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The Scholar and Feminist Online
Published by The Barnard Center for Research on Women
www.barnard.edu/sfonline


Double Issue 9.1-9.2: Fall 2010/Spring 2011
Critical Conceptions: Technology, Justice, and the Global Reproductive Market


Interrogating Narratives About the Global Surrogacy Market
Susan Markens

In 1985 Margaret Atwood published her award-winning book, The Handmaid's Tale. In this dystopian future, elite couples who are unable to conceive due to high rates of infertility enslave fertile women to serve as their reproductive concubines. In 1986, the following year, the world was introduced to the practice of surrogate motherhood through the infamous Baby M custody case.[1] Between 1986 and 1988, when the case of Baby M was argued first at the trial court level, and then reviewed by the New Jersey Supreme court, the case received much attention by the media. For instance, in 1987 alone the New York Times published 131 articles on surrogate motherhood, often more than one appearing on the same day.[2] Following this media attention the topic received much scholarly attention from social scientists and political and legal theorists.[3] Although there were multiple perspectives on the topic at the time, including diverse feminist positions, a dominant initial feminist view expressed concerns about the exploitation of women. These feminist criticisms of surrogacy ranged from a concern with the commodification of women's bodies and parallels between surrogacy and prostitution that would result in "reproductive brothels," to the increased possibility of using poor women, women of color and Third World women's bodies to service the reproductive desires of white elite women.[4] Subsequent ethnographic research in the U.S. has found that surrogates are not 'dupes' but are agents, using their bodies to simultaneously reinscribe and challenge traditional notions of motherhood/family. Furthermore, surrogate narratives speak of a desire to 'help a family' as the primary motivation in becoming a surrogate, downplaying economic factors as secondary or irrelevant.[5]

Fast forward two and half decades from the hoopla of the Baby M case and surrogacy is once again in the news. Oprah Winfrey devoted an entire show to issues of assisted reproduction, subtitled "Wombs for Rent." CBS News ran a segment titled "Outsourced 'Wombs-For-Rent' in India." Headlines from The New York Times, The Wall Street Journal, The Boston Globe, The Washington Post, and Los Angeles Times read "Outsourced Wombs," "India Nurtures Business of Surrogate Motherhood" "Outsourcing Childbirth," "The Globalization of Baby-Making," "Rent-a womb in India fuels surrogate motherhood debate," and "Wombs for Rent, Cheap."[6] Pictures that accompanied these articles depict rows of Indian women sitting docilely in a clinic wearing pink and blue gowns with matching head covers and masks that cover their entire faces except their eyes,[7] or women in saris standing, their faces not shown, but their naked and protruding pregnant bellies prominently displayed.[8] The feminist dystopia—of reproductive inequality and exploitation—imagined by Atwood and feared by many feminists since the Baby M trial has seemingly come to fruition at the dawn of the 21st century. And once again, feminist scholars are paying attention to the topic of surrogate motherhood, and the broader issue of reproductive outsourcing between bodies and across continents. Emerging ethnographic research on Indian surrogates has found some similarities with U.S. based research—from the agency of the surrogates to the specialness they feel in helping a couple create a family. However, and not surprisingly, Indian surrogates, unlike most of their American counterparts, do clearly acknowledge the monetary aspects of the situation to explain and justify their decision to become surrogates.[9]

As someone who has already published research on American cultural politics of surrogate motherhood that existed around the time of the Baby M case, I too have been drawn back to the topic with the recent media attention given to surrogacy and reproductive tourism. I am currently working on a research project comparing the media and cultural discourses used to frame the issue of surrogate motherhood in the late 1980s and early 1990s to those that are deployed in current media accounts of and public debates about the topic. For this new study, I am analyzing all articles that pertain to surrogacy from 1980 through 2009 that appeared in The New York Times, The Washington Post and Newsweek, as well as stories appearing in other major news venues in the last several years. Additionally, due to the changes in media brought on by the Internet, I have also collected over a thousand online reader responses to three prominent stories that appeared in 2008.

