This blog has looked closely at plagiarism
in relation to Margaret Wente. Today, a
look at other problems in the most recent of her articles on infertility and older
parenting. And a personal perspective.
The
Globe and Mail’s house contrarian offers up a regular parade of caricatures - silly
young men, entitled young women, various incarnations of “elites” (a class she
pretends not to belong to). Recently,
she had another go at “grey parents”, with some alarming claims about autism.
Mostly, she goes after older mothers, who she regularly characterizes as
waiting around for a late appointment at the IVF spa. But for some women, and I’m one of
them, not doing IVF can be risky,
even life threatening.
To begin with, in the opening of Why old-age parenting is a bad
idea,
Wente seems to leave readers with the impression that the
availability of IVF and other fertility procedures to older women can lead to autism.
After opening with the American
Society for Reproductive Medicine’s latest
recommendations for (some) women, and her standard observation that infertile
women are just “too busy” to notice the biological clock, Ms. Wente
laments the “hundreds of thousands of
useless and costly medical procedures, thwarted expectations, marital stress,
heartbreak and an epidemic of children
with autism, learning disorders and perhaps even schizophrenia.”
That last
bit (my emphasis) was surprising, and anyone who stopped reading a few
paragraphs in would think this “epidemic” had something to do with older
mothers. That’s because it’s not until much further down a page focused almost exclusively
on women that Wente offers some sentences about mutations in the sperm of older
men.
They echo a BBC
report
which says: "Men over 45 may have offspring which have a higher likelihood of
neuro-cognitive disorders, such as autism and schizophrenia.” Or the CBC: “A child is more
likely to be born with autism if their father is over the age of 35 compared
with a younger dad,” (though Scientific American cautions that, “The study does
not prove that older fathers are more likely than younger ones to pass on
disease-associated or other deleterious genes”).
Despite this, Wente links these genetic problems to older women,
implying that it’s because of older moms that men are fathering these kids.
But older fathers do not equal older mothers. The same BBC report notes the
dramatic rise in older fathers having children with younger mates: “it's to do with the rise in second
marriages for men, sometimes with younger women, which can mean becoming a
father again at a more advanced age”.
We know this even without the stats. There’s been a bump in men starting second
families with partners often a generation their junior.
So you’d think if
one were genuinely concerned about an “epidemic” of autism, learning disorders and
schizophrenia, the number of aging dads would be important. Numbers
like these: “a dramatic rise in the number of
men having children in their 50s and 60s…official statistics show the number of
over-50s fathering children has risen by 40 per cent in 12 years.”
But Wente seems fixated on straw women, and provides figures only
for “grey” (over 35) mothers, concluding with advice to the
daughter she didn’t have: “I’d
tell her to get on with it”. That’s remarkable too. Since, given the evidence, it would be better
to advise older men not to get it on with her daughter.
Wente also
uses statistics from a survey that appeared in a November 2012 Globe article by
Tralee
Pearce. From there, numbers diverge. Pearce says: “In
Canada, the pregnancy rate is 18 to 20 per cent for women 40 to 41 years old who
complete a cycle of IVF using their own eggs…”. Wente, on the other hand, writes: “the
odds of having your own biological child after 40 are no better than they were
20 years ago. With each cycle of in vitro fertilization, the success rate is 11
per cent”.
But the
odds are changing, as the lede in Pearce’s
article indicates: “American researchers have just
announced they have a method that gives a 40-year-old woman the same chance of
conceiving via in vitro fertilization with her own eggs as a 32-year-old.”
It’s
pretty clear what Ms. Wente wants readers to believe. But why? Oddly enough, in 2006 she took a position
completely opposite to the one she adopts now, even writing a glib, upbeat
defense of a 63 year old mom: “Women are no longer enslaved by their
reproductive organs — and a good thing too. If technology can give women wider
reproductive options — as men have always had — that's fine with me. And
because we're living so much longer and healthier, 63 is no longer old”.
Wente also
describes how she herself was too busy for children and later realized that, “my
poor old eggs were past their sell-by date”.
For her, that was fine: “the
childless life has its compensations”. Perhaps - if you have a well paying job with
lots of travel. For others, rewards may
be few, especially when couples with less income spend everything they have trying
to have kids. I’m not sure those
compensations should include passing judgment on families who struggle with
infertility or pregnancy loss for medical reasons very different than one’s
own.
As Dr.
Carl Laskin
says to Pearce, “IVF
is a tool”. It can be an important one. I know.
I have two IVF kids – one born at 39, the second at 42. Had I done IVF years earlier, I would have been
spared five pregnancy losses (three of which nearly cost my own life). For
some women who want to have children, not
doing IVF can be risky. That’s why
simplistic negative commentary like that regularly dispensed by Ms. Wente is
problematical. Not only is it
inaccurate, it has the potential to scare women away from appropriate treatment
by suggesting the success rate is low, the procedure overly risky, or now, that
their kids might be autistic.
Like thousands of women, my medical problems weren’t caused by
being too career centered. Like
thousands of women, I had a condition that made pregnancy difficult (and dangerous)
at any age.
Here’s a glimpse of what that was like: We lived in small village at the time. Pregnant for the fifth time, my husband and I
had driven an hour to a larger hospital in a nearby city for morning blood tests
to determine if the baby we had tried so hard to have would make it to delivery.
