Recently I was alerted to a new movie on the Lifetime channel, Switched Before Birth, a movie inspired by IVF stories of real-life couples, as it covers a topic near and dear to my heart and profession. 

This movie touches on a myriad of subjects of interest to our CBC readers: surrogacy, sperm donation, and the importance of biology, embryo sex-selection, the familial tension and strain on relationships that third-party reproduction and #BigFertility can cause, the financial and emotional cost of fertility treatments, the lack of oversight and regulation in #BigFertility, and, of course, the crux of the film, the heartbreak and devastation of carrying a child that is not “yours.”

In the film’s opening, we meet Olivia and Brian Crawford, a couple struggling with infertility. Under the care of Dr. Nori, Olivia has already endured two IVF cycles ending in miscarriage and is begging Dr. Nori to allow her to try a third time, before considering hiring a gestational surrogate. Olivia pleads with Dr. Nori, “This whole thing is a bit like a game. You know, it’s the high stakes and we bet our money and take our chances.” In this one sentence, the writers have accurately captured the risky nature of #BigFertility. Fertility clinics work in tandem with the media to romanticize the industry and gloss over some of its harsh truths, distorting facts about IVF success rates and constantly peddle IVF add-ons, exploiting the desperation of intended parents.

After meeting Olivia and Brian, viewers are introduced to Anna and Gabe Ramirez, a couple that seem to have it all—all, that is, except a baby. Anna admits that she has always been successful, except in this one area. 

The couple find themselves at the same IVF clinic as Brian and Olivia, also under the care of Dr. Nori. It doesn’t take a film critic or a scientist to draw the conclusion that this is where the plot begins to thicken. Viewers know that somehow these two women will have babies that are switched before birth. Anna and Olivia first meet at the clinic’s “congratulations corner”, a wall of success stories at the fertility clinic, strategically dangling that carrot of hope in front of their clients.

Watching Switched Before Birth, I noticed the complete absence of meaningful communication between the couples and the knee-jerk response to any concerns or suggestions by others. For example, Olivia’s father reminds her that there are so many children in need of good homes, but she and Brian quickly reject the proposal. Both Anna and Olivia are desperate for a baby, no matter the cost, and they allow this longing to dictate everything else.

The two couples have one important difference that’s worth mentioning: Gabe and Anna use a sperm donor because Gabe is infertile. In a fleeting conversation, in front of Dr. Nori at the fertility clinic, Gabe expresses his concern that it won’t be his biological baby. Anna reassures her husband that there is more to fatherhood than biology and reminds him that they agreed to do whatever it takes to become parents. Gabe agrees and that’s that. Another ephemeral conversation with a remarkable amount of weight and importance. 

For those that haven’t seen the film and want to, here is your official SPOILER ALERT! Stop reading now and come back when you’re done. 

On the day of the embryo transfer, Olivia and Anna are scheduled for back to back appointments. Brian is running late, so Anna offers to switch Olivia and go first. The transfers commence, and viewers learn that both were successful. Both women are pregnant; Olivia with twins and Anna with a single boy. Anna and Gabe chose sex-selection to ensure that Gabe could have the son he always wanted. Unfortunately, at 16-weeks, Anna tragically suffers from a late miscarriage.  

Expectedly, Anna and Gabe’s relationship quickly transforms. The once happy and optimistic couple become distant and angry, even officially separating. Gabe unsuccessfully tries to support his wife, while dealing with his own loss. During a feud, after attempting to attend Olivia’s baby shower, Gabe tries to comfort Anna by saying he lost a child, too. She snaps back, “but it wasn’t your biological son.” 

Olivia’s pregnancy continues blissfully and one-day, while working, her water breaks and she is rushed to the hospital where she gives birth to twins; a boy and a girl. Right away the audience notices that the twins don’t look like brother and sister. 

Later, while a tired Olivia works on her baby book, she notices that baby Sam, her little boy, doesn’t share either her or Brian’s blood type. 

At the fertility clinic, Dr. Nori, and presumably his lawyer are sitting with an angry Crawford couple. It’s here we find out that there was an error at implantation and that their son is not genetically theirs, but the family he belongs to is waiting to meet them. As Olivia and Brian storm out, unwilling to cooperate or meet this other family, they run into Anna and Gabe. The lightbulb goes on. Of course, Sam was Anna and Gabe’s embryo. 