Despite the growth and changes in the surrogacy industry in the last twenty-five years, I have actually found that there is a great deal of continuity in the debates about the merits and problems with surrogacy. In particular, I find that two main competing discursive frames about surrogacy continue to focus either on concerns about commodified reproduction or defenses of reproductive freedom. In my earlier work I identified "baby selling" and "the plight of infertile couples" as the two main competing frames in debates over surrogacy in the 1980s and I argued that both these frames tend to reinforce cultural notions of a public-private divide.[10] Drawing on preliminary data and illustrative examples from my current project, the following are some further observations I've made about the frames used to construct narratives about surrogacy and the additional cultural assumptions they seem to share. My goal is not to evaluate whether surrogacy is "good" or "bad." The issues I raise are also not meant to be an exhaustive list of the multitude of dimensions by which the global reproductive market can be analyzed. Instead I hope to point out a few overlooked topics and assumptions in current accounts of and debates about the surrogacy industry.

First, as discussed above, much recent attention to surrogacy is concerned about global outsourcing. This is evident in the renewed scholarly attention to the topic, including this very issue of The Scholar & Feminist Online. This is also evident in media coverage of the surrogacy industry in India that emphasizes its growth and expansion. Media framings that present a burgeoning industry in which Western couples are increasingly hiring Indian surrogates include articles that claim: "... reproductive outsourcing is a new but rapidly expanding business in India. Clinics that provide surrogate mothers for foreigners say they have recently been inundated with requests from the United States and Europe"[11] and "... an increasing number of infertile couples from abroad are coming here in search of women ... who are willing, in effect, to rent out their womb."[12] Yet such media accounts of the expanding global reach of the reproductive industry that focus on India have the effect of rendering invisible the fact that a primary destination for reproductive tourism, specifically surrogacy, remains the U.S.[13] Thus analyses of reproductive outsourcing tend to neglect a key component of the global surrogacy market—American surrogates and their bodies. This does not mean that American surrogates are never discussed. In fact, I have found that media coverage of surrogacy is still more likely to report stories on surrogates located in the U.S. than elsewhere. Yet, when surrogacy is discussed in relation to a global reproductive market—the type of sensational media account that often receives a lot of attention, as well as scholarly analysis—American surrogates usually disappear from the discussion.[14]

Second, then, in bringing an analytic focus back to American surrogates is the question of how are they discursively constructed in the media and public discourse? As found in much of the ethnographic literature on surrogacy, a key discursive trope about surrogacy transactions used by its defenders are the largely altruistic reasons that motivate women to become surrogates. For instance, in her Personal Health Column in the New York Times, Jane Brody highlights the "altruistic motives" of surrogates and quotes a surrogate mother profiled in the article who states that "People don't become gestational carriers as a way of making money."[15] The de-emphasis on money is key to presenting surrogates as not poor, in other words as not desperate or needy. This surrogacy narrative is presented in Alex Kuczynki's widely discussed New York Times Sunday magazine cover story about her battle with infertility and her experience of hiring a surrogate to bear her son. In describing the potential American surrogates she screened she writes, "None were living in poverty. Lawyers and surrogacy advocates will tell you that they don't accept poor women as surrogates ...."[16] Similarly, in a cover page story on surrogacy in Newsweek—a focus of which was the supposed large number of surrogates who are married to U.S. servicemen—a surrogate mother explains: "Poor or desperate women wouldn't qualify [to be surrogates]."[17] Meanwhile, in her essay Kuczynski recounts that she chose the surrogate she did because she "told me that her motivations were not purely financial .... She wasn't desperate for the money." Online reader comments from surrogates also vigorously present the narrative that surrogates are not poor or needy as do these two reader responses to the Newsweek cover story: "... the vast majority of us [surrogates] ARE educated, and NOT poor and NOT on a fixed income;"[18] and, "I carried twins as a gestational surrogate, and I am college educated, on my way to being an RN, and my husband is a postal worker. We have no money problems."[19]

Popular cultural representations of surrogate motherhood also reflect this cultural theme about "good" versus "bad" surrogate mothers. For instance, from soap operas to prime time television, favorable and normalizing presentations of surrogacy tend to involve a sister or friend who volunteers to serve as a surrogate for an infertile couple.[20] Meanwhile, in the 2008 Hollywood film Baby Mama the hired surrogate, a working class and down and out woman, is presented as unscrupulous and duplicitous when it is revealed that she is partaking in a money-making scam. Contempt and/or distrust of surrogates from less well-off backgrounds is also visible in the precedent-setting California custody case, Johnson v. Calvert, where the gestational surrogate was described in the press as a "welfare cheat."[21] This unsympathetic and critical take on "unscrupulous" surrogates is also visible in the outrage expressed in response to the Newsweek cover story on American surrogates. While not the entire focus of the article, a main storyline was the supposedly large proportion of American surrogates who are the wives of men in the military. Although concern was expressed that these women became surrogates because their husbands were not being paid enough, a vocal stream of discontent was that military wives became surrogates because their pregnancies were covered by the military health plan. This resulted in a construct of surrogates as manipulators who engage in "fraud" and "abuse," like "pirates" vividly seen in the following online reader comments: "Taxpayers should be questioning this FRAUD!!!"; "These military wives are profitting at the taxpayers expense"; and "The military wives who do this are PIRATES."[22]

