1
00:00:43,320 --> 00:00:47,000
Speaker 1: Hi, I'm Aaron Welsh and this is This Podcast Will

2
00:00:47,080 --> 00:00:50,560
Speaker 1: Kill You. Welcome to the latest episode in the tp

3
00:00:50,880 --> 00:00:54,040
Speaker 1: w k Y book Club series, where I bring on

4
00:00:54,160 --> 00:00:57,520
Speaker 1: authors of popular science and medicine books to chat about

5
00:00:57,560 --> 00:01:00,960
Speaker 1: their latest work. Over the years, we've gotten to cover

6
00:01:01,080 --> 00:01:05,520
Speaker 1: some fascinating books on subjects ranging from the history of

7
00:01:05,600 --> 00:01:09,679
Speaker 1: refrigeration to the evolution of language, from the concept of

8
00:01:09,880 --> 00:01:13,400
Speaker 1: proof to the story of syphilis, and so much more.

9
00:01:13,920 --> 00:01:15,840
Speaker 1: If you'd like to check out the full list of

10
00:01:15,840 --> 00:01:18,440
Speaker 1: books we've covered so far, as well as ones on

11
00:01:18,520 --> 00:01:21,600
Speaker 1: the horizon, head over to our website This Podcast will

12
00:01:21,680 --> 00:01:24,440
Speaker 1: Kill You dot com. Once you're there, click on the

13
00:01:24,520 --> 00:01:27,840
Speaker 1: Extras tab and then Bookshop, which will take you to

14
00:01:27,880 --> 00:01:32,080
Speaker 1: our affiliate page that has several podcast related lists, including

15
00:01:32,280 --> 00:01:35,640
Speaker 1: one for this book Club. If you've just read or

16
00:01:35,680 --> 00:01:37,679
Speaker 1: heard about a cool book that you think would be

17
00:01:37,720 --> 00:01:41,399
Speaker 1: a good fit, please let us know. I always appreciate

18
00:01:41,480 --> 00:01:44,360
Speaker 1: getting recommendations, and I've taken you all up a few

19
00:01:44,360 --> 00:01:47,720
Speaker 1: times on those recommendations. The best way to get in

20
00:01:47,760 --> 00:01:50,600
Speaker 1: touch is through the contact us form on our website,

21
00:01:50,640 --> 00:01:53,920
Speaker 1: which you can also use to share topic suggestions, your

22
00:01:53,960 --> 00:01:56,760
Speaker 1: first hand account, or any other thoughts you might have

23
00:01:57,520 --> 00:02:00,080
Speaker 1: two quick things before we can move on to the

24
00:02:00,080 --> 00:02:02,360
Speaker 1: book of the week, and that is to please rate,

25
00:02:02,480 --> 00:02:05,960
Speaker 1: review and subscribe. It really really does help us out.

26
00:02:06,480 --> 00:02:09,799
Speaker 1: And secondly, we are on YouTube. That's right. You can

27
00:02:09,800 --> 00:02:13,320
Speaker 1: now find full video versions of most of our newest episodes.

28
00:02:13,760 --> 00:02:16,440
Speaker 1: Make sure that you're subscribed to the exactly Right Media

29
00:02:16,520 --> 00:02:19,640
Speaker 1: YouTube channel so you never miss a new episode. Drop

30
00:02:20,560 --> 00:02:24,880
Speaker 1: social media ads for egg Freezing IVF clinics boasting about

31
00:02:24,960 --> 00:02:29,200
Speaker 1: success rates, surrogacy contracts approaching the length of a book,

32
00:02:29,639 --> 00:02:33,520
Speaker 1: websites where breast milk can be bought and sold. These days,

33
00:02:33,720 --> 00:02:38,200
Speaker 1: the maternal body is increasingly seen in terms of monetary value.

34
00:02:38,919 --> 00:02:43,239
Speaker 1: Does this leave people more vulnerable to exploitation or might

35
00:02:43,320 --> 00:02:47,880
Speaker 1: it actually be empowering? As this week's book shows, there

36
00:02:48,040 --> 00:02:51,960
Speaker 1: is no right answer. Journalist Alev Scott joins me to

37
00:02:52,040 --> 00:02:55,800
Speaker 1: discuss her latest book, Cash Cow, How the maternal body

38
00:02:55,840 --> 00:02:59,519
Speaker 1: became a global commodity and the hidden costs for women.

39
00:03:00,280 --> 00:03:04,760
Speaker 1: Scott takes readers through her personal and compassionate exploration of

40
00:03:04,800 --> 00:03:09,600
Speaker 1: the fascinating and at times deeply disturbing underbelly of the

41
00:03:09,600 --> 00:03:14,040
Speaker 1: global fertility industry. She explores the three main elements that

42
00:03:14,080 --> 00:03:18,880
Speaker 1: have undergone this commodification breast milk, eggs, and womb and

43
00:03:18,960 --> 00:03:22,000
Speaker 1: delves into how each has been turned into a business

44
00:03:22,000 --> 00:03:26,880
Speaker 1: opportunity with little to know public scrutiny the breast milk market,

45
00:03:27,120 --> 00:03:31,120
Speaker 1: who's buying and who's selling in this completely unregulated space.

46
00:03:31,919 --> 00:03:37,440
Speaker 1: Future fertility fairs promoting cutting edge technology alongside shamanic nutritionists

47
00:03:37,720 --> 00:03:41,160
Speaker 1: are claims of success required to have support. The wide

48
00:03:41,240 --> 00:03:45,720
Speaker 1: range of surrogacy legality across the globe, which countries allow

49
00:03:45,800 --> 00:03:50,520
Speaker 1: for profit surrogacy versus altruistic only surrogacy versus surrogacy being

50
00:03:50,600 --> 00:03:54,240
Speaker 1: labeled a crime against women. The regulation of sperm donation.

51
00:03:54,480 --> 00:03:58,200
Speaker 1: Should a donor's identity be visible or should they remain anonymous?

52
00:03:58,920 --> 00:04:02,840
Speaker 1: To say the ethics are complicated is quite the understatement,

53
00:04:03,360 --> 00:04:06,760
Speaker 1: but that is where the power of cash Cow truly lies.

54
00:04:07,360 --> 00:04:10,480
Speaker 1: Readers are forced to confront their feelings and have their

55
00:04:10,520 --> 00:04:16,040
Speaker 1: assumptions questioned. Where does the line between exploitation and empowerment lie?

56
00:04:16,560 --> 00:04:19,919
Speaker 1: Sitting in that moral gray zone is not a comfortable

57
00:04:19,960 --> 00:04:23,479
Speaker 1: thing to do, but it is crucial, especially since the

58
00:04:23,520 --> 00:04:26,640
Speaker 1: global fertility market will only continue to grow in the

59
00:04:26,640 --> 00:04:30,640
Speaker 1: coming decades. I found this book to be a revelation,

60
00:04:31,040 --> 00:04:34,040
Speaker 1: one of those books where for weeks after you're telling

61
00:04:34,040 --> 00:04:36,880
Speaker 1: your friends about what you learned. I do want to

62
00:04:36,920 --> 00:04:41,200
Speaker 1: mention that this conversation features discussions of pregnancy, loss, abuse,

63
00:04:41,320 --> 00:04:45,880
Speaker 1: and overall exploitation. So please listen with discretion. Let's take

64
00:04:45,880 --> 00:05:12,200
Speaker 1: a short break and get started. Alev, thanks so much

65
00:05:12,200 --> 00:05:15,240
Speaker 1: for joining me today. Thank you for having me in

66
00:05:15,279 --> 00:05:18,320
Speaker 1: the prologue of your book, cash Cow. You drop readers

67
00:05:18,440 --> 00:05:22,920
Speaker 1: right into this strange world really of the breast milk market,

68
00:05:23,120 --> 00:05:25,159
Speaker 1: which you later explained, you know, kind of planted the

69
00:05:25,200 --> 00:05:28,640
Speaker 1: seed for this idea of this book. How did that

70
00:05:28,800 --> 00:05:29,479
Speaker 1: seed grow?

71
00:05:29,680 --> 00:05:29,760
Speaker 2: Like?

72
00:05:29,839 --> 00:05:32,320
Speaker 1: When did you go from the breast milk market to

73
00:05:32,400 --> 00:05:36,599
Speaker 1: kind of seeing the commodification of fertility everywhere you looked.

74
00:05:37,279 --> 00:05:40,040
Speaker 3: I really didn't set out to write about the fertility

75
00:05:40,080 --> 00:05:44,920
Speaker 3: industry or the breast milk market, but it kind of

76
00:05:44,960 --> 00:05:48,200
Speaker 3: came about serendipitously when I had my first child a

77
00:05:48,200 --> 00:05:50,680
Speaker 3: few years ago. It sort of did come from that

78
00:05:50,800 --> 00:05:54,200
Speaker 3: initial encounter I had with the online breast milk market,

79
00:05:55,040 --> 00:05:58,640
Speaker 3: and I suppose it was natural for my curiosity to

80
00:05:58,800 --> 00:06:01,479
Speaker 3: go from there to other parts of the maternal body

81
00:06:01,480 --> 00:06:04,760
Speaker 3: that are commodified. I was extremely lucky. I had a

82
00:06:04,880 --> 00:06:09,680
Speaker 3: very easy, heteronormative route to motherhood. I didn't go through IVF,

83
00:06:09,720 --> 00:06:12,560
Speaker 3: but many of my friends have either gone through IVF

84
00:06:12,760 --> 00:06:16,480
Speaker 3: or are considering doing so, or they're having their eggs frozen,

85
00:06:17,160 --> 00:06:21,440
Speaker 3: or they're looking at surrogacy. And so when I'd encountered

86
00:06:21,440 --> 00:06:25,599
Speaker 3: that world before, i'd seen it through their eyes, but

87
00:06:25,680 --> 00:06:29,880
Speaker 3: I began to see it a bit more from this perspective,

88
00:06:29,920 --> 00:06:32,320
Speaker 3: I suppose of like, what are we actually doing here?

89
00:06:32,360 --> 00:06:35,320
Speaker 3: Like what does the industry entail? How is it that

90
00:06:35,320 --> 00:06:38,160
Speaker 3: there are such different laws and regulations in one country

91
00:06:38,560 --> 00:06:42,120
Speaker 3: from the other, And how much does cultural attitude play

92
00:06:42,120 --> 00:06:45,200
Speaker 3: into that? To be totally honest, I felt quite protective

93
00:06:45,240 --> 00:06:48,039
Speaker 3: of some of my friends when they were embarking on

94
00:06:48,080 --> 00:06:51,400
Speaker 3: these IVF journeys, because I could see that they were well,

95
00:06:51,400 --> 00:06:53,480
Speaker 3: they were obviously desperate to have children, but they were

96
00:06:54,080 --> 00:06:57,560
Speaker 3: they were very, very vulnerable as consumers as well. So

97
00:06:57,720 --> 00:07:00,599
Speaker 3: I was looking at it from a kind of mark lens.

98
00:07:00,640 --> 00:07:03,640
Speaker 3: I suppose. I don't know how better to explain it, really,

99
00:07:03,680 --> 00:07:08,000
Speaker 3: other than my very personal, very visceral encounter with the

100
00:07:08,040 --> 00:07:12,600
Speaker 3: breast milk industry online sort of matched up with my

101
00:07:12,640 --> 00:07:14,960
Speaker 3: curiosity about the IVF market in other ways, and they

102
00:07:15,040 --> 00:07:16,600
Speaker 3: kind of came together in this.

103
00:07:16,600 --> 00:07:22,160
Speaker 1: Book, and you arrange this book in three main big chapters.

104
00:07:22,680 --> 00:07:24,840
Speaker 1: Can you tell me a little bit about that structure

105
00:07:24,880 --> 00:07:26,560
Speaker 1: and how you landed on that structure.

