The Politics Of “Fertility Fog”

Amy Klein investigates why many women remain steeped in misinformation about their reproductive health:

The Committee Opinion [of the American Congress of Obstetricians and Gynecologists (ACOG)] recommends education about age and fertility for ‘the patient who desires pregnancy’ – and that is a quote. In other words, only women who are already trying to get pregnant or thinking about it should be counselled about how age affects fertility.

But what about the other women – the ones who do not realise their fabulous health might not protect them from age-related declining fertility; the ones who might want to start thinking about freezing their eggs while they’re still young enough; the ones who are waiting for one reason or another to have a baby and don’t know that perhaps, like me, they don’t have that much time. Does ACOG believe it’s the doctor’s responsibility to bring up the subject?

‘We feel that women should be able to talk to their ob/gyn about fertility,’ said Sandra Carson, ACOG’s vice president for education. ‘We certainly want to remind women gently that, as they get older, fertility is compromised, but we don’t want to do it in such a way that they feel that it might interfere with their career plans or make them nervous about losing their fertility.’ In other words, there are no guidelines for talking to a woman about her fertility unless she herself brings it up.

All this talk of ‘gentle’ reminders and ‘appropriate’ counselling has a history – a political one. Back in 2001, the [American Society of Reproductive Medicine (ASRM)] devoted a six-figure sum to a fertility awareness campaign, whose goal was to show the effects of age, obesity, smoking and sexually transmitted diseases on fertility. Surprisingly, the US National Organization for Women (NOW) came out against it. ‘Certainly women are well aware of the so-called biological clock. And I don’t think that we need any more pressure to have kids,’ said Kim Gandy, then president of NOW. In a 2002 op-ed in USA Today, she wrote that NOW ‘commended’ doctors for ‘attempting’ to educate women about their health, but thought they were going about it the wrong way by making women feel ‘anxious about their bodies and guilty about their choices’.

Although the ASRM denies the backlash is connected, its spokesman Sean Tipton says the organisation has not done a fertility awareness campaign since.