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The blond ovule
An approach to the problematic of the demand for immigrant women from Eastern Europe as ovule donors
Carolina Puga “The idea is to increment the number of women with Caucasian features since the flow of British clients is increasing” [1]
In this frivolous way, which may sound scary for many of us, is how Dr Raúl Olivares from Marqués Institute of Barcelona speaks when referring to the incessant search for fertile young ladies who donate their ovules.
He is not talking for any local newspaper but for the newspaper “The Guardian” from Britain, where these clients who are said to be increasing come from.
Spain has turned since some
years ago into the European capital of the so called “reproductive tourism”.
This is because of the low costs of the treatments compared to other
countries and the prestige of the professionals. But the definite migration
of the stork from Paris to its new comfortable house in the Passeig de
Gràsia is mainly due to lax laws which allow, among many other things, to
keep the identity of the sexual gamete donors under complete and absolute
secret.
Society, this third nominal which involves multiple actors, can adopt different positions regarding men, women or couples with impossibilities to procreate and demanding intervention. Strings can be pulled in favor of protecting ones more than others. Strong and vulnerable characters appear.
What is the place given to the immigrant woman in this new reproductive model which crosses (at least as an option) every woman’s health? What is her assigned role? Who assigns it? What for? In what way?
This short essay is part of a broader work based on this problematic.
In the following part, some
fundamental concepts will be briefly (maybe scarcely) revised in order to be
able to analyze with enough elements the situation of the immigrant woman
later on.
Assuming that reproduction is
turning into a business
Assisted Reproduction clinics have been rapidly growing in quantity not only in Spain or Europe but also in the rest of the globe. What has happened different from the past for this to happen? Are there more infertile women and men? Undoubtedly the demand for the services these clinics provide has also grown but we cannot directly attribute that to a growth of infertility. Neither can we attribute it to scientific progresses on this field since, (although vertiginous), they are previous to this phenomenon. For some reason, there are every time more places willing to offer (and people willing to demand) procedures that for the time being are not easy, unsafe and many times traumatic for the ones who experiment them.
The amounts of money these procedures imply are not to disregard at all. Assisted reproduction treatments are long and expensive (each treatment may cost 9000 Euros, needing in general more than one [2])
Finally, the language, eternal denouncer, tells us that the semen is kept in “banks”, the embryos are “products” and the movement from the test tube to the uterus is a “transference”.
These factors (and some others I will mention later on) seem to indicate we are witnessing how human reproduction is turning into a business [3].
Health is many times used to make profits, and under that framework, reproductive health and its different fields can be also used for that sake.
Semen donation, ovocytes donation, artificial insemination, In Vitro fertilization, subrogated maternity and many others. It is impossible to deny that each of these concepts has its corresponding monetary value, independently from the justifications for that value (for the treatment, for the inconvenience of”, etc).
To be able to make a critical exam, it is essential to discuss what the conception of a new being. means. Especially because in our society, when given the conditions and the freedom to do so, any of these procedures can be turned into a business, as we will see later on with the immigrant woman’s role. Only by assuming this undeniable reality and by adopting a position about it will we be able to try, if that is what we wish, to differentiate the hand which pulls the string in the market from the one which does it in the Assisted Reproduction procedures.
All the procedures of Assisted Reproduction can be done heteronomously, that is to say with a gamete from the one who demands the treatment (either the woman herself or her couple) and another from a donor.
Unlike what happens with the human reproduction being turned into a business, the topic of donors and all it involves hasn’t been so carefully disguised, so that we can find gaps and cracks from where to start knowing, recognizing and revealing certain aspects in a deep way.
The data shows that 40% of couples, who asked for an assisted fertilization treatment last year, did it by using gametes from donors [4].
It also shows that ovule donation has doubled in almost five years [5]…why?
Donation as an altruist fact
Economical remuneration to sperm and ovocyte donation is supported by the idea that the donor is an altruist, somebody whose only wish is to help couples who can’t procreate by themselves. The policies and laws are thought (or they are supposed to be thought) from that perspective.
The donor, as the pages of the clinics put it, “gives away” something they “have in excess”
In March 1999 an advert published in the most prestigious universities of the United States offered 50.000 dollars (currently in Spain the payment is about 700 Euros) to the young lady who, meeting certain characteristics, would accept to donate her ovules. 200 women responded to that call by contacting the lawyers who had made the offer. This fact itself doesn’t say much except when we compare it with the only 6 altruists who had responded to the same advert five month before, when the amount of money rewarded hadn’t been mentioned [6].