106
00:07:27,280 --> 00:07:30,080
Speaker 3: I forced myself to be quite literal about what I

107
00:07:30,160 --> 00:07:32,960
Speaker 3: was doing, which was really kind of breaking the maternal

108
00:07:33,000 --> 00:07:37,200
Speaker 3: body down into its composite parts, the sort of byproducts

109
00:07:37,240 --> 00:07:40,440
Speaker 3: of fertility in a way, or the stepping stones to

110
00:07:40,760 --> 00:07:43,720
Speaker 3: having a child. And it made me think of a

111
00:07:44,200 --> 00:07:47,840
Speaker 3: Dutch book I'd encountered, which was written by a Dutch

112
00:07:47,920 --> 00:07:53,400
Speaker 3: artist about the uses of one commercially raised pig, and

113
00:07:53,800 --> 00:07:57,920
Speaker 3: she detailed hundreds of uses of its body parts, everything

114
00:07:57,920 --> 00:08:02,280
Speaker 3: from cigarettes to body like to pay to bullets, like

115
00:08:02,600 --> 00:08:06,680
Speaker 3: crazy stuff. Anyway, that made me think about how the

116
00:08:06,680 --> 00:08:10,440
Speaker 3: bits of the maternal body are commodified. And it is

117
00:08:10,480 --> 00:08:15,800
Speaker 3: a bit of a start comparison perhaps, but I thought, actually,

118
00:08:15,840 --> 00:08:19,280
Speaker 3: it's effective, and those are the three main parts of

119
00:08:19,280 --> 00:08:22,960
Speaker 3: the maternal body that we do commoditize. So that's how

120
00:08:22,960 --> 00:08:24,400
Speaker 3: I kind of landed on that structure.

121
00:08:25,240 --> 00:08:28,480
Speaker 1: I really love how throughout the entire book you are

122
00:08:28,520 --> 00:08:34,720
Speaker 1: constantly probing the question of exploitation and empowerment and where

123
00:08:34,800 --> 00:08:37,160
Speaker 1: does it lie, and does it lie in a different

124
00:08:37,160 --> 00:08:40,120
Speaker 1: place for different people, or different countries, or different experiences

125
00:08:40,200 --> 00:08:45,120
Speaker 1: or different practices, And just so much of these questions

126
00:08:45,160 --> 00:08:50,200
Speaker 1: that I think that many of us don't really consider

127
00:08:50,320 --> 00:08:53,160
Speaker 1: that deeply or like unless we are confronted with it.

128
00:08:53,600 --> 00:08:56,000
Speaker 1: And throughout the course of reading your book, I found

129
00:08:56,040 --> 00:08:59,760
Speaker 1: myself confronted a lot by these ethical questions that I

130
00:08:59,760 --> 00:09:01,439
Speaker 1: did know the answer to and I still don't know

131
00:09:01,480 --> 00:09:04,400
Speaker 1: the answer to. And you discussed this as well, how

132
00:09:04,720 --> 00:09:08,920
Speaker 1: some of your preconceptions about parenthood and fertility were overturned

133
00:09:09,559 --> 00:09:12,400
Speaker 1: throughout the course of writing this. What were some of those?

134
00:09:13,200 --> 00:09:17,160
Speaker 3: I think the subject I knew least about well. I mean,

135
00:09:17,440 --> 00:09:20,080
Speaker 3: I knew very little about lots of things when I

136
00:09:20,120 --> 00:09:24,480
Speaker 3: started this research. Sarrogacy was something that I didn't know

137
00:09:24,600 --> 00:09:26,880
Speaker 3: very much about. I didn't actually know how I felt

138
00:09:26,920 --> 00:09:29,280
Speaker 3: about it, because, like you, I'd never forced myself to

139
00:09:29,320 --> 00:09:32,440
Speaker 3: confront any of the ethical questions that it brings up.

140
00:09:33,040 --> 00:09:35,920
Speaker 3: I have to say that when I set out looking

141
00:09:36,000 --> 00:09:40,480
Speaker 3: at the American model, I sort of expected to find

142
00:09:40,520 --> 00:09:42,720
Speaker 3: it a bit in your face, a bit crass, like

143
00:09:42,760 --> 00:09:44,680
Speaker 3: the commercial aspects of it, because I live in a

144
00:09:44,679 --> 00:09:49,400
Speaker 3: country where only altruistic surrogacy is allowed, and in Europe

145
00:09:49,559 --> 00:09:55,040
Speaker 3: sarrogacy is either banned in certain countries like Spain for example,

146
00:09:55,120 --> 00:09:58,600
Speaker 3: or Italy, or it's allowed in a strictly altruistic sense,

147
00:09:58,720 --> 00:10:01,360
Speaker 3: like in the UK or the nether So I was thinking, Okay,

148
00:10:01,360 --> 00:10:02,920
Speaker 3: this is going to be a bit weird looking into

149
00:10:02,960 --> 00:10:04,880
Speaker 3: the US market, and it was a bit weird. And

150
00:10:04,920 --> 00:10:06,959
Speaker 3: the first time I read a surrogacy contract, I was

151
00:10:07,080 --> 00:10:10,239
Speaker 3: very taken aback by some of the clauses in that contract.

152
00:10:10,880 --> 00:10:15,520
Speaker 3: Having said that, by the time I finished my research,

153
00:10:15,640 --> 00:10:18,760
Speaker 3: and by the time I'd looked into surrogacy markets in

154
00:10:18,840 --> 00:10:23,480
Speaker 3: other parts of the world where surrogacy is not strictly illegal,

155
00:10:23,480 --> 00:10:24,760
Speaker 3: but it's not really legal either.

156
00:10:24,800 --> 00:10:25,760
Speaker 2: It's this gray.

157
00:10:25,520 --> 00:10:28,760
Speaker 3: Area and there's a lack of regulation and no one

158
00:10:28,880 --> 00:10:31,840
Speaker 3: really knows how the surrogates involved are treated. It depends

159
00:10:31,840 --> 00:10:35,400
Speaker 3: from agency to agency. Those markets worried me so much

160
00:10:35,440 --> 00:10:37,000
Speaker 3: more that I came round to the view that the

161
00:10:37,080 --> 00:10:42,079
Speaker 3: US market is probably the safest in terms of well

162
00:10:42,120 --> 00:10:45,240
Speaker 3: in terms of safeguards expectations from both sides.

163
00:10:45,400 --> 00:10:47,640
Speaker 2: It doesn't mean it's perfect at all. There've been a

164
00:10:47,640 --> 00:10:50,600
Speaker 2: couple of viral articles recently I don't know if you've read.

165
00:10:50,960 --> 00:10:53,800
Speaker 2: There was one in Wired recently in New Yorker.

166
00:10:54,720 --> 00:10:57,120
Speaker 3: For me, I was really glad those articles are written,

167
00:10:57,160 --> 00:10:59,559
Speaker 3: not because I am critical of surrogacin and I want

168
00:10:59,600 --> 00:11:02,200
Speaker 3: there to bad press about surrogacy out there, which, by

169
00:11:02,240 --> 00:11:03,200
Speaker 3: the way, some people assume.

170
00:11:03,240 --> 00:11:05,640
Speaker 2: Some people assume my book is anti sarrogacy. It's not.

171
00:11:06,120 --> 00:11:08,640
Speaker 3: I just want to open up the conversations about the

172
00:11:08,640 --> 00:11:11,760
Speaker 3: pitfalls and the weaknesses in the system, even in the US,

173
00:11:11,800 --> 00:11:14,959
Speaker 3: which is held up as like you know, the post

174
00:11:15,000 --> 00:11:18,199
Speaker 3: a child of a sorrogcy industry. It's it's much better

175
00:11:18,280 --> 00:11:21,040
Speaker 3: than many other markets. It's not perfect, and we need

176
00:11:21,040 --> 00:11:22,440
Speaker 3: to talk about why it's not perfect.

177
00:11:23,080 --> 00:11:26,360
Speaker 1: Yeah, showing the full range of there is no one

178
00:11:27,040 --> 00:11:30,720
Speaker 1: answer necessarily or one way to feel. And you do

179
00:11:30,800 --> 00:11:34,839
Speaker 1: this right away in your chapter on breast milk and

180
00:11:34,960 --> 00:11:37,720
Speaker 1: how you know you talk about that your first exposure

181
00:11:37,720 --> 00:11:40,480
Speaker 1: to the fertility industry for this book was through the

182
00:11:40,480 --> 00:11:43,840
Speaker 1: breast milk market. Can you tell me about this market?

183
00:11:43,920 --> 00:11:46,080
Speaker 1: You know, who's on the market selling, who's on the

184
00:11:46,080 --> 00:11:50,199
Speaker 1: market buying. Are there laws or regulations surrounding this, What's

185
00:11:50,240 --> 00:11:52,040
Speaker 1: what's going on with the breast milk market?

186
00:11:52,520 --> 00:11:55,320
Speaker 2: Great question, so I knew very little.

187
00:11:55,320 --> 00:11:57,560
Speaker 3: I didn't know there was a breast milk market until

188
00:11:57,600 --> 00:12:01,439
Speaker 3: I had my child, and I hadn't supply of milk.

189
00:12:01,520 --> 00:12:04,040
Speaker 3: So I had all this frozen breast milk in the

190
00:12:04,080 --> 00:12:05,920
Speaker 3: freezer and it was going to go to waste, and

191
00:12:05,960 --> 00:12:08,320
Speaker 3: I wanted to donate it. I knew that was possible,

192
00:12:08,679 --> 00:12:12,079
Speaker 3: although it isn't widely known. Actually, I happened to have

193
00:12:12,160 --> 00:12:15,680
Speaker 3: a friend in Amsterdam who donated her breast milk to

194
00:12:16,000 --> 00:12:17,920
Speaker 3: the hospital. So that's what I set out to do.

195
00:12:19,000 --> 00:12:22,120
Speaker 3: And what I discovered while I was researching that was

196
00:12:22,280 --> 00:12:25,840
Speaker 3: the online market, which took me by surprise. I decided

197
00:12:25,840 --> 00:12:28,640
Speaker 3: to post an ad in this spirit of research.

198
00:12:28,679 --> 00:12:29,400
Speaker 2: I was never.

199
00:12:29,240 --> 00:12:33,800
Speaker 3: Intending to sell my milk because morally, I personally didn't

200
00:12:33,800 --> 00:12:36,120
Speaker 3: want to do that. I've tried to be very open

201
00:12:36,120 --> 00:12:38,959
Speaker 3: minded in my research and non judgmental about women who

202
00:12:39,000 --> 00:12:41,040
Speaker 3: do sell their milk, but I personally didn't want to.

203
00:12:41,280 --> 00:12:43,520
Speaker 3: I didn't feel comfortable, but I wanted to see who

204
00:12:43,559 --> 00:12:46,600
Speaker 3: would approach me, and I also wanted to kind of

205
00:12:46,720 --> 00:12:48,720
Speaker 3: just get a sense of the market and talk to

206
00:12:48,800 --> 00:12:52,960
Speaker 3: other women selling their milk online. So I posted an

207
00:12:53,000 --> 00:12:57,480
Speaker 3: ad and I made it very kind of clinical almost.

208
00:12:57,480 --> 00:12:59,920
Speaker 3: It was just a photo of some milk that I'd pumped,

209
00:13:00,679 --> 00:13:03,080
Speaker 3: and some details about the fact that I had an

210
00:13:03,080 --> 00:13:06,560
Speaker 3: oversupply and that I donated to hospital previously, So in

211
00:13:06,600 --> 00:13:11,440
Speaker 3: other words, it was not phishing for attention. But most

212
00:13:11,520 --> 00:13:14,000
Speaker 3: of the replies I got, most of the requests I

213
00:13:14,080 --> 00:13:16,960
Speaker 3: got were from men within hours of posting that ad.

