Thursday 27 June 2013

A closer look at surrogacy

Is commercial surrogacy, or 'fertility tourism', necessarily exploitative?

In the 21st century, technology has helped us broaden the traditional boundaries we typically put around the notion of the family. One of the latest trends in reproduction is surrogacy, where a couple (or single person) who, for whatever reason, cannot have children, hire a woman who can to carry their offspring. Often, the childless couple is a wealthy, Western one that, driven by high prices and heavy restrictions in their home country, opts to travel to developing countries, where the costs are lower and the legal environment more welcoming. For this reason, this type of surrogacy is known as ‘outsourced pregnancy’ or ‘fertility tourism’, and it is a booming industry. In India especially, clinics have popped up all over the country and many impoverished women, knowing the pay they receive will be enough to totally change their circumstances, are all too happy to sign up to be surrogates.

Though there are certainly moral questions that have rightly been raised, the global surrogacy industry should be recognised for the overwhelmingly positive impact it has had on people all over the world. Not only does it bring the miracle of life; it injects much-needed cash into impoverished areas. Nevertheless, there are many who are opposed - Westerners especially. They make the comparison between this benign industry, where all involved participate freely, and Margaret Atwood’s Handmaid’s Tale, a dystopian reimagining of a society in which a women and their reproductive capabilities are controlled outright by men. The comparison is a terrible one, one which completely misunderstands what is really going on. Rather than oppressing women, surrogacy gives women opportunities they can choose to act on or not, and those who oppose it would rob participants of their right to self-determination.

Dissenters argue that surrogates in developing countries, many of whom are uneducated, cannot give their informed consent because they cannot understand what is really expected of them. This argument is pure condescension. Just because a person is uneducated does not mean they are incapable of rational thought. Most surrogacy clinics in India require that surrogates have already had multiple children of their own, ensuring they will be fully aware of the physical and emotional toll pregnancy will take. Furthermore, many surrogate mothers are anxious to be surrogates two or three times, suggesting that the experience can be as beneficial to surrogates as it is to the people who commission the child.

Another point of contention is the health risks involved in surrogacy. To be sure, this is one area that needs to be studied further, and potential surrogates need to be informed of the risks they are taking before they get involved. As far as we know now, though, the health risks are fairly low, and manageable; surrogates face only slightly greater risks than an average woman would normally face during pregnancy. Some surrogates react negatively to the fertility drugs used to increase the chances of successful fertilisation, and in rare instances, severe ovarian hyper-stimulation syndrome can occur. In general, however, surrogate mothers receive excellent healthcare, as it is in the clinic’s best interest to ensure the health of their surrogates.

There are, of course, instances where a woman’s health is negatively impacted by surrogacy, but these are the exception, not the rule. We should remember that there are health risks associated with many kinds of occupations, such as with mechanics or construction workers, but we do not argue that cars should not be fixed or homes not built because of the risk to the workers. Firemen and construction workers are adults who know the dangers and are capable of making their own decisions, as are surrogate mothers. The emphasis needs to be on ensuring that women are properly informed and taken care of, rather than condemning surrogacy altogether.

The most commonly used argument against fertility tourism, however, is that it is exploitative: it takes advantage of poverty-stricken women and pays them far less than a surrogate would usually be paid in a developed country, which is true. Though estimates vary, surrogacy in the West can cost tens of thousands of dollars more than in India, where, depending on which clinic you choose, the total fees could be as little as $12,000. Of this, the surrogate will usually receive around $6,000. The difference is how much that $6,000 is worth. In India, that is enough to buy a house, or start a business, or send one’s children to school. It can make an incredible impact on a woman’s life, breaking the cycle of poverty for her and her family.

Moreover, attempting to discredit surrogacy because of the money involved is simply unrealistic. By this line of reasoning, anyone who does anything for pay is being exploited. There are various unpleasant aspects to pregnancy, and human beings rarely do unpleasant things without being rewarded. Obviously few women would agree to be surrogates if they were not being paid, but payment does not delegitimate the practice.

What this all really comes down to is an inability to comprehend why surrogates behave in ways that contradict traditional ideas of motherhood and womanhood in general. In ‘Oh Baby Baby: The Problem of Surrogacy’, for instance, Matthew Tieu argues that there are certain unbreakable bonds which naturally develop between a mother and the unborn child she carries during pregnancy. Surrogate mothers, says Tieu, will inevitably face great psychological trauma when forced to give up the baby. Those who do not are simply repressing their true, deeply-seated feelings. This suggests that all women possess the same maternal instincts (and emotions they have no control over), and those that do not are unnatural, or somehow emotionally incomplete. In reality, there is little empirical evidence to prove that there is really a ‘special tie’ between birth mother and fetus, and even if there is, most clinics counsel surrogates to prepare them to give up the baby. They are not damaged, but they are not unnatural either.

Before I conclude, I would like to make one last point that I realise people are not homogenous, and their motives and experiences with surrogacy will of course vary. Not all people who seek surrogates do so because they are infertile; some might be motivated by a fear of pregnancy, or something else. Likewise, surely not all surrogates volunteer to be so out of an altruistic desire to provide for their families; it is entirely possible that they may simply want to buy a shiny new car. Whatever the motivation or rationalisation, though, it just doesn’t matter. Adult men and women have a right to make their own decisions and do what they want with their bodies, and until their actions do harm to another person, their moral status is really not our business.

All of this is not to say that those who oppose surrogacy are entirely wrong to be wary of the practice. For centuries, the weight of the world has been pressed down upon female bodies and their reproductive organs, and we should certainly be suspicious of anything that seems as though it may be taking advantage of women. But when we look closer at surrogacy and abandon our preconceived ideas of motherhood, we can see that it should be seen as a source of empowerment, not oppression, for women. Far from a come-to-life Handmaid’s Tale, surrogacy is a business where the providers, clients, and many of the entrepreneurs who run the industry are all women. As technology continues to revolutionise reproduction, we should not only accept but welcome the new opportunities that redefine motherhood and the family, and give us the power to control nature.


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