The new Hulu series The Handmaid's Tale has only been out for a few days, but it's already stirring up a bunch of discussion. It's an eerily relevant show right now for many reasons — especially when it comes to the handmaids' horrifying "job" and the way their society views women's bodies primarily as baby vessels. But when it comes to the mass infertility the story's characters deal with — the reason the handmaids were created — how much is based in reality?
In the Margaret Atwood novel the series is based on, most people are infertile thanks to exposure to pesticides, toxic chemicals, and STIs. Although there's no proven link between the pesticides used today and fertility issues, the STI concern is definitely real: If left untreated, both chlamydia and gonorrhea can lead to pelvic inflammatory disease. As the CDC explains, that condition can cause damage to your reproductive organs and, therefore, infertility. Unfortunately, rates of chlamydia and gonorrhea are at an all-time high right now in the U.S. Of course, that doesn't mean that mass infertility necessarily follows that trend, but it is a good reminder to keep your sex safe, to regularly check in with your gyno about your risk for STIs, and to definitely not delay treatment if you do think something might be off.
So what about our overall infertility? Well, it's complicated. Recent statistics have shown that fertility in the U.S. has been on the decline since the 1960s, but those numbers are actually a little more complex than they seem. That's because one way we measure fertility is simply the birth rate for an average individual (or "completed fertility" rate). So it's important to remember that this isn't a measure of our potential to have babies, it's whether or not we've had them. In other words, though the birth rate may be down, that doesn't necessarily mean the infertility rate is up.
Another stat we track, the "total fertility rate" measure, attempts to take this into account and predict how many children we're likely to have in our lifetimes. But those numbers are still based on the current baby-making trends at the time. So, as the Pew Research Center explains, it overinflated the fertility rate after WWII when people were having children much younger than they had before. Compared to that procreational boom, our birth rates are definitely lower. But that moment was a bit of an anomaly, so it's not exactly a fair comparison.
With that comparison in mind, the "total fertility rate" may very well be underestimating our current fertility levels, as people are now delaying pregnancies further into their lives than they have before. The bottom line is that this is a surprisingly complex trend to measure, but none of our estimates suggest we're heading for a Handmaid's Tale -level infertility event.
In fact, birth rates among women over 35 in the U.S. are actually rising. That's thanks in large part to reproductive techniques, such as egg freezing and in vitro fertilization, which just weren't as much of A Thing in 1985 when The Handmaid's Tale was originally published. Today, those dealing with infertility have a comparatively wide range of options available to them.
But that certainly doesn't mean that fertility-related anxieties aren't still real. Yes, treatments exist, but they're usually expensive, rarely covered by insurance, and never a guarantee of success. Not to mention the fact that fertility issues are wrapped up a whole bunch of emotions and often outdated societal expectations. So our world still has plenty of fertility questions to address — even if (one hopes) the answers don't involve handmaids.
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