Surrogacy

A Human Rights Violation

Renate Klein

• Publisher: Spinifex Press
• Year: 2017
• Print ISBN:
  9781925581034
• eBook ISBN:
  9781925581065
• Edition: 1
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

A critical examination of surrogacy as a violation of women's human rights. This book exposes the exploitative practices of the surrogacy industry and its impact on women and children worldwide.

Renate Klein dissects the short- and long-term harms inflicted on surrogate mothers, egg providers, and children born through these arrangements. She argues that surrogacy, whether altruistic or commercial, can never be ethical, and calls for resistance to this dehumanizing trade. This book is for feminists, human rights activists, and anyone concerned about reproductive justice.

• Understand the ethical implications of surrogacy.
• Examine the exploitation of women in reproductive technologies.
• Discover the forms of resistance to stop surrogacy now.

From reproductive technologies to the commodification of human life, this book challenges the prevailing narratives and offers a path towards a more just and equitable future. Join the fight to Stop Surrogacy Now.

Chapter 1

What is surrogacy?

Pared down to cold hard facts, surrogacy is the commissioning/buying/renting of a woman into whose womb an embryo is inserted and who thus becomes a ‘breeder’ for a third party.

In a ‘traditional’ surrogacy, the ‘surrogate’ is inseminated with the sperm from the husband/partner of the commissioning heterosexual couple. The sperm fuses with her own egg cell(s) and creates an embryo which then, if successful, implants itself in her womb.

If the partner/wife is infertile, an egg ‘donor’ will provide egg cells that are fertilised in the laboratory with the husband’s/partner’s sperm. This is called ‘gestational surrogacy’. In the case of two gay men who can only ever provide sperm, an egg donor is always necessary.

‘Traditional’ surrogacy is rarely done any more because, with this method, the birth mother’s genes form half of the child’s genetic heritage, apparently making her more prone to resist relinquishing her baby.

But also, if ‘gestational’ surrogacy which always needs in vitrofertilisation (IVF) is used, this is a much better source of income for fertility clinics as they get new clients: the egg ‘donors’ and the so-called surrogate mothers. Moreover, the embryo created from the donor eggs and buyer(s)’ sperm can be subjected to prenatal genetic diagnosis (PGD) before it is inserted in the rented woman’s body. In this way, more money can be made from multiple screening tests for abnormalities and sex selection (where allowed) which is nothing short of eugenics in action. Because IVF pregnancies continue to have a high failure rate – still close to 80% according to UK IVF Pioneer Lord Winston⁵ – surplus embryos can be frozen and more surrogacy cycles can be sold.

The parties involved in these transactions include a fertility clinic with IVF doctors, a surrogacy law firm (in the US often a surrogacy broker), a surrogacy agency with a register of available ‘surrogates’, and an egg ‘donor’ agency with suitable young and good looking women on their website. And there are third-party surrogacy facilitators who oversee transnational egg and embryo transfers, and, in some cases, counsellors. New business opportunities are aplenty with enterprises such as ‘Eggspecting’, ‘Complete Surrogacy Solutions’, ‘Surrogacy Beyond Borders’, ‘Family Inceptions International’ and many more. Importantly also, there are pro-surrogacy advocacy groups such as ‘Families Through Surrogacy’ in Australia who organise yearly (inter-) national conferences, offer advice on transnational surrogacy, and ‘altruistic’ surrogacy at home, put prospective parents in touch with egg ‘donors’ and women willing to act as ‘surrogates’. ‘Grooming’ is another term to describe these activities.

Then there is the so-called surrogate, a misnomer as this is a woman who will grow the baby for nine months from her own body and give birth to it. In commercial surrogacy, this birth mother is always from a lower socio-economic class and often also from a different ‘lower-ranked’ ethnicity than the commissioning couple. Race and class issues abound: we are yet to see a (white-skinned) CEO who carries a baby for her (brown-skinned) cleaner. The surrogacy/egg ‘donation’ transactions are between well-off people and poor(er) women. Going to countries such as India, Cambodia or Ukraine because of much lower prices means that the ‘surrogates’ are inevitably poor women with little education, often kept in prison-like camps for the duration of their pregnancy and often ‘pimped’ by their husbands who have come to see surrogacy as a lucrative income-generating scheme (Sangari, 2015, p. 120).

