other people smoke marijuana. My aunt and cousin probably use it once daily, and my mom and brother once or twice a week, and my dad on occasion. While they never permitted any drug usage as a teenager, I found out and smoked with family after turning 19. Obviously this is a huge part of the reason why I can’t seem to convince myself that marijuana is “bad.”

This new city will not have any marijuana contacts for my fiancé and me, and it is my plan to stop smoking when we move. But really, I don’t want to stop at all, and I feel like I’m lying to myself by thinking that a new city will stop me from finding a way to do it. Plus, my fiancé is moving first, and we will be apart for a month (we’ve never been apart for longer than 10 days in the past four years). I know that with him gone, I will want to smoke even more. Especially because I feel like I want to get as much smoking in before I “can’t” anymore.

I know several people who use marijuana more than I do and who firmly believe that no one can get addicted to it. I guess I’m not so sure about this, but I would like to believe it because then I’m just a hippie and not an addict. I worry about the usage affecting the physiotherapy on my back, but since we aren’t trying to get pregnant, I still smoke whenever I want to. My fiancé knows that I smoke too much, he knows that I KNOW that I smoke too much too. But month after month he still brings it home for us. I have tried to quit before, asking him to keep it all hidden and out of sight. This always fails, because I will find it and sneak some or bug and bug him to get it out of hiding for me.

I don’t think I can stop until he stops bringing it into the house and we get rid of all the marijuana paraphernalia that is around our place. If my fiancé doesn’t want to quit with me, I would be disappointed. But as long as he kept everything out of our house and cars, I think I could do it. I really do want children in the long run and better physiotherapy results in the short term. What do I do?

Moving and Shaking

Dear Moving and Shaking,

You are using marijuana to relieve stress.

Stress is your problem. Whether you stop smoking marijuana or not, you need to learn more and better ways to relieve stress.

Start doing tai chi; start doing yoga; meditate; take naps; breathe deeply a lot; do biofeedback. If you are doing any of these activities already, don’t conclude that since you’re doing it a little it must not work. Instead, do it more.

You may need higher doses of yoga to get relief. Also, if you are consuming lots of caffeine, see about cutting back. Try substituting some herbal teas for caffeinated beverages now and then. Notice the difference. Especially in the afternoon, cut out the caffeine so you can get a better night’s sleep.

You will notice things about yourself this way. You will notice the different qualities of consciousness that arise from various techniques. It will be entertaining and interesting. You will notice a gradual improvement in your ability to go through life in a relaxed, worry-free way. Unpleasant activities like work and dealing with power-hungry blockheads will go more smoothly.

During this time, you might want to experiment with not smoking for a time. Pick an occasional time when you are stressed out, and instead of smoking, do 15 minutes of meditation, or some tai chi or yoga.

Don’t try to quit all at once, especially not on your own. Just learn some better relaxation techniques. Take it easy. Look for gradual improvement.

Once you’ve found other ways to relieve stress, you may not feel so fearful about the idea of quitting marijuana for good. Try going without for a few days at a time and see how that goes. You can always smoke. But experience what it’s like to handle life without it. Try to get accustomed to that feeling. You may feel slightly on edge, but take a deep breath of fresh air instead of a hit of weed.

The thing is, whether you call yourself an addict or not, changing habitual behavior is hard, and it’s especially hard to do alone. It’s hard to do without a program. It takes time, effort and support, and there are ups and downs. So I wouldn’t recommend trying to stop smoking marijuana on your own, or just with your fiancé.

As you say, for a variety of reasons, you are going to want to quit. So what I’m suggesting is that you prepare, in these ways, for the day when you will need to quit. I’m sure marijuana gives you other things besides stress relief; it probably gives you a heightened sense of the beauty of life, of tastes and sounds, and of general well-being. These things you may need to seek out in life; I find that there are other ways to feel these momentary highs. Seek them out.

For quitting things, as you probably know, I favor the 12-step method because it has added benefits: It helps you get your life together and is a lasting program of living. It is a community. It works for a lot of things.

When and how you quit is up to you. I can say that based on experience, it is definitely possible. You can quit and lead a normal, happy life, when you’re ready to. My bottom line is just that A) You should acquire new stress-relief methods first, before trying to quit, and B) what was B? Oh yeah, B) Don’t try to quit on your own. If and when you do decide to quit, do it with a group or a program behind you.

And, hey: Good luck. You sound like really nice people and I wish you the best in life. And say hello to the kids when they come. And say hello to the mountains.

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Cary Tennis

Cary Tennis writes Salon's advice column, leads writing workshops and creative getaways, publishes books, plays guitar, performs in art galleries, writes an occasional newsletter and tweets as @carytennis.

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Was I selfish to have fertility treatments?