To consider donation as an act of solidarity is the first crack we find when speaking about donors. If we compare it with, for instance, the donation of a kidney, we will also consider this last one an act of solidarity, even because the procedure to extract a donor’s kidney is much more complicated than the one to obtain an ovule, needless to say a sperm. Nevertheless, kidney donation is not remunerated in any case. It is also quite clear that in general, the altruist act of donating a kidney just before clinical death is due to affective bonds with the receptor, and no other thing is requested.
If we compare it with blood donation as well, much simpler but generally much more urgent than the one ovules or semen require, nothing is paid for it.
There are no doubts about the fact that in order to heal, our society needs more urgently and more amount of organ or blood donors than sexual gamete ones. So…why is money offered for the second ones and not for the first? Why is semen donation considered “a nuisance” and susceptible of being remunerated and not blood donation if both are equally altruistic acts? Why are the first ones being multiplied year after year instead of the second ones? Would young people donate their ovules for nothing when their own body is at stake? Six American university students said yes, would they be enough to carry on with an assisted reproduction clinic?
Sexual gamete donation as a purely altruistic act is definitely untenable. The truth is that the donors receive an amount of money never thought for other donations…and a hick of a lot less than what the claimants pay. It is the doctor or the clinic the one who mediates between this offer and this demand where the sexual gametes seem to be essential raw material to get to the product: embryo.
Despite of all this evidence, medicine and law still consider donation as an act of solidarity. The problem is that if we accept at least the possibility of the donor being moved by economical interests, we would also have to think this character as a vulnerable actor inside the process.
About the anonymity
Eyes color, weight, childhood illnesses, job, family history…everything can be known about a sexual gamete donor…everything except their name. Donor’s anonymity is maybe the darkest crack when analyzing assisted reproduction as well as the justification for the Spanish “boom”.
The secret about the identity of the sexual gamete donor appears as an institutionalized secret, that is to say anchored in the norms and rules of society and not in individual wills. But also as a legitimized secret: accepted by justice and law, perceived as licit and genuine.
What is behind this secret? By being legitimist and mandatory its importance is shown. Why? Who is it for? What is so urgent and powerful to make this secret go beyond the individual control (parents who don’t want to tell their child) and become a law?
From the donor’s point of view, it can be said that they have no intention to procreate…Can we think then, that the anonymity releases the donor from the effective biological procreation? Of course not. It can, however, release the donor from the consequences and responsibilities this fact may have in the future.
Anonymity, from the donor’s point of view, is a denying and childish resource to avoid taking responsibilities. The question is what would happen if donation weren’t anonymous any more…would all donors assume the responsibility of having to respond to people willing to meet their biological parents some years later?
Following the idea developed in the previous section, we may think that if donation is altruistic, the donor would be proud of having helped infertile parents to procreate…then, why would they want to hide themselves?
The truth is that revealing the donor’s identity would have the same consequence as not paying for donation: a fewer number of donors and the loss of our “raw material”.
And this is when the amount of
British clients increases (clients, not patients) as the doctor from the
Marqués institute referred to. By the time a law which banned donor’s
anonymity was approved in that country last April, clients increased between
50 and 100% [7].
They also come from France where economical compensation to donation is not
allowed, Germany, Austria, Switzerland and Italy where it is also forbidden.
The more clients there are, regardless of their nationalities, the more ovules are needed. But the ovules are carefully chosen since they have to be not only young but also white, blond and light-colored eyes, and if possible with Greta Garbo’s walking style.
There aren’t, or at least I haven’t seen, not even one clinic of reproduction whose web page doesn’t repeat when referring to their donors: “they are university students” over and over again. Although the universities were certainly the places where, not long ago, most of the campaigns to attract donors were carried out, the reason for this is probably not the degree or a cultural level susceptible of being genetically inherited, but the fact that most of those students respond to the physical requirements desired.
It has been said that the
university donor reassures the altruism, since most of them are not
economically urged. This idea, weak as it is, is completely refuted when,
eureka, the possibility of turning into donors immigrant women from Eastern
Europe appears.
The arrival of immigrant women from Eastern European countries started when the socialist Soviet Union collapsed and a series of social and political changes took place, apart from the liberalization of border policies by the end of the 80’s. All these events coincided with the opening of a new stage in the Spanish migratory cycle whose main characteristics were: increasing flows, high economical content and its heterogenic ethnic composition [8].
