Articlebodies - families - healthcare

The morality of contract surrogacy.
United States surrogates’ perspectives

foto Flickr/Michelle Tribe

For a fuller comparative understanding of surrogacy, it is beneficial to contemplate U.S. surrogates’ point of view. Their views, although consequential, are often ignored by both opponents and proponents of this practice

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As debates about surrogacy have been proliferating in many European countries, where surrogacy is banned, opponents and proponents weigh practical and ethical issues as they have done also in the U.S. where surrogacy has been legal. For a fuller comparative understanding of these issues, it is beneficial to contemplate U.S. surrogates’ point of view. Their views, although consequential, are often ignored by both opponents and proponents of surrogacy. My decade-long ethnographic research of www.surromomsonline.com (SMO), the largest moderated U.S. surrogacy information and support website, provides insights into the issues its members care about the most. Discussions illuminate how surrogates understand financial, contractual, and relationship matters. SMO threads also reveal surrogates’ definitions of moral commitments not only to “deserving couples” – typically middle-class, stable, well-educated, straight or gay “loving couples” who may have experienced failures and losses in their pursuit of a child – but also to the baby, who, as some say, “entrusted his life” in the surrogate when “choosing to take hold and grow.”

The morality surrogates embrace is rooted in their understanding that contract surrogacy –the contractual relationship in which a woman carries and gives birth to a child for “intended parents” (IPs) and gets financially compensated – is a “journey of love” that involves reciprocal giving. When surrogates emphasize emotional involvement, they are highlighting the moral, private, and unique nature of the relationship, elevating it above the contractual arrangement.  Surrogates nurture the fetus as the intended parents’ “unborn child” because of their promise to the couple they have bonded with or hope to bond with. Numerous threads discuss what surrogates most often call “chemistry:” “Don't ya love it when you just "click" with your IPs?” “OMG YES! It is like the best feeling ever. It feels like we have known each other for years.” When surrogates describe “clicking,” and their IPs as the “right couple,” they narratively situate the interaction in the intimate sphere, where baby-making belongs. They also assert the private and non-negotiable aspect of individual choice: “I don’t care what others think as long as I know in my heart that I am doing what I was meant to do.”

Surrogates increasingly think that what they are also meant to do is to protect the “most vulnerable, the unborn”. Surrogates’ heated debates about selective reduction (i.e. reducing the number of fetuses in a multifetal pregnancy via an abortion procedure) and termination of pregnancy in cases of non-life-threatening abnormalities, such as Down syndrome, are good indications of their views on moral responsibility. Many surrogates say they are “pro-choice” but would never terminate a pregnancy; choice means women should be able to do what they want with their body, be it surrogacy or egg donation. Many others are proudly “pro-life”. Yet all surrogates acknowledge the problem of third-party reproduction: gestation and parenting are done by different people who have different perspectives of and involvement in the process. Increasingly, surrogates have defined the solution in a way that respects these differences, insisting that if the parties do not agree, they should not embark on a surrogacy journey together. SMO discussions reiterate that surrogates and IPs should be “on the same page” before signing the contract about how many embryos to transfer (i.e. the procedure whereby fertilized ova are transferred to the gestational surrogate’s uterus) and under what conditions to terminate a pregnancy. The journey is official when the contract is signed, and contracts should reflect the thoughtful agreement on all the sensitive issues.  “Shame on all of you if your contract doesn't cover [all] this,” was a concise response to a post about termination-related disagreement.

The majority of women on SMO hold that the surrogate’s responsibility begins before conception because “life begins at conception;” conceptions should be planned so as to provide the best conditions for the “unborn babies.” The older SMO consensus, “transfer as many as you are willing to carry,” has given way to “transfer as many as your IPs are willing to raise,” often coupled with an emphasis on responsibility to “the unborn babies:” “think of the health of the babies.” Surrogates who “transfer whole soccer teams” (i.e. several embryos) are criticized as uninformed and uneducated.

Discussions testify to surrogates’ efforts to balance the emotional understanding of surrogacy with insistence on well-informed and prudent behavior. Women embrace the morality of both empathy and rationality. But because there is no language to precisely convey the coexistence of warm empathy and reliable professionalism, women often alternate between the languages of love and work. “Some people may not agree with the term ‘job,’ because as surrogates we don't want to be thought of as employees,” wrote Millie, “however,…it is our ‘job’ to carry the child/ren, follow doctors’ orders, and abide by our contract.” Becca did indeed disagree:  “Surrogacy is definitely not a job. I don't think anyone could pay me enough to carry their baby if I really didn't have the heart to do it…You know that in your heart you really don't think surrogacy is a job. I hope you find a great couple…that really will love you.” Becca pointed to a key difference: surrogacy, unlike employment, is not simply a market transaction. According to SMO consensus, surrogates don’t sell reproductive services; it takes more than money to make a surrogate. Surrogates often write about the interrelated desires to “create happy families” and “make a difference.” Families in which stable, “deserving couples” plan, and overcome obstacles, to have children are generally understood as the building blocks of a better society.

Surrogates define surrogacy as reciprocity rather than employment:

It's a mutual project with the parties having different rewards in the end, but a friendship that hopefully will last…we discuss, we agree, or not agree…even though I would go to great lengths to do things that are agreeable to my IFs [intended fathers]. Therefore, not an employee, but a partner.

Surrogacy is understood as a partnership of shared responsibility and reciprocal giving. “I help them and they help me and my family.” Surrogates embrace the notion that surrogacy is “giving the gift of life.” Gifts signify ongoing relationships and symbolize the opposite of pure utility. “We both gave gifts…in surrogacy, it’s not a tit for a tat…we don’t keep score,” explained Naomi. Gift exchange and the bonds it fosters represent moral obligations by moral actors.

The “gift of life” is considered the “ultimate gift;” this rendering carries distinctive Christian associations of sacrifice. “How anyone could think I would or could carry someone else's children, keeping them safe and sound until their birth, and be doing it strictly as "a business transaction," truly doesn't understand what it takes to give of yourself.”  As countless discussions indicate, “the gift of life” is not the baby; all surrogates claim that the baby was never theirs to give because it belongs to the couple who wanted it. In a somewhat dramatic vein, Sandra defined the gift she and other surrogates give: “I am offering the risk of my LIFE for people to have a child. That is the gift I offer.” The gift is surrogates’ willingness to give of themselves and endure the “pain and suffering” and responsibilities of pregnancy and birth. Surrogates affirm that SMO is a community of intelligent, informed, and generous givers rather than professional service providers.

Surrogates expect to see their IPs’ happiness in return for the gift of parenthood. “I wanted to see the joy through their eyes. I wanted to feel the excitement through their smiles,” is a typical sentiment. Most surrogates wish for some continued contact, such as cards, emails, photographs; they are satisfied when IPs “stay in touch” in some way. However, not all IPs do so. Some misconstrue surrogates’ expectations of an ongoing friendship, fearing potential future demands. Surrogates, who invested in a reciprocal relationship and took on complex responsibilities, are deeply hurt when IPs cut ties or redefine surrogacy as a terminable business transaction in which they had “paid in full.”

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