Gilead rose to power in large part because no one was making babies any more. Even though baby-making is a two-person process, society has shifted all the blame for infertility onto women:
There is no such thing as a sterile man anymore, not officially. There are only women who are fruitful and women who are barren, that's the law. (11.18)
Gilead's solution to this problem is to parcel out the few fertile women left to powerful men and their wives. In order to make this seem legitimate and proper, the government has made people follow Ceremonies and read the Bible before engaging in a very particular kind of sex. Presumably, in order to make it seem like a baby born to a Handmaid will really belong to the wife, the man and the Handmaid are required to have businesslike, non-erotic sex with the wife present. The Handmaid lies between the wife's legs while the man has sex with the Handmaid. This arrangement is echoed in childbirth, should any household be so lucky as to get to that point: the wife sits with her legs around the Handmaid as she endeavors to give birth.
Despite all these arrangements, nothing is working and not enough babies are being born. Everybody is secretly breaking the rules. We're constantly reminded of the lovelessness and absence of eroticism in this society, as well as the absence of choice and free will. (For more on fertility, see "Flowers" and "Eggs" in this section.)