Why reproductive fertility technology is not the solution to age-related infertility

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In countries all over the world, more and more women are postponing childbearing. In my research on fertility, the women who I interview frequently cite their age as a reason for difficulties in achieving conception and/or maintaining a pregnancy. Many point to career or educational goals as reasons for delayed childbearing. While infertility is caused by a variety of factors, age can certainly play a role. With age-related infertility on the rise, more and more, assistive reproductive technologies (ARTs) are being advertised as a solution. ARTs are technologies that assist in achieving and maintaining a pregnancy. ARTs, however, are a problematic medical solution to what, in many cases, is actually the result of a set of larger social problems.

According to the UK Office for National Statistics, the average age of mothers for first births in England and Wales is on the rise. In 2011, the average age was 27.9 years. Similar trends are evident in other European countries, as well as in Canada, the United States, and various countries in Asia. In Canada, for instance, 11% of first births occur in women aged 35 years of age or older. The rise of delayed childbearing has been in part responsible for an increase in the use of ARTs. The ART market is a thriving one. According to the European Society of Human Reproduction and Embryology, approximately 1.5 million ART cycles are performed worldwide each year. Among the most popular ARTs is in vitro fertilisation, which can be used to overcome female, male and unexplained infertility. A newer addition to the list of ARTs, oocyte cryopreservation (egg freezing), was just over a year ago declared by the American Society for Reproductive Medicine to no longer be considered ‘experimental’. Egg freezing allows women to freeze their eggs for later use due to social or medical reasons. Unlike previous ARTs, egg freezing is promoted as a preventive technology that allows women to avoid age-related infertility, ideally, allowing women to prolong their fertility.

Why are women prolonging motherhood?

ARTs certainly have many advantages. They can allow couples to overcome infertility caused by a variety of reasons from premature ovarian failure to cancer treatment. They allow couples, who might not otherwise have been able to, to have a baby. They also help couples with genetic disorders conceive healthy babies. However, when it comes to many cases of age-related infertility, considering ARTs as a solution distracts us from the fundamental sociological question: why are women postponing childbearing?

In addition to risks to fertility, women who delay childbearing face increased risks of pregnancy complications and adverse pregnancy outcomes. These risks are most likely to appear in pregnancies of first-time mothers who are 35 years of age, or older. Two important and reoccurring reasons why women are postponing childbearing are: wanting financial security and a career before having a family. Women fear that having children will negatively impact their career. Research in this area has demonstrated that in many cases babies do have an impact on women’s careers across a number of professions. This is particularly the case when women are in the early stages of their career – often women in their late twenties, or early thirties. Having a baby can affect salary, position and promotions. In the UK, women continue to do almost twice as much childcare and housework as men. These factors do not make having a child an appealing option for young women in the midst of building their career.

While there are many benefits to ARTs, ARTs, like egg freezing, should not be seen as a solution to age-related fertility caused by postponed childbearing. They offer people a false sense of security in technology that cannot always compensate for the effects of ageing. They are invasive, risky and expensive. Their high price tags make them only really accessible to the people who are already more likely to have the flexibility and support at work to balance an early-stage career and children. ARTs take our focus away from deep-seated gender inequalities at work and in the home. They provide a medical solution to a social problem that can only truly be addressed through an ongoing commitment to bettering working conditions and gender equality at home.

*Katie Hammond [2011] is doing a PhD in Sociology at the University of Cambridge, having completed an MPhil in Multi-Disciplinary Gender Studies. Her research looks at assistive reproductive technologies, the resulting markets, and their regulation. Picture credit: arztsamui and http://www.freedigitalphotos.net.

Truth and reconciliation in Canada

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On a recent visit, the UN’s special rapporteur on the rights of indigenous peoples, James Anaya, said that while Canada is among the most developed countries in the world, the living conditions of its Aboriginal peoples more closely resemble those of much poorer nations. Anaya wasn’t exaggerating. The average child poverty rate is 40% among Canada’s Aboriginal population, compared to 15% for non-Aboriginal children. Health inequities are rife – while Canada has one of the lowest overall tuberculosis rates in the world, TB disproportionately affects Aboriginal communities. Why such stark inequality in an otherwise ‘developed’ country, and how can we begin to address it?

