Forced hysterectomy or societal surrogacy – an ethical solution for falling birth rates?

Birth rates have been falling steeply over the past decades in many parts of the world, leading to a plethora of economic, social and demographic problems.

In Japan, which has one of the lowest birth rates in the world, a controversy erupted recently when Naoki Hyakuta, a conservative politician and leader of a minor opposition party, urged that women should be prevented from attending university, and should be threatened with the removal of their uteruses at the age of 30 in order to increase the birth rate. Hyakuta has since apologised, claiming that the proposal was not intended as a serious policy measure.

But there is a serious side to this debate. Plummeting birth rates are indeed a growing concern, and Japan is not alone in struggling to deal with women’s apparent reluctance to have babies. A study recently published in the Lancet reports that by 2050, over three-quarters of countries will have fertility rates below replacement levels, rising to 95 percent of countries by 2100. The authors argue that we need to prepare for new challenges to the economy healthcare systems and geopolitical stability caused by these demographic changes.

So how can we prepare? If threatening women with hysterectomies after the age of 30 seems unacceptable how should we deal with the problems caused by falling birth rates?

'Immigration!' I hear you. After all, Japan, along with many other countries facing falling birth rates, has an acceptable solution right at hand. Open the borders for immigration, and all the problems are solved.

But is this suggestion really as appealing as it first seems? I suggest not. Whose offspring will bolster the economies of wealthier countries? In Hyakuta's dystopian vision it seems the role should fall on women debarred from education, deprived of equal opportunities and denied reproductive choice. There is a correlation between poverty and high birth rates that the European political classes have tried to end for a century now. But being poor or oppressed does not make women superfertile, or yearn to have as many children as possible; it simply ensures that they lack the means to avoid doing.

It is self-evident that Japan – along with other countries with dwindling birth rates such as the UK, Italy and Spain – is a place where women do indeed have choices that are not open to others: they can – for now – choose whether they have children, and they can choose to attend university even if the conditions for women and mothers are not perfect from a feminist perspective, in that heavily gendered expectations remain pervasive. If there is anywhere that does come close to being perfect in this respect, it is the Scandinavian countries. Yet Nordic countries are also struggling with lower than replacement rate fertility, despite having the some of the most favourable socio-economic conditions for women in the world, and a social expectation of equality in parenting.

The facts are clear. If women have the choice of whether to reproduce, fertility rates fall to below replacement-level, however good the social, economic and political counter-measures may be. Given that women in wealthier nations are choosing not to reproduce, relying on women who have no alternative to provide the workforce for countries struggling with low birthrates is deeply repugnant. It rests on a kind of exploitation for which there is no name, but which resembles in some degree both slavery and surrogacy. Perhaps it is best termed as 'societal surrogacy': a form of surrogacy with no ethical oversight, no legal contract, no safeguards, no consent and no payment.

By all means let us mock the blatant misogyny of Hyakuta's proposal. But to do so while blithely encouraging wealthy nations to profit from the labour of others is hypocritical.

Hyakuta may not have meant that women should really be banned from university or have their wombs removed. But the fact that this idea is so ludicrously misogynistic should not blind us to the fact that this dystopian vision is not far from reality in many countries. The wealthy world is increasingly reliant on women who lack access to education, contraception and abortion, to provide its human resources. Not only this, but it is because of these dystopian circumstances that women are having many babies. Not because they want to, or because motherhood is their highest value in life, but simply because they cannot prevent it.

As the Lancet article warns, the implications of increasing women's access to education and reproductive choice are alarming for governments who foresee challenges for economies, political stability and healthcare. Yes, societal surrogacy will keep our workforces going for a while. But if we want a world that does not rely on mass unpaid surrogate labour, we have some hard thinking to do about the future of reproduction.

There is a choice here between clinging to the old ideology of motherhood as a necessary and intrinsic part of a woman's life, and having the courage to address the facts as they appear before us: equal opportunities are incompatible with replacement level fertility rates.