Cash and Carry

The surrogacy industry shows how difficult it will be to make new reproductive technologies benefit all.

Newborn babies in a Connecticut nursery. Blaine Harrington Age / F1online

Last year, a couple from Australia abandoned one of the twin newborns they had commissioned from Pattharamon Chanbua, a surrogate from Thailand. As the international media recounted, the surrogate mother’s family then embraced the child, who has Down’s Syndrome and came to be known as Baby Gammy. Thousands of dollars in donations poured in.

After the international coverage, Gammy — who remains with his “surrogate” mother — was granted Australian citizenship. Because he emerged from Chanbua’s womb, however, Gammy was legally a Thai citizen as well.

The case was more than grist for the tabloid mill. It highlighted the shortcomings of the standard discourse around surrogacy, forcing commentators to grapple with the role of prospective parents in perpetuating inequality, and the possibility that surrogacy presents many of the same moral problems as the family proper.

While contemporary transnational surrogacy reflects global disparities in wealth and distant divisions of care labor of various kinds — Thailand is also an Australian sex-tourism epicenter — it also evokes the possibility of a different world of reproduction, premised on mutual aid and non-proprietary relations with kids.

Because she opened her arms to Baby Gammy, Chanbua has been turned into a cardboard saint by millions of fans keen to spit on the Australian couple. But this shouldn’t minimize her and her family’s intentional, interesting, kind, and non-obvious adoptive act, which is irreducible to “maternal instinct.”

It becomes easier through the Pattharamon Chanbuas of contemporary history to see what a surrogate politics might entail: an anti-proprietary, un-heterosexual mothering power. This is a politics grounded less in the boutique volunteerism of “surromoms” in the Global North than in the majoritarian force of the gestational contractors Holly Donahue Singh dubs “the world’s back womb.”

At the same time, a wide array of reproductive struggles have called into question the possibility for humane and unalienated social regeneration. Witness the historical phenomenon of the “motherhood strike,” embodied lately by young women in Cameroon who defied their husbands to walk in their shoes for a month; or of underground midwives operating today in North Carolina; the clandestine Ireland Abortion Support Network; or any number of other collective parenting traditions.

Radical feminists across the world focus heavily on reproductive freedom, struggling both for abortion rights and against the sterilization drives that, ironically, used to target many of those who are now surrogate workers.

Yet the politics proper of making children, and reinventing what it means to be kin, fails to animate many radicals today — with the notable exception of the queer and trans communities, whose right to state-funded, technologically mediated procreation is contested. For them, and for anybody cast out of the nuclear family, tender attention to such questions has often spelled the difference between life and death.

From the invented homes nurtured by homeless queer youth, to the many decidedly non-nuclear household models found everywhere on earth, a wealth of practices defy the regime some have begun to call “repro-normativity” — the softly coercive culture that champions biological reproduction by straight couples as the be-all and end-all of an individual’s self-fulfillment.

For the broader left, the intriguing problem of the family has been successfully depoliticized by, on the one hand, this mainstream repro-normative politics, and on the other, the collapse into liberalism of the spirit of the utopian communal family experiments of the sixties and seventies.

But thinking about supplementing “kinship” with alternative, intentional, egalitarian, and gender-liberatory relations is not liberal lifestylism. New reproductive technologies could be an emancipatory terrain for existing feminisms. At present, however, the frontier of repro-tech is doing little more than providing companies with a means of capitalizing on reproduction at the global periphery.

The legality and regulations regarding surrogacy vary from country to country.

Surrogacy in the United Kingdom is completely illegal if deemed commercial; in practice, it is untracked, unorganized and unregulated. Amateur charitable agencies struggle to facilitate agreements on home territory that are “expenses only.” Meanwhile, the vast majority of children that are brought, as Britons, from India, Thailand, Mexico, and elsewhere never get registered as surrogacy babies: the estimates from those countries dwarf those on British records.

As Oxfordshire housewife Octavia Orchard explained to the Daily Mail, there’s no reason not to erase a nameless surrogate from the picture. “Her function is to sustain the fetus we have created . . . she is just the vessel.”

In the United States, where the largest payments take place, surrogacy is also officially organized — in states where it’s legal — as sponsored volunteering. But no court has yet ruled against intended parents on account of their surrogate having profited. Intended parents spend roughly between $70,000 and $130,000 in total, of which around $30,000 goes to their carrier as “compensation,” imaginatively conceived, and $30,000 to the agency.