214
00:13:17,000 --> 00:13:18,719
Speaker 3: They were predominantly men.

215
00:13:18,880 --> 00:13:19,920
Speaker 2: Which I think.

216
00:13:19,960 --> 00:13:21,880
Speaker 3: I'd had an idea that maybe there might be a

217
00:13:21,880 --> 00:13:24,440
Speaker 3: few men approaching me, but I hadn't expected it to

218
00:13:24,480 --> 00:13:27,320
Speaker 3: be the vast majority. I thought the majority would be

219
00:13:27,360 --> 00:13:31,880
Speaker 3: other parents, maybe mothers with milk supply, or gay or

220
00:13:31,920 --> 00:13:35,560
Speaker 3: adopted parents looking for breast milk, so that was a

221
00:13:35,640 --> 00:13:39,960
Speaker 3: huge surprise. Some of them didn't come straight away with

222
00:13:40,000 --> 00:13:43,679
Speaker 3: sexual requests. They said they were bodybuilders it's very big

223
00:13:43,760 --> 00:13:45,800
Speaker 3: in the bodybuilding industry. Or they said they had a

224
00:13:45,800 --> 00:13:49,160
Speaker 3: health concern like IBS, or they were cancer survivors or.

225
00:13:49,160 --> 00:13:49,760
Speaker 2: Something like that.

226
00:13:49,840 --> 00:13:53,440
Speaker 3: But often when we got into a correspondence, the sexual

227
00:13:53,520 --> 00:13:54,480
Speaker 3: element would come out.

228
00:13:55,640 --> 00:13:57,800
Speaker 1: Let's take a quick break, and when we get back,

229
00:13:57,920 --> 00:14:19,480
Speaker 1: there's still so much to discuss. Welcome back everyone. I've

230
00:14:19,520 --> 00:14:22,600
Speaker 1: been chatting with elev Scott about her book cash cow,

231
00:14:22,760 --> 00:14:26,080
Speaker 1: how the maternal body became a global commodity, and the

232
00:14:26,200 --> 00:14:30,480
Speaker 1: hidden costs for women. Let's get back into things with

233
00:14:30,720 --> 00:14:34,960
Speaker 1: this market. Is their regulation, for instance, like when you

234
00:14:35,000 --> 00:14:38,440
Speaker 1: were looking into the breast milk market and selling milk online,

235
00:14:38,800 --> 00:14:41,480
Speaker 1: what are the different places where people can do this

236
00:14:42,240 --> 00:14:45,400
Speaker 1: and what are their regulations surrounding these websites.

237
00:14:46,120 --> 00:14:50,600
Speaker 3: So in very few countries are there regulations. In a

238
00:14:50,640 --> 00:14:53,720
Speaker 3: few countries it's banned altogether for reasons I go into

239
00:14:53,760 --> 00:14:56,040
Speaker 3: in the book. There's often been a scandal and the

240
00:14:56,120 --> 00:14:59,360
Speaker 3: government ends up saying, you know what, sales of breast

241
00:14:59,360 --> 00:15:01,680
Speaker 3: milk at night banned now. But that's only happened in

242
00:15:01,720 --> 00:15:07,400
Speaker 3: like two three countries. By and large, it's not It's

243
00:15:07,440 --> 00:15:10,240
Speaker 3: not regulated in the UK and the US, it's actually

244
00:15:10,240 --> 00:15:13,600
Speaker 3: classed as a food, So breast milk is the only

245
00:15:13,640 --> 00:15:18,640
Speaker 3: bodily fluid substance that's classes as of food. The FDA

246
00:15:18,760 --> 00:15:23,680
Speaker 3: and the FSA both advise against sales of breast milk,

247
00:15:23,720 --> 00:15:27,520
Speaker 3: but it's not illegal. And honestly, I don't know who

248
00:15:27,560 --> 00:15:32,720
Speaker 3: would trust breast milk that is sourced online because the

249
00:15:32,800 --> 00:15:36,200
Speaker 3: dangers for the consumer are like obvious. Right, So when

250
00:15:36,240 --> 00:15:38,320
Speaker 3: I donated to a hospital. I had to go through

251
00:15:38,360 --> 00:15:40,520
Speaker 3: so many hoops. I had to have my blood tested

252
00:15:40,520 --> 00:15:44,000
Speaker 3: for STDs, for all sorts of things like I had

253
00:15:44,000 --> 00:15:46,760
Speaker 3: to promise. I had to sign forms promising not to

254
00:15:46,840 --> 00:15:51,440
Speaker 3: have ibuprofen avil. I can't remember it. It was a

255
00:15:51,480 --> 00:15:56,000
Speaker 3: big kind of saga to get through before they even

256
00:15:56,440 --> 00:16:00,000
Speaker 3: agreed to accept my milk, which was then screened for pathogens.

257
00:16:00,920 --> 00:16:02,080
Speaker 2: It was pasteurized.

258
00:16:02,160 --> 00:16:05,880
Speaker 3: You know, it's being given to premature babies in hospitals,

259
00:16:05,960 --> 00:16:09,440
Speaker 3: so the protocol is very strict. There's obviously none of

260
00:16:09,480 --> 00:16:13,160
Speaker 3: that for something you're buying online. That kind of goes

261
00:16:13,200 --> 00:16:16,680
Speaker 3: without saying. I don't think a lot of the men

262
00:16:16,760 --> 00:16:18,640
Speaker 3: buying breast milk online care about that.

263
00:16:18,680 --> 00:16:19,360
Speaker 2: I don't.

264
00:16:19,360 --> 00:16:21,720
Speaker 3: They probably wouldn't care if it was actually cow's milk

265
00:16:21,760 --> 00:16:24,800
Speaker 3: that some random person is, you know, putting into bottles

266
00:16:24,840 --> 00:16:27,200
Speaker 3: and shipping to them. It's the idea of buying it

267
00:16:27,240 --> 00:16:30,680
Speaker 3: that they like. So I'm less concerned about them about

268
00:16:30,760 --> 00:16:36,800
Speaker 3: those particular consumers being defrauded. I'm more concerned about parents

269
00:16:36,840 --> 00:16:41,200
Speaker 3: and babies being defrauded. But yeah, it's interesting. It's not

270
00:16:41,240 --> 00:16:44,760
Speaker 3: regulated because it's not really legal, but it's not really illegal.

271
00:16:44,800 --> 00:16:47,360
Speaker 2: It's just sort of there.

272
00:16:47,560 --> 00:16:49,520
Speaker 3: It's just out there. It's just one of these things

273
00:16:49,560 --> 00:16:52,680
Speaker 3: you can sell your used knickers online if you want to,

274
00:16:52,880 --> 00:16:55,720
Speaker 3: Like there's it's just kind of the market's there if

275
00:16:55,720 --> 00:16:56,200
Speaker 3: you want it.

276
00:16:56,800 --> 00:17:00,280
Speaker 1: There is so much discourse today surrounding breast milk, and

277
00:17:00,320 --> 00:17:04,159
Speaker 1: there's shame and judgment surrounding breastfeeding or not breastfeeding, whether

278
00:17:04,200 --> 00:17:07,359
Speaker 1: that's a choice, whether that's something that you want to

279
00:17:07,400 --> 00:17:10,959
Speaker 1: breastfeed but you cannot. And I couldn't help, but think of,

280
00:17:11,000 --> 00:17:14,760
Speaker 1: you know, as reading your chapters, how technology has really

281
00:17:14,960 --> 00:17:19,520
Speaker 1: transformed the way that we approach breastfeeding. Where there are

282
00:17:19,560 --> 00:17:23,760
Speaker 1: pumps available, there'sctation consultants, there's formula available, and so there

283
00:17:24,160 --> 00:17:28,960
Speaker 1: kind of then leads to the stigma surrounding breast milk

284
00:17:29,640 --> 00:17:32,639
Speaker 1: that is not something that you produce directly that you

285
00:17:32,720 --> 00:17:38,080
Speaker 1: either purchase or you know, formula or wet nursing for instance.

286
00:17:38,240 --> 00:17:40,639
Speaker 1: And it's like technology has kind of in a way

287
00:17:40,680 --> 00:17:44,800
Speaker 1: further the stigma and narrowed the acceptable range for if

288
00:17:44,840 --> 00:17:47,679
Speaker 1: you do not breastfeed. Is that something that you kind

289
00:17:47,720 --> 00:17:50,120
Speaker 1: of encountered throughout this I.

290
00:17:50,080 --> 00:17:54,160
Speaker 3: Think there's a lot of kind of not just social stigma,

291
00:17:54,160 --> 00:17:58,440
Speaker 3: but political stigma that surrounds breast milk because, as you say,

292
00:17:58,480 --> 00:18:02,879
Speaker 3: breastfeeding is now this hot potato where I don't know

293
00:18:02,880 --> 00:18:04,840
Speaker 3: about in the US, but in the UK certainly we

294
00:18:04,920 --> 00:18:08,280
Speaker 3: used to have this slogan and breast is best that

295
00:18:08,359 --> 00:18:11,040
Speaker 3: I think was used by the NHS, our National Health Service,

296
00:18:11,119 --> 00:18:13,679
Speaker 3: and it was seen to be the best thing to

297
00:18:13,680 --> 00:18:17,119
Speaker 3: give your child, but it came under this backlash because

298
00:18:17,880 --> 00:18:20,800
Speaker 3: it was seemed to also shame women who chose not

299
00:18:20,840 --> 00:18:23,440
Speaker 3: to or struggled to breastfeed and needed or chose to

300
00:18:23,560 --> 00:18:27,400
Speaker 3: use infant formula instead. So I've now visited the milk

301
00:18:27,400 --> 00:18:32,040
Speaker 3: bank where I donated my milk, and for premature babies,

302
00:18:32,200 --> 00:18:35,560
Speaker 3: certain premature babies, they actually do need breast milk like

303
00:18:35,720 --> 00:18:38,639
Speaker 3: they cannot digest infant formula right, So it's not a

304
00:18:38,680 --> 00:18:41,639
Speaker 3: matter of like, oh, ideally they would have this or that,

305
00:18:41,760 --> 00:18:43,919
Speaker 3: or it doesn't matter. They just they need it. So

306
00:18:44,200 --> 00:18:46,960
Speaker 3: donations are absolutely crucial for saving the lives of premature

307
00:18:47,000 --> 00:18:51,000
Speaker 3: babies in some instances, which is why I feel conflicted

308
00:18:51,040 --> 00:18:54,320
Speaker 3: about the kind of open market which treats breast milk

309
00:18:54,320 --> 00:18:56,080
Speaker 3: as it commodity which could go.

310
00:18:56,040 --> 00:18:58,440
Speaker 2: To a baby in need, or it could go to a.

311
00:18:58,359 --> 00:19:02,600
Speaker 3: Man because I on the one hand, I feel like, look,

312
00:19:02,800 --> 00:19:05,080
Speaker 3: as long as a baby isn't being deprived, if mother,

313
00:19:05,119 --> 00:19:08,080
Speaker 3: if a lactating mother at home, has got enough for

314
00:19:08,119 --> 00:19:10,560
Speaker 3: her baby and she's got this excess, who am I

315
00:19:10,640 --> 00:19:13,000
Speaker 3: to say where she sells it or who she sells

316
00:19:13,040 --> 00:19:16,119
Speaker 3: it to, or whether she donates it. You know, I

317
00:19:16,160 --> 00:19:18,880
Speaker 3: think we expect a lot more altruism of women than

318
00:19:18,880 --> 00:19:21,480
Speaker 3: we do of men. And I think that's another stigma

319
00:19:21,480 --> 00:19:23,280
Speaker 3: that kind of plays into all of this, is that

320
00:19:23,320 --> 00:19:26,280
Speaker 3: we were like, what kind of mother sells her milk? Like,

321
00:19:26,400 --> 00:19:28,600
Speaker 3: surely she would want to donate it to a hospital,

322
00:19:29,280 --> 00:19:34,000
Speaker 3: and actually, like, you know, that woman is probably excluded

323
00:19:34,040 --> 00:19:36,320
Speaker 3: from the labor market. It's a way for her to

324
00:19:36,359 --> 00:19:39,080
Speaker 3: remain at home with her baby and make some money

325
00:19:39,119 --> 00:19:41,080
Speaker 3: on the side to support her family. Who am I

326
00:19:41,119 --> 00:19:43,080
Speaker 3: to say shouldn't be doing that? And if that means

327
00:19:43,080 --> 00:19:45,440
Speaker 3: selling to men, maybe that just means selling to men.

