Baby Blues

Today, IVF, IVI, donors, surrogates, etc. all have been developed to the fertility challenged, at a cost.

Malati has been married for 3 and half years now. She hasn't conceived to date. She works as a housemaid/cook/governess rolled in one. The children she took care of, whom she spoiled with treats, bathed, dressed, disciplined into doing their homework, kissed their hurts away, wiped tears are grown, on their way to college and beyond. Less indulgent, they resent her shortened temper.

She started young, yet now is reaching an age defined by doctors as less than ideal for childbearing. Her spouse's sperm count is on a lower end – not quite infertile, but not enough motile sperm. All tests show that she has patent tubes, is producing eggs, and the uterus is fine.

The question remains – how can she get a child of her own? Certainly, she cannot afford the expensive IVF treatments available to the rich. Will she accept a sperm donor, will her husband accept one?  Even if they do who will do the procedures, to make it happen?

The plight of many like Malati is tragic on several levels. She is barely literate –though she can read three languages – Hindi, Oriya and English. She studied in a village school to the eighth class and then chose to come to Delhi, looking for work to help out her family. Her education, for what it was, ended then and there. She then lived with various families, working full days and a half, earning a living to take care of her family that included parents, a brother and a sisters’ illegitimate daughter. She supported them, saving nothing for herself; each trip to the village was made laden with gifts for everyone which, to my mind, were ill afforded.

She has no idea of how the body works, how she can increase her chances of conceiving. She cannot afford private treatment from specialists who would take time to patiently explain to their paying patients the workings and mechanics of the reproductive organs. She is dependent on government hospitals and much overworked doctors who have little time and energy required to educate as they treat.

She has to travel to the hospital, taking time off for her treatment. It has to be workdays, has to be a peak hours when traffic is horrendous, the weather often inclement. Will her employers give her that time off especially when it will mean, should the treatment succeed, that they will have to choose between giving time off to a very efficient maid, or look towards replacing her? Should they replace her, she will be left in the unenviable position of having to look after an extra mouth with a lower family income. If they keep her on, they will have to support some form of child care plan – either she would come to work with her child, or would need to hire someone to look after her child. Given our propensity to forget our trials, it seems unlikely, though her employers would have gone through the hell themselves.

Before that situation ever arises, she must surmount the challenges in following instructions that the doctors treating her give. They would write it out in English, in the medical shorthand that few outside comprehend. She must afford the cyclical medication to increase egg production. She must afford the trips to the hospital for follicular monitoring. Her husband has to take time off to provide sperm samples for IVI treatment.  She must afford nutritious food to have a healthy baby.

And there are many who would say that she should not enjoy motherhood as she can ill afford it. Really? Is that how we will define who has and who does not have children?