Surrogacy without infertility: Is career reason enough?

| April 23, 2014
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(Credit: Daniel Lobo/Flickr)
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In a recent Elle piece, Sarah Elizabeth Richards tells the story of Mari Smith (a pseudonym), a high end wedding photographer nearing 40 who decided that surrogacy was the right choice to begin a family. Smith wasn’t suffering from infertility, her decision was based on convenience. Smith was running out of time to have a child and didn’t feel that she could be away from her job if she developed awful morning sickness or was put on bed rest.

Discussing the idea with a friend who worked to match couples with surrogates, Smith realized she and her husband could cover the $100,000 cost.

Smith’s mother voiced her disbelief when hearing the plan:

“Are you joking?” she asked when the couple mentioned their plan one evening. “You’d have a stranger give birth to my grandchild?” The next day, the mother-in-law fired off an e-mail: “This is not right…. I thought only people who can’t have kids do this. But not wanting to do it because of work? Who does that?”

In a traditional surrogacy, a couple uses IVF to create embryos with their own sperm and egg. Those embryos are then implanted into the uterus of a surrogate who carries the pregnancy to term. The baby is the genetic child of the couple. In some surrogacies a couple may use the surrogates eggs or donor gametes.

Surrogacies based on convenience are not common. David Smotrich, a San Diego fertility specialist, estimated they made up about 5 percent of the surrogacy cases he has work with. But, the trend may be increasing.

The American Society of Reproductive Medicine recommends against convenience surrogacy limiting the practice to “when a true medical condition precludes the intended parent from carrying a pregnancy or would pose a significant risk of death or harm to the woman or the fetus. The indication must be clearly documented in the patient’s medical records.”

But medical necessity can be subjective: post traumatic stress disorder, needing medication for depression that’s contraindicated in pregnancy or a history of severe anxiety may qualify.

In states where surrogates can legally be paid for their services, a woman can earn between $30,000 and $50,000 for carrying a pregnancy. But some states are fast making any payment outside of medical cost and loss of work coverage illegal. Louisiana passed a bill to that effect earlier this month. The bill was also criticized because it only legally recognized a contracts between heterosexual married couples and surrogates, excluding both same sex and unmarried couples. In other states, like California, pay is explicitly allowed in contracts.

Although it is not an explicitly stated reason for legislation, pay limitations may curb the supply of willing surrogates, especially in cases of convenience:

Therein lies perhaps the biggest challenge of social surrogacy. Women want to feel like heroes (or “angels,” in message-board parlance) for doing it. “The whole idea is wanting to help someone who couldn’t have a baby otherwise. When it’s for nonmedical reasons, it’s harder to wrap your head around,” says Kymberli Barney, spokeswoman for Surrogate Mothers Online and a mother of four who’s twice served as a surrogate. “Pregnancy is a sacrifice. If you’re not willing to make that sacrifice for yourself, why would you ask someone else to do it for you?”

We live in both an age of outsourcing and an age of motherhood idolatry. Smith and other women like her make a good, if not well received,  point: not every woman wants to be pregnant, but some of these women may want to have a child. So why not engage the free market to find a consenting, adult woman to carry her child in a regulated and medically responsible way?

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The GLP featured this article to reflect the diversity of news, opinion and analysis. The viewpoint is the author’s own. The GLP’s goal is to stimulate constructive discourse on challenging science issues.

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