328
00:19:46,280 --> 00:19:51,199
Speaker 3: On the other hand, I have seen how important from

329
00:19:51,240 --> 00:19:54,680
Speaker 3: a health perspective donated breast milk is and how dependent

330
00:19:54,720 --> 00:19:58,520
Speaker 3: on donations hospital milk banks are, So it's difficult for

331
00:19:58,560 --> 00:20:01,640
Speaker 3: me to keep that entirely out of my mind. If

332
00:20:01,680 --> 00:20:04,080
Speaker 3: I thought that the private online market was so big

333
00:20:04,119 --> 00:20:07,800
Speaker 3: that it was seriously threatening donations to the nonprofit sector,

334
00:20:08,240 --> 00:20:11,720
Speaker 3: I'd be more worried, I think, even though it's much

335
00:20:11,760 --> 00:20:17,280
Speaker 3: bigger than I expected, this online market, I instinctively I

336
00:20:17,320 --> 00:20:21,399
Speaker 3: don't feel like it's leaching those nonprofit donations personally, but

337
00:20:21,480 --> 00:20:23,520
Speaker 3: I might be wrong. I'm not an expert, That's the thing.

338
00:20:23,560 --> 00:20:26,080
Speaker 3: I'm not an expert in any of these fields. All

339
00:20:26,119 --> 00:20:28,040
Speaker 3: I'm saying as a journalist is what I've found in

340
00:20:28,040 --> 00:20:34,960
Speaker 3: my research. But that's where the interesting kind of ethical

341
00:20:35,000 --> 00:20:38,400
Speaker 3: conundrums come from. Is like we don't really know actually

342
00:20:38,720 --> 00:20:39,080
Speaker 3: m hm.

343
00:20:39,280 --> 00:20:43,960
Speaker 1: Again, this question of empowerment versus exploitation, and who gets

344
00:20:44,040 --> 00:20:48,200
Speaker 1: to decide that whether something is exploited and versus empowering.

345
00:20:48,520 --> 00:20:50,800
Speaker 1: Is it the individual, is it society? Yeah, I feel

346
00:20:50,840 --> 00:20:53,840
Speaker 1: like there are so many dimensions.

347
00:20:53,520 --> 00:20:56,119
Speaker 3: Definitely, And I think also at this part of the

348
00:20:56,160 --> 00:21:00,080
Speaker 3: book where I talk about the Cambodian example, where very

349
00:21:00,119 --> 00:21:02,680
Speaker 3: poor women in Cambodia were being paid by an American

350
00:21:02,840 --> 00:21:06,560
Speaker 3: company to I mean they call it compensation. Essentially, they

351
00:21:06,560 --> 00:21:09,359
Speaker 3: were being paid for their milk. And women's rights groups

352
00:21:09,359 --> 00:21:11,359
Speaker 3: got to know about this and there was this big

353
00:21:11,440 --> 00:21:14,320
Speaker 3: backlash in Cambodia ended up being one of the first

354
00:21:14,320 --> 00:21:17,119
Speaker 3: governments to say when banning exports of breast milk, and

355
00:21:17,160 --> 00:21:20,359
Speaker 3: the company shut down its operations in Cambodia, and so

356
00:21:20,480 --> 00:21:23,960
Speaker 3: these women no longer sold their milk, and this was

357
00:21:24,000 --> 00:21:26,439
Speaker 3: hailed as a great victory by these women's rights groups

358
00:21:26,480 --> 00:21:30,080
Speaker 3: who rights groups. Actually, if you read the local media

359
00:21:30,400 --> 00:21:33,520
Speaker 3: stories where they interview the women and ask them what

360
00:21:33,520 --> 00:21:36,720
Speaker 3: they feel about it, they're upset, they're angry. They didn't

361
00:21:36,800 --> 00:21:39,840
Speaker 3: want that income to be shut off. And so for me,

362
00:21:40,119 --> 00:21:43,960
Speaker 3: that's a really good example of the empowerment versus exploitation debate,

363
00:21:44,040 --> 00:21:48,640
Speaker 3: because are we just being patronizing with these Western ideas

364
00:21:48,640 --> 00:21:50,840
Speaker 3: of coming in and being like, oh, these poor Cambodian women,

365
00:21:50,840 --> 00:21:53,399
Speaker 3: they shouldn't be allowed to sell their milk. Really, like,

366
00:21:53,440 --> 00:21:54,800
Speaker 3: what's it like to be in their shoes?

367
00:21:55,560 --> 00:21:55,760
Speaker 1: Right?

368
00:21:56,200 --> 00:21:56,400
Speaker 2: Right?

369
00:21:56,640 --> 00:21:59,280
Speaker 1: I feel like you do such an amazing job of

370
00:21:59,800 --> 00:22:02,680
Speaker 1: for the reader to kind of go, well, wait a second, now,

371
00:22:02,840 --> 00:22:05,639
Speaker 1: like think about this in this way and from this perspective.

372
00:22:05,880 --> 00:22:07,159
Speaker 1: And the flip side of the corner is that, of

373
00:22:07,160 --> 00:22:11,240
Speaker 1: course there are companies that do prey on people's intense

374
00:22:11,320 --> 00:22:15,960
Speaker 1: desire to have a baby, a biological child as part

375
00:22:16,000 --> 00:22:18,840
Speaker 1: of your research. You went to the Future Fertility Show,

376
00:22:18,960 --> 00:22:22,800
Speaker 1: which features this dizzying range of clinics and services from

377
00:22:23,200 --> 00:22:26,280
Speaker 1: I think you described a consultation from a shamanic nutritionist

378
00:22:26,800 --> 00:22:30,840
Speaker 1: to legal representation sperm analysis. I mean that seems like

379
00:22:30,880 --> 00:22:33,720
Speaker 1: such an eye opening experience, Like what was it like

380
00:22:33,880 --> 00:22:37,120
Speaker 1: to wander around this show and what do you think

381
00:22:37,160 --> 00:22:41,840
Speaker 1: it says about the global fertility industry or the fertility

382
00:22:41,880 --> 00:22:44,320
Speaker 1: industry you know where this show was held.

383
00:22:45,119 --> 00:22:48,119
Speaker 3: Yeah, it was a really really interesting experience and I

384
00:22:48,280 --> 00:22:49,560
Speaker 3: definitely felt.

385
00:22:49,280 --> 00:22:54,000
Speaker 2: Like a consumer walking around that show. And that is.

386
00:22:53,960 --> 00:22:57,280
Speaker 3: Another kind of interesting point for me about the whole

387
00:22:57,280 --> 00:23:02,200
Speaker 3: fertility industry, is to what extent are people consumers versus patients.

388
00:23:02,920 --> 00:23:07,160
Speaker 3: So obviously a lot of fertility treatment is elective. There

389
00:23:07,160 --> 00:23:09,359
Speaker 3: are certain cases where I don't know. For example, the

390
00:23:09,440 --> 00:23:13,199
Speaker 3: woman who's been diagnosed with cancer has to freeze her

391
00:23:13,240 --> 00:23:16,360
Speaker 3: eggs if she wants any chance of having children after treatment.

392
00:23:16,800 --> 00:23:19,520
Speaker 3: But usually it's women electing to do that because they're

393
00:23:19,560 --> 00:23:21,760
Speaker 3: worried that at some point they'll want a child and

394
00:23:21,760 --> 00:23:24,840
Speaker 3: they'll no longer be fertile, and that worry, that anxiety

395
00:23:25,440 --> 00:23:28,639
Speaker 3: is something that's very much monetized, arguably exploited I had

396
00:23:28,680 --> 00:23:32,199
Speaker 3: so many kind of philosophical conversations during my research with

397
00:23:32,280 --> 00:23:36,080
Speaker 3: people outside and inside the industry about what that line is.

398
00:23:36,760 --> 00:23:40,280
Speaker 3: I had a really interesting conversation with a surrogacy lawyer

399
00:23:40,400 --> 00:23:44,119
Speaker 3: in California where I kind of said, look, it seems

400
00:23:44,160 --> 00:23:46,840
Speaker 3: to me there is an exploitative nature sometimes in the

401
00:23:46,880 --> 00:23:49,399
Speaker 3: promises that are made to these people who are desperate

402
00:23:49,480 --> 00:23:52,679
Speaker 3: for children. Is it to you is there an element

403
00:23:52,680 --> 00:23:55,040
Speaker 3: of exploitation? And he was like, absolutely not, It's just

404
00:23:55,119 --> 00:23:59,800
Speaker 3: taking advantage of a need that exists. And we had

405
00:23:59,800 --> 00:24:03,760
Speaker 3: this sort of weird semantic discussion about what the difference

406
00:24:03,800 --> 00:24:07,600
Speaker 3: is between taking advantage and exploitation, and then I realized

407
00:24:07,640 --> 00:24:09,600
Speaker 3: that he was coming at it from quite a kind

408
00:24:09,680 --> 00:24:12,280
Speaker 3: of well obviously a very capitalist, but a kind of

409
00:24:12,320 --> 00:24:15,840
Speaker 3: business perspective of taking advantage as a positive thing, like

410
00:24:15,880 --> 00:24:18,200
Speaker 3: there's a market that exists, let's take advantage of it,

411
00:24:18,680 --> 00:24:21,879
Speaker 3: as opposed to like, is there a vulnerability about this

412
00:24:21,960 --> 00:24:25,959
Speaker 3: particular patient stroke consumer demographic that we should be more

413
00:24:26,000 --> 00:24:29,199
Speaker 3: careful of exploiting. So that's what came out to me

414
00:24:29,400 --> 00:24:33,160
Speaker 3: from well, from that conversation and other conversations, I thought

415
00:24:33,160 --> 00:24:35,320
Speaker 3: it was very interesting that the Future Fertility Fair was

416
00:24:35,359 --> 00:24:39,960
Speaker 3: actually part of a bigger fair that was the Future

417
00:24:40,080 --> 00:24:43,760
Speaker 3: Beauty Fair or something show trade show. There were so

418
00:24:43,840 --> 00:24:47,240
Speaker 3: many women kind of wandering between the two, and in

419
00:24:47,280 --> 00:24:50,280
Speaker 3: one hall they were being offered the chance to look

420
00:24:50,520 --> 00:24:54,880
Speaker 3: younger and more beautiful and if you're being cynical, more

421
00:24:55,280 --> 00:24:58,240
Speaker 3: capable of attracting a mate perhaps, and then in the

422
00:24:58,280 --> 00:25:00,840
Speaker 3: other hall, they were being offered the chance to either

423
00:25:01,520 --> 00:25:05,919
Speaker 3: fix or kind of stave off invitility. And it just

424
00:25:05,920 --> 00:25:08,160
Speaker 3: seemed to me two sides of the same coin. And

425
00:25:09,080 --> 00:25:11,040
Speaker 3: I'm not saying, by the way, that these shows shouldn't

426
00:25:11,040 --> 00:25:14,879
Speaker 3: exist or that the market shouldn't exist. And obviously I

427
00:25:14,920 --> 00:25:18,800
Speaker 3: think IVF is a wonderful innovation and it's helped so

428
00:25:18,800 --> 00:25:22,400
Speaker 3: many people. I do think that the way the industry

429
00:25:22,400 --> 00:25:25,480
Speaker 3: markets itself can be problematic, and I do think there

430
00:25:25,520 --> 00:25:28,760
Speaker 3: is an exploitative nature that is not just limited to

431
00:25:28,760 --> 00:25:30,480
Speaker 3: a few bad actors. Which is what a lot of

432
00:25:30,480 --> 00:25:32,360
Speaker 3: people have suggested to me, is just like, oh, yeah,

433
00:25:32,400 --> 00:25:36,520
Speaker 3: some clinics overpromise or overtreat, Because a lot of clinics

434
00:25:36,520 --> 00:25:39,760
Speaker 3: do overtreat. They offer sort of almost endless rounds of

435
00:25:39,800 --> 00:25:43,520
Speaker 3: IVF when it's probably obvious that they're not going to work,

436
00:25:44,200 --> 00:25:47,600
Speaker 3: for one example, or they target egg freezing at women

437
00:25:47,600 --> 00:25:49,960
Speaker 3: in their forties, which I was told by several gynecologists

438
00:25:50,080 --> 00:25:53,159
Speaker 3: is like pretty much a waste of money. And I

439
00:25:53,320 --> 00:25:54,760
Speaker 3: was told, you know, well, yeah, of course there are

440
00:25:54,760 --> 00:25:56,560
Speaker 3: a few bad actors. There are a few bad clinics.

