Mary Barton (obstetrician)

Mary (née Worthington) was born in Lowestoft, Suffolk, in a family of several generations of surgeons and doctors. She attended Norwich High School for Girls from 1915 to 1923, and in October 1923 she commenced studies at the London School of Medicine for Women. She received her Bachelor of Medicine and Bachelor of Surgery from the University of London in 1929. She married Douglas Barton, a doctor who was based in Dera Ismail Khan, a city in what was then British India's Northwest Frontier Province, and is now Khyber Pakhtunkhwa in Pakistan. The couple practised in a missionary hospital. They divorced in 1939; she retained his name for the rest of her professional career. Mary Barton married Austrian physiologist Bertold Paul Wiesner in 1943. They had a son, Jonathan, and a daughter, Ruth. ==Early career==

Mary Barton and her first husband were medical missionaries in pre-partition India, then still ruled by Britain. She witnessed the way in which women would be punished or even killed for being childless. At the time, it was taboo to suggest that it might be the husband, and not the wife, who was infertile - not only on the Indian subcontinent but also in the United Kingdom. == The Barton Clinic ==

's site in Gray's Inn Road, as Barton would have known it. Mary Barton returned to London and established a fertility clinic as early as 1940, one of the first people to do so. and in Wimpole Street in the 1960s. Barton also worked at a fertility clinic at the Royal Free Hospital, a significant teaching hospital which became part of the newly formed National Health Service in 1948. It is likely that this was a "clinic" shared with colleagues. Her private clinic, on the other hand, operated outside of the NHS. Barton's second husband, biologist and physiologist Bertold Wiesner, was associated with the Royal Northern Hospital, as was genito-urinary surgeon Kenneth Walker. == Controversial nature of insemination ==

In 1945 Barton, Walker, and Wiesner published a paper about artificial insemination in the British Medical Journal. The main focus of the article was artificial insemination by husband, used in cases of impotence, failure to ejaculate during intercourse, and female dyspareunia (painful intercourse). They also noted that donor sperm had been used in rare cases of male sterility or to avoid hereditary disease. It was argued that artificial insemination was a form of adultery. Artificial human insemination was seen as posing social and legal threats to the institution of marriage and the status of children, not least due to secrecy and deception around a child's paternity. The commission noted that children of donors might intermarry and commit incest without knowing that they were closely genetically related, with genetic risks to their offspring. Another fear was that preferential choice of male children might cause a gender imbalance in society. The commission called unsuccessfully for AID to be made a criminal offense. It was chaired by Charles Duncombe, 3rd Earl of Feversham Blackford had moved to make artificial insemination by donor illegal, as being a form of adultery, but in the end he withdrew his motion. He stated that his second objective, a full debate on the topic, had been achieved. In this context, Lord Blackford's comments on Mary Barton, who he identified as "a leading exponent in this field", are of particular interest. Others who read the Feversham Committee's report considered that, far from reflecting a full debate, it was lacking in necessary factual background, "vague", "superficial", "totally inadequate", and in the end "inconclusive". The committee clearly disliked the idea of AID. At the same time, they did not consider regulation practical, and feared to increase AID's visibility by giving it any form of official recognition. ==Choice of donors==

A concern of both critics and proponents of artificial insemination was the quality of the donor sperm. Barton emphasized that donors should be free of disease (transmissible or hereditary) and "characteristics of possible genetic significance" (which included both alcoholism and criminality). The Wand Report worried that donors might have "absurd and inflated opinions of [their] own worth and ability", and be attracted by pride, personal power, and freedom from responsibility for progeny. Were those attracted likely to be "abnormal and unbalanced" or even "psychopaths"? Would such characteristics appear in their children? The possibility of paying for sperm donation also raised concerns about the desirability of the possible donors. In contrast, obstetrician Margaret Jackson argued that a sperm donor was likely preferable genetically to a random sexual encounter or "fling" with a "fancy man". As Barton and others informed the Feversham commission, it was difficult to find donors. They were often former patients, husbands of patients, members of the doctors' family, or acquaintances. In 1945, Barton warned of the emotional danger attendant on donation from a known individual such as a husband's brother; such situations often resulted in "emotional disturbance" for all involved. Donors were expected to remain separate from the families whose children they engendered. It was recommended that donors and recipients be kept unaware of each other's identities. An unfortunate result of such secrecy, pointed out by the Wand and Feversham reports, was a lack of research on the impact on families, either positive or negative. ==Identity of donors==

In their 1945 paper in the British Medical Journal, Barton and fellow authors Walker and Wiesner explained that they used a "small panel of donors" that they considered of "intelligent stock". Another major donor was neuroscientist Derek Richter, who may have fathered more than a hundred babies. It is unclear whether Barton knew that much of the sperm used came from her husband. She kept records of donors identified with code names. Documentary filmmaker Barry Stevens has stated "it's possible he [Bertold Wiesner] didn't tell his wife and she believed the donations were coming from a lot of different men". Regardless, as a scientist specialising in fertility (among other areas), Wiesner himself should have been aware that there were genetic risks created by his fathering so many children. Such risks were known and were identified in the Wand Report. == Legacy ==

Mary Barton's clinic was one of the first in Great Britain to offer artificial insemination. The clinic helped an unknown number of previously childless women to conceive babies. Estimates are that thousands of women were able to conceive as a result of artificial insemination with their husband's sperm. Possibly as many as 1,500 more women conceived using artificial insemination by donor. The majority of the sperm donations may have come from a few progenitors. Mary Barton and Bertold Wiesner likely believed that after the destruction of the clinic's records, the parentage of the children conceived at the clinic would be untraceable. They could not have foreseen the implications of contemporary research into the structure of DNA. The increasing availability of consumer genetic tests has made the anonymity of sperm donation practically impossible. Laws regulating human artificial insemination were eventually introduced, but not until Britain's Human Fertilisation and Embryology Act of 1990. Availability and quality of donor sperm continue to be concerns. Barton died in 1990. == References ==