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Post Magazine
This Week: Infertility and the Poor
Hosted by Liza Mundy
Washington Post Staff Writer

Monday, April 21, 2003; 1 p.m. ET

Infertility treatments cost thousands of dollars. So, what do you do if you are poor, can't conceive and really want to have a baby? And what obligation, if any, does society at large have to help people in such circumstances?

Liza Mundy, whose article "A Special Kind of Poverty" appeared in Sunday's Washington Post Magazine, was online Monday, April 21 at 1 p.m. ET, to field questions and comments about the article and about the double impoverishment that infertile poor people can face.

Mundy is a Magazine staff writer.

A transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

Liza Mundy: Hello and thanks for writing in. There are a lot of questions here and a diverse array of opinions and I'll try to get to as many as possible.

Sterling, Va.: Super article, and one of the few Post Magazine features that I've read in its entirety the Sunday it arrived.

One factor that wasn't explored but is certainly present is that of race. You mentioned the popular perception of the "fertile poor" without directly addressing the stereotypes. Did this come up in any of your interviews?

I'm thinking particularly of the two former drug addicts who didn't even bother applying to adopt. Yes, there is tremendous competition for children to adopt, but if you remove white, healthy infants from the equation, the odds jump tremendously.

Liza Mundy: Thanks very much. Yes, I probably could have addressed race more explicitly and more at length, but there is only so much you can get to in one story. I am not quite sure whether you are more interested in talking about the race of would-be parents, or the race of adoptive children. THey are related topics, of course, but they also raise different issues. For example, I just got a letter from a woman saying that she thinks people of color who are dealing with infertility get less sympathy from doctors and people in general: she feels that people of color are seen as having enough children already. So that's one stereotype, something that clearly adds to the stress of infertility.

Then there is the question of the race of adoptive children. It's shockingly true that children of color are "cheaper" than Caucasian children. Meaning, it literally costs less to adopt them. I find this fact astonishing. In fact, for a child to be considered "special needs" (and therefore qualifying for some public subsidies) it is sometimes enough for the child to simply be a minority. This is another amazing, awful stereotype. I recently talked to mother who has adopted two African American children--both beautiful, wonderful girls--and she says it just boggles her mind to think that these girls cost "less" to adopt than white infants would have.

Washington, D.C.: I have to tell you I have very mixed feelings about your story. I was adopted as a child into an average middle-class home (not rich by any stretch of the imagination). The wait for my parents was long and arduous. There weren't other options in the sixties but to wait. Now, I am a mom. Still living in a middle-class home. I understand these women's desires to have children. Have any of them considered adopting older children who need homes? Being a parent doesn't mean having an infant! There are children out there who needing loving homes and who would consider themselves "rich" living in an apartment with parents who love them!

Liza Mundy: Yes, the Pooles have certainly considered adopting an older child rather than an infant. Before they conceived their one child, they were pursuing becoming foster parents, which probably would have meant they'd have an older child, since very few babies are available through public adoption or foster care. However, now that they have a biological son who is very young, they are reluctant to adopt an older child, because this would suddenly mean that their existing son would become a younger brother. You may or may not agree, but this thinking makes sense to me.

Washington, D.C.: One thing that might help some of these couples is to know that generally less income is necessary in order to adopt a special needs child (meaning a child who is older and/or has medical or mental or emotional problems). In most cases the state will pay a monthly subsidy for the child until he/she is 18, and sometimes also covers the costs of special treatments if the child needs therapy or extra medical care.

Liza Mundy: That's true. And as I mentioned above, "special needs" can mean a whole huge host of things. It can mean a child is disabled, or it can simply mean that a child is of color. The only thing that I was warned about, time and again, from adoption experts, is that some "special needs" children can sometimes--SOMETIMES--require medical treatment, therapy, etc, and this can be hard for lower-income parents to pay for. There are some subsidies, but once a child is adopted, some of these subsidies dry up.

Pittsburgh, Pa.: What can we do to get Congress to move on legislation to require coverage for infertility treatments? There are a few states where this coverage is mandated, but sometimes with restrictions (no coverage for txs for women over 35 or 40, only one IVF tx is covered). This legislation has been circulating in Congress for years, yet they haven't moved on it. Who can we contact? Write? Call?

Liza Mundy: You can contact Resolve, the national infertility advocacy group, or, more locally, a group called INCIID, which is also an infertility support and advocacy group. I don't have the web addresses handy, but a Google search should yield the home pages of both organizations.