441
00:25:56,560 --> 00:25:59,000
Speaker 3: There always are in every industry. I'm not sure about that.

442
00:25:59,080 --> 00:26:01,200
Speaker 3: I think it's more pervasive than.

443
00:26:01,119 --> 00:26:04,320
Speaker 1: That, and I think it makes it so much more

444
00:26:04,600 --> 00:26:08,840
Speaker 1: difficult to know what is an ethical clinic, what's a

445
00:26:08,880 --> 00:26:13,159
Speaker 1: good clinic? How how are they measuring success? You know,

446
00:26:13,280 --> 00:26:17,919
Speaker 1: if you have a choice, then the one clinic is

447
00:26:17,960 --> 00:26:20,240
Speaker 1: going to want to stand out in some way, whether

448
00:26:20,240 --> 00:26:22,760
Speaker 1: that's for egg freezing or IVF or anything like that.

449
00:26:23,600 --> 00:26:28,080
Speaker 1: How do you sift through as a consumer patient? How

450
00:26:28,119 --> 00:26:31,439
Speaker 1: do you sift through what is a good or ethical

451
00:26:31,440 --> 00:26:36,400
Speaker 1: clinic from a bad one? And is it ever that obvious? Yeah?

452
00:26:36,480 --> 00:26:39,800
Speaker 3: I don't think it is that obvious. I think most

453
00:26:39,920 --> 00:26:44,119
Speaker 3: patients probably don't actually come at it initially from a

454
00:26:44,119 --> 00:26:45,760
Speaker 3: perspective like is this ethical or.

455
00:26:45,720 --> 00:26:47,159
Speaker 2: Is this not? Am I going to be taken for

456
00:26:47,240 --> 00:26:47,760
Speaker 2: a ride?

457
00:26:48,080 --> 00:26:50,080
Speaker 3: They just want a baby, So they're looking at success

458
00:26:50,160 --> 00:26:54,720
Speaker 3: rates and that's all important to clinics. Like their success rates,

459
00:26:54,760 --> 00:26:58,200
Speaker 3: that they're everything. That's what makes like high profile fatility

460
00:26:58,240 --> 00:27:01,439
Speaker 3: docs is extremely competitive with each other, and that is

461
00:27:01,440 --> 00:27:03,560
Speaker 3: something I go into in the book, like what has

462
00:27:03,600 --> 00:27:05,199
Speaker 3: that actually led to in practice?

463
00:27:05,520 --> 00:27:05,959
Speaker 2: I don't know.

464
00:27:06,000 --> 00:27:08,960
Speaker 3: I have talked to fertility doctors who admit that the

465
00:27:09,000 --> 00:27:12,399
Speaker 3: competitive element is a problem, and they sort of accuse

466
00:27:12,520 --> 00:27:17,720
Speaker 3: their rivals of acting in unethical ways and they say, look,

467
00:27:17,760 --> 00:27:21,760
Speaker 3: I'd never do that. You know, obviously this isn't a charity.

468
00:27:22,359 --> 00:27:25,000
Speaker 3: A clinic is a profit making enterprise. But I would

469
00:27:25,080 --> 00:27:29,359
Speaker 3: never put the needs of my patients behind you know,

470
00:27:29,480 --> 00:27:30,320
Speaker 3: financial gain.

471
00:27:30,520 --> 00:27:33,760
Speaker 2: So they are aware of it. They're definitely aware of it.

472
00:27:33,960 --> 00:27:37,359
Speaker 3: And I'm not a doctor, so I don't I can't

473
00:27:37,480 --> 00:27:40,800
Speaker 3: judge what they're doing with sort of clinical eye. What

474
00:27:40,840 --> 00:27:42,919
Speaker 3: I do know is that, for example, in London, there

475
00:27:42,920 --> 00:27:45,800
Speaker 3: are some clinics who are like big clinics, and they

476
00:27:45,840 --> 00:27:49,320
Speaker 3: have they have good reputations, but they're known for pushing

477
00:27:49,320 --> 00:27:53,879
Speaker 3: treatments on patients when they're probably not needed. Add Ons

478
00:27:53,920 --> 00:27:56,679
Speaker 3: for example, all these things that you can pay extra

479
00:27:56,800 --> 00:27:59,880
Speaker 3: for or you know, hidden costs, like they'll advertise as

480
00:28:00,600 --> 00:28:03,520
Speaker 3: price on their website, but then they won't include the

481
00:28:03,520 --> 00:28:06,720
Speaker 3: medication or some of the testing that has to be done,

482
00:28:06,840 --> 00:28:09,240
Speaker 3: certainly not the storage cost. So you go in thinking

483
00:28:09,240 --> 00:28:10,920
Speaker 3: you're going to pay a certain amount and then it's

484
00:28:10,960 --> 00:28:14,720
Speaker 3: like three times that amount in some cases. So I

485
00:28:14,720 --> 00:28:17,399
Speaker 3: think it's very difficult to judge which clinics are ethical

486
00:28:17,480 --> 00:28:19,840
Speaker 3: or not. And I don't even think most people care

487
00:28:19,920 --> 00:28:22,280
Speaker 3: that much as long as they get a baby, right.

488
00:28:22,600 --> 00:28:25,199
Speaker 1: It's so hard because you have people who might have

489
00:28:25,320 --> 00:28:28,479
Speaker 1: vastly different experiences, like you talk about between you know,

490
00:28:28,880 --> 00:28:31,920
Speaker 1: within one clinic, one person goes, they love their experience,

491
00:28:31,960 --> 00:28:35,040
Speaker 1: they everything worked out for them, and another person who

492
00:28:35,760 --> 00:28:39,640
Speaker 1: really had the opposite experience, and so again shows how

493
00:28:39,680 --> 00:28:41,800
Speaker 1: personal this journey can be.

494
00:28:42,480 --> 00:28:42,720
Speaker 2: Yeah.

495
00:28:42,720 --> 00:28:45,959
Speaker 3: Absolutely, And it's really interesting actually looking at Google reviews

496
00:28:45,960 --> 00:28:49,080
Speaker 3: of fertility clinics because I don't know if you're familiar

497
00:28:49,120 --> 00:28:54,360
Speaker 3: with the Jacob phenomenon of most online Google reviews are

498
00:28:54,400 --> 00:28:57,560
Speaker 3: generally like very bad or very good, because it's only

499
00:28:57,640 --> 00:28:59,920
Speaker 3: people who are kind of really motivated to write them,

500
00:29:00,080 --> 00:29:01,400
Speaker 3: of you who are going to do that. But it's

501
00:29:01,440 --> 00:29:06,480
Speaker 3: particularly acute in fertility clinics, I think, because you either

502
00:29:06,480 --> 00:29:08,600
Speaker 3: get a baby at the end or you don't, and

503
00:29:08,880 --> 00:29:11,960
Speaker 3: often if you don't, you feel like it's been denied

504
00:29:11,960 --> 00:29:14,000
Speaker 3: to you in some way, or you've been treated badly,

505
00:29:14,080 --> 00:29:15,880
Speaker 3: or there's been a mistake, there's been a kind of

506
00:29:15,960 --> 00:29:18,920
Speaker 3: human error, or the doctor's been really unkind when you've

507
00:29:19,040 --> 00:29:21,680
Speaker 3: miscarried or whatever. It is like you feel strongly about

508
00:29:21,680 --> 00:29:24,400
Speaker 3: the fact that it went wrong, or you feel very

509
00:29:24,400 --> 00:29:26,080
Speaker 3: strongly about the fact that it went well and you've

510
00:29:26,080 --> 00:29:29,160
Speaker 3: got a baby, so you're incredibly grateful. Very few people

511
00:29:29,200 --> 00:29:32,520
Speaker 3: seem to have a mediocre experience freezing their eggs ort

512
00:29:32,880 --> 00:29:35,000
Speaker 3: like some people do. Some are like, eh, it wasn't great,

513
00:29:35,040 --> 00:29:37,920
Speaker 3: but it was fine. But that's particularly the case with

514
00:29:37,920 --> 00:29:41,280
Speaker 3: egg freezing, obviously, because most people never use their frozen eggs,

515
00:29:41,280 --> 00:29:43,719
Speaker 3: so you don't actually know how that process is going

516
00:29:43,760 --> 00:29:45,480
Speaker 3: to pan out in the long term. But in terms

517
00:29:45,480 --> 00:29:48,560
Speaker 3: of IVF and actually trying for a baby, it feels

518
00:29:48,600 --> 00:29:50,560
Speaker 3: like there are two extremes of the experience.

519
00:29:51,720 --> 00:29:54,280
Speaker 1: Let's take a quick break here, we'll be back before

520
00:29:54,280 --> 00:30:12,120
Speaker 1: you know it. Welcome back, everyone, I'm here chatting with

521
00:30:12,200 --> 00:30:15,200
Speaker 1: the wonderful I Love Scott about her book cash Cow.

522
00:30:15,480 --> 00:30:19,280
Speaker 1: Let's get into some more questions. We've mostly I feel like,

523
00:30:19,320 --> 00:30:23,000
Speaker 1: been talking about IVF within either the UK or a

524
00:30:23,000 --> 00:30:26,120
Speaker 1: little bit in the US, but there's also the swath

525
00:30:26,200 --> 00:30:29,600
Speaker 1: of international IVF clinics where people may elect to go

526
00:30:29,640 --> 00:30:33,640
Speaker 1: to another country to go through this IVF experience, and

527
00:30:33,840 --> 00:30:37,880
Speaker 1: your book explores some of the gray market kind of

528
00:30:37,920 --> 00:30:41,040
Speaker 1: place where these agencies live. Can you tell me more

529
00:30:41,080 --> 00:30:45,080
Speaker 1: about the legal landscape that these clinics operate within and

530
00:30:45,360 --> 00:30:46,760
Speaker 1: what has driven their growth.

531
00:30:47,120 --> 00:30:48,680
Speaker 2: Well, I wish I could tell you more about the

532
00:30:48,760 --> 00:30:50,480
Speaker 2: legal landscape. It's very opaque.

533
00:30:50,600 --> 00:30:53,080
Speaker 3: I don't think even the clinics themselves are entirely clear

534
00:30:53,080 --> 00:30:54,400
Speaker 3: about the legal landscape.

