Surrogacy in Russia

An Ethnography of Reproductive Labour, Stratification and Migration

Christina Weis

• Publisher: Emerald Publishing Limited
• Year: 2021
• Print ISBN: 9781839828973
• eBook ISBN: 9781839828980
• Topic: Social Sciences
• Subtopic: Anthropology
• Index: Social Sciences

This timely and fascinating feminist ethnography is the first of its kind to focus on commercial surrogacy workers in Russia and from other countries of the former Soviet Union. Examining surrogacy workers' reproductive labour, and experiences of stratification and migration, the study presents innovative insights into current research on global surrogacy practices and travels for assisted reproduction. It links to wider fields of studies, such as ethnicity, feminism, women's and gender studies in the post-Soviet sphere.

Weis expertly brings together rigorous ethnographic research, feminist debates and anthropological theory to explore the attributed significance of origin, citizenship, race, ethnicity and religion, and the cultural framing and social organization of surrogacy as an economic exchange; thereby challenging and contributing to the discourse of surrogacy as a gift, a labour of love, a maternal sacrifice or work.

Tracing surrogacy workers' journeys for surrogacy work across Russia, Weis introduces geographic and geopolitical stratifications as two new lenses of stratified reproduction to analyse how surrogacy in Russia builds on and propels surrogacy workers' mobility and results in reproductive migrations.

Given the rapid global increase in the use of surrogacy and its increasingly internationalised nature, Weis's research has implications for surrogacy users, medical practitioners and regulators, as well as researchers concerned with (cross-border) surrogacy, reproductive stratifications and reproductive justice.

Shortlisted for the Foundation for the Sociology of Health and Illness Book Prize 2022

Chapter 1

Introduction: Surrogacy in Russia

I absolutely understood, from the beginning, that those are their children. That there is nothing of me. I was like a nanny. A good nanny during the time of the pregnancy. And so, these are completely their children. [Emphasis hers.]

(Daria, surrogacy worker (two pregnancies including one twin pregnancy), November 2014)

Surrogacy is commonly defined as an arrangement whereby a woman conceives in order to give birth to a child or children for another individual or couple to raise. However, we cannot talk about ‘surrogacy’ as a single category. In other words, ‘surrogacy’ does not exist, but surrogacies. ¹ A first distinction needs to be made between genetic and gestational surrogacy arrangements, and commercial and ‘altruistic’ forms of surrogacy. In a genetic surrogacy arrangement, also referred to as ‘traditional’ or ‘host’ surrogacy, the ‘surrogate mother’ provides her own eggs and is inseminated to conceive. It is impossible to trace the beginnings of genetic surrogacy. It has been practiced in various cultural contexts, with some ‘surrogate mothers’ voluntarily engaging in genetic surrogacy arrangements for altruistic or commercial reasons, while others were and continue to be forced to do so. In gestational surrogacy arrangements, the ‘surrogate mother’ does not provide her own egg(s) and is, therefore, not genetically related to the child. Gestational surrogacy has become possible with the invention of in vitro fertilisation (IVF) (Spar, 2006). It emerges from a plethora of arrangements, in which intended parents' sperm or ova are used, or gametes are provided by or purchased from third-party donors. In commercial surrogacy, as the name implies, the gestating woman is financially compensated for her reproductive labour, whereas in altruistic arrangements, she is expected to receive compensation only for immediately related expenses, such as medication, travel or childcare provision, but no additional financial reward is to be paid. Further to these four distinctions, surrogacy arrangements are shaped within their varying legal, social, cultural and religious settings (Berend, 2016b; Gerrits, 2016; Jacobson, 2016; König, 2018; Majumdar, 2017; Rudrappa, 2015; Twine, 2015; Whittaker, 2018). Surrogacy arrangements continue to be controversial. They are a topic of ongoing debates, such as whether they constitute women's exploitation, a commodification of women and children, whether they should be prohibited or not and who should have access and who should not (Anderson, 2000; Dworkin, 1983; Ekman, 2013; Lewis, 2019; Majumdar, 2014; Mamo & Alston-Stepnitz, 2015; Rothman, 1988; Svitnev, 2012b).

In this book, I address commercial, gestational surrogacy, as it is practiced in Russia.

Surrogacy in Russia

In Russia, the first gestational surrogacy pregnancy was conceived in St. Petersburg in 1995 and resulted in the birth of twins (Isakova, Korsak, & Gromyko, 2001). In the years that followed, surrogacy arrangements were barely regulated and sparsely practised due to the high cost and the novelty of the procedure. Yet about two decades later, the practises of assisted reproduction have been normalised (Burfoot, 1990), and St. Petersburg and Moscow have developed into reproductive hubs with the numbers of surrogacy arrangements increasing, especially since 2010. In comparison to the United States, surrogacy costs in Russia are low. Recent clampdowns on surrogacy arrangements in countries popular for transnational surrogacy arrangements, such as India, Nepal and Thailand (Rathi, 2020; Zimmerman, 2016), have contributed to a steady increase of international client parents accessing the Russian market. Russia's most recent increase in demand has come from client parents from China (Weis, 2021).