 The story begins in the 1880’s, when the Canadian government, with the help of Christian churches began administering an education system meant to assimilate more than 150,000 First Nations, Métis, and Inuit children into white colonial settler society. At one point there were 130 of these schools across the country – the last closed its doors in 1996. Under this system, Aboriginal children were taken from their families and placed in boarding-style schools designed to strip them of their culture and sense of heritage: they were not allowed to speak their native languages, and mental, sexual and physical abuse were rampant. It’s been reported that at least 3,000 aboriginal children died from exposure to disease during this time. There are estimates that approximately 80,000 survivors of residential schools live throughout Canada today.

It was only in 2008 that the Canadian government finally issued an official apology. Part of this apology involved the creation of a Truth and Reconciliation Committee (TRC), committed to uncovering the truth of what happened in the residential schools and informing the Canadian public. Among other consciousness-raising activities, the event consisted of public hearings where residential school survivors and their relatives could share statements about their experiences. These opportunities for public dialogue are healing events for families and communities impacted by this dark legacy.

A friend recently called me after attending a TRC event in Vancouver. The event impacted him profoundly. Despite the fact that he grew up living only a few kilometers away from one of Canada’s many Aboriginal land reserves, he was entirely unfamiliar with this piece of history. This speaks both to inadequate coverage of the residential school question and reconciliation process by the mainstream media, as well as the historical absence of these important issues in Canadian public school curriculum.

 Conflict surrounding land rights, problems with abuse, drugs, alcohol, and suicide in Aboriginal communities are commonly highlighted in public discourse – and usually in a way that is more derogatory than constructive. Indeed, discrimination against, and marginalisation of, Aboriginal people is systemic and pervasive. What is discussed much less frequently is that the history of residential schools is intimately tied to the fact that Aboriginal peoples in Canada experience poverty at a rate several times higher than other Canadians.

The TRC sessions are an excellent way for Canadians to become educated on a crucial part of their history. Uncovering past injustice and inviting it into public discourse is a basic step in addressing discrimination against Aboriginal communities. Understanding this troubled history should foster a more complete, compassionate and just understanding of current issues. This should be the first step in addressing the glaring gap in living conditions highlighted by the UN special rapporteur.

 *Tara Cookson is a Gates Cambridge Scholar and is doing a PhD in Geography. She is critically exploring the effects of the more recent post-neoliberal policy shifts on women’s lives as carers within the Latin American region, focusing specifically on those policies that seek to ‘empower’ women and alleviate poverty.  Picture credit: domdeen and http://www.freedigitalphotos.net.

Why the energy technology revolution hasn’t happened

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It’s always encouraging to see the nations of the world talking seriously about how to address the problem of climate change, and one can’t help but get a warm and fuzzy feeling from the recent announcement by US Secretary of State John Kerry that America intends to push more aggressively on this issue in the years ahead.  But, alas, we’ve seen this movie before: silver-tongued politicians have been delivering speeches on this very topic for decades, yet we have precious little to show for it.

In fact, 2012 was a rather unfortunate milestone for human civilisation inasmuch as it was the 20th anniversary of the much-ballyhooed Earth Summit.  In 1992, 172 nations came together in Rio de Janeiro and agreed that climate change was a major global threat that needed to be tackled in a coordinated way.  Despite this unprecedented commitment to change, however, very limited progress has been made since then.  There’s no denying that clean energy technologies have made some noteworthy gains over the years, but the brutal truth of the matter is that we’re still failing.  What’s the world’s fastest growing energy source today?  Coal.  The energy technology revolution that so many of us were hoping for still hasn’t arrived.

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World Energy Consumption 1986-2011
Source: BP’s Statistical Review of World Energy 2012

The way I see it – and as I explain in a recent talk that I gave on this topic – there are a few explanations for this rather pronounced lack of progress.  Maybe the 172 delegates in Rio were being less than sincere when they made all those promises back in 1992.  But the discussion has continued and gathered momentum since that time, so I suspect that other forces might be at work here.  Instead, I believe that there were market dynamics that stood in the way between us and the well-intentioned agreements struck in Rio.  These forces and dynamics were less understood at that time, however, and were accordingly under-emphasised by policymakers of the day – but are now starting to come into focus.

