Sex and the Planet

What if human reproduction was always elective? A prominent bioethicist speculates about the possibilities—and the likely consequences.

What would the world be like if all pregnancy was intended, not unintended as it is nearly half the time now? Considerably better, Margaret Pabst Battin suggests in Sex and the Planet, a provocative thought experiment with far-reaching real-world implications. Many of the world’s most vexing and seemingly intractable issues begin with sex—when sperm meets egg, as Battin puts it—abortion, adolescent pregnancy, high-risk pregnancy, sexual violence, population growth and decline. Rethinking reproductive rights and exposing our many mistaken assumptions about sex, Sex and the Planet offers an optimistic picture of how we might solve these problems—by drastically curtailing unintended pregnancies using currently available methods.

How we see this picture—as recommendation, prediction, utopian fantasy, totalitarian plot, hypothetical conjecture, or realistic solution—depends to a great degree on which of thirteen problematic assumptions we maintain, assumptions Battin works to identify and challenge. Taking on sensitive topics like abortion and rape and religious issues around contraception, she shows how a fully informed, nonideological approach could defuse much of the friction such issues tend to generate. Also, in her attention to male contraception and the asymmetry of female and male reproductive control, she pulls in the 50 percent of the human race—those with Y chromosomes—largely left out of discussions of reproductive health. Sex and the Planet, finally, takes a global view, inviting us to consider a possible—even plausible—reproductive future.Introduction:           
Part I: The Opt-In Conjecture: Reversing the Default Outcome of Sex
1. What if Human Reproduction Were “Opt-In,” “Always Elective”?                           
2. The Opt-in Conjecture and the Real World                 
3. Why the Pill Isn’t Quite Good Enough: Modern Methods of Fertility Management           

Part II: Resolving Five Large-Scale Reproductive Problems of the Globe
4. How to Solve the Wars Over Abortion                 
5. Adolescent Pregnancy Around the Globe: Child Brides and Teens Taking Chances
6. Coerced Sex, Coerced Reproduction     
7. High-Risk Pregnancy: Maternal Illness, Drugs, and Bad Stuff in the Environment   
8. Global Population Growth and Decline     

Part III.  Men, Religion, and Money
9.  Men. The Asymmetry of Female vs. Male Fertility Control   
10. “Double Coverage”:  Why Not Both, Females and Males?     
11. Religious Opposition and the Embrace of Procreation     
12. Money, Money: The Low Low Cost of Opt-In Reproduction     

Part IV. What We Think and Where We Go Wrong
13. Problematic Assumptions about Sex and its Reproductive Consequences         
14. How Not to Read this Book and Don’t See the Movie“In this superbly constructed treatise, I am in awe of how Professor Battin runs so much further with the opt-in concept, ending with this perfect summary: ‘that everyone can have full personal control of their own fertility is among the greatest gifts we could give ourselves and our planet.’”
—John Guillebaud, Emeritus Professor of Family Planning and Reproductive Health, University College London
 
“A brilliantly original perspective on reproductive freedom and all its social and environmental ramifications. Battin’s conjecture liberates us to explore the many impacts of unplanned pregnancy without the stigmas attached to contraception, abortion, or ‘population control.’ It reveals a much kinder world we can all help to bring about.”
—Jane O’Sullivan, University of Queensland, Australia
 
“The public conversation about abortion is polarizing. It consists of the repetition of stale ideas about right and wrong, women or fetuses. Margaret Battin in Sex and the Planet goes beyond those ideas and offers a much needed third path: safe and effective long-term contraceptive methods one opts into for their reproductive lifetime and opts out of when one is ready to have a baby. Good medicine and good ethics.  A book worth reading.”
—Frances Kissling, President, the Center for Health, Ethics and Social Policy, Washington, DC
 
“Sex and the Planet is an impressive tour of human sexuality, contraception, and reproduction, imagining a world in which 100 percent of reproduction is planned by the universal use of male and female long-acting reversible contraceptives.”
—John K. Amory, Professor of Medicine and Section Head, General Internal Medicine, University of Washington Medical CenterMargaret Pabst Battin is Distinguished Professor of Philosophy and Adjunct Professor of Internal Medicine, Center for Health Ethics, Arts, and Humanities, at the University of Utah. She has written, cowritten, edited, or coedited some twenty books, including The Least Worst Death and other volumes on end-of-life issues.