Extra living expenses, lost wages, maternity clothes, and life insurance can also accrue. Lawyers take up to about $20,000. Egg retrieval and IVF, which include a suite of aggressive drugs, cost up to $20,000 as well. Increasingly, fertility centers and surrogacy agencies even offer loan financing for their own services, allowing would-be parents to go into debt to the tune of $100,000.

Military wives are heavily represented in surrogacy forums and support networks. Given the pregnancy and maternity coverage included in health care packages for the defense sector, many military wives have established themselves as high-value altruistic domestic “carriers” for other people.

In general, those in the United States for whom surrogacy is a kind of career can exercise significant control. They tout their track records and bodily credentials to prospective parents online, but it’s the latter who are vetted and selected as business partners by the women.

Some of these people may not necessarily be struggling, but simply do not want to go through pregnancy themselves. Women who are biologically equipped to gestate but do not want to are routinely smeared, even in surrogates’ web forums like the US-based SurroMomsOnline, as unfit mothers — a trend epitomized by the phrase “vanity surrogacy.”

This attitude exemplifies the strong strain of reactionary family values to be found among American surrogate amateurs, who ironically believe, despite their livelihoods, that “natural” pregnancy always ought to be preferable. Here, the industry imperative to encourage as many people as possible to seek technological assistance is in direct tension with ingrained family values, a pro-normal natalism which tamps down this eagerness by insisting it remain an exception and a medical remedy only.

Most assistance takes the form of mixing an egg and some sperm to form a normal embryo that is introduced into a third party’s uterus. Thus, even merely workaday surrogacies give a third party — the so-called surrogate — the task of activating foreign genes, involving several persons in the creation of a new body. While surrogacy agencies aim to convince clients otherwise, this plural co-operation potentially unsettles the structure of social reproduction through the couple.

Not surprisingly given the atomized, individualist spirit of our times, for many commissioning parents, the less they know about the intermingling of the surrogate’s body with “their” baby’s, the better. The third party should not, as far as many future parents are concerned, have a claim to be a part of the family, but should act strictly as a silent helpmeet, incubator, or oven. Yet the physical facts of human gestation betray any account of surrogacy that renders the material being of the baby and the surrogate as distinct from one another.

Materially, it is composed of reproductive workers themselves, though they are far from passive tools. Nor are surrogates simply vectors of an inorganic nature whose vital force is being harnessed through the creative labors of scientists. Their bodies’ potency simply continues to elude the automation dreamed of by patriarchs and Shulamith Firestone alike.

Unsurprisingly, right-wing opponents of queerness, sex education, and planned parenthood are divided when it comes to the new baby-making technologies, and many are reluctant to condemn outright anything that also helps god-fearing infertile straight people procreate.

Medical tourism thus exhorts clients to “be fruitful and multiply.” Conservatives might even be swayed by the common references to surrogacy in the Old Testament. One pre-capitalist, scriptural precedent in particular is frequently invoked: assisted reproductive technology (ART) can be godly because Hagar bore a child for Abram and his barren wife Sara.

Yet Hagar, when she “gave the gift of life,” was actually an indentured slave in a feudal economic system — certainly not a volunteer helping her friends on equal terms. Hagar’s impregnation by her master resonates, as a form of bodily alienation, with today’s colonization of the womb by laboratory biomass — but it is also distinct from it.

As the living property of her master and mistress, Hagar gestated her own gametes on the basis of an unspoken social contract stating that the child would be Abram and Sara’s kin on birth. Modern-day Hagars, by comparison, are “free” salespersons of their gestational labor-power and can sometimes litigate.

Regulatory frameworks for ART are now hotly contested topics in every journal of law. There, the humanist legal fictions of personhood die hard, whereas the instrumentalization of female bodies as reproductive technology evolves from century to century.

Gestational surrogacy is booming mostly within the Global South. India’s state-subsidized export industry in medical tourism, to take one example, was estimated in 2014 to be worth $2.5 billion, having quintupled from the figure of $449 million in 2006. Laboring wombs are now fully a standard post-Fordist service on a truly global scale. Keeping surrogacies local isn’t necessarily crucial to progressively politicizing them.

Yet under capitalism, it’s nearly impossible to imagine transnational surrogacies that operate on an egalitarian basis. Cheapness is, for intending parents, the primary reason for finding a surrogate “over there,” but the geographic chasm between the parties’ lives is doubtless a secondary motivation. Indian agency websites sometimes explicitly list as an advantage the fact that the surrogate cannot, later on, come knocking.