535
00:30:55,320 --> 00:30:57,480
Speaker 2: But yeah, I focused a.

536
00:30:57,400 --> 00:31:01,280
Speaker 3: Lot of my research on Northern Cyprus, which happens to

537
00:31:01,320 --> 00:31:02,840
Speaker 3: be where my mother is from and where I spend

538
00:31:02,840 --> 00:31:06,680
Speaker 3: a lot of time as a child. And it's not

539
00:31:07,840 --> 00:31:12,200
Speaker 3: an internationally recognized country. It's actually viewed as occupied territories.

540
00:31:12,280 --> 00:31:16,000
Speaker 3: So the reason that's significant is that it operates in

541
00:31:16,040 --> 00:31:18,560
Speaker 3: many ways, and not just in the fertility sector, but

542
00:31:18,600 --> 00:31:21,280
Speaker 3: in other ways where regulation is just not really a

543
00:31:21,320 --> 00:31:24,480
Speaker 3: thing and they don't have to sign up to like,

544
00:31:24,760 --> 00:31:28,040
Speaker 3: you know, EU regulations or anything like that. I should

545
00:31:28,120 --> 00:31:31,360
Speaker 3: say that clinics in Northern Cyprus generally have a very

546
00:31:31,360 --> 00:31:35,400
Speaker 3: good word of mouth reputation and they're cheap. The IVF

547
00:31:35,720 --> 00:31:38,280
Speaker 3: sector is part of their tourism industry, which is huge.

548
00:31:38,280 --> 00:31:42,280
Speaker 3: It's like, by far the biggest economy within that country,

549
00:31:42,320 --> 00:31:46,600
Speaker 3: and so it's hard for me to say, look, it's

550
00:31:46,640 --> 00:31:48,640
Speaker 3: you know, a dodgy place to go and freeze your

551
00:31:48,680 --> 00:31:52,840
Speaker 3: eggs or have IVF, because actually I was quite impressed

552
00:31:52,840 --> 00:31:54,720
Speaker 3: by the clinics I went to, and I have heard

553
00:31:54,760 --> 00:31:59,680
Speaker 3: many good stories there, but I did encounter practices that

554
00:31:59,760 --> 00:32:01,640
Speaker 3: I well thurrogacy.

555
00:32:01,720 --> 00:32:02,840
Speaker 2: Aside, if we're keeping.

556
00:32:02,640 --> 00:32:07,040
Speaker 3: With IVF strictly IVF and egg freezing, there are things

557
00:32:07,080 --> 00:32:09,960
Speaker 3: that are done there that just aren't legal in many

558
00:32:10,040 --> 00:32:13,760
Speaker 3: other countries. So for example, women up to the age

559
00:32:13,760 --> 00:32:17,360
Speaker 3: of fifty five are treated that you can undergo IVF

560
00:32:18,320 --> 00:32:22,960
Speaker 3: in Northern Cypress. And I spoke to a gynecologist in

561
00:32:23,000 --> 00:32:25,240
Speaker 3: the National Health Service here in the UK who was

562
00:32:25,280 --> 00:32:28,200
Speaker 3: complaining about the number of women she treats who go

563
00:32:28,240 --> 00:32:31,200
Speaker 3: and get pregnant and then have these extremely dangerous, high

564
00:32:31,280 --> 00:32:35,560
Speaker 3: risk pregnancies where they're often you know, they're often pregnant

565
00:32:35,600 --> 00:32:38,840
Speaker 3: with like twins or triplets, because that obviously in IVF,

566
00:32:39,160 --> 00:32:41,320
Speaker 3: the more embryos you implant, the higher your chance of

567
00:32:41,920 --> 00:32:42,800
Speaker 3: achieving pregnancy.

568
00:32:42,800 --> 00:32:44,200
Speaker 2: But that can lead to multiples.

569
00:32:44,280 --> 00:32:47,760
Speaker 3: So you know, a woman in her fifties coming back

570
00:32:47,840 --> 00:32:51,960
Speaker 3: from Cypress to the UK pregnant with twins, and you

571
00:32:51,960 --> 00:32:54,040
Speaker 3: know that's that's a big burden on the NHS. So

572
00:32:54,080 --> 00:32:57,040
Speaker 3: that's a bigger conversation about like kind of picking up

573
00:32:57,080 --> 00:32:59,760
Speaker 3: the slack of people choosing their treatments abroad and coming

574
00:32:59,800 --> 00:33:04,280
Speaker 3: back and needing treatment for high risk pregnancies. But also

575
00:33:04,320 --> 00:33:07,040
Speaker 3: I'm not sure. I'm not sure what I think about

576
00:33:07,960 --> 00:33:12,920
Speaker 3: the availability of that and other things like gender selection

577
00:33:13,000 --> 00:33:16,240
Speaker 3: of embryos that's legal in the US, it's really really

578
00:33:16,280 --> 00:33:19,480
Speaker 3: frowned upon in other countries, including the Ugay and most

579
00:33:19,480 --> 00:33:22,080
Speaker 3: of Europe. Like I said before, I'm not you know,

580
00:33:22,280 --> 00:33:24,960
Speaker 3: I'm not a specialist in these in bioethics.

581
00:33:25,000 --> 00:33:25,320
Speaker 2: I'm not.

582
00:33:25,520 --> 00:33:28,200
Speaker 3: I don't have a degree in that. I don't have

583
00:33:28,280 --> 00:33:30,640
Speaker 3: ready answers here. All I'm saying is that some of

584
00:33:30,680 --> 00:33:34,680
Speaker 3: these things made me feel like, oh, this is this okay,

585
00:33:34,720 --> 00:33:37,520
Speaker 3: I don't know, Like it's a really extreme example of

586
00:33:37,560 --> 00:33:41,040
Speaker 3: a totally open market where if you want it, it's

587
00:33:41,120 --> 00:33:42,040
Speaker 3: there and it's cheap.

588
00:33:42,800 --> 00:33:45,840
Speaker 1: You bring up this great question of like why does

589
00:33:45,960 --> 00:33:48,640
Speaker 1: the ethics or the laws regulation, why do they differ

590
00:33:48,800 --> 00:33:52,600
Speaker 1: so drastically in different countries. You know, you use surrogacy

591
00:33:52,680 --> 00:33:55,880
Speaker 1: as an example, where in the US it's a it's

592
00:33:55,880 --> 00:33:59,719
Speaker 1: a thriving industry and in some ways, and and you

593
00:34:00,280 --> 00:34:03,440
Speaker 1: more about that industry in your book, But in Spain

594
00:34:03,680 --> 00:34:07,960
Speaker 1: it's completely illegal. And what do you think contributes to

595
00:34:08,160 --> 00:34:12,239
Speaker 1: some of the regulations or just the general sense of

596
00:34:12,280 --> 00:34:15,400
Speaker 1: ethics varying across the landscape.

597
00:34:16,160 --> 00:34:20,759
Speaker 3: Okay, starting with Europe, I think that a really interesting

598
00:34:20,800 --> 00:34:25,360
Speaker 3: commonality I noticed was Catholic Southern European countries like Spain

599
00:34:25,480 --> 00:34:29,360
Speaker 3: and Italy, they both have a real aversion to surrogacy.

600
00:34:30,000 --> 00:34:32,880
Speaker 3: In both countries. It's not just not allowed, it's a crime.

601
00:34:33,120 --> 00:34:36,240
Speaker 3: In Spain, it's class as a crime against women. In Italy,

602
00:34:36,560 --> 00:34:40,479
Speaker 3: a politician described it recently as worse than pedophilia. And

603
00:34:40,600 --> 00:34:43,200
Speaker 3: not only is it illegal in the country in Italy,

604
00:34:43,239 --> 00:34:46,560
Speaker 3: for example, but they're now beginning to prosecute parents who've

605
00:34:46,600 --> 00:34:49,520
Speaker 3: gone abroad for surrogacy and come back, which has really

606
00:34:49,520 --> 00:34:51,920
Speaker 3: spooked a lot of people obviously, and they're kind of

607
00:34:52,160 --> 00:34:56,000
Speaker 3: striking off parents from birth certificates retrospectively.

608
00:34:56,560 --> 00:34:58,800
Speaker 2: So that's a pretty extreme example.

609
00:34:59,520 --> 00:35:02,200
Speaker 3: And if we look at Spain, Spain is so interesting

610
00:35:02,239 --> 00:35:06,319
Speaker 3: because it's the country in which most egg donations are

611
00:35:06,360 --> 00:35:08,080
Speaker 3: performed in Europe.

612
00:35:08,160 --> 00:35:08,920
Speaker 2: It has an.

613
00:35:08,760 --> 00:35:11,400
Speaker 3: Incredibly high number of like lots of people go to

614
00:35:11,480 --> 00:35:14,719
Speaker 3: Spain to have their eggs frozen or to donate, and

615
00:35:14,840 --> 00:35:18,400
Speaker 3: it's a big IVF center in general. But all donations

616
00:35:18,440 --> 00:35:21,960
Speaker 3: have to be strictly anonymous, and so there's this dual

617
00:35:22,000 --> 00:35:24,320
Speaker 3: thing where like they never have a shortage of eggs,

618
00:35:24,880 --> 00:35:27,319
Speaker 3: unlike for example, the UK, where you're not allowed to

619
00:35:27,320 --> 00:35:30,920
Speaker 3: be an anonymous donors. So unsurprisingly, not that many people

620
00:35:30,960 --> 00:35:35,000
Speaker 3: want to donate, so they're always having to import import

621
00:35:35,040 --> 00:35:38,080
Speaker 3: eggs and sperm from other countries like the US and Denmark.

622
00:35:38,680 --> 00:35:40,600
Speaker 3: Spain doesn't have that problem, and it has plenty of eggs,

623
00:35:40,600 --> 00:35:44,560
Speaker 3: plenty of sperm, loads of anonymous donations, so that side

624
00:35:44,600 --> 00:35:47,080
Speaker 3: of things is like thriving. But then the surrogacy is

625
00:35:47,120 --> 00:35:51,719
Speaker 3: completely illegal. And I have a vague theory about like

626
00:35:51,760 --> 00:35:54,799
Speaker 3: Protestant versus Catholic countries and their different atgues, because if

627
00:35:54,840 --> 00:35:57,680
Speaker 3: you look at say the UK and the Netherlands, it's

628
00:35:57,719 --> 00:36:00,719
Speaker 3: non anonymous donations, which means it's that doesn't mean by

629
00:36:00,719 --> 00:36:03,960
Speaker 3: the way that as a parent stroke client, you know

630
00:36:04,160 --> 00:36:07,800
Speaker 3: or you can choose a lot of detail about your donor.

631
00:36:08,040 --> 00:36:11,160
Speaker 3: The donor is anonymous by name to the people using

632
00:36:11,520 --> 00:36:15,720
Speaker 3: those sperms or X, but the child, any resulting child

633
00:36:15,800 --> 00:36:18,400
Speaker 3: from this donation, when they turn eighteen, they're allowed to

634
00:36:18,640 --> 00:36:22,719
Speaker 3: contact and find out who they're biological parents. So but

635
00:36:23,000 --> 00:36:26,560
Speaker 3: on the other hand, out surrogacy, altruistic surrogacy is allowed

636
00:36:26,640 --> 00:36:28,799
Speaker 3: in the UK and the Netherlands. So that was just

637
00:36:28,840 --> 00:36:32,640
Speaker 3: a weird sort of divide that I found, And I

638
00:36:32,800 --> 00:36:34,960
Speaker 3: don't really know. I would have to talk to sort

639
00:36:35,000 --> 00:36:40,279
Speaker 3: of sociologists or anthropologists. I don't exactly know what's going

640
00:36:40,320 --> 00:36:42,000
Speaker 3: on there, but there does seem to be a link

641
00:36:42,040 --> 00:36:46,640
Speaker 3: between anonymous donation and a negative attitude towards surrogacy in

642
00:36:46,680 --> 00:36:49,799
Speaker 3: these Catholic countries, which I don't know, if it's like you,

643
00:36:49,960 --> 00:36:53,880
Speaker 3: they want to sort of eliminate any tie between a

644
00:36:54,000 --> 00:36:57,680
Speaker 3: child and a parent that isn't sort of present in

645
00:36:57,719 --> 00:37:01,439
Speaker 3: their life or I don't know. It's a strange thing.