In 2013, the Russian Public Opinion Research Center survey (WCIOM, 2013) found that 51% of respondents considered surrogate mothers to be ‘doing something necessary and useful’. Likewise, 16% of respondents regarded the act ‘completely acceptable’, whereas 26% rated surrogacy to be ‘morally intolerable’. Analysing Russian print media, Nartova (2009, p. 79) found the widespread message that ‘the only legitimate, normal and morally approved uses of surrogate motherhood (…) are those related to overcoming infertility’ in heterosexual, ideally married, couples. Many conservative and influential religious voices publicly oppose surrogacy and repeatedly demand its prohibition (Agadjanian, 2017; Kirpichenko, 2017; ROC, n.d.); in 2013, for instance, Yelena Mizulina, then chairperson of the Duma Committee on Family, Women and Children, likened surrogacy to nuclear weapons in its threat to humanity, by ‘[destroying] natural ways of giving birth to children and natural ways of human reproduction’ (SVPRESSA, 2013) (see Chapter 5 for a detailed discussion). Supporters of surrogacy, especially fertility doctors, in turn consider it to be a timely method of infertility management and a way of taking action against national fertility decline (see for instance Konstantin Svitnev in an interview with Rossiyskaya Gazeta, Novoselova, 2006). Discussing the societal and political attitudes towards surrogacy with the endocrinologist Dr Alexey, he summarised his and his colleagues' approach boldly: ‘If a woman does not have a uterus, let another woman with a uterus carry the pregnancy for her’. In his opinion, opting for surrogacy to resolve infertility is the only ‘sane attitude’ a woman with fertility impairments can display. Whereas women who decide against surrogacy, despite the possibilities it offers and despite their financial capacity to do so, not only showed backward attitudes incompatible with a modern society but also failed in fulfilling their societal roles as mothers, according to Dr Alexey. Motherhood continues to be considered ‘the highest embodiment of the feminine’ in Russia (Vasyagina & Kalimullin, 2015, p. 61; see also; Rusanova, 2013). Highlighting the country's fertility decline, the proponents of surrogacy press for wider access and even state-subsidised IVF cycles to boost Russia's population growth (Svitnev, 2007). As Sarah Franklin (2013) remarks, trying to have children – by any means that are accessible – has become a new norm, and Russia is no exception.

Even though surrogacy is legal (for more details, see below) and increasingly well established as an infertility treatment, many surrogacy workers and client parents prefer to not disclose their identities (see also Khvorostyanov & Yeshua-Katz, 2020). For surrogacy workers, non-disclosure often is a strategic choice to avoid censure, belittling as ‘breeders’, or discrimination against their own children. Surrogacy workers themselves do not regard their occupation as morally reprehensible (see Chapter 2); on the contrary, many perceive surrogacy to be a sincere and even commendable way to support themselves and their families, taking the stance men'she znaesh', kreptche spish' (‘the less you know, the better you sleep’) to spare their families from public scrutiny and their parents from unnecessary worry. To achieve this, some surrogacy workers ceased visiting family and friends, or even relocated from their social surroundings to another part of the city or to another city altogether once their belly started showing. Others continued their everyday lives and jobs while covering up the absence of a child after birth with the ‘white lie’ of stillbirth. Ilya, for instance, who worked as a surrogacy worker three times, jokingly narrated how she bought her teenage son's compliance of silence with computer games and twice cunningly faked grief over alleged miscarriages at work. Karina, who carried three surrogacy pregnancies, always took paid maternity leave, then gave notice after the delivery and cut all ties with her former colleagues. In a less drastic manner, Olesya arranged herself in family pictures so that she hid her protruding belly. By posting the photos below (Fig. 1.1, reproduced as sketches) on her public social media account during her pregnancy while she was concealing the pregnancy, Olesya was actively writing her own (social media) history as ‘not pregnant’.

Fig. 1.1. Sketches of Olesya Concealing Her Surrogacy Pregnancy. Fieldnotes. Left: Olesya is lifting her jacket off her protruding belly and pulling it forward as she is holding her son's shoulder to conceal the shape of her pregnancy. Right: Olesya, in swim wear, is posing hugging her husband, hiding the pregnancy.