Entrepreneurs and start-ups

Underpinning these forces are the mechanics of how technological revolutions tend to unfold.  Sometimes an industry incumbent comes up with an innovation that represents a fundamental departure from what was there previously, and the marketplace is changed forever.  Very often, however, these kinds of dramatic changes are delivered to the market by entrepreneurs and relatively small start-up firms.

Despite the nimbleness that their small size affords these startup companies, however, it often acts as a structural disadvantage in the energy technology space because of the industry’s extremely slow clockspeed.  The energy sector is uncommonly capital-intensive and involves assets typically designed to last for decades, and the sector tends to absorb new technologies much more slowly than many other industries as a result.  Whereas some sectors like IT and computing quickly develop and adopt new technologies within a few years, the better part of an engineer’s career can go by before promising innovations properly find their way into the energy sector.  The figure below compares the upstream oil & gas sector to other industries on this front, but many other parts of the energy industry – including nuclear power, electrical transmission, etc – also frequently behave in this same way.

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Rates of Technological Change in Different Industries
Source: Shell International Exploration & Production presentation at SPE-IADC Conference 2005

And therein lies the root of the problem: small start-ups have trouble surviving for 20-30 years while they’re waiting for their promising new energy technology ideas to catch on in the marketplace.  Big companies can “play the long game” and be patient for innovation-related investments to pay off, but small companies usually have to fret over shorter-term concerns like making next month’s payroll and keeping the lights on.  My own research in this area over the past couple of years (which is still being groomed into a publishable form) shows that the industry’s extremely slow clockspeed frequently causes a lot of pain within energy technology start-ups, and other researchers looking at different data have landed on similar types of conclusions.  It therefore follows that a dot-com style revolution within the energy industry was probably unlikely.

So what should we be doing instead?  As MIT Technology Review’s David Rotman contends: “As venture investors and start-ups recognise how much time and money it takes to establish truly innovative clean-energy technologies, they’re embracing the value of working closely with the large companies that will dominate the industry for the foreseeable future.”  In the two decades that have passed since the Earth Summit, we’ve bet heavily on technologies and business models designed to set in motion a revolution that would effectively supplant all of the trillions of dollars in energy-related infrastructure that is already in place.  That strategy has delivered shockingly little progress.  There is an obvious romantic appeal and natural attractiveness to the idea of a revolution, but it’s becoming increasingly clear that this was always a long shot – and the stakes are simply too high for us to gamble away the next 20 years in the way we did the last 20.

It’s time to change gears and start developing business models and government policies that encourage large incumbents to work collaboratively with the start-up firms that are championing breakthrough energy technology ideas.  The energy revolution didn’t unfold in the way many of us hoped it would but, with a bit of ingenuity and fresh business models, we can still figure out how to make the world’s energy system evolve quickly enough to bring about the changes that we’ve been calling for since the Earth Summit.

*Robert Perrons [2001] was a Gates Cambridge Scholar at the University of Cambridge, where he received a PhD in Engineering.  He is currently an Associate Professor at the Queensland University of Technology in Brisbane, Australia.  His research mainly focuses on innovation management and new technologies in the energy and resources sectors. Top picture credit: xedos4 and http://www.freedigitalphotos.net.

San Quentin: starting a prison revolution?

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“San Quentin, what good do you think you do?

Do you think that I’ll be different when you’re through?

You bend my heart and mind and you warp my soul,

your stone walls turn my blood a little cold.”

In the ‘60s Johnny Cash famously described San Quentin’s negative reputation as a prison. As a criminologist doing my post-doc at UC Berkeley, I had to visit San Quentin. My visit was depressing and positive at the same time. Depressing because it hurts to see how many lives have been traumatised by violence, crime and by life in prison. Positive because I visited a special programme called GRIP – Guiding Rage Into Power. GRIP seems to fit with Cash’s words about bending “my heart and mind” and warping “my soul”, but in the opposite way than he intended almost 50 years ago.

