Killing the Black Body: Race, Reproduction, and the Meaning of Liberty

In this chapter, Roberts examines “the reasons for the racial disparity that marks the new reproduction”—that is, women’s access to fertility treatments and egg donation (232). Reproductive technologies offer hope to infertile couples while creating “family arrangements that break the mold of the traditional nuclear family” (233). A child can have up to five parents: the genetically- related parents, the surrogate mother, and the parents who intend to raise the child. The technologies fulfill a couples’ wish to have a blood-related child. Pregnant women who have amniocentesis or other diagnostic procedures can terminate pregnancies upon discovering a genetic defect. In the future, gene alteration may help remedy genetic disorders or enhance certain characteristics.

Roberts asserts that these technologies encourage conformity instead of challenging the status quo. While they’ve helped single women and LGBTQ people become parents, most in-vitro fertilization (IVF) clinics’ clients are still heterosexual couples. At the time of this book’s publication, state statutes permitted insurance to cover IVF only when a husband’s sperm fertilized his wife’s eggs. In addition, courts have been willing to grant parental rights to sperm donors. Some feminists have contended that new reproductive technologies reinforce “traditional patriarchal roles that privilege men’s genetic desires and objectify women’s procreative capacity” (234). The procedures allay male anxiety about paternity. For women, the IVF process is arduous, requiring hormone injections, egg retrieval, and often disappointment. In extreme instances, IVF can result in damage to a woman’s reproductive organs, including ovarian cysts.

Roberts contends that couples pursue IVF because of the stigma of infertility and the wish to bear a blood-related child. Some women who undergo IVF are fertile, while their husbands aren’t. So, the decision to pursue IVF often connects to the husband’s insistence on a genetically related child.

Surrogacy can also fulfill a man’s wish to pass on his genes. The procedure impregnates the gestational mother with the man’s sperm. The money that a surrogate receives “pays for the surrender of her parental rights” (235). Roberts contends that the law should rule in favor of gestational mothers who wish to keep their offspring—“not because the mother’s genetic tie is more important than the father’s but because the mother has already established a relationship with the baby” (236). Instead, gestational mothers provide a service to biological fathers: facilitating his genetic bond to a child.

Few fertility clinics have Black patients. In all, only about 10-15% of infertile couples sought IVF and other reproductive treatments at the time of this book’s publication. In the mid-1990s, only 12.8% of Black women used those services, compared to 27.2% of white women.

News stories about reproductive technology usually feature images of white people, particularly those who are blond and blue-eyed. Stories about Black children produced through these technologies “are usually sensational stories intended to evoke revulsion precisely because of the child’s race” (237). Roberts gives the example of a white woman who sued a fertility clinic because, she claimed, they “had mistakenly inseminated her with a Black man’s sperm, instead of her husband’s” (237). She demanded compensation for emotional distress “due to the unbearable racial taunting her daughter suffered” (237).

Roberts wonders what the connection is between race and fertility, particularly when Black people are 1.5 times likelier to be infertile. She specifies, too, that the rate may be higher “due to underreporting of infertility by married Black women” (237). Reasons include a higher incidence of sexually transmitted diseases, such as chlamydia and gonorrhea, which lead to pelvic inflammatory disease (PID). Other problems are nutritional deficiencies, environmental racism, workplace hazards, and complications from abortions and prior childbirths.

The median cost of IVF at the time of the book’s publication was $8,000. When one used donor eggs, the procedure, at the time, the cost was anywhere from $10,000 to $20,000. Most insurance plans don’t cover IVF, and no Medicaid benefits package includes it. Ten states were exceptions, passing legislation between 1985 and 1991 that required insurance coverage of infertility treatments. Eight states paid for IVF treatments. Around the same time, “at least eight states prohibited Medicaid coverage for fertility drugs and therapies in response to taxpayer protest against paying these costs” (239).

Undergoing IVF treatments requires not only money but also the time to devote to “daily hormone shots, ultrasound examinations, blood tests, egg extraction and implantation, travel to and from a fertility clinic, and often multiple attempts” (239). Roberts contends that Black people’s limited access to fertility services is yet another example of their “marginalization from the health care system” (240). In addition, evidence suggests that some doctors deter Black patients from seeking reproductive treatments. Prospective IVF patients often must pass eligibility tests, such as proving that they’re in stable unions and have the financial wherewithal to provide for a child.

Another reason for the racial disparities in fertility treatments may be that Black people have internalized myths about their own presumed fertility. In addition, the Black community, which is averse to genetic interference, has a deep and legitimate distrust of the medical establishment. Also, a racial difference exists in adoption expectations: Infertile white couples typically look to adoption as a last resort, while the system expects Black people who are financially secure to take in the many Black children in need of homes. Some Black people think that Black adoptees should be with Black families to transmit cultural identity. Meanwhile, white couples often spend copious sums to produce white children, sending “the unmistakable message that white children merit the spending of billions of dollars toward their creation” (253).

