You Can Have a Baby: Everything You Need to Know About Fertility. By Dr. Joseph H. Bellina & Josleen Wilson. Crown Publishers Inc. $18.95; The Mother Machine: Reproduction Technologies. By Gena Corea. Harper & Row, $18.95; Making Babies: The New science and Ethics of Conception. By Peter Singer and Deane Wells. Charles Scribner's Sons. $14.95.
The business of having babies used to be simple. Society, though of course not biology, generally confined it to married couples. And the couples had it down to a three-step process -- intercourse, pregnancy, baby -- with the occurrence of the second and the qualities of the third pretty much dependent on luck.
The failure to have babies was also simple. Sometimes pregnancy just didn't happen, and the almost universal assumption -- although the subject was too taboo for anyone to be voicing assumptions -- was that the woman was "barren."
Of course, the emotions and ramifications of reproducing, or failing to, are rarely simple. But the technological limitations of the past did, at least, allow a sense of finiteness and fatalism about one's reproductive future.
No more. In the 1980s, determinism has given way to determination, and science has gone into overdrive to produce technologies that make it all work out.
The world is not sitting back and blinking indifferently. The new techniques have vociferous champions, among them researchers, physicians and others working on infertility problems; entrepreneurs who see opportunity in assisting people who have those problems; nerve-wracked, hopeful infertility patients; and opponents who see the work as tampering with nature.
All of these developments, reactions and concerns have found their way into a plethora of writings on infertility problems and solutions, including these three recent books.
"You Can Have a Baby" has one dreadful flaw: its title, which is both overly rah-rah and in some cases -- medical advances and personal desire notwithstanding -- just plain false. The book, however, should not be judged by its cover, or title. It is encyclopedically packed with valuable information.
Dr. Joseph Bellina, director of a New Orleans infertility research and treatment center called the Omega Institute, and Josleen Wilson, a science writer, have tried to get at least a little of everything into the book.
For people looking for straightforward explanations and suggestions, Bellina and Wilson provide them in abundance, and generally achieve both detail and clarity. Some of the simplest things they do -- such as lists of what to look for (and what to look out for) in a team of fertility specialists, and what women and men should each expect in fertility workups -- will likely mean the most to their readers.
They do repeat themselves from chapter to chapter, but that suits a book many people are likely to read a section at a time. There is an extensive glossary and a directory of resources for further information on infertility, adoption and surrogate parenting.
Although much of "You Can Have a Baby" is matter-of-fact, well-illustrated biology, Bellina and Wilson also offer advice, opinions and low-key criticisms. They find fault with medicine's historical handling of infertility, and they find reasons to caution against headlong entry into new reproductive territory. But -- as that title makes clear -- they are mostly upbeat, trying to inform rather than to pick fights or even provoke terribly deep thoughts.
For provocative thoughts, turn to either of the other two books. For fight-picking, focus on "The Mother Machine." Gena Corea, author of "The Hidden Malpractice: How American Medicine Mistreats Women" and a founder of the Feminist International Network on the New Reproductive Technologies, comes out swinging from a fierce feminist stance that she makes clear right on page two: "I emphasize that reproductive technologies are a political issue, and I will sometimes refer to the physicians, embryologists and others involved as 'pharmacrats.' " "Pharmacracy," she says, is a word coined by the psychiatrist Dr. Thomas Szasz that means "political rule by physicians."
Corea's views and warnings are worth attention, as is her vast and assiduous research. It is true, as she points out, that women have been abused at numerous stations on the reproductive trail -- from wetnurses who worked in nearly slavelike conditions to women who gave uninformed "consent" for drug or surgical treatments that permanently damaged their reproductive capacities. It is also true that most people in positions of medical authority have traditionally been men.
However, it is at least syllogistic and at worst reckless to conclude -- to absolutely conclude, as Corea does, rather than to thoughtfully caution -- that women are in for more of the same, that men are out to turn us into male-controlled breeding machines by perfecting the panoply of new technologies. Corea offers the intriguing theory of "reproductive continuity," in which she suggests that men have always felt disconnected from the reproductive process after intercourse and are now striving to turn the tables on women. Unfortunately, though, her tone in explaining this and her other ideas is too combative to be truly persuasive.
"Making Babies" touches on many of the same subjects as "The Mother Machine," but in a much more cool-headed way -- though Corea would no doubt argue that because the authors of "Making Babies" are men, they have every reason to be cool-headed. Peter Singer and Deane Wells are from Australia, which has been in the forefront of researching, practicing and regulating the new reproductive technologies. Singer is a philosophy professor and director of the Centre for Human Bioethics at Monash University; Wells is a member of the Australian Parliament.
"Making Babies" devotes one third of its pages to in vitro fertilization, going step by methodical step from the earliest research to the most troublesome issues, such as what to do with "extra" embryos not implanted in the woman who undergoes the procedure. They then go on to discuss the more futuristic technologies, from surrogate parenting to genetic engineering.