Why so much emphasis on the lack of financial incentives motivating American women who serve as "good" surrogates and what does this discursive framing reveal more broadly about cultural assumptions of mothering in the U.S.? As I argued in my earlier work, this framing of "good surrogates" distances supporters from charges of exploitation revealing a strategic need to disassociate the practice from charges of commodified reproduction and "baby selling." Yet, this is not the only cultural assumption this strategic framing reveals. I suggest this framing of who is and who isn't a "good" surrogate also illuminates broader assumptions about poor women in the U.S. That is a discourse about avoiding poor (i.e. "bad") surrogates reveals underlying cultural assumptions about poor women in general as bad women/mothers and irresponsible reproducers. This narrative frames poor women in the U.S. as both undeserving and untrustworthy (surrogate) mothers. As a result, narrative frames of surrogacy that downplay the fiduciary aspects of the transaction are drawing on and reproducing dominant cultural ideologies of undeserving women/mothers found in discourses from welfare to population control.

Of note, however, is that this discursive construction of "good" versus "bad" American surrogates—that "needy"/poor surrogates are "bad" surrogates—contrasts with surrogacy advocates' framing of Indian surrogates. For instance, in a Los Angeles Times article on the surrogacy industry in India a local surrogate broker unapologetically "acknowledged that money was the primary reason these women had queued up to be surrogates; without it, the list would be short, if nonexistent."[23] Yet, despite the economic need driving these women to be surrogates their motives and characters are not denigrated. In her online blog about Indian surrogates Judith Warner also points out this contradiction "... when the women in question are living in abject poverty ... [t]hen selling one's body for money is not degrading but empowering."[24] Ironically, then, in the global political economy of mothering, while poor women in the U.S. are constructed as irresponsible and bad (surrogate) mothers, poor women elsewhere aren't necessarily viewed with the same scorn and distrust—at least when they serve to "empower" themselves by acting as surrogates.[25]

Are media accounts and discursive narratives that present more critical frames of surrogacy better with regard to class-based assumptions about good parenting and deserving motherhood? Detractors of the practice do often frame their discursive narratives around issues of class, privilege, and reproductive inequality. For instance, there is often much disdain and concern expressed regarding the amount of money spent by the intended parents—the baby-buying aspects of the practice and the possible exploitation of needy women. As bioethicist George Annas succinctly states in a New York Times article, "[Surrogacy] really does treat children like commodities. Like pets."[26] Narrative frames about the exploitation of those who are economically desperate are also found in the Times public editor Clark Hoyt's follow-up to the Kuczynski article in which he pointed out that for many readers the practice "screamed rich woman exploiting poor woman,"[27] and a Wall Street Journal article's opening sentence that begins, "Here's another sign of the tough economic times: some clinics are reporting a surge in the number of women applying to donate eggs or serve as surrogate mothers for infertile couples."[28]

At the same time, people's "natural" desire to parent is often recognized as legitimate—thus revealing the cultural salience of the "plight of the infertile" narrative. As a result, in this framing of surrogacy, adoption is often presented as a preferable option, one that doesn't "waste" money and that can "help" rather than exploit. Examples of this narrative story about less exploitative and financially wasteful ways of creating families are illustrated in online reader comments that make the following pleas to infertile women in response to Kuczynki's Times story and the Newsweek cover story, respectfully: "So adopt one. Or even better, more than one. There's so many precious kids out there that need a good home. Women—stop spending all that money on IVF and surrogacy, and spend it helping it others,"[29] and "Has anyone ever heard of adoption? People waste so much money on these procedures ... years and years of wasted money trying to get pregnant themselves. You could spend that money to adopt a baby that will otherwise most likely grow up in a bad situation."[30]