Stanardsville, Va.: First, a big THANK YOU! for covering the issue of infertility at all. As a fertile woman married to an infertile male and living in a rural area, I have great sympathy for the people you wrote about. They're the reason I always write my check to RESOLVE, the national organization for those afflicted with infertility, for $75 instead of $55. I like to think that extra $20 goes toward subsidizing the cost of membership for those who can't afford the regular dues. I should pay more.

Second, I absolutely adore your writing. I don't let myself buy The Post too often -- because I'll do nothing but sit there and read it and get none of my Sunday afternoon chores done -- but whenever I do I tear away greedily at the "real" paper to get to the magazine and read your column. I like the fact you're from Roanoke, because I'm from Lexington.

And oh yes, a question: from one journalist to another, how on earth did you find this story? Tell, tell, please!

Liza Mundy: Thanks for all that. As for how I got the story: I was talking to an editor who has been through the experience of infertility herself, and during that difficult process it occurred to her to wonder what it must be like for people with very little money. I thought that was a great question.

It was not easy getting people to talk. Infertility is a very private issue, and so is income. I got help from doctors and low-income clinics, and I'm very grateful to those people who did let me use their stories. As you will see from some of the postings that will follow, readers are amazingly judgmental about their situations, and I admire their willingness to expose themselves to this.

Capitol Hill, Washington, D.C.: Great Article!

I was very troubled reading the story of the Simpsons. What kind of life are they providing for their son Jordan or for their new baby? It seems to me they are being very selfish. Did they address that with you?

Liza Mundy: I don't understand what you mean by "selfish." It seems to me they've given everything they can to get this child, and I suspect the child will be very grateful.

Arlington, Va.: Liza,
I think your article might have had more resonance if you'd chosen genuinely child-free couples. Granted, Sam's stepchildren were described as adults, but to also use two other couples that already had one child kind of took away from my sympathy for their plight. Even if it's from a previous marriage, if you marry someone with a child, then you have a child! It seems to me you could have found lower-income actually-childless couples to illustrate the issue of access to fertility treatments. Are they that scarce?

Liza Mundy: Actually, couples with no children at all were somewhat hard to find. I began to wonder whether, if a person is lower-income, he or she is somewhat more likely to have borne at least one child at an early age; I tried this theory out on a doctor but there is simply no evidence that it is true. I do know that among, say, Latino immigrants, there is a strong pattern in which a woman bears one or two children, very young, in her home country; then gets sterilized, often encouraged by the doctor or the state; then emigrates to this country with the hope of starting a new life, and with it a new family, only to find that this is impossible. I suspect that there is a whole other story to be written about unwanted tubal ligations in poor communities, and I wonder, sometimes, if poor women are more likely to be given tubal ligations after one or two children, then find years later that their lives have settled down adn they would like to have more children but are unable.

I understand that many readers are more sympathetic with a couple who has no children than with a couple who, say, has one child but now finds they cannot have more. I do not share this attitude. For people with "secondary infertility," I suspect that it greatly adds to the stress and sadness. In the case of the Pooles, one reason they want a second child is for the sake of their son. This seems to me entirely understandable. And I do sometimes wonder if there is, among some readers, some sort of prejudice against people for whom happiness is four or five children, not one or two.

Whole lotta judging going on, is my feeling.

Springfield, Va.: Excellent article. How about doing another one, this one about ONLY the lack of insurance coverage for infertility? I have already decided in favor of adoption if and when I am ready for another child, because I simply can not afford the financial risks of infertility treatment. I would rather spend the money on something guaranteed -- adoption.

Liza Mundy: I know that there are other people who feel this way, including the Pooles, who felt that adoption was a better investment than IVF.

I'll post some other opinions about insurance coverage for IVF. After thinking about it a lot, I have to say that to me, it seems self-evident. It's our goal, as a species, to reproduce; if biologically someone cannot reproduce, that seems to me a medical problem that insurance should address.

Washington, D.C.: Good afternoon,
People who want to become parents, no matter what their income, need to do some serious financial calculations to figure out how much they can afford RIGHT NOW to have a child and raise it to age 18 (I'm not even counting college tuition).

I read the article and it sounded to me like many of the couples pursued having a baby without much thought to the finances involved. Many also sounded like their feelings for having a baby were socially driven -- friends and relatives asking them when the baby would come, etc. Having a baby because someone else is pressuring you to have one is precisely the WRONG reason for anyone to have a child.

