Time for a pregnant pause in progress?

On Being Born and Other Difficulties
April 8, 2005

On a first reading this book gives extraordinary insights into how we have arrived at our current stand on fertility and reproduction, but the ideas appear even more original and provocative on a second reading. I could dip into it time and again but would rather invite the courtly professor to dinner to pick his brains. I can imagine no more entertaining guest. I have never met F. González-Crussi and there is no photo or biography on the dust jacket of this book. I imagine him looking like Edward G. Robinson in The Cincinnati Kid , but avuncular with it, and sounding like Professor Bronowski of yesteryear or his present-day equivalent, Robert Winston, polymaths all. These are men whose curiosity, leaping intellect and impish erudition have forced us to address some of the major questions of our times where technical advances are ahead of our moral grasp of their implications for mankind.

To get back to our dinner: why entrust a precious free evening to a stranger? On this showing, I am confident his baroque turn of phrase and dense learning would beguile me well beyond the coffee. It would be quite a challenge: I am not sure I could parry his mordant wit and I know for sure he would leave me trailing behind in the wisdom and insight stakes. But just think of the menu we could tackle in trying to review the underlying theme of this book - the logical progress of our evolution with the often illogical explanations we have come up with over the ages to account for it. The professor would lead me, as he does in his book, through art, history, religion, myth and literature to biology, medicine and philosophy in surveying a vast field of opinions and theories about the intimate apparatus of birth.

González-Crussi takes pleasure in pointing out that, over the millennia, great thinkers got it wrong. How persistent some of the misunderstandings have been; and because birth is essentially a female business, nearly all were to the detriment of women. Here, as in so many conceptual matters, Aristotle is largely to blame. He represented woman as nothing more than a thwarted or incomplete man and that concept of inferiority remained the official doctrine in medical teaching until way after the Renaissance. It was also a myth taken up by the Old Testament (Eve created from Adam's rib) and thence to the Holy Fathers who, not being able to stomach Jesus having a girlfriend, labelled Mary Magdalene a prostitute.

As late as the end of the 17th century, Thomas Sydenham, the father of modern medicine, reinforced woman's secondary role by coming up with the concept of hysteria, a disease of the mind that blamed the womb (Greek - hustero ) as the cause of mental imbalance, a thesis later championed and promulgated by Freud. Accordingly, official medicine (and the Church) taught early marriage and closely spaced pregnancies, for only by keeping the womb satisfied with semen would mental instability be avoided. This kind of thinking served only to transmit and perpetuate irrational fears of sexuality and unbounded praise for celibacy and virginity.

Virginity became so highly rated that during the 18th century there was plenty of work for a celestina (any woman of the world who was a dab hand with the needle and a capsule of stage blood) who would reconstitute the hymen of a bride-to-be with such skill that the bridegroom would be persuaded of his bride's virginal status. To this day a woman's body remains a tantalising mystery, still looming large in men's imaginations, still evoking emotions that range from awe and reverential fascination to outright fear and barely disguised hostility: male surgeons perform twice as many hysterectomies as female surgeons.

The biggest difficulties of the title, however, are 21st-century ones that González-Crussi describes as "flowers of evil in the garden of biology". And he is right. The mistakes we made in the past are insignificant when compared with the potential monumental errors we may make today. Our ability to manipulate DNA and genes is certainly frightening, but the idea of performing in the laboratory what does not occur spontaneously in nature - taking genes from one species and inserting them in another - is terrifying.

And while saving very premature babies verges on the miraculous, it is nonetheless irresponsible if we do not take account of the lifelong handicaps contingent on prematurity. Intracytoplasmic sperm transfer (ICSI) allows infertile men to father babies, but their sperm, rescued from the depths of their testes, have not been tempered by the hazardous journey from vagina to fallopian tube to beat the rest to the ovum. It now looks like children fathered in this way have more chromosomal abnormalities and malformations than those conceived traditionally.

New technology poses more questions than it answers. We can freeze eggs, even slices of ovarian tissues, so that women, rendered infertile by chemotherapy can have babies when they are cancer-free. This poses the question of whether fertility could extend well beyond its natural limits.

New pregnancies for old. But does a dangerous postmenopausal pregnancy best serve an ageing body? This fascinating scamper over research procedures that were legitimised and transformed into action with heady and sometimes rash speed is introduced on page 176 of a 203-page book. Why so late? I am afraid that as the pudding is served I will be upbraiding the professor for devoting so little space to these pressing questions.

Miriam Stoppard is a writer and broadcaster.

On Being Born and Other Difficulties

Author - F. Gonz lez-Crussi
Publisher - Duckworth
Pages - 216
Price - £14.99
ISBN - 0 7156 3359 7

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