Alexa Warnes


Globally, procreation is highly valued, and motherhood has long been seen as the normative role for women. Production of a biologically-related family in keeping with social norms is a key driver of the growing demand for assisted reproductive technologies as a ‘cure’ for infertility, which includes the provision of in vitro fertilisation (IVF) within the UK’s National Health Service (NHS).

In this paper I argue that pronatalism – a social bias in favour of biological motherhood – entrenches harmful social norms for women as a group. I will question whether assisted reproductive technologies in the form of IVF bring radical change to women, or whether radical change is in fact required before assisted reproductive technologies can be considered to be liberating. I will explore whether the NHS access criteria for IVF are enabling or restrictive of women’s reproductive autonomy, paying particular attention to how the restrictions on sexuality and age contribute to this debate. I argue that despite the social harms of pronatalist bias, eliminating public funding of IVF would wrongfully target those women who are reproductively marginalised, for example, same-sex couples, trans groups, women of advanced maternal age and women who are unable to pay for treatment. Instead, I argue that access to IVF within the NHS should be maintained, but I propose amendments that ensure that the service is more equitably distributed to those in same-sex couplings. Further, I suggest ways that IVF can be included in a wider range of measures that tackle the social issues of infertility in women of advanced maternal age. Finally, I make recommendations for the medical profession to help reduce pronatalist bias, ensuring maximum autonomy for women when they are considering their reproductive futures.

Author Biography

Alexa is currently in year 5 of undergraduate training to become a doctor, and has developed a keen interest in feminist literature alongside their medical studies. This interest came largely from the inspirational tutors within Brighton & Sussex Medical School’s medical ethics department, to whom Alexa is eternally grateful for all their support and encouragement. Looking ahead to their career in medicine, Alexa very much hopes to continue contributing to the important area of feminist bioethics.