Rah Old Indian IVF Moms

Thursday the Post lamented the fact that India (population 1.2 billion) is growing twice as fast as China (population 1.3 billion), and may soon have by far world’s most in vitro fertilizations, perhaps 600,000 a year (~2% of India births), costing about $2500 each.

The Post reserved its strongest disapproval (between the lines, but still pretty clear) for the fact that many Indian IVF moms are 60 and 70 years old, and so are taking on bigger health risks. Supposedly regulation is needed to keep such women from succumbing to “cultural pressures.” Apparently, since Post reporters know no colleagues who would consider taking such an action, they conclude that elderly Indian IVF moms must be suffering from some horrible patriarchy. (No further evidence of illicit pressure is given.)

This seems to me cultural arrogance of the worst sort. Yes, new people induce some negative externalities, such as congestion. But overall economists’ best estimate is that new people give others a net benefit, especially via increased innovation. Thus creating (and raising) a new person is an incredibly altruistic act. The new person gets to have a life, and the rest of the world gains as well.

Yes, creating more people may reduce per-capita wealth in the short run, but if [most] everyone benefits, what’s wrong with that?  Yes, a high enough mom health risk could make this a net bad deal. But the Post quotes a 60% baby success rate, and I’ll bet mom mortality is below 6%, which means there’s at least a ten to one life gain ratio. And the gain ratio must be far larger in quality-adjusted life years.

These Indian women are not taking advantage of some overly-generous health insurance loophole – they are paying cash from their own pockets to give life to a new person. And they are not acting on some strange perverted desires – they are expressing an extremely basic, ancient, and revered desire, the desire to mother a child. Who are US elites to tell elderly Indians that their altruistic gift is not worth the cost? Shouldn’t we be subsidizing such altruism, instead of discouraging it?

This seems a lot like the phenomena of “Looking Too Good“:

Unselfish members (those who gave much toward the provision of the good but then used little of the good) were also targets for expulsion from the group. … Social comparison tends to induce feelings of inter-personal competition. People feel driven to outdo the group member who is setting the standard. … Removal of this person would eliminate that competitive standard.

If we praised poor elderly Indian IVF moms, that would implicitly criticize rich Western women who refuse to have even one kid even when young and healthy. Rather than raise our altruism standards, we’d rather exclude these women from the group of reasonable altruists. Quotes from that Post article:

Rohtash is a 60-year-old mother of five and a grandmother of eight. She’s also nine months pregnant, the result of an in vitro fertilization clinic, one of hundreds that have opened recently in India. …

With 1.2 billion people, India is still growing rapidly, and there are few efforts to control population growth, in sharp contrast to China’s one-child policy. Some planning advocates argue that India’s population is stalling [India’s] development. There are no government regulations for IVF clinics, especially in rural areas of northern India, and women older than 50 make up a surprising number of their patients, in a country where giving birth to many children defines a woman’s worth. …

In the past 18 months, the doctors at this clinic have helped 100 women older than 50 become pregnant. About 60 were able to carry those pregnancies to full term. … “The women come to us and say, ‘Even if I die, at least I won’t face the stigma of being barren.’ … They may die, but their family and country will live.”

Many fertility experts say performing IVF on women older than 45 can be dangerous for the mother, a stress on her heart and blood pressure. … The baby is also more likely to be born premature and to face health problems. The average life expectancy in India is 63. … One of the country’s leading centers … discourages the procedure after age 55. …

Fertility experts here say India is facing a unique problem because there is so much pressure for women to have children and the technology is relatively affordable. One IVF attempt at this clinic costs about $2,500, while in the United States it can run up to $15,000. … About 150,000 cycles were performed in the United States last year and about 80,000 in China, Pai said. No data were collected for India … but some experts think the number could reach 600,000 in the next three years. …

“The need of the hour is regulating these clinics.” … United States … doctors advise against IVF after 45 and can refuse in situations in which it is considered too risky. “There’s an argument that says that if a man of 70 years and can have a child, why can’t a woman of 70 have a child. … But what we need in India, because of our cultural pressures, is a policy to advise against it. It’s not safe.”

At the Hisar clinic, hundreds of worried-looking couples — ranging from those in their 20s to senior citizens — clutched scans and medical forms.

M.R. Bishnoi sat in his medical office under a poster of the Hippocratic oath and photographs of happy babies.

[IVF doc] Bishnoi … offered evidence that his procedures are safe by introducing … Lohan, 72, who gave birth to a daughter, Naveen, 18 months ago. … But Lohan has several health problems. Her husband, Balaram, is a farmer who always wanted a child. … He asked Lohan to try IVF after he read about the clinic in a Hindi newspaper. A relative donated an egg. His sperm was used.

Lohan said she worked through her pregnancy, milking cows, … After Naveen was born, she was even able to breast-feed. Bishnoi said his clinic bought life insurance for Lohan and her husband so their daughter will receive money when they die.

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