In ‘altruistic’ surrogacy in which no money is supposed to change hands (except quite considerable payments for ‘expenses’), it is often fertile family members such as sisters, cousins or aunts who are so moved by the plight of their infertile relatives – or gay family members – that they offer their bodies (and souls) for this self-sacrificing ‘service’. Changing their mind about the growing baby is next to impossible as that would involve being ostracised from their families. When it is non-family members who become altruistic ‘surrogates’, they dissociate from the child growing in their bodies: “not my baby but my passenger, he was just sitting on my bus for a while.”⁶

After nine months, the resulting baby is removed, usually by Caesarean section, and handed over to the ‘commissioning parents’ who pay the final instalment for their product(s), often twins. Child buying or child trafficking is a suitable term for such transactions. The connection between birth mother and the new parents is either non-existent from the day of birth, or, mostly, short-lived. The child(ren) only rarely will have a connection to the woman who grew them from her own flesh, bones and blood and retains some of her baby’s cells for decades (Dawe, Tan, and Xiao, 2007).

The child buyers put their names on the birth certificate⁷ and name themselves the baby’s ‘parents’, rationalising that it is the sperm donor’s genes who are in this child, hence it is his and has no connection to its birth mother. Strangely, in this tale of alleged gene superiority that bestows child ownership, the genes of the egg provider, if there was one, are routinely ‘forgotten’ – another woman who is crucial to the process of gestation – but does not matter. That the children might want to know at some point who gave them half of their genes, appears to be of no concern.

Naturally, this version of surrogacy has a fairy tale ending: The commissioning parents are besotted with their child(ren) and love them to bits. They dress them in pink or blue designer clothes and enrol them in programs for gifted pre-schoolers. The children turn out super intelligent and well behaved. They neither ask about, nor miss, the two women who contributed to their existence – the birth mother and the woman who provided the egg cell – and grow into happy, well adjusted, high achieving, teenagers and adults.

These ‘bare facts’ of surrogacy of course leave out the traumas that can arise during the ‘manufacturing process’: the quality of the sperm or the donor’s egg cells are inferior; the embryo transfer fails; the developing embryo is ‘imperfect’ and needs to be aborted; the ‘surrogate’ refuses an abortion and a ‘defect’ baby is born (as happened in the Baby Gammy case); the ‘surrogate’ mother falls ill, miscarries or dies; the commissioning couple divorces, or one partner dies; the ‘surrogate’ mother changes her mind during pregnancy and wants to keep the child. Or the couple did not do their homework and are now stranded in a far away country with ‘their’ baby for whom their home country is not issuing a visa – as has happened to citizens from Switzerland, France, Germany and Norway.⁸

Of course, those who support surrogacy and believe that someone’s individualistic desire for a child equals the need for – and gives them the right to – a child, whatever the price, and whoever gets left behind on this journey, will vehemently disagree with my description of surrogacy so far. For them, surrogacy is a precious act of wonder and kindness.

Similarly, those in the liberal harms-reduction camp will find my words harsh: surely these practices can be regulated and exploitation can be minimised. They will accuse me of unkindness: I must be a heartless person who has no understanding of the profound grief and despair infertility can cause, or in the case of two men, their inability to give birth to a child themselves.

To them I reply that as a matter of fact I do understand only too well. My research into Australian women’s experiences with IVF in the 1980s (Klein 1989a) as well as editing major feminist anthologies on new reproductive technologies (Arditti, Duelli Klein and Minden, 1984; Klein 1989b) led me to experience many instances in my interviews with women undergoing IVF where their desperation about wanting a child was heartbreaking. Because IVF was (and is) traumatic and the failure rates were (and are) enormous (then 90%, today 70% to 80% depending on age and honest reporting by the clinics), for many women it was still possible to stop the brutal IVF journey and find other ways of having children in their lives. They had the support of much of their community who helped them through this sad period in their lives. Alas this changed in the 21st century: with egg ‘donation’ and surrogacy the new ‘products’ on the IVF clinics’ supermarket shelves, and regularly featured glowingly in women’s magazines when yet another celebrity had a ‘surrogate’ child. Women who are in their 40s and have gone through IVF ten to fifteen times (and are deep in financial debt already) are not allowed to stop. Another woman will now ‘gift’ them an egg cell, and a second woman will carry ‘her’ baby (and the fee paying – as well as the anxiety – will continue).

Their ultimate ‘uselessness’ as a ‘proper’ woman confirmed by their family as well as society at large, they must now welcome this arrangement, be thankful to the IVF clinic for their miracle work – and hide their pain. And of course then be the perfect and joyful mother to another woman’s child – if there is one. Or repeat the process until a baby is born.

