Cristina Odone

Journalist, novelist and broadcaster

Is there a link between NHS-funded IVF and the adoption crisis?

April 21, 2011 @ 11:48 am

Is the link between IVF and adoption really unexamined? Well: no. (Photo: Getty)

Is the link between IVF and adoption really unexamined? Well: no. (Photo: Getty)

My colleague Cristina Odone writes today about the crisis in adoption rates. She is right, I think, to say there is a need for an overhaul of the system, and that it is too difficult at the moment for prospective parents to adopt. It's easy to decry "red tape" and "bureaucracy", and of course if the Government relaxed the rules to the point that children were being placed in the care of unsuitable parents there would rightly be an outcry. But, from my limited understanding of the situation, good people are being denied the chance to be parents, and unfortunate children the chance to have parents.

It should be pointed out, though, that Cristina strays off the path of accuracy a couple of times. First, she points out, truthfully, that "the number of adoptions has shrunk over the past 20 years – from over 20,000 in 1971 to only 3,200 in 2009-2010." But that does not imply that 17,000 children each year are being shovelled into care. As the link she provides says, "In the 1970s, there was a rapid decline in the number of children available for adoption following the introduction of legal abortion in the Abortion Act 1967 and the implementation of the Children Act 1975." I have been trying to find the number of children who were actually awaiting adoption in 1971 compared to 2009, but it seems to be difficult to tease out – do let me know in the comments if you have a source. But it certainly appears to be significantly fewer. Many of you will, I appreciate, be appalled that this decrease is due to an increase in abortion, but that is a separate discussion. The fact is that the reduction in the number of children adopted is at least partly due to a reduction in the number of children awaiting adoption, rather than Government indolence or potential-parental indifference.

But second, and more important, she explicitly blames "the IVF industry" for the crisis, suggesting that childless couples who would previously have sought to adopt can now seek to have their own children, with the help of in vitro fertilisation techniques. "One issue remains unexamined: the link between IVF and adoption", she says. She suggests that making IVF treatment unavailable on the NHS unless you have first sought to adopt would improve the situation.

Now. Call me old-fashioned, but I tend to think that if you're going to suggest that something is unexamined, you might want to check first whether it has, in fact, been examined. In this case, it most certainly has, as five minutes on Google Scholar would reveal.

"Trading-Off Reproductive Technology and Adoption: Does Subsidizing IVF Decrease Adoption Rates and Should it Matter?", an August 2010 paper by Glenn Cohen of the Harvard Law School  and Daniel L. Chen of Duke University's School of Law, published in the journal Minnesota Law Review, looked into this very question. They ask "does state subsidization of reproductive technologies through insurance mandates actually reduce adoption; that is, is there a trade-off between helping individuals conceive and helping children waiting to be adopted?" Their method is to look at states before and after the introduction of state-subsidised IVF, and seeing whether there is a change in the rate of adoption.

They find that "Contrary to the assumption of the substitution theory, we find no strong evidence that state support of IVF through these mandates crowds out either domestic or international adoption." An earlier, similar paper, by Cohen alone, presented at the annual meeting of the The Law and Society Association in May 2010, found "no strong evidence that state support of IVF through these mandates crowds out domestic adoption", although it did "find some evidence" that "the introduction of these mandates is associated with diminutions in international adoptions" – which, of course, would have no effect on the number of children remaining unadopted in Britain.

These are only two papers, one of which is clearly a precursor to the other,  and I may be unaware of other papers, so perhaps there is more to be discovered. But it is clearly not true to say that the link is "unexamined". Cristina's position that IVF reduces the demand for adoption in the parental marketplace, if you'll forgive the phrase, makes intuitive sense. But intuitive sense is an inadequate guide to empirical fact, as Niels Bohr would be happy to tell you.

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