Liza Mundy: Actually, everybody in this article has given careful, agonizing thought to how much having a baby--and raising it--is going to cost. And they still want to have that baby.

Upper Marlboro, Md.: I wanted to thank you for writing that article and increasing the awareness of infertility issues. I have been trying to conceive for six years, unsuccessfully. This month I will make another attempt and if the frozen embryo transfer doesn't work, I may have to come to the realization that I may be childless simply because I can't afford to continue the treatment. There are a couple of bills in Congress/House that focus on infertility coverage, are you aware of them and if so what is the status?

Liza Mundy: I don't know the exact status of the bills you mention, but the Resolve site has a wealth of information.

Chicago, Ill.: If society at large has a responsibility to subsidize fertility treatments (a reproductive choice), then this logic - if logic it is - will have to apply both ways: society at large also has a responsibility to subsidize abortion and birth control (also reproductive choices).

Liza Mundy: Actually, I'm not sure that's true. In general, insurance companies seem to have a lot of trouble figuring out how they feel about reproductive issues; it was not until Viagra came on the market, and was immediately covered, that companies sheepishly started covering birth control pills.

But it seems to me that infertility, of all the topics you mention, is clearly a medical disability, and therefore should be covered. Doubtless others will disagree.

Washington, D.C.: My sister, who is a single 40-year-old professional, recently adopted two healthy one-year-olds from China.I understand that there are also many healthy American babies available for adoption, yet grow up in foster care because they are non-white. No mention of either option was made in your article, and I wonder if any of the couples considered them?

Liza Mundy: International adoption is, by far, the most expensive route of all; for all of the couples I profiled, it was not in any way a possibility.

Washington, D.C.: I just want to thank you for a very thought-provoking piece. My husband and I had a fascinating debate on whether bearing children is a "right" or a "privilege." I think that's what is at the crux of this issue -- health insurance should pay for what you NEED, but not, necessarily, what you want. I believe that there are some people who should not have children because their bodies cannot bear them -- health problems (lupus), chemical exposure, obesity, very poor nutrition (any of which might be hurt additionally by poverty)... at what lengths do government/health programs have to go to fight nature? And yes, rich people can afford to go these additional lengths to overcome nature, but then, rich people can afford a lot of things people living at the poverty line cannot. That's the way it is.

It's a tough issue, Liza, and thanks for bringing it to our attention!

Liza Mundy: Thanks for your comments. I'm just going to post these, so as to get your views out there.

North Billerica, Mass.: If someone can't afford, or can barely afford, to feed, house, and clothe oneself, how can they expect to feed, house, and clothe themselves AND a newborn (which will become a child, and then a pre-teen, and a teenager who wants to go to college)?

Is this how to best spend America's tax dollars, by adding an ever-growing debt (i.e. a child) to someone's already seemingly insurmountable poverty?

Is it wiser to help the poor escape their poverty, or to reinforce their poverty?

Sentimentality is nice, but in this case, wouldn't you agree that short-term sentimentality would lead to long-term poverty?

Which is more important: having a baby, or digging oneself out of poverty to create an environment more conducive to raising a child?

Liza Mundy: I'm just going to post this one, too.

Alexandria, Va.: Hi Liza: Thanks for an interesting article that highlighted a serious concern for the infertile community, particularly those who cannot afford the high cost of treatment.

I have two comments. First, I would just like to note that infertility treatments are ALWAYS expensive (and hardly ever covered by insurance), for ALL those affected. As a solidly middle-class infertile woman, clearly I have more options to pay for my treatment than those you profiled. However, I don't want others to get the misconception that those in the middle-class can "easily" afford infertility treatments. The high cost of such treatments often threaten middle-class status -- ironically, when we should be banking money to help support our future family, instead we're spending it hand-over-fist to try to get the family.

Secondly, I couldn't help but notice that at least two of the couples you profiled already have a child. Was that a consideration when you found people to interview? While I do sympathize with the large number of women who experience "secondary infertility," I can't help but think less of their plight in comparison to those of us who haven't been so blessed.

Thanks for your comments.

Liza Mundy: In the piece I point out that infertility is expensive and stressful for everybody. As for your feelings about secondary infertility, I address that above. I suspect that on chat rooms for secondary infertility, a major thread would be the sympathy you don't get, that people with primary infertility do. As for me, I have two children, and can easily understand how in some ways it's almost harder when you have one but can't have two, because now you know what the experience is like, and you'd like to have it again, and whereas millions of people out there who want to experience that feeling again and again CAN do so, you can't. It may be a different kind of sadness, but I can guarantee you, it's a sadness all the same. It's real.

