Reproduction is a collaborative effort, yet the number of collaborators—doctors, employers, legislators, insurers, and a burgeoning fertility industry—continues to grow, often promising more than just a child, but an enhanced one. This intricate web of influence and intervention is explored in Anna Louie Sussman's new book, "Inconceivable: The Impossibility of Family in an Age of Uncertainty." Sussman, a journalist who has extensively reported on individuals' struggles to build families, argues that simple metrics like income, marriage, and education fail to capture the full picture of declining birth rates. Instead, she posits that the barriers are deeply personal and resistant to easy measurement.
Sussman's research delves into the economic, political, and psychological negotiations that stand between people and the children they desire. She challenges the notion that falling birth rates can be solely attributed to quantifiable factors. Instead, she emphasizes the more intimate and immeasurable aspects influencing family formation decisions.
The conversation around fertility and family planning has evolved significantly over the seven years Sussman spent researching her book. She notes increased attention to family issues on the political left, citing initiatives like the Congressional Dads Caucus and care infrastructure proposals within legislation. Simultaneously, she observes a rise in pronatalist sentiments on the right, coupled with a fascination among some in Silicon Valley with advanced reproductive technologies and the concept of "super babies." The overturning of Roe v. Wade also emerged as an unexpected development, without a commensurate increase in support for mothers and children on the right.
Emerging Rhetoric and Reproductive Technologies
Sussman expresses surprise at the resurgence of eugenicist rhetoric among some philosophers, who seek to "reclaim the spirit" of figures like Charles Darwin and Francis Galton. Concepts like "liberal eugenics," grounded in parental freedom to enhance offspring, and a perceived "duty of procreative beneficence"—selecting embryos or fetuses most likely to lead "the best life"—are gaining traction. While acknowledging that some philosophers distinguish between individual parental choices and state-sponsored programs, Sussman highlights the underlying attitude as a cause for concern, arguing it requires critical examination.
This discourse coincides with rapid advancements in reproductive technologies. Sussman points out that while some may differentiate between individual choices and state programs, the underlying attitude is what needs addressing. The drive to develop technologies that could facilitate such choices, she suggests, is fueled by an attitude that has historically manifested in subtler forms, including embryo selection and pregnancy terminations based on genetic conditions.
The Case of Alexandria Ocasio-Cortez and Egg Freezing
Representative Alexandria Ocasio-Cortez's public discussion of her egg-freezing journey and her advocacy for expanded insurance coverage and federal support for fertility treatments offers a lens into the current moment. While her contemplation of a presidential run is exceptional, Sussman notes that her experience—being a single, city-dwelling professional in her late thirties—mirrors that of many women who can afford to freeze their eggs. Research indicates that the primary motivation for these women is not career advancement, but rather the desire to preserve the option of having a family due to the lack of a partner, with 82 percent citing this as their main reason.
Other countries offer insights into the demand for such services. Tokyo's subsidized egg-freezing program was oversubscribed, and France has also begun offering similar initiatives. Many nations provide IVF coverage, treating infertility as a disease, as defined by the World Health Organization. In Denmark, where extensive publicly funded fertility treatments are available, approximately one in nine children are born via assisted reproductive technologies, compared to about one in 36 in the U.S. This disparity suggests a significant unmet demand for accessible reproductive technologies.
Personal Negotiations and Societal Support
Historian Sara Matthiesen's argument that legal abortion has contributed to viewing pregnancy as a choice, thereby diminishing societal obligation to parents, is a perspective Sussman finds persuasive in understanding how some avoid state responsibility. However, she also notes the paradox that post-Roe, the choice to remain pregnant has been taken away in many areas, yet this has not led to increased societal support for mothers and children.
Sussman contrasts her ex-boyfriend's view that a second child would be unaffordable with the optimism of a pregnant woman in Venezuela who believed, proverbially, that "a baby comes with a loaf of bread under his arm." She acknowledges that while faith, agency, and disposition play roles, the decision to have children is deeply personal. Demographics are often discussed in terms of measurable data, but Sussman emphasizes the subjective nature of these negotiations, where personal sacrifice and expectations are paramount.
Journalists, Sussman suggests, face a challenge in distinguishing between genuine financial impossibility and the fear of insecurity, to avoid a future where only the wealthy feel encouraged to have children. While she wishes to be more optimistic, she highlights the precariousness of financial security in the U.S. and the lack of a robust social safety net, making it difficult to assure people that everything will work out.
Sussman hesitates to label having children as definitively "good" in a normative sense, recognizing the gendered implications and potential burden on women. However, she asserts that loving relationships are good, and parenthood, for those who desire it, can be an exceptional and amazing experience. She advocates for policies that make this relationship more accessible, not just for individual fulfillment but as a social good that supports society's present and future. She notes that while many people may not have explicitly desired children historically, choices and desires can change, influenced by societal narratives and media. Many young people struggle with caregiving, feeling ill-equipped to care for others when they can barely care for themselves, in a society that does not make caregiving easy. Ultimately, Sussman believes that children often need less than commonly imagined, and that personal expectations and the willingness to sacrifice are key considerations in the deeply individual journey of family formation.