Client parents' reasons for non-disclosure included shame over their impaired fertility, fear of discrimination, and paramount, the fear that their children would suffer discrimination. To maintain their secret, client mothers strapped on artificial bellies to suggest a pregnancy and had their husband stroke these bellies for others to see. However, many client mothers reported their fear of being found out as well as the effort and discomfort of strapping on a silicon ‘pregnant belly’ that weighed several kilos. Client mother Katarina described that she felt like ‘I was carrying my own personal sauna on my belly. It was like a real sauna. I was constantly dripping sweat’, and Anastasia recalled how she feared surprise visits from relatives, or simply going out on the street and possibly getting involved in an accident and having paramedics notice the fraud. Prior to the birth, many client mothers even rented a hospital room and took advantage of their maternity hospitals' offer to photo-document ‘their birth’. After the birth, many cut all ties with the surrogacy worker to avoid information about the surrogacy being leaked or the need to live with the fear that the woman might one day contact them again.

Setting the Scene: The Legal Settings and Social Organisation of Surrogacy in Russia

The legal regulations and medical guidelines for surrogacy in Russia are minimal. In fact, regulations are so limited that lawyer, legal expert and member of the Russian Association of Human Reproduction (RAHR), Konstantin Svitnev,

…[considers Russia] as a sort of reproductive paradise, being the country with the most favorable legislation for intended parents, where no specific federal law regulates any aspect of assisted reproduction.

(Svitnev, 2011, p. 155)

The Federal Law on Citizens' Health No. 323 permits altruistic and commercial surrogacy and defines surrogate motherhood and the requirements for a woman wanting to be a surrogate as follows:

Surrogate motherhood is the gestation and birth of a child (including premature birth) under a contract concluded between a surrogate mother (a woman who gestates the foetus after receiving an embryo transfer of a donated embryo) and potential parents whose gametes were used for fertilization, or a single woman, for whom the gestation and birth of a child is impossible for medical reasons.

A surrogate mother may be a woman between the age of twenty and thirty-five, who has at least one healthy child of her own, who has received a medical certificate attesting satisfactory health status, and has given written, informed and voluntary consent for this medical intervention. A woman who is married, registered in accordance with the procedure established by the legislation of the Russian Federation, may be a surrogate mother only with the written consent of her spouse. A surrogate mother cannot simultaneously be an egg donor.

Further, the Medical Order 107 lists the medical testing required to determine whether a woman is suitable to be a ‘surrogate mother’. In addition, although it is not listed in the requirements, agencies and most doctors require surrogacy workers to have delivered vaginally to qualify. According to Russian law, the ‘surrogate mother’ is the legal mother and guardian of the child she births. In order to obtain legal parenthood status, client parents need to register as the child's parents at the civil registry after the child's birth and provide documentation from the fertility clinic, the maternity ward and show evidence of the ‘surrogate mother's’ written consent. Only then does a child's birth certificate list the client parents as the parents. ²

According to the current Russian law (as constituted in 2011), seeking a surrogate in Russia is permitted for married and unmarried heterosexual couples and single women (Russian citizens, residents and foreigners alike). Single men are not mentioned in the law, but over the past decade, surrogacy agencies and specialised lawyers have developed different strategies to enable single men to become fathers through surrogacy. Two strategies that I have witnessed during my fieldwork in St. Petersburg included involving a specialist lawyer to fight for the single father's paternity in court, or taking an informal route whereby the surrogacy worker does not relinquish the child, but registers as the mother and arranges with the client father for him to have parental rights and duties. One of my participants, Matvey, a single man in his early 60s, opted for this route. He also entrusted me with the information that he is gay and that neither his surrogacy worker nor his agency were aware of this. Instead:

I believe Olya [the surrogacy worker] thinks that I am a lost cause and so on… and here my age [63] obviously helps me to maintain that impression. She might think ‘ah well, maybe he has had broken marriages’. She never asked. I believe, the older the man, the less likely one is to have to answer questions about one's sexual life.

(Matvey, client father, February 2015)

According to Matvey, as long as he lives in Russia, nothing further would be needed from Olya. However, if he wanted to move or travel abroad, he would need her permission, certified by a notary.

As same-sex marriage is not permitted and the Russian state doesn't acknowledge two fathers as a child's legal parents, only one man in a same-sex relationship can act as a father. Nevertheless, some agencies offered gay couples the opportunity to each provide a sperm sample to create two batches of embryos, each fertilised with one man's semen, to subsequently transfer one embryo from each and ‘with a bit of luck’, have a twin pregnancy to ensure each man's genetic connection. The resulting children would then be genetic half-siblings, sharing origin from the same egg provider. But, as of 01 January 2021, this very arrangement is no longer possible, as the newest amendment to the family law prohibits assisted reproduction without using at least one intending parent's gamete (Loktionova, 2020). That means, in a married couple, either the client father or the client mother have to provide either egg or sperm, and in case of a gay couple, only the provider of the sperm can be recognized as the father. Two fathers, even if genetically related to two children carried by their surrogacy worker in a twin pregnancy, are not legally recognized by the law on Citizens' Health, and recognizing a father who has no genetic link is prohibited by the recent amendment to the family law. Furthermore, surrogacy for single and gay men in Russia could be prohibited in 2021 if the Russian State Duma accepts the draft bill proposed in January 2021 (for details, see Chapter 5).

