The womb, whatever its condition otherwise, has become a fertile ground for debate since the Union Cabinet passed the Surrogacy (Regulation) Bill, 2016 last month. What made headlines and opinions was the bias with which the government eyes a whole section of modern relationships and lifestyle choices. Bad, but for the issue at hand, absolutely irrelevant. What did not make up the majority of headlines is what award-winning journalist Pinki Virani’s new book is about.

Politics of the Womb: The Perils of IVF, Surrogacy and Modified Babies is the first book of its kind that charts the unregulated operations of a booming reproductive technology industry. An industry which was sparked by an innovation and fuelled by its money-making possibilities, and which raced far ahead in marketing its miracles before research about its consequences could catch up, or even begin.

Whether surrogacy or other assisted reproductive technologies like in-vitro fertilisation — the devil is in the details. Even such minute details as to be overlooked such as the naming of the technology itself. It was MART (for buying and selling babies?) before possibly some lobby made it ART (of creating?) Mart for Medical assisted reproductive technologies. Even such minute details have been overlooked for centuries: the sterile (antiseptic, disinfected) male and the infertile/barren female. The male that discharges the seminal (determining, influential, decisive, shaping) fluid carrying the “seed” to the woman’s stationary egg. No matter that both are equally important, and therefore the “seeds”, in the biological scheme of things.

Virani exposes much in wordplay as she does in her analysis and research, which she said in an interview that she has accumulated since 2007. She writes with clarity and sensitivity on an issue that demands to be treated responsibly and thoroughly, achieving both. Virani’s book is about making an informed choice — IVF success rate is 25% — and it is about individual choice, which includes the “right to choose to not choose to have a child”.

Above all, the book is unapologetic. “Any country which allows its women citizens to turn into renters of uteri and vendors of ova is guaranteeing the commodification of its girl children,” Virani writes. This is a stand that many opinion-shapers have willingly or unwittingly omitted in their preliminary outrage against the recent Bill.

Politics of the Womb is an illuminating read even for those who are clued in to the repro-tech debate. For instance, Virani strikes at the root of the infertility problem only to discover that there really is not so much of a problem after all. “At which point exactly did fertility become an international disease? And why? Why is any body’s inability to produce another body made to feel so mortifying? The way a disease works is that no appropriate intervention can lead to a fatality. Here it is the ostensible cure that is causing fatalities.”

It does lead one also to wonder whether infertility would have been a disease had it been the so-called Third World that was primarily affected by it.

To build a foundation for what is to come afterwards, Virani also breezes the reader through a crash course on the reproductive system (though she has reservations about calling it so), the fertilisation process and the menstrual cycle, which may end in periods or a baby — both equally acceptable. No surprises for a high school science student there, but the lively narrative would put to shame many a dry biology textbooks that could take lessons from the former.

The book exposes the business of baby-making, how unscrupulous doctors might unleash a new eugenics and propagate the older one plaguing this country — that of selective killing of the girl child. 

While the book deals with the many perils of assisted reproduction, where the unnatural-ness and exploitation of the intending mother and child begins can be understood by a rough analogy.

Fertilisation is a complex process and each step in this, let’s say, dance of creation, is orchestrated by hormones darting from one place to another, like stage crew behind the wings who keep a performance together. But unlike stage crew these hormones have the authority to down the curtains on a show if they will it. That is not implant an embryo therefore terminate pregnancy.

A lot goes into preparing the body for a baby. When the body expects a pregnancy, natural immunity starts building— “an immunity that is unparalleled outside the womb which protects the pinpoint cells till they embed in the walls of the uterus”.

If (as in IVF), the embryo is artificially implanted into the uterus, everything is thrown out of gear, like an unplanned performance suddenly staged without rehearsal and an unprepared crew left to deal with the consequences. IVF circumvents the slow hormonal build-up routine by injecting artificial (synthesised) hormones administered to sustain the pregnancy, which is not guaranteed of course and the cycle repeats — fresh embryo, stronger drugs and a woman who is slightly more defeated.

Ultimately, in all this IVF hype, the onus of bearing a child is placed squarely on the woman, even if the infertility arises from the man.

An excerpt from Virani’s interview with an unnamed patient: “Last time it was my fault. They said drink three litres of water. Maybe I drank only one and a half litre…I lost the baby.”

There may have been none to lose in the first place, Virani writes. 

Her book exposes the business of baby-making, how unscrupulous doctors might unleash a new eugenics and propagate the older one plaguing this country — that of selective killing of the girl child. Cancer risks, deformities, genetic anomalies, and trafficking.

Finally, the book is a guide for couples who wish to take the IVF route to have a baby in full knowledge of what it entails for the mother (birth mother or surrogate) and the future child.

It is a timely book and a highly recommended one.

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