The studies based on these groups of people are scarce and quite out of date. They are mainly based on Poland and tend to consider the people coming from Eastern Europe as a homogeneous group without paying much attention to their different migratory history and their social and economical conditions.
Following a general tendency of migration, ovule owners are more than men, observing more feminization in these migratory groups than in other regions.
This feminization has to do with an increasing competition in the labour market forcing immigrant women to not only maintain their families but also travel alone hoping to achieve the reasonable stability to be able to get together with her relatives and friends.
In general, immigrant women work in sectors of the market which are scarcely or non-regulated. The three ones with major feminine presence are: domestic jobs, nursing (looking after sick people) and prostitution. All of these are sectors in which exploitation is inherent to the activities themselves. Besides, there are some other aspects we can add which contribute to the marginalization within the labor market. These aspects are:: lack of linguistic knowledge, low educative level, irregular status and the discrimination for the simple fact of being immigrants plus the fact of “being women”, which is many times suffered by native women as well.
They are docile, cheap and flexible employees. Regarding genre, they earn less than men. Regarding precedence, they earn less than native women.
In relation to their health, many articles explain they are healthy and naturally fertile as well.
But social limitations in the receptive society such as social segregation, housing problems and working conditions may have a high negative effect on their health. Sanitary problems are mainly due to a life of marginality.
Besides, they are considered highly vulnerable (more than men) to psychosocial pressures, expectation from a new culture and the need to carry on with work and family. “The immigrant woman presents more frequently than men psychological alterations due to rootlessness, stress, anxiety an adaptation which end up affecting their health” [9].
Finally there are difficulties with the sanitary service since immigrants are often not aware of the structures and means of access apart from the idiomatical and mainly cultural barriers (different concepts of health and illness) which play a fundamental role.
The immigrant woman is then vulnerable since she becomes a victim of mechanisms of social exclusion, being this concept broader than the one of poverty, therefore assuming the lack of participation in discussions, exercises and social rights which conforms all together what is known as social integration.
It is this woman and no other the one from the tale which says that one day, being alone and bored in the park, eager to help a couple she doesn’t know she decides: I’m going to donate my ovules.
In 2001 the opinion group of the Observatori de Bioética y Dret Parc Cientific of Barcelona was already recommending: “Advertising campaigns for the promotion of donation must be addressed to a public able to value correctly the risks involved. The adverts of programs must be mainly informative instead of competitive and also describe how ovocytes are extracted.”[10]
“You are young and have thousands of them. Become an ovule donor” is the slogan of the campaign taken as a model by this report. In this campaign as in any other, the image takes over the words. It is meant to impact, to call attention, never to inform.
The combination of these campaigns with the substantial amounts of money offered (reaching a thousand Euros) makes private medicine be better supplied with ovules than the public one.
The procedures for ovule extraction involve a high risk for women’s health. The ovarian hyper-stimulation produced, may provoke hemorrhages, infections, and many other problems [11]. There was for example one case in which the traffic of ovules from a Rumanian clinic to the United Kingdom was brought to light when many donors denounced the clinic after suffering a syndrome of ovarian hyper-stimulation which almost led them to death [12].
Some women are invited to undergo three or even four hyper-stimulations per year and a donor’s record is created in order to know how many women would accept becoming regular donors.
Undoubtedly, not only immigrants but also all the other women to whom these campaigns are addressed to, are submitted to a situation of pressure and abuse as well as being exposed to psychological damages and the lack of genetic identity rights through the anonymity (what happens if one day the donor wants to know about her ovules?).
Nevertheless, the immigrants from Eastern Europe appear as specially exposed for more than one reason. On the one hand, a high remuneration turns to be very attractive for these women in no good economical conditions. A thousand Euros are not the same for a university student who works or not, who lives with her parents or not, than for a domestic employee who works…or not.
On the other hand, there is an issue with the access to information. And here comes the surprise since many clinics have worried about launching campaigns in the immigrants’ mother tongue. However, this doesn’t mean the system has overcome the language barriers we mentioned before, on the contrary, it means that the ones who want to denounce the degrading way in which this practice is being carried out, lose own voice. Or our voice is not heard. Therefore the immigrant (compared to the local) has a limited access to information.