As the mother of twins, I know people suspect I had help getting pregnant. But why am I so self-conscious about it?

(Credit: Franz Pfluegl via Shutterstock)

When I found out I was pregnant with twins, one of my first thoughts was, “Great. Now everyone’s going to wonder if I had fertility treatments.”

And they do: People ask all kinds of probing questions — from the sometimes innocent, “Do twins run in your family?” to the blatant, “Was it natural?”

And it wasn’t. Our twins were the result of ovulation stimulation drugs and an IUI (intrauterine insemination).

But the question I started asking myself was: Why should I care if people suspected or knew I needed “help” getting pregnant? Especially in an age in which so many women seek medical intervention when they have trouble conceiving. And especially at a time when twins are becoming the new normal: Recently, the CDC reported that 1 in every 30 babies born in the United States today is a twin.

Part of my self-consciousness came from the fact that infertility treatments are an intimate affair. Your private parts are prodded, your internal organs scrutinized, and your bodily fluids drawn. Nobody looks at one little baby and thinks, “Gee, wonder how that thing got made?” whereas multiples beg the question: How exactly did that happen? I wasn’t crazy about my reproductive process being speculated upon or, more to the point, given any thought at all.

But there was more to it than that.

Was I simply ashamed that I couldn’t get pregnant on my own? Did I feel inadequate or even “broken,” as a friend of mine who recently had IVF said she did? Not really. There were times when my husband and I felt frustrated and angry at our inability to conceive, but I never worried that other people would judge me for something beyond my control. Nor do I have any religious or ethical qualms about responsibly administered fertility treatments (i.e., the kind carefully monitored so as to avoid higher-order multiples). No one has ever scolded me for going against “God’s plan,” but if they did, I would politely tell them I disagree. To me, assisted fertility is no more “playing God” than administering CPR.

It is, however, a choice. And in the eyes of many people it’s a selfish one. Just read the comments thread under any story on this topic. And this, I realized, was at the heart of my reluctance to let people know how my twin daughters came to be. I worried they would think I’d acted selfishly. On some level, I wondered if they were right.

Having infertility treatments is selfish, the argument typically goes, because the world population is burgeoning. Meanwhile, there are thousands of children out there in need of good homes. So why don’t infertile couples (or “these women,” as it’s more typically put, as if their partners are merely being dragged along for the ride) just adopt?

Back when we were in our 20s, my husband and I always said we’d adopt if we weren’t able to get pregnant on our own. If it wasn’t meant to be, it wasn’t meant to be. But when I was just shy of 30, the desire to have a baby kicked in, and it kicked in hard. I wanted to experience pregnancy, and both of us wanted the experience of creating and nurturing a person who was genetically linked to us. It was a primal and surprisingly powerful urge.

By that time we’d learned that “just adopting” is anything but simple. Fees and expenses can run anywhere from $5K-$50K and whether you adopt domestically or internationally, the process can take years, and can be a roller coaster of anticipation, disappointment and complex legal issues. In addition, adopted children are more likely to have special healthcare needs, developmental delays and mental health issues.

So when making a baby on our own proved challenging, we didn’t say, “Guess we’ll just adopt.” We went to a fertility clinic, got tested, and talked over our options with the doctor. They were confident that they could help us, and we agreed to give it a shot. This was what we wanted.

Our insurance required that we try the least invasive approach first: ovulation stimulation drugs, with careful monitoring to try to prevent a multiple pregnancy. We were fortunate that our route to conception was a relatively simple one. On our third attempt, I was pregnant. And we were thrilled — in spite of being taken aback by the fact that there were two babies on the way.

Now, our daughters are 5 years old, and we can’t imagine life without them. These days, I don’t much care if people think I was selfish to have undergone treatment to help conceive them. I honestly don’t think my choice was any more selfish than anyone’s choice to have a child.

One woman I spoke to recently on this topic put it perfectly. Like many women who struggle with infertility, she was asked by friends if she considered adoption before getting infertility treatments. She said to me, “I always wanted to ask them, the ones who were parents, in particular: Did you consider adopting before you went and tried to have a baby on your own? And if you didn’t, why should I?’”

Why, indeed, should infertile couples be automatically expected to adopt? Why should the onus be on them to make this noble and unselfish choice, when the desire for a biological child is something shared equally by fertile and infertile couples?

Yes, my husband and I would probably have pursued adoption if we had exhausted the possibilities for having our own children, provided we could muster the financial and emotional resources to do so. Adoption is a wonderful avenue for building a family. But the technology was there for us to conceive a child — and, as it turned out, children — of our own. We had every right to use it.

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Jane Roper’s memoir of twin pregnancy, parenting and clinical depression, "Double Time," will be published in May by St. Martin’s Press. She blogs at Baby Squared on Babble, and lives in the Boston area.

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