Surrogacy at Its Best?

I came across this story on the web this AM.   It seems to me to illustrate surrogacy at its finest.   Because I’ve gone at length about surrogacy at a number of different times  in the past, and because I am deeply skeptical of much about surrogacy, I thought it might be worth lingering here for a few moments. 

Jamie Underwood Collins is 8 1/2 months pregnant with a baby that is intended for a New York couple.    She’s married and has four kids of her own.   While she’s being paid something around $25,000 it doesn’t seem that the need for money was her primary motivation.   Rather, this was something Collins wanted to do for someone.   There’s nothing shameful about being a surrogate, at least as Collins sees it.   (She wears a T-shirt that says “This is not my husband’s baby” on the front and “But it’s not mine either.  I’m a proud surrogate” on the back.  

Surrogacy (Again) in the NYT–Talking to the Children

Once again there is a story in the NYT about surrogacy.   This one is about how people who have used surrogacy talk to their children about the children’s conception and birth.    There’s many things I’d like to say about this one, though if I’m not sure they will all fit together into some grand point. 

First off, the story includes some statistics I find astonishing.   It reports that according to the American Society for Reproductive Medicine–the relevant medical special organization–there were between 400 and 600 birth a year resulting from gestational surrogacy.  (This is surrogacy where the woman who gives birth is not genetically related to the child.  Instead, the egg comes either from one of the intending parents or a donor.)   Now that is a tiny number.     If you poke around the web or this blog you can find some data on the number of live births in the US per year.  From this study it looks to me to be around 4 million births per year.  

Now these numbers are disputed even within the article and I will accept that they are low.   (I will note, though, that I am a bit skeptical of the statistics reported by someone whose income is dependent on the business of promoting surrogacy arrangements.   They might have an interest in erring on the high side.) 

The Logical Extension?: Buying a Child

Over the last year or so there have been occasional stories about the globalization of surrogacy, some of which I’ve commented on here.  Two related stories from the UK have made me want to revisit this thread.   

This story (with it’s rather spectacular headline, but then, this is UK journalism) is really just another instance of the global surrogacy–a minor variation on an established theme.    Here, a UK couple (Nicky and Bobby Bains) purchased a donor egg which was fertilized with the husband’s sperm.   The resulting pre-embryo was then implanted in another woman’s womb.   This last women–the surrogate–eventually gave birth to the child.  

This is essentially routine gestational surrogacy, of the commercial sort, with a global twist.  

Global Surrogacy and Legal Parentage

Just a quick note here about a recent article from the UK press that raises a rather troubling prospect:  People using global surrogacy (the article mentions specifically people working through India)  may not end up as legal parents of their children.

This is really in the category of “variations on a theme” for me–it probably goes in the portable parenthood file.

I’ve also written about surrogacy in India before.   India is a destination for people from many parts of the world who want to use surrogacy.  Some come from parts of the world where commercial surrogacy is illegal.   Others come from places where surrogacy is unaffordable.

You could comply with Indian law and return home to where you came from with a child, but your legal relationship with that child in your home country may not be entirely clear.   This is the problem referred to in the article.   It seems to me to be quite plausible that you’d do nothing further when you came home.  But will your home country recognize you as a parent of a child?  Suppose you have no genetic connection to the child in question, but your home country weighs the DNA link heavily as a criteria for parenthood?   It does make me wonder.

More From the Free Market–Supply of Sperm and Eggs Up, Demand Down

As I’ve noted before, we have a free market for reproductive materials here in the US.   These materials are widely bought and sold.

I’m neither a tremendous fan of nor an expert on how markets work.  But the basic dynamics don’t seem all that tricky to me.   And so this story isn’t really surprising.   People need money.  Thus more are looking to sell what they can, including sperm and eggs.

At the same time supply is up, demand is down.  (The article refers to this as a paradox, but it doesn’t seem so to me.   There’s less money out there, so people have less to spend.   ART is expensive, and if it is successful you end up with a child, which is even more expensive.)

I assume this is really just one manifestation of a broader societal condition.   I wouldn’t be surprised to find that more women are willing to be paid surrogates, for example.    I haven’t seen that story, but it ought to be out there, too.

Now I would expect that if the supply is up and the demand is down that the prices will fall.  Isn’t that the way economics is supposed to function?

Surrogacy Gone Bad

I digress from my discussion in progress to comment on this item from today’s news.   This is indeed surrogacy gone bad but not, I suspect, in the manner that most people think about.

It appears that SurroGenesis, a for-profit web-promoted, globally marketed surrogacy agency, has taken the money and run.   (I’m astonished to find that the website it still up and running.  I imagine it won’t be for long.)  SurroGenesis is one of a number (does anyone have any idea how many?) of for-profit surrogacy agencies that essentially act as a brokers and facilitators.  They locate surrogates and intended parents, as well as egg donors.   They connect them up with each other and, at least ostensibly, deal with a host of details.   Perhaps most important for the moment, they hold the money that is to be paid the surrogate.