In February 1982, the media highly publicized “a medical study claiming that women between the ages of thirty and thirty-five risked a nearly 40 percent chance of being infertile” (253). Overnight, there was an infertility epidemic. The media ignored another study, released three years later, showing that the infertility rate for the same group was 13.6%. The original study blamed women’s careers for incidents of miscarriage, endometriosis, and abnormal babies. During this decade, the media portrayed Black women as hyper-fertile and white women as insufficiently fertile—which, Roberts writes, had eugenic overtones. Some scholars purported that reproduction in the West was failing to keep pace with that in the non-industrialized world. Television evangelist Pat Robertson worried publicly about the “depopulation of the West” and the diminishing “power of Western industrialized democracies” (254).

Interracial adoptions—which represented fewer than 10% of all adoptions in the 1990s—are primarily adoptions of children who are neither Black nor white. The trade in international adoptions has come with charges that Western brokers exploit women and children from poor countries. In the US, adopting a white child may be twice the cost of adopting a Black child. In Latin American countries, adoption price depends on traits such as skin, eye, and hair color. As of this book’s publication, 54% of children in foster care were nonwhite, while 87% of prospective adoptive parents were white. Black families who use formal adoption services tend to encounter more barriers: In addition to financial barriers, they face cultural insensitivity from social workers, who are usually white. Nevertheless, Black middle-class couples are likelier than white couples to adopt. A 1987 survey, however, found no instances of interracial adoption by a Black mother.

While society often regards a white family adopting a Black child as improving the child’s circumstances, when the reverse occurs, society regards the Black family’s authority over the white child as “an injury to the child” (257). This was the ruling in a 1950s decision that barred a Black man from adopting his white stepchild. Though the case is from long ago, finding instances of an adoption agency offering a white child to Black parents is still difficult.

Roberts points out that devaluation of Black maternity occurs in surrogacy too. Some feminists have asserted that surrogacy is exploitative because it commodifies a woman’s reproductive capacity. Those who employ a surrogate tend to be wealthy, while the gestational mothers are usually not. Other scholars, such as Margaret Jean Radin, have argued that “surrogacy impermissibly alienates a fundamental aspect of one’s personhood and treats it as a marketable commodity” (260). The practice puts a price tag on the gestational mother’s personal traits and allows the contracted parents involvement in every aspect of her behavior. Roberts wonders if Radin’s view of surrogacy arises from the characteristics it shares with slavery. Enslaved women were like surrogate mothers in that they had no claim on the children they bore, who simply became the property of their owners.

However, Roberts asserts that feminists miss an important detail in criticizing surrogacy for reducing women to fungible commodities. Black surrogates, she writes, aren’t exchangeable for white ones. Gestational surrogacy divides the biological connection between mothers and children into gestational ties and genetic ties. The gestational mother is an incubator for the prospective baby. In Johnson v. Calvert, the gestational mother, a Black woman named Anna Johnson, changed her mind about giving the baby to the contracting parents. Crispina Calvert, the genetic mother, was Filipina. Mark Calvert, the genetic father, was white. The press focused more on Johnson’s race than on Crispina’s. Johnson was also a welfare recipient. Judge Parslow, who presided over the case, ruled against Johnson, denying her the right to custody and even visitation, and granted the Calverts sole custody of the child. Judge Parslow elevated the Calvert’s genetic relationship over Johnson’s gestational one. When Johnson appealed the case, the California court of appeals agreed with Parslow. Roberts contends that this primacy on genetic relation is flawed. A court is unlikely, she writes, to claim that a woman who donates her eggs to an infertile couple is their offspring’s legal mother. Instead, the Johnson v. Calvert case provided legal precedent for courts to never regard a Black woman as the “natural mother” of a white child.

In Italy, a Black woman and her white husband, who provided sperm, fertilized a white woman’s egg with the intention of producing their own child. She selected the white woman’s egg, holding that her child would have better life prospects if white. The story made international news. Experts wondered about “designer babies.” The outrage over a Black woman’s selection of a white woman’s egg overlooked the fact that most white couples who undergo IVF also choose to have a white child when selecting “the race of a sperm or egg donor or a surrogate mother” (265).

Reproductive technologies, Roberts writes, reflect the existing racial caste system. It reinforces ideas about the relative value of Black and white children. It also makes the poor more likely to have children with genetic disorders and deformities. While birth control has provided a tool for negative eugenics, reproductive technologies risked becoming tools of positive eugenics.

Governments have interfered little in technology that assists with reproduction. However, the liberty to procreate is inextricable from equality and social justice. Previous Supreme Court decisions asserted the connection between human dignity and reproduction. Thus, Roberts considers “a system of procreative liberty that privileges the wealthy and powerful particularly disturbing” (270). Some Marxist feminists have argued that contracted surrogacy should be outlawed due to its exploitation and commodification of women. Roberts asserts that just as “obstetrics and abortion services are subject to regulation” (272), procreative technologies should require government supervision.

Meanwhile, getting insurance companies to cover the cost of reproductive treatments would require raising premiums for everyone. Roberts wonders if society could justify spending so much on IVF, given its risk and high failure rate, “when so many basic health needs go unmet” (273). Roberts instead encourages adoption programs and the provision of basic needs like nutritious food. Additionally, she points out that the federal government has done little to reduce the spread of STDs, such as chlamydia, which contributes to infertility, particularly among Black women. However, the medical establishment earns more from lucrative infertility treatments than it does from research. Roberts concludes that American society’s vision of reproductive liberty must include overcoming group oppression and not merely protecting and ensuring reproductive rights for the wealthy.