Yet, while the narrative of adoption as a better (i.e. less exploitative) alternative to surrogacy is attuned to issues of class and privilege (and lack there of), I suggest that this frame also negates issues of parenting, class, and privilege by not reflecting on whose/which children are available for adoption. Whether domestically or abroad, poverty is a key factor affecting who relinquishes children for adoption (voluntarily or involuntarily).[31] This surrogacy narrative thus, perhaps inadvertently, also disregards the mothering capabilities of women with fewer resources—this time both in the U.S. and elsewhere. In the end, both supporters and detractors of surrogacy thus elide issues of class in their strategic discourses by reinforcing class-based notions of "good" parenting and deserving motherhood. Ironically then, and as I found in my earlier work, while seemingly at odds with each other, alternative and opposing frames of surrogacy can also end up reinforcing the same dominant cultural ideologies, ideologies which may conflict with feminist goals of expansive notions of reproductive rights, freedoms, and equalities. And this is just one of the many complexities and contradictions that feminist scholars should be attuned to as we analyze the consequences, materially and culturally, of the global reproductive marketplace for what it offers to women of various social locations.

I thank Jonathan Markovitz and Rebecca Young for their comments on earlier versions of this article.

Endnotes

1. Baby M was the product of a surrogacy contractual arrangement between William and Elizabeth Stern and Mary Beth Whitehead. Baby M was genetically related to both Mary Beth Whitehead and William Stern (she was inseminated with his sperm which is now known as "traditional surrogacy." Most surrogacy arrangements now involve IVF and are called "gestational surrogacy"). After the baby was born, Mrs. Whitehead decided she wanted to keep the baby and the infamous custody case ensued. A New Jersey trial judge upheld the surrogacy contract in 1987, validating the termination of Mary Beth Whitehead's parental rights and giving custody of Baby M to the Sterns, but a year later, in 1988, the New Jersey Supreme Court invalidated the surrogacy contract. Mary Beth Whitehead's parental rights were restored by the New Jersey Supreme Court decision. However, using the legal standard of "the best interests of the child," permanent custody was assigned to the Sterns while Whitehead was awarded visitation privileges. See In the Matter of Baby M, 109 NJ 396 (1988). [Return to text]

2. For further discussion of media coverage of surrogacy see: Susan Markens, Surrogate Motherhood and the Politics of Reproduction (Berkeley: University of California Press, 2007). [Return to text]

3. Some academic journals publishing exchanges about the topic in immediate response to the Baby M case include: Gender & Society 1.3 (1987); Law, Medicine and Health Care 16.1-2 (1988); Society 25.3 (1988), Harvard Journal of Law and Public Policy 13.1 (1990), among many others. [Return to text]

4. See for example: Rita Arditti, Renate Duelli Klein and Shelly Minden, eds., Test-tube Women: What Future Motherhood? ( London: Pandora, 1984); Gena Corea, The Mother Machine: Reproductive Technologies from Artificial Insemination to Artificial Wombs (New York: Harper & Row, 1985); Gena Corea, et al., Man-made Women: How New Reproductive Technologies Affect Women (Bloomington: Indiana University Press, 1987); Angela Davis, "Outcast Mothers and Surrogates: Racism and Reproductive Politics in the Nineties," in American Feminist Thought at Century's End: A Reader, Linda S. Kaufman, ed. (Cambridge, MA: Blackwell, 1993); Andrea Dworkin, Right-Wing Women (New York: Perigee Books, 1983); and Barbara Katz Rothman, Recreating Motherhood: Ideology and Technology in a Patriarchal Society (New York: Norton, 1989). [Return to text]

5. See ZsuZsa Berend, "Surrogate Losses: Understandings of Pregnancy Loss and Assisted Reproduction among Surrogate Mothers," Medical Anthropology Quarterly 24.2 (2010): 240-62; Gillian Goslinga-Roy, "Body Boundaries, Fiction of the Female Self: An Ethnographic Perspective on Power, Feminisim, and the Reproductive Technologies," Feminist Studies 26.1 (2000): 113-140; Gillian Goslinga-Roy, "Naturalized Selves and Cyborg Bodies: The Case of Gestational Surrogacy," in Biotechnology, Culture and the Body, Paul Brodwin, ed. (Bloomington: Indiana University Press, 1998); Helena Ragoné, Surrogate Motherhood: Conception in the Heart (Boulder, CO: Westview Press, 1994); Elizabeth F.S. Roberts, "'Native' Narratives of Connectedness: Surrogate Motherhood and Technology," in Cyborg Babies: From Techno-Sex to Techno-Tots, Robbie Davis-Floyd and Joseph Dumit, eds (New York: Routledge, 1998); Elizabeth F.S. Roberts, "Examining Surrogacy Discourses Between Feminine Power and Exploitation," in Small Wars: The Cultural Politics of Childhood, Nancy Scheper-Hughes and Carolyn Sargent, ed. (Berkeley: University of California Press, 1998). [Return to text]

