Procreation has changed an awful lot in the past few decades. Do you remember Louise Brown? She was the very first ‘test tube’ baby (aka known as the result of the first successful in vitro fertilization.) Her mother’s story (splattered on every British tabloid) was an international shock. Would the child be normal? Should we be making people in a laboratory? Were eugenics far behind? What kind of person goes to such sci-fi lengths to replicate themselves? Even the Pope weighted in. Well, little Louise is 34 years old now and my have times changed. Medical advances have redefined not just how we make babies but when mothers can be made as well.

Thirty plus years ago a pregnant woman over the age of 35 raised eyebrows. The elevated eyebrows were less about impropriety and more about biology. “Geriatric pregnancy” is an actual medical term and has nothing to do with walkers or graying hair. The human body is designed to be at peak fertility and health before age 35. Specific gestational and delivery risks are more probable after this age. Medical advances have made it safer (through early detection methods) for older women to carry and deliver, but the risks still exist. Historically women over 40 have had children, often quite by surprise. It is not unusual for a woman to develop a (false) sense of infertility security at the start of menopause. But it is only in the last decade or so that women over 40, trying to become pregnant has become normative. It was as recent as 1995 that (actress) Jane Seymour made magazine covers and evoked national gasps by becoming pregnant (with twins) at 44. Public judgments were made about her vanity and sense of entitlement. “She’ll be over 60 when they graduate!” It’s rather unlikely that today such an endeavor would warrant mention let alone prompt a national discussion.

Celebrities (and regular folk) routinely become parents at an older age; often through elaborate intervention. A woman can use her eggs (if they are viable) or a donor’s eggs. She can use her own or someone else’s uterus. Sperm is easily and equally transferable. There are many means and methods of now creating people. It’s hard to imagine that any new configurations could possibly be discovered/invented. All of this progress brings its own host of issues. Medical ethicists must smack their lips and rub their hands together every time a surrogate is hired. What does it mean to create a population who may never know to whom they’re related? Will children grow up and marry their siblings? What does it mean when the eggs of a woman with cancer are frozen for future use? Do doctors have a medical (and ethical) imperative to determine any genetic component to her cancer before fertilizing the eggs? And while we have the ethicists in the room: should health insurance cover fertility expenses? Is replicating one’s genes and/or having a birth experience, medically necessary? If not, are only the wealthy then entitled to these means to parenthood?

And what of other means to parenthood? What is the (current state and) future of adoption? International adoption has become a bit trendy as a few celebrities publicize their children’s origins. But limits to these adoptions are imposed everyday. What of domestic adoptions? There was a time that celebrities regularly and publicly adopted locally out of need. Fertility, contractual obligations, marital status or state of marriage necessitated adoption. If celebrities are adopting domestically today they’re doing it quietly behind closed doors (as the surrogate signs over her rights.) There will never be a shortage in this country of children needing parents. Accidents happen, death happens, life happens; and children are left in precarious situations.

There is no one way or even right way to make a family. In fact often it’s the messiest and most complicated households that are the richest. However as we make these incredible medical advances in maternity let us not lose sight of what we want parenthood to be. Nurturing and guiding a human being is an incredibly rewarding endeavor. Giving a child solid roots and the freedom to fly is the greatest of gifts. How that child arrives into your home and life is immaterial.