Except, of course, in this case they didn’t hold the money.  They took it.   Perhaps as much as two million dollars all told.   For some couples this means they’ve paid SurroGenesis and lost their money.   That’s bad, of course, but there are a small number of people who find themselves in a much worse position.  In at least two instances recounted in the paper, there are women who are pregnant as surrogates, expecting to be paid and to deliver the children (in both senses of the words) to the intended parents in the not-too-distant future.  But now the money that made these transactions work is gone.  The intended parents have paid it, but the surrogates have not (and likely never will) receive it.  

If it’s all for sale: Market Forces

This is a continuation of the thread from yesterday’s post, which in turn suggests you read a couple of other things.  So you might want to go back to that first.   But it’s also a larger point that ties back to discussions of what I called “commercial surrogacy” for a while.

I just want to offer a quick note here that ties into a lot of other things as well.   I’ve talked about sale of sperm and embryos, about commercial surrogacy, about how the expense of ART serves to restrict access to it.   All of these topics are, in part, about the operation of the free market.

So, for example, sperm is freely sold in the US (though this can be controversial).   That’s so even though  some things cannot be sold--say, kids?    And as you know if you’ve been reading here, there are other things I have misgivings about buying/selling.     (There’s a lot back there about surrogacy that has to do with commodification.)

Despite various problems with access and some tough moral/ethical/cultural tough lines to draw, I suspect that the free market approach to ART has made it more widely available.   (Not always a good thing–see Nadya Suleman and the octuplets.)   So, for example, restrictive rules that bar delivery of services to single women or to lesbians and gay men might be rejected by providers because they limit the market for their services.       

Regulating Reproduction, Artificial or Otherwise?

I want to pick up on yesterday’s thought, but also try to open up the field of consideration.     Part of the point of yesterday’s post was that it seems that you can indulge yourself in whatever reproductive technology you care to if you have the money.

This is true in two senses.   One is that if you have the money, you can afford to purchase whatever materials and services you might want and, given the robust and unregulated US ART market, that practically means you can buy anything short of an actual living child.  (Note that while you technically cannot buy pre-embryos, you can buy all the constituent parts and the services to create them, so it’s pretty much a technical bar, I think.)  Indeed, given commercial surrogacy, I’m sure there are some who would say that you can indeed purchase a child, so long as you go about it the right way.

The second is that if you have money it is far more likely that your choices will be deemed private, and hence, your business only and hence, socially acceptable.   A huge brood of children is fine if the public doesn’t have to pay for them.   People may look at you like your are slightly crazy, but it’s still your choice.   (The recent NYT article about large families essentially walks this line.)

Surrogacy Round-Up

A couple of different items relating to surrogacy have come across my desk (figuratively, anyway) in the past week or two.   Rather than do a series of short posts, I thought I’d try putting them together and then offering some comments.

But before that, a general observation:   It’s striking how much surrogacy is in the news these days.   I know that, given the commercial media and the Internet, news coverage begets more news coverage–once the NYT magazine runs a story on surrogacy, a thousand blogs (mine among them) comment on it and then more news outlets pick it up, some developing their own angles, creating their own news.    Still, even if I do a discount for that, surrogacy seems to be much in the news–more than a year ago or two years ago or five years ago.

Now it is not that the technology has suddenly changed.   The technology of surrogacy (which is basically IVF) has been around for a while now.   I’m sure the techniques and their reliability have improved, but I don’t think it is changing technology that has propelled the issue to higher visibility.    

Master/Servant; IP/Surrogate

I am interrupting my own thread because there is this ill-formed idea that has been bothering me I want to try to write about.   You will recall that NYT magazine piece  on surrogacy?   I wrote about it a bit earlier and there has been discussion of it all over the web.  (I’ve actually written quite a lot about surrogacy over the last year, which you can find under the various tags.)

Really the catalyst for this post is one of the pictures in the article.   (There was an interesting sort of follow-up about it in the public editor’s column section this past Sunday, which in part discusses the selection of pictures.)   This picture.   One could write quite a bit about it, I’m sure, and much has been written.   For the moment, let’s just say it is fine depiction of master (mistress?) and servant.   No question really about which is which.

Once you see master and servant you see a whole set of power and class relationships, too.   The master controls, the servant is controlled.   The master is strong (at least with regard to the relationship), the servant is weak.   The master is unique, the servant fungible.   The master has more, the servant has less.   I’m not saying that all of these things are necessarily true in every master/servant relationship, but they are generally part of the assumed picture.