Surrogacy

Overview

A surrogate mother is a woman who agrees to bear child for a couple, sometimes on a contractual basis where it includes agreed fees and conditions; though arrangements can be either commercial or altruistic. In commercial surrogacy, the surrogate is paid a fee and any other fees incurred during the pregnancy whereas in altruistic surrogacy, the surrogate may only be paid for the expenses or not paid at all.

Types of Surrogacy

The two main types of surrogacy are traditional and gestational, within each category are sub categories of the procedure.

Traditional Surrogacy:

In traditional surrogacy, the surrogate serves as both the carrier for the embryo and the donor of the egg. The surrogate mother is impregnated with semen from the intended father through the means of artificial insemination which can be performed either at home or at a fertility clinic. This procedure also includes: TS/DS.

Gestational Surrogacy:

In gestational surrogacy, a procedure called in vitro fertilization (IVF) is utilized in which the eggs are removed from the intended mother's ovaries and becomes fertilized by sperm in a laboratory. If the fertilization occurs, the egg becomes an embryo which is then grown in the lab for several days then places within a surrogate woman’s uterus and continue to develop so a full pregnancy can ensue. In this case, the resulting child has no genetic relations with the surrogate. This procedure also includes: GS/IP, GS/ED, GS/DS and GS/DE.

History

Early History

• 1978 The first child ever conceived by IVF- Test Tube Baby: Louise Joy Brown
• 1980 First Paid Traditional Surrogacy Arrangement- Elizabeth Kane Article
• 1983 First Successful Pregnancy via Egg Donation
• 1985 First Gestational Surrogacy
• 1986 Baby M Case
• 1988 Patty Nowakowski Custody of Surrogate Twins Article
• 1994 European countries begin to prohibit or restrict surrogacy
  • France's civil code to forbid all surrogacy agreements Article 16-7

Recent History

• 2004 Surrogacy agents considered illegal under the Assisted Human Reproduction Act in Canada

Psychological Concerns

In general, there are many factors to consider when becoming a surrogate mother, as the mother is considered to be a third party within the traditional two people family structure. Concerns vary from financial exploitation, fear of non-relinquishment of the child, legal work, emotional stigma to genetic links.

The Surrogate Mother

Research shows that the motivations behind a mother willing to be a surrogate stems from the feeling of being able to "give the gift of life", many have stated that after experiencing the process of surrogacy, there were an increase in levels of self worth and self confidence. Majority of surrogate mothers have stated that they did it for altruistic reasons combined with feelings of empathy for the childless couple and want to help them experience the joys of parenthood. The surrogate herself realizes the importance of her role within a commissioning couple, and her state of being is canonized as she is seen as an heroic figure to the "emotionally impoverished" couple. Being a surrogate helped the individuals undergo a phase of self development, allowing them to accomplish and start new interests based on the experience itself.

It goes against nature to relinquish a baby upon delivery, as based on societal standards, mothers are intended to nurture and care for their baby from childhood to adulthood. Due to attachment women feel towards their fetus, surrogate agencies assist with the cognitive structuring such as ensuring that surrogate mothers are well informed prior to their surrogacy and allowing them to understand that the baby they are carrying is not theirs and must be relinquished in due time. Some surrogates stated the feelings of being exploited due to the expectations of continuing contact to a certain extent with the intended couple’s family. In some cases, contact ceases preceding the delivery of the baby and once legal proceedings has been completed. Surrogates see this as betrayal when the intended couple removes from the surrogates life. Surrogate mothers also experience decrease in satisfaction over time as contact with the parents decreases, it is acknowledged that therapy prior the surrogacy and during, may be beneficial for the surrogate to increase satisfaction rates.