Thus, the current Russian legal framework defines the contract partners, regulates the initiation of a surrogacy programme and, to some extent, its ending. However, as has already been raised by feminist and legal scholars (Khazova, 2013; Kirillova & Bogdan, 2013; Kirpichenko, 2017; Sokolova & Mulenko, 2013), the legal framework around surrogacy in Russia is riddled with shortcomings that may expose surrogacy workers to risks; it is not clear whether a surrogacy contract is legally binding (Khazova, 2013, p. 317). This means that if the client parents abandon the child during the commissioned pregnancy or after delivery, the surrogacy worker remains the legal guardian and is confronted with the option of keeping and raising the child, or giving the child up for adoption. The client parents are not obliged to pay the surrogacy worker for her labour. There is no upper limit of how many embryos can be transferred at once, or guidance for spacing between embryo transfers. According to the Federal Law No. 323, the surrogacy worker has the right to terminate the pregnancy like any pregnant woman up to the 12th week, or for medical reasons, at any point during the pregnancy. However, having entered a surrogacy contract, the contract commonly stipulates that the rights to make these decisions lie with the client parents, pitching state law against contract law. Hence, if a surrogacy worker aborts without the client parents' consent, the client parents can sue her and demand that she reimburses all the expenses they have incurred (medical expenses, travel expenses, etc.). There is no guidance on what measures should be undertaken if a child is born disabled. Further, there is no legal age limit for the client parents (Rusanova, 2013), and various agencies in my sample obliged their surrogacy workers to undergo amniocentesis if their client mothers provided their own eggs and were older than 40. Moreover, surrogacy workers in agency arrangements don't have the right to know prior to the transfer whether their client mother is the egg provider and her age, so that she can decline the arrangement, as eggs of women with advanced age have a lower chance of resulting in pregnancy.

There are two main ways to arrange surrogacy pregnancies in Russia: either through commercial surrogacy agencies or through direct arrangements. Surrogacy agencies are private commercial enterprises. They select suitable surrogacy workers among interested women, match them with client parents, provide client parents with legal guidance, supervise the pregnancies, provide a notary to take surrogacy workers' consent to hand the baby over after childbirth, administer the payment of the surrogacy workers and, finally, guide the client parents through establishing legal parenthood. ³ In Russia, no consideration of statutory conditions or licencing is required to open a surrogacy agency, or in the words of agency owner Alexander, ‘[opening a surrogacy agency] is as simple as opening an ice cream parlour’. When agencies match surrogacy workers and client parents, they commonly advise their clients to not seek personal contact with their surrogacy worker and prefer to match according to availability by menstrual cycle and blood type rather than clients' preferences. For a surcharge, client parents can choose from the agency's catalogue, decline a match or request a personal ‘viewing’. However, agencies advise against personal contact during the arrangement. One agency employee, for instance, remarked that if client parents insisted, they advised them to at least wait until the pregnancy had survived the ‘critical first trimester’, so they did not get emotionally invested in the foetus or the surrogacy worker, in case the pregnancy failed. Not only would that spare them avoidable emotional turmoil, but it would also speed up the process of starting the next attempt with the next available and suitable surrogacy worker, rather than insisting on waiting for the doctor's approval to repeat an attempt with their first match because of their emotional investment. Unlike the client parents, the surrogacy workers receive no informati...

Table of contents

• Cover
• Series Title
• Title
• Copyright
• Dedication
• Table of Contents
• List of Figures
• Note on Conversion
• Acknowledgements
• Prologue: From Moldova to Russia for Surrogacy. Gabriela's Story
• Chapter 1 Introduction: Surrogacy in Russia
• Chapter 2 Becoming a Surrogacy Worker
• Chapter 3 Making the Relationship Work
• Gabriela's Story Continued
• Chapter 4 Reproductive Migrations
• Chapter 5 Disruptions and Reconfigurations
• Conclusion: At Crossroads
• Appendix 1 Overview of Participants
• Appendix 2 Notes on Research Relationships
• Appendix 3 Emotion Work
• Appendix 4 Surrogacy Workers' Accommodations Index References
• References
• Index