Using a surrogate mother has brought fulfilment and happiness to thousands of would-be parents across the world. But this cross-border ‘trade’ in reproduction is rife with problems. Miranda Davies highlights some of the key issues addressed in her ground-breaking international collection, Babies for Sale? (Zed Books, 2017).
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From the birth of the first test-tube baby, Louise Brown, in 1978 through to the mushrooming of surrogacy websites that target gay men seeking parenthood, advances in assisted reproductive technologies (ARTs) have provided unprecedented opportunities for LGBTQ communities, single people and couples with infertility to create a family of their own.
Today, for the first time in the history of surrogacy a couple or individual in one country can sign up with a specialist agency online, select a donor almost anywhere and fertilise her extracted eggs; the resulting embryos are then frozen and flown to a clinic, perhaps in another continent, where they will be thawed and implanted into the womb of a gestational surrogate. Once established, the baby will grow, nourished and protected by a woman it will never know and to whom it has no genetic tie. As the day of the birth approaches, the intended parents will fly out, pick up their offspring and return home with a ready-made family.
It was hearing such a story – involving a gay couple in Australia who hired a donor in New Zealand and surrogates, first in Thailand and later Nepal – that led me to write and commission Babies for Sale?.
As in most countries, commercial surrogacy is prohibited in Australia. Consequently, people who find their desire for parenthood obstructed increasingly turn to one of the hundreds of agencies that advertise overseas surrogacy packages online. The couple in question – I call them Tony and Luke – signed up with such an agency. The next step was to find an egg “donor” – one of several euphemisms used in this business given that, of course, this is a commercial transaction: donor eggs are sold. They purchased an egg catalogue online listing the origins, age and mental and physical characteristics of potential “donors”, and after initially opting for a blonde, blue-eyed sporty “type” of Scandinavian origin, they were matched with a woman with similar characteristics from New Zealand.
In due course her eggs were sent to Sydney where they were fertilised by both men; the resulting embryos were swiftly frozen and flown to Thailand where, at a designated clinic, they were thawed and transferred into the uterus of a Thai woman. Nine months later the couple travelled to Thailand to collect their baby daughter.
I was fascinated by this story. In most cases of infertility treatment babies are created from their parents’ own eggs and sperm. This was different: now women are being hired to gestate and give birth to babies to whom they have no genetic link, hand them over to the intended or commissioning parents and never see them again. And it is happening across the world, driven by the demands of the relatively well off in one country matched and facilitated by the availability of cheap female labour in another, often thousands of miles away. Human reproduction has become big business with the commercial surrogacy industry estimated to be worth around 2.3 billion dollars annually.
Winners and losers
Who gains from this global market in reproduction and who, if anyone loses? Leaving aside the online services and other brokers who reap the highest financial rewards from surrogacy arrangements, the three main parties involved are the intended parents, the surrogate and the child. Their relationship shares much in common with members of the adoption triangle (adoptive parents, birth mother and adopted child). But while adoption necessitates the protective services of social care, legal and sometimes medical professionals, surrogacy tends to entail a far greater but less legitimate cast of characters, including recruiters, insurance brokers, local guides, travel agencies, and others employed in the surrogate’s country to ensure that the whole process runs as smoothly as possible.
Generally the interests of the parents as “customers” are paramount. Those of surrogates and children – both their own (surrogates usually have to be married with at least one child before they can enter into an agreement) and the baby they have carried for someone else – are rarely considered. Much excellent research has been published about the position of surrogates, how far they understand the surrogacy contract, their degree of agency and control and the extent to which they unknowingly put themselves physically and psychologically at risk; far less has been written about the offspring and the psychological implications of being born this way.
Studies into identity development in relation to adoption have revealed the importance for adopted people of knowing about their birth family and the circumstances of their birth, and the damage that can be done from only finding this out in later life. As donor-assisted conception and surrogacy become more common, so will the demand for genetic and gestational origins. This makes it all the more crucial that details of the surrogate’s and egg provider’s name, date of birth, nationality, how they were recruited, fees paid and any advice or counselling given be recorded for safekeeping – routine practice in few, if any, of the countries that allow cross-border surrogacy in 2017.
These are just some of the complex legal and ethical issues discussed by over 30 leading activists and scholars in Babies for Sale? Would-be parents like Tony and Luke will always follow their hearts, but as Sonia Allan states in her closing chapter (p. 372):
‘Decisions about addressing these issues must take precedence over any singular desire to have a family, and must include considerations of all factors that shape the situation of people seeking children, women who may consider bearing children for others and the children that may be born as a result.’