646
00:37:01,520 --> 00:37:04,759
Speaker 3: But the US is obviously a whole different landscape.

647
00:37:04,360 --> 00:37:09,080
Speaker 1: Yeah, the US, and the commerciality within the US I

648
00:37:09,120 --> 00:37:14,239
Speaker 1: think is highlighted so well, especially in the surrogacy aspect

649
00:37:14,360 --> 00:37:18,239
Speaker 1: of it, where you talk about the surrogacy contracts where

650
00:37:18,239 --> 00:37:20,360
Speaker 1: you can start to see evidence of like the different

651
00:37:20,360 --> 00:37:22,799
Speaker 1: things that can go wrong or have gone wrong wrong

652
00:37:22,840 --> 00:37:25,719
Speaker 1: in the past, and then lead to these like clauses

653
00:37:25,760 --> 00:37:30,680
Speaker 1: upon clauses upon clauses, like what does a surrogacy contract.

654
00:37:30,160 --> 00:37:30,760
Speaker 2: In the US?

655
00:37:30,840 --> 00:37:31,879
Speaker 1: What does it look like?

656
00:37:31,880 --> 00:37:32,000
Speaker 2: Like?

657
00:37:32,000 --> 00:37:35,880
Speaker 1: What are the expectations for the surrogate and the intended parents.

658
00:37:37,040 --> 00:37:41,360
Speaker 2: It's very long. Most contracts I read. Most contracts I

659
00:37:41,400 --> 00:37:42,000
Speaker 2: read and U s.

660
00:37:42,040 --> 00:37:47,280
Speaker 3: Were maybe fifty to sixty pages, and one parent described

661
00:37:47,320 --> 00:37:49,759
Speaker 3: it to me as this very sort of sad experience

662
00:37:49,800 --> 00:37:53,800
Speaker 3: reading it because all the clauses that prohibit certain behaviors

663
00:37:53,840 --> 00:37:57,680
Speaker 3: will kind of worn against certain scenarios. Are basically saying

664
00:37:57,800 --> 00:38:00,560
Speaker 3: this went wrong this one time, or you know this

665
00:38:00,640 --> 00:38:02,600
Speaker 3: has gone wrong in the past, therefore we have to

666
00:38:02,600 --> 00:38:04,320
Speaker 3: guard against it in this particular contract.

667
00:38:04,320 --> 00:38:06,839
Speaker 2: So in a way, it's good that those clauses are there.

668
00:38:07,120 --> 00:38:09,640
Speaker 3: It's also very sad to read them because you kind

669
00:38:09,640 --> 00:38:11,920
Speaker 3: of imagine, like, oh, my god, that happened to someone.

670
00:38:12,840 --> 00:38:17,400
Speaker 3: One clause I found very upsetting was one in which

671
00:38:17,760 --> 00:38:21,120
Speaker 3: the surrogate's husband, So if a saragut is married or

672
00:38:21,200 --> 00:38:24,920
Speaker 3: possibly even in a partnership, but that partner O husband

673
00:38:25,000 --> 00:38:28,439
Speaker 3: has to be a cosignatory on the contract, so they

674
00:38:28,480 --> 00:38:32,200
Speaker 3: agree to certain things, and this clause prohibited or said

675
00:38:32,239 --> 00:38:37,000
Speaker 3: that if the sarrogut's husband hit, punched, kit, you know,

676
00:38:37,160 --> 00:38:41,440
Speaker 3: abused in some way hurt the surrogate, he would be

677
00:38:41,520 --> 00:38:45,280
Speaker 3: liable for the financial damages that would result in terms

678
00:38:45,280 --> 00:38:47,520
Speaker 3: of like hospital bills for her, or if there was

679
00:38:47,560 --> 00:38:51,399
Speaker 3: any damage done to the fetus or fetuses. And it

680
00:38:51,440 --> 00:38:54,000
Speaker 3: was written in such a way that it wasn't at

681
00:38:54,000 --> 00:38:56,440
Speaker 3: all about the fact that that was a criminal offense

682
00:38:56,560 --> 00:38:56,920
Speaker 3: or that that.

683
00:38:56,880 --> 00:38:59,120
Speaker 2: Would just be an abhorrent thing to do. Obviously, I

684
00:38:59,160 --> 00:39:00,640
Speaker 2: mean it's legal, legal document.

685
00:39:00,640 --> 00:39:02,360
Speaker 3: It's not going to go into like all of the

686
00:39:02,400 --> 00:39:04,560
Speaker 3: ins and outs of how terrible that situation would be.

687
00:39:04,560 --> 00:39:07,400
Speaker 3: But just the coldness with which it kind of focused

688
00:39:07,440 --> 00:39:10,560
Speaker 3: on the financial damages that would imclude from that really

689
00:39:10,680 --> 00:39:12,880
Speaker 3: upset me and I was thinking about it for many

690
00:39:13,160 --> 00:39:17,799
Speaker 3: many weeks afterwards. Other quite upsetting examples like more to

691
00:39:17,800 --> 00:39:20,800
Speaker 3: do with money, like if you're if a sarrogut's carrying

692
00:39:21,000 --> 00:39:23,000
Speaker 3: multiples and one of them dies in the womb and

693
00:39:23,040 --> 00:39:25,600
Speaker 3: the other survives, like how does that affect her pay?

694
00:39:25,680 --> 00:39:29,600
Speaker 3: It's kind of pro rated and how much money would

695
00:39:29,640 --> 00:39:32,440
Speaker 3: she get from the day of the sonographer, just like

696
00:39:32,760 --> 00:39:36,680
Speaker 3: you know, finding there's only one heartbeat until delivery, and

697
00:39:36,719 --> 00:39:40,920
Speaker 3: like all that really kind of detail oriented stuff which

698
00:39:41,280 --> 00:39:43,680
Speaker 3: happens in contracts, Like it is about the details, it

699
00:39:43,719 --> 00:39:47,400
Speaker 3: is about the money, but somehow there's an added emotional

700
00:39:47,400 --> 00:39:50,160
Speaker 3: element to it in this in something like a surrogcy contract,

701
00:39:50,160 --> 00:39:53,040
Speaker 3: because it's like, that's just really unpleasant to think about.

702
00:39:53,560 --> 00:39:55,440
Speaker 3: And by the way, I should say that, like I

703
00:39:55,480 --> 00:39:57,640
Speaker 3: think in the US, like you said, because it is

704
00:39:57,719 --> 00:40:04,680
Speaker 3: so normalized and accepted, it feels like if you say

705
00:40:04,719 --> 00:40:07,720
Speaker 3: anything negative about the industry, you're seen as a critic.

706
00:40:08,560 --> 00:40:11,960
Speaker 3: So I feel like there will probably be people who

707
00:40:12,000 --> 00:40:14,120
Speaker 3: read the book and read those things. For example, when

708
00:40:14,120 --> 00:40:17,000
Speaker 3: I discuss how unpleasant the contract is in these ways,

709
00:40:17,000 --> 00:40:20,239
Speaker 3: who will think, oh, she's just anti surrogacy and this

710
00:40:20,360 --> 00:40:23,080
Speaker 3: is out this is like a skewering of this surrogacy industry.

711
00:40:23,920 --> 00:40:28,000
Speaker 3: Because broadly speaking, if surrogacy is a choice, it's about choice.

712
00:40:28,040 --> 00:40:30,560
Speaker 3: It's a positive thing, it's a progressive thing, and in

713
00:40:30,600 --> 00:40:33,480
Speaker 3: some cases rightly so. But it feels like if you

714
00:40:33,560 --> 00:40:36,799
Speaker 3: ever point out that there are maybe some aspects that

715
00:40:36,800 --> 00:40:41,640
Speaker 3: should be modified or regulated or changed. It's assumed that

716
00:40:41,680 --> 00:40:44,560
Speaker 3: you're kind of against the whole industry, but.

717
00:40:44,560 --> 00:40:47,400
Speaker 1: There needs to be room for nuance in these discussions

718
00:40:47,400 --> 00:40:49,640
Speaker 1: about it. And this is what I loved so much

719
00:40:49,680 --> 00:40:52,400
Speaker 1: about your book is that how much nuance you explored

720
00:40:52,440 --> 00:40:56,120
Speaker 1: in each aspect of the global fertility industry. You also

721
00:40:56,560 --> 00:41:00,520
Speaker 1: touched on some ethical examples too that will like, Okay,

722
00:41:00,680 --> 00:41:03,360
Speaker 1: here is something that seems to be working well, that

723
00:41:03,440 --> 00:41:05,880
Speaker 1: seems to be in agreement. What were some of the

724
00:41:06,239 --> 00:41:09,000
Speaker 1: examples of ethical practices that you encountered.

725
00:41:09,440 --> 00:41:13,440
Speaker 3: Personally, I'm a big fan of the legal changes that

726
00:41:13,480 --> 00:41:16,080
Speaker 3: happened here in the UK. For example, back in two

727
00:41:16,080 --> 00:41:20,920
Speaker 3: thousand and five. Previously donors could choose to be anonymous,

728
00:41:20,960 --> 00:41:23,400
Speaker 3: as I mentioned, and in two thousand and five a

729
00:41:23,480 --> 00:41:25,960
Speaker 3: law came in to change that so that any donor

730
00:41:26,360 --> 00:41:29,759
Speaker 3: signing up for any clinic or bank would have to

731
00:41:29,840 --> 00:41:33,680
Speaker 3: agree to be contacted by any resulting biological children when

732
00:41:33,680 --> 00:41:37,360
Speaker 3: those children turn eighteen. And the reason that the regulatory

733
00:41:37,360 --> 00:41:39,640
Speaker 3: body here in the UK gave for that decision was

734
00:41:39,680 --> 00:41:41,759
Speaker 3: they said that the rights of a child to know

735
00:41:41,800 --> 00:41:44,360
Speaker 3: their biological parent trumps the right of a donor to

736
00:41:44,360 --> 00:41:46,800
Speaker 3: remain anonymous. They thought it was more important for a

737
00:41:46,880 --> 00:41:50,279
Speaker 3: child to know about their biological origins, and this has

738
00:41:50,280 --> 00:41:52,080
Speaker 3: come up in a lot of research that it's really

739
00:41:52,160 --> 00:41:54,960
Speaker 3: beneficial for children to have answers to the questions they

740
00:41:54,960 --> 00:41:57,120
Speaker 3: may have if they know their donor conceived or suspect

741
00:41:57,120 --> 00:42:02,000
Speaker 3: their donor conceived or born from a whatever it is. Basically,

742
00:42:02,000 --> 00:42:07,040
Speaker 3: secrets are bad and not being totally transparent with children

743
00:42:07,200 --> 00:42:09,200
Speaker 3: within a family about how it came into the world

744
00:42:09,320 --> 00:42:12,520
Speaker 3: is generally not a good thing. So I personally think

745
00:42:12,560 --> 00:42:16,439
Speaker 3: that's a really good change. Having said that, I can

746
00:42:16,480 --> 00:42:20,000
Speaker 3: see that there's an issue with a shortage of donated

747
00:42:20,280 --> 00:42:22,400
Speaker 3: eggs and sperm in this country. As I said before,

748
00:42:22,400 --> 00:42:24,600
Speaker 3: like we have to import a lot from the US

749
00:42:24,640 --> 00:42:28,600
Speaker 3: from Denmark, So is it feasible you know, if every

750
00:42:28,640 --> 00:42:31,840
Speaker 3: country did that, we wouldn't have enough donated sperm or eggs,

751
00:42:31,960 --> 00:42:35,120
Speaker 3: certainly in the future as the industry grows at the

752
00:42:35,200 --> 00:42:39,600
Speaker 3: dizzying rate that it's currently growing. So sometimes what's ethically

753
00:42:39,640 --> 00:42:42,440
Speaker 3: the right choice might not be workable, And then you

754
00:42:42,520 --> 00:42:43,960
Speaker 3: have to look at the bigger picture and you have

755
00:42:44,040 --> 00:42:45,799
Speaker 3: to say, Okay, do we say do we just say

756
00:42:45,800 --> 00:42:49,400
Speaker 3: that this is the way it is, or do we say, actually, no,

757
00:42:49,480 --> 00:42:52,600
Speaker 3: we need to promote more donation. This is what we need.

