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The New York Times has an article about surrogacy in today's health section, pegged to Sarah Jessica Parker and Matthew Broderick's use of a surrogate to have their just-born twins, Marion and Tabitha. Of course this does not eclipse the most famous Times piece about surrogacy—Alex Kuczynski's deliciously self-absorbed tale from last year of using a surrogate, "Her Body, My Baby." But both pieces have in common that they focus on positive tales of surrogacy.
The new piece glosses gently over the negatives ("Surrogate pregnancies don’t always blossom into lasting friendships, of course, and many people consider the process repugnant") but doesn't really talk to anyone who actually had a negative experience with surrogacy. I fear that the women who become surrogates—who are often less educated than the women paying for the womb space—and have bad experiences are not being given enough of a voice. This is something that is so physically and emotionally complicated, I imagine that for these "gestational vessels" things are not always sunshine and lollies and warm altruistic feelings.
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Jess, I don’t quite agree that the New York Times article you mention makes surrogacy out to be all sunshine and rainbows. What I’m reading is an articulation of the narrow conditions under which the modal New York Times reader will find surrogacy culturally acceptable. We’re reassured that “virtually every” woman who opts for surrogacy can’t have her own children, just as we’re reassured, multiple times, that surrogates don’t need or want the money they’re receiving. “People don’t become gestational carriers as a way of making money,” a lawyer explains. “Rather, their motives are altruistic.”
I’ve no doubt that this is what people want to hear, but what an oddly binary way of considering the motivation to express and nurture another person’s genetic information—money or altruism, transaction or gift. Human beings are more complex than this. Ask a man why he sells his genetic legacy to the local sperm bank, and he’s likely to give you more than one reason—a bit of money, the chance to help someone, the idea that his code might live on. But whether selling eggs or womb space, women seem to be faced with this stark division of motivational labor: Are you doing it for the cash (in which case you’re being exploited) or out of pure, unadulterated kindness (in which case you’re eccentric)?
An article that questioned rather than pandered to these social anxieties would be a great read. Why is it that we must be assured that a woman seeking a surrogate is infertile rather than merely disinclined to undergo the pain of childbirth? (And why is it then OK to search for a surrogate rather, than, say, adopt?) And who are we to demand that any woman who chooses to help be motivated by compassion alone?
Photograph of a pregnant woman by Digital Vision/Getty Images.
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Kerry, you’re right that surrogates need not be motivated by compassion alone. That’s because being a surrogate is a tough job. Never mind the social stigma they face explaining to their families and neighbors why they’re carrying someone else’s kids.
Surrogates often have to deal with multiple births, Caesarian sections and mandatory bed rest. One Arizona surrogate even carried quintuplets for one couple.
Many standard contracts require that a surrogate undergo six inseminations or three rounds of in-vitro fertilization. And she may not receive full payment unless one of these efforts results in a pregnancy. Before she even gets the job, she may have to submit to extensive psychological, drug and medical screening—while being at the mercy of notoriously sketchy agencies or inexperienced couples who try to broker contracts on their own. Even though she can earn up to $20,000, the fee may not cover unexpected expenses, for everything from maternity clothes to time off work due to pregnancy complications.
And while many surrogates say they love being pregnant, they can’t escape the toll pregnancy takes on their bodies: stretch marks, heartburn, weight gain, insomnia and hemorrhoids. (Some surrogates even go out of their way to send their intendeds pictures of their growing bellies or offer to nurse the babies after they are born.) Many employers (called “intended parents”) are obviously grateful, giving the women titles such as “Our Angel” or “Special Auntie,” inviting them to visit—or, the biggest honor, asking them to carry a sibling.
But surrogates may be disappointed when their intendeds don’t appreciate the sacrifice, regard them as hired incubators, and want as little to do with them as possible—perhaps out of fear that the women will form an emotional attachment to the children they're carrying. Surrogate message boards, such as those on the site Surromomsonline, are full of tales of alleged poor treatment by intended parents, who literally take the babies and run. One particular complaint: Not being allowed to hold the baby you carried and delivered. One surrogate wrote that the experience was so heartbreaking she’d never do it again. Then there are the frequent squabbles over medical coverage, lifestyle, or birthing protocol. Did the surrogate agree to a natural delivery? Go to pre-natal yoga? Eat enough organic produce?
A surrogate needs a lot more than compassion to be successful in this business. She needs resilience, dedication and, if she is financially compensated, the up-front understanding that she will earn every cent.
