According to Barn, the societal orientation towards individualism also shapes how we understand involuntary childlessness and reproductive autonomy. ‘Medical interventions such as IVF are often seen as the answer, even though they primarily focus on the individual and have disappointing success rates.’ In her new philosophical research, Barn argues for greater attention to be placed on the social conditions that determine whether and when people are able to have children.

Additional pressure on women

This focus on medical solutions has direct consequences for women, Barn argues. “IVF has effectively become the primary response to ‘treat’ infertility, even though in the majority of cases it does not result in a birth and often causes additional distress both during a treatment and when a treatment ‘fails’.”

According to Barn, this says a great deal about the pressure placed on women. “Women often feel an enormous responsibility to make the treatment succeed. That pressure is not only medical, but also social. The idea that failure is a personal failure is constantly looming.”

Individual choices in a social context

Barn notes that early feminist responses to IVF already pointed out that much of the suffering surrounding childlessness stems from norms about womanhood and motherhood. “Childlessness can be painful because it can feel as though you are not living up to what society expects of you. Historically and culturally, motherhood is still seen as a natural part of a ‘successful’ woman’s life.”

“That analysis has somewhat faded from view now that the focus lies primarily on individual choices, even though those choices are always made within a broader social context”, Barn says. If we rely mainly on medical solutions, she warns for a risk that these norms are reinforced and underlying social causes remain out of sight.

More than a medical issue

Barn therefore stresses that involuntary childlessness cannot be separated from broader societal conditions. These include having children later in life due to work demands, financial insecurity, and career structures that are difficult to combine with caring for young children.

As well as this, she points out that environmental factors such as pollution, toxins, and poor nutrition, negatively impact reproductive health. And that miscarriage rates are higher amongst socially disadvantaged sections of society.

“The aim of IVF is to increase well-being and reduce the suffering associated with involuntary childlessness,” she says. “But IVF cannot address the fact that infertility may also be socially determined.”

Societal support

With her philosophical approach to reproductive justice, Barn advocates placing societal support alongside medical treatments. Think of better childcare, a fairer distribution of care responsibilities where raising children is also seen as a societal responsibility, and career paths that do not stall after parenthood.

“As a society, we should be concerned with the pain and suffering related to people’s desires to have children. And if we truly take well-being seriously, we need to look beyond technology and focus on structural solutions too.”

Details article

Barn G. Do Assisted Reproductive Technologies Promote Well-Being? Hypatia. Published online 2026:1-25. doi:10.1017/hyp.2025.10054