San Quentin, beautifully located on the San Francisco Bay, is a special prison in a country characterised by mass incarceration with a focus on punishing instead of rehabilitating offenders. Contrary to most US prisons, San Quentin offers several programmes to inmates. Around 4,000 volunteers work with inmates who can take undergraduate college courses, produce their own newspaper, create theatre productions and so on.

The critical reader will wonder why prisoners should be allowed to take all these courses? Aren’t they in prison for a reason?

The central aim of incarceration is punishment in the form of deprivation of liberty. People should go to prison as punishment, not for punishment. Isn’t it horrendous enough to have lost the ability to decide what you do when you want? Another aim of imprisonment is to reduce crime. The hope is that people learn from their sentence and will not reoffend when they return to society. In the current prison system, around 60% of people reoffend within three years of their release so the system does not work very effectively in helping people to stop committing crime.

Prisons appear to be universities of crime. When someone leaves prison he has had many opportunities to acquire criminal skills, has probably lost many pro-social relationships and has trouble finding a job and a home. In the current prison system, it is almost a miracle if a prisoner stops offending after his sentence. We currently live in a punitive society where people want to lock up offenders for as long as possible. This is clearly visible in the US, where one in 100 Americans are currently in prison. Among African American men between 18 and 35 years old, one in eight are in prison. This is more than the number of African American men who go to college…. One year in a Californian prison costs $50,000 (or $10,000 more than studying at Stanford, all costs included).

Emotional intelligence

GRIP and San Quentin are a welcome change from this situation. Before I visited GRIP, I was afraid that the participants would feel like I was an intruder, someone wanting to observe or spy on them. There was I, this privileged person going to UC Berkeley. Boy, was I wrong! When Jacques, the director, asked whether someone could explain what GRIP means, the men were eager to tell us: they were taking responsibility for their crimes – almost all of them had committed serious violent offences, had learned how to change rage into something other than violence, had developed emotional intelligence by recognising physical sensations and emotions and had stopped using violence. After half an hour Jacques had to interrupt them because otherwise there would have been no time for the rest of the programme. These men were grateful and extremely motivated about the opportunity they got to learn about their own emotions and violence: something they all wished they had learned when they were younger.

US prisons are strange places. They are riven with racial segregation: whites live, sleep and eat together with whites, African Americans with African Americans, Asians with Asians, etcetera. You can trust nobody in prison and have to be on guard constantly. Within GRIP, however, 34 men from all backgrounds talk about their emotions and their youth. The community sense is strong and the men collaborate to change their behaviour. Each group has a name; the one I saw was tribe 928. This name is the total number of years that these men have been incarcerated. Yes, these men have been incarcerated for on average 27 years each…

I was impressed by how well the programme impacted on the men. Jacques challenges them. We were discussing quotes. I had to read this one a couple of times before understanding it well:

Whoever survives a test, whatever it may be, must tell the story. That is his duty. I don’t want my past to become anyone else’s future. Suffering confers neither priviliges nor rights. It all depends on how one uses it. If you use it to increase the anguish of others or yourself, you are degrading, even betraying it. And yet the day will come when we shall understand that suffering can elevate human beings. God help us to bear our sufferings well.” Elie Wiesel

The men, however, immediately began to relate the quote to their own lives. Recently, I visited GRIP with five undergraduate students. One of them said that she didn’t think she could be as open and honest about her emotions as this group of men and that she didn’t know anyone else who was so emotionally intelligent. I agree with her. San Quentin and GRIP are a great example for the rest of the US. Hopefully, they are contagious and lead to a revolution in prison life around the US so prisons will more positively bend prisoners’ hearts and minds while turning their blood warm instead of cold.

Because images can tell so much more than just words, here’s a video about GRIP made by PBS.

*Sytske Besemer [2008] recently finished her PhD in Criminology and is now at UC Berkeley. Picture credit: Wiki Commons and Jitze Couperus.