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Jessica, Kerry, and Sarah, your posts have me curious about the price of parenthood in surrogate situations, for both “intended parents” and surrogates. I crunched some numbers using the $20,000 payment that you mentioned, Sarah, and was shocked to realize that a surrogate making that much for a full-term pregnancy would earn less than half the federal minimum wage. When you consider that a pregnant woman is pregnant all day, every day, for nine months, $20,000 amounts to about $3 an hour.
This is obviously a highly unscientific calculation. You can be pregnant and continue to work (although you can also be pregnant and miss work because you’re at the doctor, or throwing up, or asleep). So help me out, DoubleXers who have had kids: At what point in a pregnancy does the forthcoming bundle of joy really start interfering with your life? How many “billable hours” could a pregnant woman expect to rack up? And is there any way to figure out just compensation for an endeavor as complicated as carrying someone else’s child?
Photograph of a pregnant woman by David DeLossy/Getty Images.
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In response to Meredith's request to the mothers among us to tote up the number of "billable hours" in a pregnancy: This sum seems inherently incalculable, not only because it would differ wildly and unforeseeably from person to person and pregnancy to pregnancy, but because the normal model of pay for work just doesn't apply to bearing a child for someone else in exchange for money. A closer model might be civil compensation, such as if someone were hurt in an accident and a jury had to calculate how much her comfort, freedom of movement, quality of life, etc. were affected in order to reach a settlement.
Also, of course, a surrogate is incurring risks to her own health, agreeing to go through the pain and potential injury of labor, so there are things you're being compensated for over and above an hourly wage. I agree that $20,000 seems low (especially if you figure in that pregnancy doesn't really last nine months, but closer to 10, and that there's a significant recovery period after giving birth). But dividing the total sum by the number of hours you're pregnant (or the number of those hours that are experienced as inconvenient) doesn't really get at the problem.
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Jessica, Kerry, Sarah and Meredith. I have a confession to make: I'm 34, separated, and because I would like to have a kid one day but not right now, I've caught myself indulging in that intimate calculus unique to the 30-something woman: What if I try to get pregnant at 36 and a year or so passes and nothing happens? What if I only feel ready at 40 but my womb has expired? Although I don't want to set a deadline ... what might that deadline be? This "womb calculus" flares up when I am reminded of my fertile powers: around the time of my period; when I get a sign I am ovulating (sharp sudden cramp, or spotting—I am not on the pill); when a friend tells me she is pregnant.
On the one hand, it seems like a good idea to include surrogacy in my calculus. Worse comes to worse I could always freeze some eggs or extract them and hire a surrogate. Paying another woman to carry and grow my genetic material seems like a decent backup plan, should it come to that. I'm not morally opposed to it. But because surrogacy is prohibitively expensive—it costs a minimum of $75,000, but with legal fees and multiple attempts it's more like $200,000—it isn't something a middle-class potential mother can consider.
What I ultimately take away from the Times article, and all surrogacy coverage for that matter, is that middle class women are the "Handmaids," to borrow Margaret Atwood's term, but not the patrons of surrogacy. I guess there is always reproductive tourism to India, where a poorer, younger or more fertile woman will opt to grow genetic material at a severely discounted price (about $7,500), a small but significant fortune over there.
How do you guys feel about that, and, if you have reasons to be concerned about fertility now or in the near future, does surrogacy enter into your calculus, or do you think about adoption?
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Kerry asks, "Why is it OK to search for a surrogate mother rather than, say, adopt?" She's asking it in the context of the way we think about surrogacy, but for a parent, or an "intended parent," those are two really separate questions. Searching for a surrogate is an extension of the search for a solution for infertility—to parent the biological child of at least one partner. To adopt is to relinquish that desire, or, at least to conclude that you can put it aside.
"Why don't you just adopt?" is not a fair question. Most adoption agencies are determined that before you start down the long and uncertain road to adoption, you've "resolved" your long and uncertain quest to produce a biological child. It's somewhat inherent in the nature of adoption post infertility that adoption is a second choice, but adopting—and I speak from experience—is difficult enough without lingering doubts about whether, if you'd just tried one more thing, you could have a child with your blood in her veins.
Photograph by George Doyle/Getty Images.
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This week's fascinating conversation about surrogacy has got me wondering: Where does race fit into this already complicated picture? It has to, somehow—doesn't it?
Way back in the early aughts, when I was a fresh-faced college graduate, an urban legend began circulating among my crowd: A girl had been approached by a friend who asked if she would consider donating some of her eggs, so that he and his partner could have a baby. In exchange, he'd buy her a classic six on the Upper West Side. She declined.
