When the writer Amanda Hess was twenty-nine weeks pregnant with her first child, her doctor, looking at an ultrasound, “saw something he did not like.” He suspected a rare genetic condition; Hess underwent an amniocentesis and then an MRI. She sought out a second opinion—which augured catastrophe and, it turned out, was completely wrong—and a third, steadying one. Her son was eventually given a diagnosis of Beckwith-Wiedemann syndrome, which puts babies at higher risk for hypoglycemia and certain cancers and makes their little bodies grow fast; often, their tongues become too large for their mouths, requiring corrective surgery.
Extensive testing showed no genetic or environmental cause for her son’s condition, yet Hess felt somehow culpable. “I worried over what I had done to trigger it, over the dark secret of my body that had determined his suffering,” she writes in her memoir, “Second Life: Having a Child in the Digital Age” (Doubleday). Her apprehensions were reinforced by her medical chart, which logged ominous-seeming F.Y.I.s that included “Advanced maternal age” (she was thirty-five), “Teratogen exposure” (owing to a tablet of the anti-anxiety medication Ativan, taken at the six-week mark), and “Anxiety during pregnancy.” These facts revealed nothing about her baby’s prospects, yet they followed Hess around like a misdemeanor rap sheet. Immediately after her son’s birth, by C-section, a labor-and-delivery nurse turned to her—“the paralyzed, split-open, twenty-second-old mother”—and asked, “When did you stop taking the Ativan in pregnancy?”
“Second Life” is not mainly a medical odyssey but, rather, a mordant contemplation of the many screens—from ultrasounds and pregnancy-tracking apps to baby monitors and children’s TV—that reflected and mediated Hess’s experience of pregnancy and early motherhood. Through the porthole of her phone, she encountered the “freebirth” movement, made up of mothers who are skeptical of prenatal screenings and tests, hospital births, and pediatric vaccines, referring to conventional pregnancy care as “birth in captivity.” Hess developed a queasy fascination with these women. “If I had had a wild pregnancy, dismissed prenatal care as a scam, I never would have received that terrifying ultrasound,” she writes. “But I also would have denied myself the information that I needed to protect my child after he was born.” The diagnosis fortunately led Hess and her husband to a physician who specialized in Beckwith-Wiedemann syndrome, and to a hospital with a suitable NICU.
Hess’s book arrives at a historical moment—post-Dobbs, pro-natalist, techno-dystopian—in which both pregnant bodies and the stuff of reproduction itself have come under an extraordinary degree of scrutiny, judgment, and control. Some states routinely charge women with child neglect or endangerment for drug use during pregnancy (and even prescription medications have raised alarms). In Nebraska, a teen-ager and her mother both served time in prison after the girl took abortion drugs and delivered a stillborn infant. And many patients, including those who receive tragic prenatal diagnoses, cannot access abortion care unless they travel long distances out of state, often at great expense and even at legal risk.
Meanwhile, on the other side of what Hess calls the “reproductive technology gap,” a number of startups are touting their powers to select for maximally optimized offspring. Sam Altman, the C.E.O. of OpenAI, is an investor in the biotech company Genomic Prediction, which offers the LifeView Embryo Health Score® Test. It claims to evaluate I.V.F. embryos for a host of polygenic conditions, including propensity for developing diabetes, certain cancers, or schizophrenia; Stephen Hsu, a co-founder of Genomic Prediction, has said that the company’s technology can also predict I.Q., but that “society is not ready for it.” A similar company, Orchid, has backing from Anne Wojcicki, the co-founder of the genetic-testing company 23andMe. “Sex is for fun, and embryo screening is for babies,” Orchid’s founder, Noor Siddiqui, has said. (Creating true designer babies using gene-editing tools such as CRISPR is still largely forbidden.)
In recent years, the term “snowplow parenting” has come into vogue to describe a certain strain of affluent, vigilant child-rearing, one that works to smooth an offspring’s life path at every turn. Polygenic embryo screening may represent the snowplow driven to its logical extreme: the kind of parent who can drop six figures on Ivy-feeder preschools or comprehensive college-admissions counselling might happily intervene at the embryonic stage if she can boost her future kid’s I.Q. The ascendance of such technology, and its prohibitive expense, is a boon to the Nietzschean wing of the Silicon Valley overclass, which has long suspected that all its money makes it special. Perhaps now its genetically advantaged progeny can remove all doubt.