Clients do sometimes come from India, as well, but their social distance up the class ladder from the surrogates makes up for any relative geographical intimacy.

To enlist one’s womb in a rental agency in India, Guatemala, Thailand, Mexico, Ukraine, Russia, or China (where the practice is entirely underground), one should ideally have the following: proven fertility, in the form of existing children; health; “reliability” — a measure of economic desperation paired with maternal commitment to aforesaid children; docility, in the form of a consenting husband and, ideally, a repressive local patriarchy; and pleasantness of demeanor.

In the docu-drama Google Baby, pioneer and star clinic director Dr Nayna Patel gestures at her gestational cohort and reassures the prospective client: “All of my surrogates are very humble, simple, nice females . . . very dedicated . . . very religious.” Despite the fact that surrogates’ genes are not involved, fair skin is often mentioned: commissioning parents sometimes like to Skype with their surrogates.

But not according to the surrogates’ wishes. Industrial norms aim to limit the surrogates’ bodily link with a foreign or upper-class citizen: strict control over communications, births timed for convenience and as caesarean sections, restrictions on surrogates’ mobility, and the express forbidding of the surrogate’s first breast milk reaching the newborn.

As in other workplaces, these measures seek to discipline the power of the producers of human beings and betray an anxiety about that power. Take, for example, the striking semantic policing of the scene in Google Baby where Patel, dressed in surgical scrubs, lifts a baby out of a woman’s abdomen and orders her staff to “take the baby outside to its mother.”

In contrast with American equivalents, life insurance for the surrogate is more or less unheard of. In the case of medical emergencies, the bodies of mother and fetus are treated in facilities paid for by those in whose interest it is that the fetus, in particular, survives.

Payments to surrogates are usually staged in connection with gestational milestones (implantation; three months; six months), and a miscarriage voids all payment. Regardless of the outcome, if we calculate an hourly wage, the financial beneficiaries are disproportionately the doctors and medical technicians rather than the laborers.

Comprehensively, a full term of gestation along with the clinical labor that takes place prior to implantation involves some seven thousand hours for the surrogate, translating to a wage of up to $1 an hour and sometimes $0.50. A great number of the women involved have been motivated by debt, and the rate is high enough to inspire many to save towards a new home or educate their own children. It does not, however, merit the self-congratulatory assertions of many intended parents that they have transformed a less fortunate family’s existence.

Surrogates face an intensified form of the selective erasure that threatens all those who contribute to social reproduction via gestation. Mothers are both glorified and poorly valued, while surrogates are sentimentally valorized but nevertheless reduced to forgettable incubators.

Surrogates’s own discussions display internalized versions of this contradiction: some joke boastfully that it takes a smart woman to get paid to have a baby — implying that it isn’t really work — while others insist that it was their “sweat and the effort”— not that of the medical technicians’ — that went into making the baby.

As the industry continues to boom, calls for the formalization and regulation of surrogacy from policymakers, NGOs, and lobbyists are becoming more common. They suggest that strong and enforceable legal acts be passed, that surrogacy be demonstrated to be a last resort, or that it be made unavailable to intended parents living in countries where it is unrecognized. But states have generally remained bewildered and reluctant to act.

Western surrogacy abolitionists, such as Kajsa Ekis Ekman, and anti-surrogacy campaigns like FINRRAGE exist today, although they pack less of a punch than their ’80s forebears, whose spokespeople were often polemical second-wave-feminist technophobes like Janice Raymond and Gena Corea.

In contemplating the handing over of a baby, many such women rightly refuse the gulf of inequality that divides human lives and the distancing mediations performed by men in white coats. But they have difficulty accepting surrogates’ own choice in the matter: there is no evidence suggesting that surrogates frequently want to “keep” the baby, and surrogate pregnancies are sought-after sources of revenue for proletarians in the present.

Meanwhile, the more common stance of those who purport to oppose surrogacy only when it is non-altruistic and commodified is equally deluded about the nature of all work, and disconnected from surrogacy’s core subjects, who are unmistakably in it for the cash. Surrogacy is no more, and no less, an abomination than other forms of work. What seems to be the only progressive position on surrogacy merely calls on states to rationalize the rules for transactions so that people can go about their private procreative business drama-free.

What we need is an approach that is less deferential to the sanctity of would-be parents’ personal undertakings, instead daring to imagine collective solidarity and new social expectations. Surrogates’s task seems to be, on the one hand, to assert their creative role in a person’s life. Whether they want to be in the family, human beings’s interdependency and bodily interconnection through childbirth is surely a compelling terrain on which to wage struggle. Indeed, there is a “surrogate” quality of so much of social life: so much of what we receive and do relies on substitution, sharing, and standing in for each other.