Alexandria, Va.: Just a comment, really, and then a question:

I have so many friends who've had problems conceiving. Thankfully, most of those friends are in financial situations where IVF and other costly procedures were attainable. Difficult and painful, financially, but possible.

I've often wondered, hearing of these friends' ordeals with drugs and procedures related to conceiving a child -- what about those who can't afford that?

So, I thank you for your insightful article, which answered my question, to a certain degree. The answer, unfortunately, isn't a happy one.

You pointed out that many who are against providing low-cost infertility treatments are of a mind that, if a couple can't afford IVF or if they don't have health insurance that covers expensive procedures, then they can't afford children. The "if you have to ask, you can't afford it" argument.

I strongly disagree. Just look at how many hard-working but impoverished people are successfully raising their children! I didn't grow up poor, but my parents weren't wealthy by any stretch. In fact, I'd probably say that if they were faced with the same misfortune as befalls those in your article, they probably wouldn't have had the funds to cover any of these treatments available today. Yet, I grew up happy, healthy, and well-adjusted.

I think this argument is missing a big point: children, no matter how they are conceived or whether they are adopted, are not just for the well-to-do.

So, this leads me to my question: is there any way to help, any organization we can donate to who covers this sort of thing?

Liza Mundy: Thanks for your views. As far as I know there is no clearinghouse you can donate to, but maybe if you contacted Resolve or INCIID, you could convince them to start one! Or you could get in touch with Madeleine Gordon, who runs the Gordon Gift of Life program in Cincinnati. Email me at Mundyl@washpost.com and I can give you her contact information. Or you can find it through Google.

Meanwhile many people have written in to ask how they can help the people mentioned in the story; I'll answer that below.

Washington, D.C.: Infertility is perhaps a medical disability when we're talking about women in their 20s or 30s, but what about older women? Lowered fertility as a woman approaches menopause is not a medical disability; it's what the body does. Should insurance cover treatments then?

Liza Mundy: Should insurance cover a person who falls off a ladder because she has decided to clean her own gutters but is in no physical shape to do so? Should insurance cover a person who is injured because he is driving after drinking? Should insurance cover a person whose medical problems are exacerbated by overeating?

Should insurance only cover medical problems when they are in no way the victim's "fault?"

Should insurance cover infertility in older women whose husbands were the ones who dallied over having children, but not in older women who made their own choice?

Dunno. It's hard. But how many medical problems out there are, in some ways, self-induced?

Alexandria, Va.: In response to some of those posts regarding how it would be wrong to subsidize people who cannot afford children I think they miss some of the complexities of the issue, at least for some of the people you've profiled. The problem is not just that these people do not have enough money -- it is that the cost of IVF treatment is so exorbitant that it can in some cases CREATE poverty for expecting couples who choose to spend $15,000 or more that they had laid away to get that child. Most people, without infertility, can use that money as a nest egg to raise the child. For those with infertility they face agonizing choices SOLELY BECAUSE there is no insurance coverage for their medical problem. They might, in many cases, be able to afford a child but suddenly they are forced to pay huge amounts to get that child, with no guarantee they will, making it harder to raise the child once it is born. It is, at the very least, more complicated than the spin being put on it by some of the previous posters.

Liza Mundy: Thanks; I'm just going to post this.

AU: Whats the matter Liza, afraid to acknowledge that society might not be responsible for people's personal satisfaction?

Having a baby is not a need. It is a want. A personal need, not a social one.

Why should I subsidize other people's reproductive choices? I have insurance, and it won't pay for the tubal ligation I desperately want but cannot afford. And that's a cheap procedure, and removes the chance that my insurance might have to pay maternity expenses for me. Why should the personal choice to reproduce, a much more expensive, risky, and uncertain process be valued more highly than my personal choice not to reproduce?

Seriously, you never explained WHY society at large should have any obligation to pay for someone's personal wish for a biological child.

Liza Mundy: And this.

Yours, Mine, Ours: To the poster who suggests that a spouse's adult children from a previous relationship count as "children," think again. My husband's adult children have never lived in my home -- they are his and his ex's children, delightful young people, but my stepchildren in name only, who live 1500 miles away. I can like them enormously, but they were not mine to nurture and I have not had the opportunity to form a mother's bond with them.