But most parents-to-be don’t breathe that rarefied air, which swirls with false expectations and, for some, carries a whiff of eugenics. Hess, who is a critic-at-large at the Times, takes an ambivalent view even of the more ordinary, in-utero technology that offered such widely diverging predictions about her baby’s health. Her prenatal diagnosis let her create a safe harbor for her newborn, yet the question of when or whether to receive such information remains an unsettling one. When a scientist tells her that, someday soon, a test that screens for Beckwith-Wiedemann and related disorders may be available much earlier in pregnancy, Hess writes, “I wasn’t sure that I wanted it to exist. I thought about the expectant parents who might jump, scared, at an early chance to prevent kids like my son.”
The “dark secret” that Hess ruminates on, one that can haunt the pregnant body and its progeny, hearkens back to a pre-Darwinian concept known as “maternal impression”—broadly speaking, the belief that a woman’s ideas, fears, and experiences during pregnancy leave an adverse physical mark on her infant. “Early modern medical manuals understood the mother basically as a psychic inscription machine,” the historian Hannah Zeavin writes in “Mother Media: Hot and Cool Parenting in the Twentieth Century.” “If she ate, thought, or did the wrong thing, it would be recorded in and on her developing child.” The maternal mind and body, Zeavin argues, was, historically, the ultimate transmission device, “the literal medium through whom the ‘message’ of the child had to pass into life.”
This idea, Hess writes in “Second Life,” “pitched forward through the centuries until it made its way to me.” She sees vestiges of maternal impression in how that single tab of Ativan—along with the anxiety it was meant to treat—was enshrined in her pregnancy records. “Teratogen exposure” refers to a substance that may cause malformation of an embryo; Hess notes, with dry horror, that the root “terato” means “monster,” and the suffix “-gen” is “thing that produces or causes.” “The online medical chart was supposed to be modern and scientific,” she writes. “But when I decoded its medical terminology, it said that I had created a monster.”
A largely unscientific hypervigilance about the blameworthy habits and behaviors of pregnant women is, as Hess discovers, a place of convergence for the medical establishment and the fringe-medicine crowd. At an outdoor retreat for freebirthers, she comes across a chiropractor-influencer who professes that most illnesses are created by “conflict shock”—some distressing life event that the patient has not resolved. When Hess later asks for “clues to why and how to treat” her son’s enlarged tongue, the influencer responds, in part, “The tongue is needed for speaking, sucking, and swallowing. During pregnancy did you experience a self devaluation related to one of these things? Did you need to ‘bite your tongue’?”
Although the reproductive-technology enthusiasts of Silicon Valley and beyond are not necessarily immune to such junk science, they are relatively sanguine about maternal impression. Elon Musk, who has fourteen-ish kids and has called declining birth rates “one of the biggest risks to civilization,” has fathered several of his children using surrogates and seems generally unfussed about where his sperm may roam. One of Orchid’s investor-clients told The Information that Siddiqui suggested she use a surrogate for her children, just because: “She was, like, ‘Well, this is nine months of your life, and it’s not that expensive.’ ” There is also the looming possibility of artificial wombs—which could eliminate the need for human labor altogether, bringing DOGE-like efficiency to the business of breeding.
It might come as a surprise that this tribe of biohacking control freaks is so blasé about outsourcing the work of gestating a human being to other, presumably less optimized vessels. And in fact the venture capitalists Malcolm and Simone Collins, who are the unofficial First Couple of American pro-natalism, have not used gestational surrogates for their children. Otherwise, though, they exemplify a hyper-rationalized faith in genetic determinism: that the message, in the form of DNA, trumps the medium. The Collinses have enlisted Genomic Prediction to run background checkson their embryos and another DNA-testing company to assess the data and then rank ideal candidates for onboarding according to criteria such as potential I.Q. and risk of developing anxiety or “brain fog.”
Within this paradigm of preselection, the work of raising children is, to some extent, completed upon implantation, and allows for what Malcolm calls “intrinsically low-effort parenting.” As depicted in a viral profile of the family in the Guardian last year, this parenting style accommodates unlimited iPad time at age two and the occasional smack across the face.
The Collinses demonstrate how advances in reproductive technology are resulting in unexpected political, social, and even aesthetic realignments. In many respects, they resemble the neo-Quiverfull, self-isolating, homeschooling families who populate so much of the Christian-MAHA sector of social media, and who overlap with the freebirthers who command Hess’s attention in “Second Life.” But the couple’s embrace of avant-garde science and medicine, Simone’s C-section births, and their autistic identities—Simone and two of their children have autism diagnoses—put them at odds with the same group, which rejects the medical establishment and fetishizes maternal impression and “natural” birth, and whose antipathy to vaccines is rooted in an irrational fear of autism.