Afterwards, we went to the hospital cafeteria for breakfast. That’s when my fallopian tube burst, and I was
rushed back to the doctor’s office. I
was lucky to be in the hospital when it happened.
This was my fourth ectopic, so I already knew exactly what the pain ripping
through my abdomen meant. The ultrasound confirmed that the pregnancy was
outside the uterus, again. Even though
it had ruptured, we could see the beating heart.
But I was already bleeding internally. As they tried to
insert the intravenous for another emergency surgery, my panicked husband said,
“You can’t operate now - she just ate”. Standard protocol didn’t apply. If they waited, I’d die.
That’s just one of the many, many, different, individual
realities of infertility. Ectopic
pregnancies remain a leading cause of maternal death. I had 4 of them, along with one miscarriage, attempts
at surgical reconstruction, and various excruciating investigations along the
way. As is the case for thousands of
women, this was not related to age. The little
malformation was there when I was younger. But problems may take so long to
investigate, treat, and resolve, that some women may be older by the time they
present to a clinic or a child arrives, if at all. It’s not fun. And it’s unfair to depict these women as latté-sipping
careerists, penciling in an appointment at the IVF spa for 40.
While IVF may be used with less success for older women with
other conditions, the ‘primary indication’ for the procedure is tubal disease. It’s the reason IVF was first developed, and it’s
a successful, cost effective therapy for women with damaged fallopian tubes who
can make up “nearly 35%” of infertility cases, according to some studies. That kind of disease alone takes a big bite
out of Ms. Wente’s cartoon. It’s also why
women with blocked fallopian tubes have been eligible for OHIP covered IVF for
decades - another important fact Ms. Wente omits in this and previous articles.
Many fertility problems have nothing to do with ones’ eggs being “past their
best before date”, as Wente likes to say.
There might be a problem with the delivery system, or some other piece of
equipment.
There’s also no correlation between various reproductive diseases
and the ‘highly educated’ but ‘deluded’ women Wente claims are the “chief
customers for fertility treatment”. Tubal abnormalities, polycystic ovaries,
endometriosis, immunity issues, along with varieties of male factor infertility,
can hit early and are evenly distributed across classes. Unsurprisingly, they fail to concentrate in
Wente’s cartoonish ‘elite’. The
infertile constitute a range of diverse medical profiles, not a simplistic
social or economic one.
The profile Ms. Wente routinely presents looks, in fact, strangely
like her own. I’m also tired of IVF kids
reading that their parents didn’t want them enough to give up their careers, or
that the biological fathers they grew up with are actually anonymous sperm donors. But mostly, I’m worried women will be swayed
by the inaccuracies in articles like this and forego effective and even necessary
treatment.
My pelvis is scarred. But let’s talk about Margaret Wente’s pelvis
for a moment – X-rays of which adorned a recent feature article about the
“nightmare” of her artificial hips. Rather than wait in line for standard hip
replacement, she’d apparently managed to get a leg up on a newer procedure
similar to ones that have since failed in other patients.
Now, Ms. Wente, like other Canadians, is certainly entitled
to as many hip replacements as she needs to allow her to continue horseback
riding into her 60s. This, despite the
fact that, like infertility, deteriorating joints would have been considered “normal”
several decades ago, and treatment for what is essentially another form of age-related
decline (like fertility) would have been more limited.
In that regard, Ms. Wente’s remarkable 2006
article on how she gained
access to quicker treatment is instructive in terms of fair and equal access. It was the subject of another article called Too many jumping health-care queues:
"Margaret
Wente, a columnist in The Globe and Mail, described how she was helped to
obtain a quicker hip replacement partly by 'pulling strings.'", Eric Dowd wrote.
When
informed the waiting list for hip replacement was "a year long", "the
columnist decided to obtain another opinion and called 'a well-placed
acquaintance,' who contacted another surgeon, who squeezed her in for an
appointment within two days".
"I
found shortcuts. I asked for favours. At first, I felt guilty", Wente wrote then.
"There
are the public, formal lists, and the private, informal ones. How quickly you
are referred and treated depends on a myriad of random factors… Knowing someone
who can make a phone call or write a nice e-mail message on your behalf is
priceless. Being on a hospital board also helps. But being educated,
middle-class, diligent and assertive is what helps the most of all. My
Portuguese cleaning lady, who barely speaks English, has arthritis too. There's
no chance she will ever get the access and the state-of-the-art treatment that
I did".
Of course Ms. Wente deserved her hip replacement. But shouldn’t treatment be just as important
for her cleaning lady, and for patients with other medical problems?
I’m not saying that all fertility treatments are necessary
or advisable, or that they should all be covered by taxpayers, especially when budgets
are tight. Nor am I arguing in favour of
extreme “grey parenting”. But let science
provide the data. And let us debate the various drawbacks, priorities and
benefits (these might even include the fact that IVF kids will pay for some of
those hips). And let fairness and consistency
be guiding principles for that discussion.
For that to happen though, journalists need to provide opinions based on
full and accurate information - not caricatures that reflect their own interests. And some of them should perhaps try, every
now and then, to look a bit more closely, and with more genuine curiosity, at
the world and the people around them.