In addition to accusing any critic of surrogacy of callousness, without fail there is a strident chorus of pro-surrogacy voices invoking ‘choice’, ‘consent’ and ‘a woman’s right to her body’, thus invariably accusing critics of presenting women as helpless victims: ‘Surrogates’ consent to what they do. Egg ‘donors’ know which procedures await them (and are handsomely paid). These women do it because they want to be life-givers, and their customers love them for it – calling them heroes and angels – and profoundly thanking them for their gift. And, in the rare cases when dodgy players might be involved, regulation is the best way to ensure problems are prevented before they occur (see Chapter 5 for details on regulation).

I disagree with these assessments. In the next section, I will examine the harms suffered by the women involved in surrogacy, and briefly discuss questions of ‘choice’, ‘consent’ and ‘self-determination’.

5 IVF ‘pioneers’ Robert Winston and Robert Edwards now warn that the hormonal drugs used in ‘assisted reproduction’ are producing ‘… chromosomal damage in at least half, if not 70%, of eggs (Winston quoted in Marsh, 2006). This is an astounding admission after decades of defending the use of an ever-increasing range of fertility drugs (and denouncing radical feminist research that found such evidence already in the 1980s, e.g. Klein/Rowland, 1988). During his 2007 visit to Australia, Robert Winston also stated on the 7:30 Report on ABC Television (12 July 2007) that the success rate from IVF was 15 to 20%: at long last a realistic assessment that, together with the worrying news about health problems in children born from IVF, hopefully will make people think twice before embarking on IVF or, indeed, surrogacy.

6 A statement made by Australian ‘altruistic’ surrogate Renee Gollard in 2015 on a panel discussion after the play e-Baby by Jane Cafarella on 8 March, 2015 in Melbourne. See also <http://www.abc.net.au/radionational/programs/drawingroom/e-baby/6273604>

7 This may take place immediately after birth, or, as in the state of Victoria in Australia, the commissioning parents have to first apply through the courts for a substitute parentage order. See <https://www.bdm.vic.gov.au/births/donor-conceived-births/surrogacy> and <https://www.varta.org.au/information-support/surrogacy/commissioning-parents/surrogacy-australia/legal-side-surrogacy>

8 <http://www.swissinfo.ch/eng/surrogate-law_a-child-is-not-a-commodity--says-top-swiss-court/41575816>

Chapter 2

Short- and long-term harms of surrogacy

In surrogacy, three women are harmed: the ‘surrogate’ mother, the egg provider and the female partner in a heterosexual commissioning couple.⁹

The part of the process to achieve a pregnancy is the most invasive in terms of daily drug injections necessary to ‘ready’ the womb and the endocrine system of the ‘surrogate’ mother for the embryo insertion. For the egg provider (who is a third party, or the female partner), this phase involves putting her first into chemical menopause and then dousing her with fertility drugs for superovulation: the production of dozens of good healthy egg cells that can be extracted and then fertilised by the buyer’s sperm to create embryos.

Daily painful injections, headaches, nausea, cramping, becoming bloated, feeling sick, dizzy and emotional and putting on weight are just some of the unavoidable adverse effects. Ovarian hyperstimulation syndrome (OHSS) can be life threatening and has resulted in serious injury such as pulmonary complications (when the lungs fill with fluid which needs to be extracted), stroke, and death. Equally worrying are the largely unknown long-term adverse effects of the drugs. Many of them, such as Lupron (leuprolide acetate), are used ‘off-label’, which means that they were never registered for use in IVF/egg ‘donation’ and as a consequence, no research was conducted to find out about any short- or long-term adverse effects when used in women. (In the USA the FDA registered Lupron as treatment for prostate cancer.¹⁰) It is a breathtaking and world-wide scandal that no country has ever mandated its IVF clinics to undertake short- and long-term follow-up of the health of women undergoing IVF, and compare ill health with the drugs that were used in individual treatments.

This is good news for pharmaceutical companies because such are the variations in drugs used in IVF since the early 1980s that, even if comprehensive studies were finally retrospectively undertaken, it will be impossible to link certain long-term adverse effects such as ovarian, uterine and breast cancer with specific drugs. At best what might be established is that women who underwent IVF end up with higher rates of these cancers, but not which drug(s) caused them. Or else it is the women themselves who are blamed for the higher cancer rates.

This is what happened in October 2015 when a r...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• Acknowledgements
• Introduction
• Chapter 1: What is surrogacy?
• Chapter 2: Short- and long-term harms of surrogacy
• Chapter 3: What of the children born from surrogacy?
• Chapter 4: Can surrogacy be ethical?
• Chapter 5: Is regulation the answer?
• Chapter 6: Resistance – past and present
• Conclusion: Stop surrogacy now
• Bibliography