Intended Parents

Commissioning mothers do not feel inclined to justify their choices for looking to surrogacy as a solution to their infertility even with the presence of stigma and the lack of public support. Many surrogate and the intended parents develop close relationships over the course of the pregnancy, whether it be negative or positive, both parties experience the many emotions, from knowing that the surrogate is pregnant to unfortunate events like miscarriages. Bonds are more commonly formed between the surrogate and the intended mother versus the fathers, as they feel a sense of awkwardness presumably due to the ambiguity of gender relationships in such arrangements. Some concerns that the intended parents may have in regards to the arrangement range from and are not limited to, financial stress, legal issues to concerns that the surrogate may neglect her own health which in turn may potentially harm the fetus. Previous studies indicate that the main motivation behind the parents decision to choose surrogacy comes from the desire to have a genetic link to the offspring and that adoption could not provide them the genetic relations they wish for their child.

The Offspring

Some studies have compared the cognitive and social development of children of those produced through IVF versus those through egg donation. It is shown that these children do not lack in aspects of proper cognitive functions. Some further avenues of research can focus on the study of the optimal period to disclose to their child of their biological origins.

Legal and Ethical Concerns

Catholic Church

The Catholic church opposes all acts of surrogacy whether it be commercial or altruistic as they describe such arrangements violates the natural order of family and how family is supposed to be created. They believe that commercial surrogacy turns human birth into a financial transaction which objectifies women to be reproductive vessels and that such acts are harmful to a healthy family relationship.

Feminists

Feminists argue that women of lower class and lower privilege are coerced to become surrogates for higher socioeconomic status intended parents. The reason mainly being that those who choose surrogacy, the intended parents are usually financially well off with average income of around $100, 000. Therefore most contractual parents are those that come from the wealthy or the upper-middle class status and that such terms "surrogate" or "surrogate mother", "delegitimizes her rights to a continuing relationship with the child". That such acts of "contracting" exploited women due to it being viewed as "baby-selling arrangements" with lower social economic status women who were coerced due to their lack of knowledge and understanding of such practice. This reason further allows for feminists to be concerned with the ethical and sociopolitical aspects of such arrangement.

Advocates

Due to the genetic link and kinships that intended parents desire for their child, advocates argue that adoption does not suffice as an alternate to surrogacy as adopting a child with no genetic ties to the intended father isn't what the couple wants. They see surrogacy as a contract to bear a child as opposed to selling of a child. The sort of arrangement is viewed to be a payment similar to how one would pay a lawyer or doctor for their services. The prohibition of commercial surrogacy is also believed to be an infringement on a women's constitutional rights to contract if considered within an American context.

Around the World

Some countries ban surrogacy completely, such as France, Italy and Germany whereas other countries like United Kingdom, United States and India are more accepting of the practice with fewer restrictions. See here: for a complete list of surrogacy laws by country.

Due to certain regulations and restrictions on surrogacy laws that don't allow for commercial surrogacy, couples tend to resort fertility tourism in which they travel to other countries seeking for clinics to bypass the regulations that they may have in their original country. Fertility tourism is especially common in India, as commercial surrogacy is legal in that country with lower costs, and impoverished women are more willing to become surrogates. Such practice has become an industry in itself with the country having generated more than $400 million a year. The proliferation of clinics all over the country increases the number of foreigners coming into the region seeking for solutions to their reproduction desires. This global affect raises significant ethical concerns on whether the exploitation of women by wealthier foreigners is a potential risk within surrogacy arrangements.

The interest for fertility tourism has also been growing largely in China as more couples are being tested infertile and previous actions to ban surrogacy. Many of the wealthy Chinese believe having their child in the USA is a good idea as the medical procedure are more advanced there. As well, there are other benefits such having their child receive USA citizenship at birth, which eventually can sponsor their biological parents for a green card at the age of 21. Surrogacy price usually costs between $125,000 and $175,000 for customers in China, depending on the wait list, which is very costly compared to the average Chinese citizen’s income. However, as of early 2016 China has reversed the ban of surrogacy in fear of population shrinkage and to encourage population growth on domestic grounds.

References

      8. Yang, Jie. "Informal Surrogacy in China: Embodiment and Biopower." Body & Society 21.1 (2015): 90-117.
      9. http://money.cnn.com/2015/08/23/news/china-us-surrogacy/