I know! I know! But that's the way the story gets told. And frankly, I can't say I would have done differently. Even then, when my real estate lust was nowhere near the fever pitch it's at now, I knew that a big Manhattan apartment represented some pretty sweet compensation. But I always hesitated, and usually decided that I would have turned it down, too—and it always came down to race.
I'm biracial, which means that, perhaps more than most people, I'm constantly aware of the fact that I'm the product of two very specific people's very specific genetic make-ups. If you see me alone with my light-skinned, Chinese mother, we don't make much sense as a unit—until my Indian father enters the picture. Obviously, I don't think genes determine "family"; I know too many blended families, and families with adopted kids, to believe that. But given my personal history, the thought of a kid out there who looked half like me, but wasn't mine, made me uneasy in a very weird, very primal way.
Double Xers who have donated eggs or are members of the surrogacy community—care to share your thoughts? How often does race come into play in these kinds of transactions?
Photograph by George Doyle/Getty Images.
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An odd, not-quite-paradoxical consensus is forming in our discussion over surrogacy. There is the assumption that the sticker price of $20,000 is surprisingly low, along with the assumption that surrogacy is so astronomically expensive that it’s only available to rich ladies with billionaire husbands and baby nurses. Both might well be true, but I’m more convinced by the former than the latter. Is surrogacy really out of the reach of your average middle-class dual-income couple that can, at any rate, afford to raise a kid for 18 years? Traditional pregnancies are by no means cost-free, so the cost of hiring a surrogate over becoming pregnant is lower than it first appears.
The real question is why, in the age of the active, mercury-avoiding, one-glass-of-Merlot-will-destroy-your-baby-forever pregnancy, wealthy women are not bidding up the price for equally vigilant super-surrogates. One could imagine surrogates charging more for promising to eat only organic, or regularly attending prenatal yoga, or blasting Mozart into their respective uteri. The market for eggs is highly differentiated; as we know, women with more education, better looks, and the right ethnicity can claim between $3,000 and something like $100,000. (The median is probably lower than $10,000.)
When I sold my eggs in order to write this article on the subject for Reason Magazine, the demands on ova-quality were so specific that I had to send the couple an official copy of my GRE scores in order to get them to upgrade my hotel room during the week of the donation. By contrast, wombs look something like a commodity, with standard prices that increase slightly with experience. (I hope the surrogate moms in comments will correct me if I’m wrong.) Does it make sense for parents to focus so intensely on the quality of genetic material and treat the gestational environment as relatively fixed? Doesn’t that run counter to every panicky, paranoid pregnancy article you’ve ever read?
Photograph by Digital Vision/Getty Images.
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Thanks to Kerry for linking to her compelling personal story of the ovum marketplace. As for the question of market forces bearing on gestational surrogacy sticker price, I have two words to illustrate the right circumstance for the right seller: Debby Rowe. $4 million payoffs not withstanding, however, I do sympathize with Kerry’s and Sarah’s observations on the hazy protection surrogacy contracts offer to potentially exploited owners of host wombs.
I remember well the first major legal case exploring rights of the surrogate involved a contract gone awry (in the opposite way of the urban legendary wealthy gay man of Nina’s classic six, were he to renege on the apartment after the baby is born). In that famous 1986 case, the surrogate, Mary Beth Whitehead, made a deal with William Stern to donate her egg and rent her womb to create a child with Stern, by artificial insemination, to be raised by Stern and his wife. Whitehead changed her mind when the little girl was born but what persuaded the New Jersey judge who eventually decided for the Sterns was the contract itself. A deal’s a deal was the thinking. When Whitehead appealed, the contract was disallowed as against public policy. Whitehead was allowed visiting privileges, but the Sterns nevertheless retained custody “in the best interests of the child” (referred to as “Baby M” in all the papers). When Baby M turned 18, she terminated her genetic mother’s rights and was adopted by Stern’s wife. Big surprise, she stuck with the parents who raised her. In 2007, with a bit of a swipe at poor Mary Beth, the former Baby M, Melissa Stern, a student at George Washington University commented to the New Jersey Monthly, "I'm very happy I ended up with them. I love them, they're my best friends in the whole world, and that's all I have to say about it."
I always felt Mary Beth had been a bit out gunned although, I have to admit, I felt less sorry for her after she wrote a book about her case and then sold it for a TV movie.
Photograph by Stockbyte/Getty Images.