Liza Mundy: And this.

Williamsburg, Ohio: There is one word which describes the people described in the article and the doctors who help them: irresponsible. To help poor people to have children is to help them become poorer. Most of us don't have everything we want in life -- why is the desire for children any different than the desire for a Corvette, for instance? Both of them are expensive, both are unnecessary, both are selfish, yet somehow the desire to have children has been exalted as if it is somehow holy.

The reason birth control is more readily available to the poor than infertility care is because it is simply good sense. The taxpayer should not be required to fund what is, after all, a lifestyle choice that can wait until the couple is in better financial shape.

Liza Mundy: And this. Though I will add that personally I do think the desire for a child is different from the desire for a Corvette.

Chevy Chase, Md.: I have a glider and ottoman in excellent condition that I would be happy to give to the Simpsons. I had twins six months ago and I'm sure that I have other items that I could give them. I would not be able to deliver the items. Is there anyway that you could check to see if they will be in our area or if someone could bring the items to them?

Liza Mundy: A lot of people have asked me about donating to the couples in the story. If you would like to do so, you can make out a check or money order to THEM, but send it to ME, Liza Mundy, The Washington Post Magazine, 1150 15th Street NW, Washington, D.C. 20071 and I'll see that it gets there. This goes for baby clothes and other smaller items, which I can handle. If it's something big, let me know separately at mundyl@washpost.com and I'll contact the couples and we can figure something out. Thank you for all the expressions of generosity. I called Teri Simpson this morning to say that there had been some inquiries of that nature, and she was moved to tears.

Silver Spring, Md.: I am a federal employee living in Maryland and participate in a federal employee health benefit program. I work in Washington, D.C. My health insurance only covers diagnosis of infertility and not assisted reproductive technologies (e.g., IVF). Your story piqued my interest, especially the information surrounding Maryland law requiring coverage of IVF. I knew nothing about this.

Where can I find information about this law? Does it cover all residents, even if one works outside the state?

Liza Mundy: Why don't you contact your local general assembly member, or else, contact the Maryland Insurance Administration, which is a federal agency in Baltimore. That's the outfit that handled the Simpson's insurance claim so they should be able to update you on the ins and outs of the law. But then again, so should your local rep.

Southern Maryland: Geez, where is all the hostility coming from?

Liza Mundy: Good question! Having written a lot about reproductive issues, I find that people tend in general to be very judgmental about other people's private choices, and that often, this has to do with choices those doing the judging have themselves made.

Or maybe it's just me, and I've made people mad.

Washington, D.C.: What about the social pressure these people were under to have a child? Do you think if they did not have the pressure by family and friends to reproduce, that they would have been less desperate to have a child?

Liza Mundy: I think that in all these cases, the desire to have a child is coming purely from the people themselves. They all strike me as totally "over" the social-pressure aspect of it.

Somewhere, USA: And in regard to the judging -- when you're asking for sympathy or handouts (coverage from insurance companies which, again, will be subsidized by the rest of us), you're opening yourself up to be judged. Don't want to be judged? Pay for it yourself. Again, parenthood is a choice, not a right.

Liza Mundy: Actually, most of the people in the story have decided to pay themselves, or forego. They're not asking for "handouts," though I have, it's true, raised the question of whether they should get them through insurance coverage or, to a lesser extent, philanthropy. ANd it's true, the Simpsons are trying to recover money that the state of Maryland has ruled is owed to them by law.

Washington, D.C.: Well, to be brutally honest, do you really mean to say we should have to pony up more money in taxes to subsidize infertility treatments for people who, by definition, are then going to need subsidies to raise these kids?

Yes, I'm very sorry for their plight, yadda, yadda, but exactly why should I have to take away from my ability to give my own kids in order to take that double whammy?

Liza Mundy: It's my impression that in the few states where infertility coverage is mandated (Massachusetts, for example) it has not broken the bank and that docs aren't suffering. It's a procedure used by a relatively small minority. And incidentally, in vitro is cheaper, like virtually all procedures, when covered by managed care. So the situation currently is that fertility treatment is cheaper when insurance covers it, and MOST expensive for the uninsured poor, who are forced to pay for it without the benefit of an insurance company large and powerful enough to bargain the price down. And in this, as I mentioned, it's like many medical procedures.

Alexandria, Va.: No question, just a comment: fabulous article -- informative and sensitively written. When can we look forward to reading your regular column again?