6. Judith Warner, "Outsourced Wombs," New York Times 3 January 2008; Amelia Gentleman, "India Nurtures Business of Surrogate Motherhood," New York Times 10 May 2008; Ellen Goodman, "The Globalization of Baby-making," The Boston Globe 11 April 2008; Krittivas Mukherhee, "Rent-a-womb in India Fuels Surrogate Motherhood Debates," Washington Post 4 February 2008; and Henry Chu, "Wombs For Rent, Cheap," Los Angeles Times 19 April 2009. [Return to text]

7. See Warner, Judith. [Return to text]

8. See Gentleman, Amelia. [Return to text]

9. For recent ethnographic research in India see, for example: Amrita Pande, "Not an 'Angel,' not a 'Whore:' Surrogates as 'Dirty' Workers in India," Indian Journal of Gender Studies 16.2 (2009): 141-73; Amrita Pande, "Commercial Surrogacy in India: Manufacturing a Perfect Mother-Worker," Signs: Journal of Women in Culture and Society 35.4 (2010): 969-92; and Kalindi Vora, "Indian Transnational Surrogacy and the Disaggregation of Mothering Work," Anthropology News February 2009. See also Vora's article "Medicine, Markets and the Pregnant Body: Indian Commercial Surrogacy and Reproductive Labor in a Transnational Frame" in this issue. Similar findings about the salience of economic factors can also be found in Elly Teman's research on Israeli surrogates: Elly Teman, Birthing A Mother: The Surrogate Body and the Pregnant Self (Berkeley: University of California Press, 2010). [Return to text]

10. See Markens, Susan. [Return to text]

11. See Gentleman, Amelia. [Return to text]

12. See Chu, Henry. [Return to text]

13. See Teman (2010) about the central role of the United States, particularly California, in the global surrogacy market. [Return to text]

14. For an exception to this see Goodman, 2008. [Return to text]

15. Jane Brody, "Much Has Changed in Surrogate Pregnancies," New York Times 21 July 2009. [Return to text]

16. Alex Kuczynski, "Her Body, My Baby," New York Times 30 November 2008. [Return to text]

17. Lorraine Ali and Raina Kelley, "The Curious Lives of Surrogates," Newsweek 7 April 2008. [Return to text]

18. Ibid. See Newsweek's website for online reader comments. [Return to text]

19. Ibid. [Return to text]

20. This altruistic storyline about surrogacy was seen, for example, in the 1990s television shows "Sisters" and "Friends" and more recently in the series "Brothers and Sisters." [Return to text]

21. See Markens (2007) for a more detailed discussion of media coverage of Johnson v. Calvert surrogate custody case. Class based assumptions about good mothering and good parenting were also critiqued during the Baby M trial. See Michelle Harrison, "Social Construction of Mary Beth Whitehead," Gender & Society 3 (1987): 300-11. [Return to text]

22. See Ali and Kelley, 2008. See Newsweek's website for online reader comments. [Return to text]

23. See Chu, Henry. [Return to text]

24. See Warner, Judith Warner, 2008. [Return to text]

25. Susan Markens, "Indian Surrogates, Military Wives, and Infertility Stories: Media Framings of Surrogacy in the 21st Century," presented at American Sociological Association Annual Meeting, San Francisco, CA, 8-11 August 2009. [Return to text]

26. Stephanie Saul, "Building a Baby, With Few Ground Rules," New York Times 13 December 2009. [Return to text]

27. Clark Hoyt, "The Privileged and Their Children," New York Times, 7 December 2008. [Return to text]

28. See Melinda Beck, "Ova Time: Women Line Up to Donate Eggs—for Money," The Wall Street Journal, 9 December 2008. [Return to text]

29. Kuczynski 2008. See nytimes.com for online reader comments. [Return to text]

30. Ali and Kelley 2008. See Newsweek's website for online reader comments. [Return to text]

31. Similarly, Dorothy Roberts argues that race, in addition to class, affects judgments about parenting and thus which children end up in the foster care system. See Dorothy Roberts Shattered Bonds: The Color of Child Welfare, (New York: Basic Books, 2002). [Return to text]

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