On the other hand, the essential similarity of surrogate pregnancies and “normal” ones suggests a provocation: why should all pregnancies not be paid? Surrogates threaten the mystification and naturalization of the heavyweight economic unit known as the family.

Why should the surrogate get paid only for the “guest” baby she produces, and not her own? Why shouldn’t her own prior pregnancies have benefited from the 24/7 state-of-the-art health care frequently found in surrogacy clinics?

A vast number of women gestate babies for free; those few women whose pregnancies are waged, much like paid caregivers and sex workers, occupy a position that speaks to millions of potential allies. Though many Marxists didn’t think of it, being in labor is labor. Mounting a “wages against pregnancy” campaign could thus refuse the difference between surrogate and normal pregnancies as a jumping-off point for questioning and denaturalizing the prevalent mode of social reproduction more broadly.

What else might this politics look like? The only documented case of the collective bargaining power of surrogates being put to the test is one where a worker was denied leave to visit her dying father, on which she and others threatened to “drop” — willfully miscarry — their babies.

Grim and unpalatable as it may be, most of all for them, this kind of leverage is essentially what the striking workforces of embodied labor have at their disposal. As workers in the field of reproductive vitality, mothers on strike can only really bargain with their ability to extinguish life — a prerogative we must support, as with struggles over abortion access.

At the same time, struggles for reproductive justice from below are incomplete if they fail to speak to the other side of the relation: to the thwarted desire to be a parent. In particular, advancing queer and trans people’s access to the pro-family medical and legal benefits and services of the (admittedly dwindling) welfare state is vital to re-envisioning reproduction. But striving beyond the state for our reproductive justice also entails the freedom to not reproduce at all, and raises all-too-often buried questions: not just “how to reproduce,” but “why”?

As Nina Power puts the problem: “What would it mean to refuse to perpetuate the ongoing processes that constitute and maintain capitalism while refusing to give up on care and other human relations that sustain us? Is it possible to separate the two adequately or at all?”

The concept of reproductive technologies is far from straightforward, for the simple reason that the very boundaries of the reproductive and the technological are enormously political.

One of the latest advances in the science of reprotech is known as somatic cell nuclear transfer, or SCNT, wherein human embryos can be crafted from more than two portions of DNA. The result is babies who have multiple genetic parents, none of them necessarily male — or female, for that matter. This opens up exciting possibilities for gay and “poly” child production.

But the focus on an embryo’s DNA as the basis for defining “genetic” or “biological” parenthood is misplaced. The human body, it seems, leaves intimate traces of itself after pregnancy, no matter how foreign the fetus. A pregnant person cannot easily be made to pass as a clean piece of reproductive technology.

As though compelled to overcome this cumbersome constraint of the reproductive body, a steady trickle of speculation flows through magazines about the advent of “ectogenesis”: gestation that would be performed entirely by machine incubators. While contemporary fantasies imagine this technology as an addition to existing class society, feminists will recall that ectogenesis was also part of Shulamith Firestone’s sketched utopia in The Dialectic of Sex.

When a fair number of orphans worldwide remain homeless, it may appear a self-indulgent privilege to dedicate medical and research resources towards bringing new lives into being through a form of reproductive alchemy unavailable to most people.

But dismissing surrogacy and multi-parent nucleus technology for that reason cedes important queer feminist terrain to technoscientists, eugenicists, and the rich. Such proponents of these supposedly apolitical methods tend to minimize and apologize for the unnaturalness of assisted reproduction, linking it to a pathologized infertility.

A counter-movement should instead make peace with unnaturalness and propose a defiantly cyborg, collective concept of human regeneration. The “normal” way of synthesizing children, after all, is natural in the same way that maternal death in childbirth is natural, which human societies still strive to eradicate.

Nature has never been a repository for liberatory politics. Even as it becomes more and more possible for an international middle class to relate to babies as programmable fetish objects that confirm the value of one’s self, the guise of the natural has served to fuel the pursuit of babies, and the paid and unpaid labor it commands.

Rather than shun ART completely, however, we could think about salvaging its uses for a world in which newborns always have the chance to be nurtured by many. We should bear in mind an uncompromising vision of abundance, in order to struggle toward it: a post-capitalist world without orphans, where everyone can splice their genes together with their friends and loved ones if they want to.