758
00:42:53,080 --> 00:42:57,120
Speaker 3: Infertility is rising, more people need donated eggs and sperms,

759
00:42:57,200 --> 00:43:00,560
Speaker 3: so we can't restrict it in this way. A pu maker,

760
00:43:00,640 --> 00:43:04,920
Speaker 3: I don't know, but personally I think that anonymous donations

761
00:43:04,920 --> 00:43:07,960
Speaker 3: are problematic. The US is a good example of someone

762
00:43:08,000 --> 00:43:10,319
Speaker 3: where both are possible. You can have anonymous and non

763
00:43:10,320 --> 00:43:13,320
Speaker 3: anonymous donation. You usually pay more for a known donor.

764
00:43:14,120 --> 00:43:16,680
Speaker 3: You pay for all the information you receive really about

765
00:43:16,760 --> 00:43:20,839
Speaker 3: donors in one way or the other. So that's one

766
00:43:20,920 --> 00:43:24,520
Speaker 3: thing that I have I suppose a relatively firm opinion

767
00:43:24,600 --> 00:43:29,360
Speaker 3: on with caveats. I think similarly, we have to be

768
00:43:29,640 --> 00:43:32,880
Speaker 3: realistic about surrogacy and the fact that it's absolutely exploding.

769
00:43:33,600 --> 00:43:36,719
Speaker 3: There are many people who would say altruistic surrogacy is

770
00:43:36,719 --> 00:43:39,560
Speaker 3: the only acceptable form. There are some people, of course,

771
00:43:39,560 --> 00:43:42,919
Speaker 3: who don't think that even altruistics surrogacy acceptable. But if

772
00:43:42,960 --> 00:43:47,520
Speaker 3: you think that altruistic is superior to commercial, fine, But

773
00:43:47,960 --> 00:43:50,640
Speaker 3: is it realistic in a world where surrogacy demand for

774
00:43:50,719 --> 00:43:53,200
Speaker 3: surrogates is booming and there just won't be enough to

775
00:43:53,239 --> 00:43:56,239
Speaker 3: go round, And if you can't afford the prices in

776
00:43:56,280 --> 00:43:58,880
Speaker 3: the US, you go to places like northern Cyprus, you

777
00:43:58,880 --> 00:44:03,719
Speaker 3: go to places like Georgia Columbia where it's not really

778
00:44:03,719 --> 00:44:08,360
Speaker 3: an established industry yet, and there are unfortunately unethical agencies

779
00:44:08,360 --> 00:44:11,879
Speaker 3: that do operate as I discovered. I don't think that's

780
00:44:11,920 --> 00:44:15,080
Speaker 3: an acceptable situation. I think broadly speaking, it should be

781
00:44:15,120 --> 00:44:18,120
Speaker 3: legal and it should be regulated, because that's the way

782
00:44:18,160 --> 00:44:20,520
Speaker 3: it's going, That is the way the industry is headed.

783
00:44:20,600 --> 00:44:23,880
Speaker 3: Is just like more demand, huge demand, not enough supply.

784
00:44:24,760 --> 00:44:26,480
Speaker 3: How do we make sure that sarahgets are treated well

785
00:44:26,480 --> 00:44:28,319
Speaker 3: and also that parents are treated well? We don't want

786
00:44:28,400 --> 00:44:30,840
Speaker 3: we don't want parents in situations like some of the

787
00:44:30,920 --> 00:44:35,520
Speaker 3: nightmare situations you discover where they've been left without their child,

788
00:44:35,560 --> 00:44:38,400
Speaker 3: having spent all this money, and also the rights of

789
00:44:38,440 --> 00:44:40,960
Speaker 3: the child. You know, those are so often overlooked. It's

790
00:44:41,000 --> 00:44:44,279
Speaker 3: all about kind of the customer and the provider, but

791
00:44:43,840 --> 00:44:44,920
Speaker 3: what about.

792
00:44:44,719 --> 00:44:45,720
Speaker 2: The babies as well.

793
00:44:46,280 --> 00:44:51,520
Speaker 3: It's just such a legal, ethical, cultural minefield the entire industry.

794
00:44:51,719 --> 00:44:55,080
Speaker 1: It really is, and it's an uncomfortable one to think about.

795
00:44:55,200 --> 00:44:58,160
Speaker 1: But all of this just speaks to how important it

796
00:44:58,360 --> 00:45:03,600
Speaker 1: is to think about this these situations deeply, and maybe

797
00:45:03,640 --> 00:45:06,279
Speaker 1: not like personally. If this is something you don't want to,

798
00:45:06,320 --> 00:45:09,040
Speaker 1: but just like at least for policymakers for regulation, because

799
00:45:09,040 --> 00:45:11,680
Speaker 1: it's not going anywhere, and it's only going to become

800
00:45:11,680 --> 00:45:14,640
Speaker 1: more abundant, it's only growing, and so these questions, these

801
00:45:14,680 --> 00:45:19,280
Speaker 1: ethical considerations are also growing along with the fertility industry overall.

802
00:45:19,960 --> 00:45:23,759
Speaker 3: Yeah, exactly. I mean, in a totally utopian future, there

803
00:45:23,760 --> 00:45:26,200
Speaker 3: would be some kind of international treaty, there would be

804
00:45:26,200 --> 00:45:29,520
Speaker 3: some kind of form of international regulation where countries would

805
00:45:29,520 --> 00:45:34,200
Speaker 3: have to sign on to certain ethical standards, and there

806
00:45:34,200 --> 00:45:37,239
Speaker 3: would be more sort of oversight and cohesion between the

807
00:45:37,280 --> 00:45:41,479
Speaker 3: different disparate markets in the global space. I really don't

808
00:45:41,480 --> 00:45:45,239
Speaker 3: think that's coming anytime soon, unfortunately, so it's kind of

809
00:45:45,320 --> 00:45:50,279
Speaker 3: up to individual governments to make those decisions. But yeah,

810
00:45:50,480 --> 00:45:53,960
Speaker 3: I've spoken to several surrogacy lawyers in the UK and

811
00:45:54,040 --> 00:45:56,719
Speaker 3: Europe who are slightly sort of in despair at the

812
00:45:56,800 --> 00:45:59,920
Speaker 3: lack of regulation in this country. For example, there was

813
00:46:00,080 --> 00:46:02,120
Speaker 3: meant to be a sort of a government body that

814
00:46:02,200 --> 00:46:05,200
Speaker 3: was going to look at reforming surrogacy law here. It's

815
00:46:05,280 --> 00:46:08,000
Speaker 3: just it's just not deemed to be a priority, particularly

816
00:46:08,000 --> 00:46:10,680
Speaker 3: because it's such a hot potato politically, right, No one

817
00:46:10,719 --> 00:46:12,640
Speaker 3: really wants to go there. No government wants to be

818
00:46:12,680 --> 00:46:18,480
Speaker 3: responsible for looking really pro anti cerebracy, really, especially if

819
00:46:18,520 --> 00:46:21,440
Speaker 3: it's a vaguely centrist government like we have currently in

820
00:46:21,480 --> 00:46:23,640
Speaker 3: the UK, Like they just don't want to touch that.

821
00:46:23,760 --> 00:46:25,600
Speaker 2: It's too it's not worth it for.

822
00:46:25,560 --> 00:46:29,239
Speaker 1: Them, too politically dangerous. Ah well, this I mean, this

823
00:46:29,400 --> 00:46:32,279
Speaker 1: is I again just thank you so much for it,

824
00:46:32,320 --> 00:46:34,399
Speaker 1: for writing this book, but also for taking the time

825
00:46:34,960 --> 00:46:37,680
Speaker 1: to chat with me today today. I really enjoyed our

826
00:46:37,719 --> 00:46:38,799
Speaker 1: conversation me.

827
00:46:38,800 --> 00:46:39,879
Speaker 2: Too, Thank you very much.

828
00:46:39,920 --> 00:46:43,280
Speaker 3: I still have so much to think about with relation

829
00:46:43,360 --> 00:46:46,400
Speaker 3: to the book and all's well, it's nooks and crannies,

830
00:46:46,480 --> 00:46:48,560
Speaker 3: so it's nice to nice to discuss them.

831
00:46:48,880 --> 00:46:49,319
Speaker 2: Thank you.

832
00:47:06,840 --> 00:47:09,400
Speaker 1: A big thank you again to Alev Scott for taking

833
00:47:09,440 --> 00:47:12,040
Speaker 1: the time to chat with me. If you enjoyed today's

834
00:47:12,040 --> 00:47:14,520
Speaker 1: episode and would like to learn more, check out our

835
00:47:14,560 --> 00:47:17,600
Speaker 1: website this podcast will kill You dot com. We're I'll

836
00:47:17,640 --> 00:47:20,359
Speaker 1: post a link to where you can find cash Cow,

837
00:47:20,719 --> 00:47:23,920
Speaker 1: how the maternal body became a global commodity and the

838
00:47:24,000 --> 00:47:26,799
Speaker 1: hidden costs for women, as well as a link to

839
00:47:26,880 --> 00:47:29,359
Speaker 1: a Lev's website where you can find her other work.

840
00:47:29,840 --> 00:47:32,480
Speaker 1: And don't forget you can check out our website for

841
00:47:32,640 --> 00:47:37,160
Speaker 1: all sorts of other cool things, including but not limited to, transcripts,

842
00:47:37,360 --> 00:47:41,759
Speaker 1: Quarantini recipes, show notes and references for all of our episodes,

843
00:47:42,080 --> 00:47:45,080
Speaker 1: links to merch our bookshop dot org affiliate page, our

844
00:47:45,080 --> 00:47:49,200
Speaker 1: Goodreads list, a first hand account form, and music by Bloodmobile.

845
00:47:49,719 --> 00:47:52,600
Speaker 1: Speaking of which, thank you to Bloodmobile for providing the

846
00:47:52,680 --> 00:47:56,399
Speaker 1: music for this episode and all of our episodes. Thank

847
00:47:56,440 --> 00:47:59,919
Speaker 1: you to Leana Squalacchi and Tom Bryfogel for our audio mix,

848
00:48:00,440 --> 00:48:03,520
Speaker 1: And thanks to you listeners for listening. I hope you

849
00:48:03,640 --> 00:48:06,680
Speaker 1: liked this episode and our loving being part of the

850
00:48:06,680 --> 00:48:11,480
Speaker 1: TPWKY book Club. A special thank you, as always to

851
00:48:11,719 --> 00:48:18,000
Speaker 1: our fantastic patrons. We appreciate your support so so very much. Well,

852
00:48:18,320 --> 00:48:20,760
Speaker 1: until next time, keep washing those hands