The distressing battle over little Sam begins, both women screaming that they are Sam’s mother. Oliva carried Sam for 9 months, along with her daughter, and has been lovingly nurturing Sam for four months of his life. Meanwhile, the Ramirez family, still mourning the loss of their baby, claims a genetic tie to this little boy they didn’t know existed. He is their new hope, but will he go home with his intended parents? 

Court proceedings commence, and both sides try to make compelling arguments as to who Sam belongs to. The Crawford’s lawyer makes the argument that biology doesn’t matter. After all, Gabe is not the biological father to Sam, so Sam should stay with the Crawford family. 

During his deciding remarks, the judge reminds the two families, that in cases like this, there are no winners. The judge decides to reunite Sam with the Ramirez family and court-appointed visitation with the family he’s known since birth is not granted. 

The film goes on too quickly rectify any hurt feelings between the two families and offers viewers the unlikely fairy tale that it all works out in the end. The film ends with the two families celebrating the children’s first birthday together. Olivia is noticeably pregnant and everyone is all smiles. 

A film that so wonderfully captures the struggles of infertility fails at the end. The film, like #BigFertility, thrives off the belief in a happy ending. Do you remember the congratulations wall where Anna and Olivia first met? A wall full of happy endings- reminding couples that it could be them? This is a false promise; there are financial, emotional, relational, and physical costs when going to be with #BigFertility. Not all stories end well.

The film also fails to hold #BigFertility responsible for the mess they have created; profiting off of infertility and heartbreak, all while making promises they can’t keep. There is a very weak attempt by the filmmakers to place a small burden on the fertility industry, by declaring “IVF is still not federally regulated” at the end of the film before the credits roll. At this point, it’s too late. 

Earlier in the film, the Ramirez lawyer reminds the couple that she wishes she could tell them that this won’t happen again and that there is no federal oversight or industry standard. She concludes with “it’s a real problem.” A real problem indeed, but not a problem that can be solved with oversight or standards. These types of “mistakes” do happen and are happening. Here are a few real-life examples: Daphna and Alexander Cardinale, Anni and Ashot Manukyan, Jessica Allen, Kimberly, Deborah and Robert Rogers

Barry Stevens, a real-life donor-conceived person, accurately reminds us in our film, Anonymous Father’s Day, there is a need for biological connection.  Babies are not sent home randomly from hospitals to just any parents, but with their biological parents. Can you imagine if you had a baby and before discharge the nurse handed you a different baby from the nursery and stated, “our policy is to send everyone home with a baby, not necessarily with your baby!”

I mentioned earlier that the film happily ends and Olivia is visibly pregnant. If you back up a few scenes, after Sam is rehomed to the Ramirez house, Brian excitedly tells Olivia he has taken a new job with “comprehensive health insurance” (code for paid-for IVF). They continue to play the game. They bet their money and took their chances, but at what real cost?

Author Profile

Kallie Fell, Executive Director
Kallie Fell, Executive Director
Kallie Fell, MS, BSN, RN, started her professional career as a scientist in the Department of Obstetrics and Gynecology at Vanderbilt University Medical Center utilizing a Master of Science degree in Animal Sciences with an emphasis on Reproductive Physiology and Molecular Biology from Purdue University. While assisting in the investigation of endometriosis and pre-term birth, Kallie simultaneously pursued a degree in nursing with hopes of working with women as a perinatal nurse. After meeting Jennifer at a conference, Kallie became interested in the work of the Center for Bioethics and Culture and started volunteering with the organization. It is obvious that Kallie is passionate about women’s health. She continues to work, as she has for the past 6 years, as a perinatal nurse and has worked with the CBC since 2018, first as a volunteer writer, then as our staff Research Associate, and now as the Executive Director. In 2021, Kallie co-directed the CBC’s newest documentary, Trans Mission: What’s the Rush to Reassign Gender? Kallie also hosts the popular podcast Venus Rising and is the Program Director for the Paul Ramsey Institute.