Signs are written in Rumanian, Russian or Polish. The information for clients (CEFER institute members are proud of saying so) in Spanish, English, Catalan, French and Italian.
Just by observing this detail can we know what role is given to each actor in the assisted reproduction process. That is the reality…on behalf of the right to be a mother, what happens with the infertile immigrant woman who desires to have a child? Where is her right? The truth is that the access to these techniques (in private and public medicine as well) is uneven. A person with a precarious job would never be able to afford an assisted reproduction, neither the money it costs nor the free time.
Paradoxically, the woman asked
for altruism is the one least taken into account by the other’s altruism.
Although enough reasons were given up to now, this is undoubtedly the cherry on top of this desperate search for “white ovules” the clinics are carrying out.
Obviously it is making reference to the absent but present “black ovules”
Either for omission, invisibility or for not being wanted the “black ovules” show, once again, the lack of dignity. They are part of the usual problem of racism and segregation.
When speaking about “black ovules”, it is not about a race we know no longer exists but in our heads, it is about Moroccan, Senegalese, Ecuadorian ovules.
Why aren’t the ovules from these women, as altruists as the others, requested by these clinics? Where is the real wish to be a father or mother when what is wanted to be held in the arms is a girl or boy with a determined physical aspect?
Two things to conclude: firstly, the practice to search and obtain ovules from Eastern European immigrants is dangerous, humiliating and dreadful and it has an inner racist component.
The second is positive: its justifications are not sustainable.
Many times, scientific progress makes us think about issues which in the past were naturally resolved. This is one of those cases.
Ethic must take over the market
by installing a social debate with proper information within the society.
The debate should not be
devoted to judging the techniques or the market itself, but to express that
many times market necessities can destroy other kinds of imperatives of
vital importance. Giving priority to our values and our ethic becomes
essential, otherwise, if we don’t reflect or act in favor of our
priorities the loss will be huge. In the assisted reproduction processes before mentioned, the woman’s body is treated as a “thing”, and it is not only the donor’s body but also the mother’s and the child’s bodies. The case of the eastern immigrants is a clear example of this.
The right for life and maternity should never be the right to generate life at any cost. Destroying the physical and mental health and the donors’ and children’s dignity is surely not what we want to as a society.
While some people think the
human being is not naturally good there are others like me, who think a
person can be good through their culture, being able to modify the life they
give to themselves and their relatives. Adopting a critical position implies
showing interest in this modification, which will have to be completely
conscious. Bibliografía
[1] “España: país favorito de los británicos que buscan donantes de óvulos” León’s newspaper. May 19th, 2006. In: www.diariodeleon.es [2] Data obtained from the “Instituto valenciano de infertilidad” (IVI) www.ivi.es [3] The amount of money adoption requires nowadays can also be thought as part of this process. [4] “La terapia con donación de óvulos se duplica en cinco años al ser necesaria en la fecundación in vitro” Europa press, May 9th, 2006. [5] “La terapia con donación de óvulos se duplica en cinco años en España” Jano on Line. May 15th 2006. In: www.new.masson.es [6] Associació Catalana d’Studis Bioetics (ACEB). Campañas de donación de óvulos (editorial). June 2000. In: http://www.aceb.org/editoriales/ 0600_cs.htm. [7] Tristán, R. “España, destino de oro del turismo de fertilidad”. May 15th, 2006. In: www.elmundo.es. [8] Hellermann, C. and Stanek, M. “Estudio sobre la inmigración de Europa Central y Oriental en España y Portugal – Tendencias actuales y propuestas” Paper of the 4th congress about migration in Spain – Citizenship and Particiation. Girona, November 2004. [9] Observatorio de desigualdades de género en la salud. Boletín Nº8. January/March 2006. In: www.genero.sespas.es. [10] Opinion group of the “Observatori de Bioética y Dret Parc Cientific” of Barcelona. “Documento sobre donación de ovocitos” Barcelona 2001. In: www.ub.es/fildt/archivos/Ovocitos.pdf [11] “Piden fin al tráfico de óvulos humanos” In: www.salud.com May 19th, 2006 [12] Idiakez Alkorta, I. “Donación de óvulos” In: El País March 18th, 2006. [13] Graffiti written in “El Ejido”, due to the conflict with the Moroccan community and the arrival of Russian immigrants to practice prostitution in that place. Bernardo Ródenas, S. “Mujer e inmigración”. In: Aequalitas magazine Nº6. June 2001.
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