Liza Mundy: Thanks! As for the column, well, I stopped writing it just because I'd been doing it for six years and was tired of the sound of my own voice. I wanted to concentrated on longer articles like this one. But feel free to contact my editor and DEMAND that he bring the column back and at the same time give me a big raise. Feel free to start, you know, a groundswell or something.

San Francisco, Calif.: This article really makes me curious about adoption. How hard is it? What is so unappealing about it and can the myths about adoption be debunked?

Liza Mundy: By no means did I intend to convey that adoption is unappealing or hard. I know people for whom it has worked out beautifully; it can be very expensive, but doesn't have to be especially if, like the Pooles, you do your research and find a religious group or charity; and I know that Amy Poole, like many people, feels a great sense of relief at embarking on an adoption quest that will, she is sure, eventually yield them a child. She said--and others have said this--that she feels as if she's much more in control of this process, after losing so much control while dealing with infertility.

Provo, Utah: I have a comment for those who say that the poor should not have children. Do you have children? What would you do without those children? Yes, we are poor, but we have been married for seven years and have not had children yet even though we did do IVF. We saved for three years for that procedure, and you do not know how much it hurt to have it end in miscarriage.

I know that many people won't understand this, but I am 27 and my fertility is declining rapidly, I feel menopause fast approaching, partly due to my condition. If I don't try now, then what will happen when my husband is finally done with his PhD and I am done with my Master's? Any chance of fertility will probably be gone. Yes, we are different from some poor, in that we know that the future will be better, but how can you deny anyone their basic right to have children, we might as well be in China, where if you have proven to be infertile, you are sterilized to make sure you don't have children.

I was raised by a single mother who did not make very much money, but, I always had what I needed, because that is what parents do, they put their children first.

Yes, we don't have very much, but that just means that we will forgo things that we want in order to provide for the welfare of the baby.

Liza Mundy: Just going to post this heartfelt comment.

Silver Spring, Md.: Liza - Does your average corporate or government health insurance plan pay entirely for these expensive fertility treatments? I can imagine with co-pays that even well insured folks could be facing large out of pocket costs. The laser eye thing seems to be subject to competition -- what's keeping fertility from coming down in price as well?

Liza Mundy: As I mentioned it, when insurance does cover fertility treatment, it is, like so many medical treatments, cheaper. I mean, the pressure from managed care brings the price down. Obviously, the docs have to make a living, but as with medicine in general, there do seem to be workable compromises.

Many corporate policies pay for three IVFS per live birth.

Washington, D.C.: I'll tell you why I'm hostile. I am hostile to the thought that every person is entitled to exactly what they want -- in this case, a biological child, no matter what the circumstances. I am also hostile to the thought that if they can't pay for it, we the people should pay for it.

No. We the people should pay for societal needs -- that is, schools, roads, police, libraries, and so on. We shouldn't be expected to pay for personal wants.

Can't you see the difference?

Liza Mundy: Dunno whether "you" in this case is me personally, or readers in general. Personally, I can say that I still don't see wanting a child to raise and shape and love as the moral equivalent of wanting, say, a big house or the aforementioned Corvette. I do see a difference there. Many readers seem to think that wanting children is just sort of a lifestyle choice, a selfish sort of craving; whereas I do think that the longing for a child is something deeper and powerful than that; that it's something holy, if you will, or for the evolutionary psychologists among us, something that's biologically programmed. I mean, there are plenty of wrong reasons for wanting to have a child, but for many people, wanting children is literally the natural thing.

But that's just me.

Thanks for writing in.

Fairfax, Va.: I think what's throwing people off is use of the word "poor." It conjures up images of welfare recipients who, for whatever reason, want to add children to society's burden. We're not talking about the homeless wanting to have children here. We're talking about folks that can support themselves and pay their bills and keep a roof over their heads. There are many people with substantial income who would have difficulty in coming up with $14,000 cash for just ONE fertility treatment.

Liza Mundy: I had to just include that one. Excellent point; I wish I had made that clearer.

Overseas: I read your article, and I would like to help the Simpsons financially. Could someone provide me with an address to which to send them a gift?

Liza Mundy: Just to repeat: Make any check out to the recipient, send it to me, Liza Mundy, The Washington Post Magazine, 1150 15th Street NW, Washington, D.C 20071.

Thanks again, all who wrote in.

© Copyright 2003 The Washington Post Company