The Tangled Web of Gestational Surrogacy

Historiann drew my attention to a fascinating essay in last weekend's New York Times Magazine by Alex Kuczynski, "Her Body, My Baby, on the experience and economics of becoming a mother via surrogacy. Historiann rightly raises a bunch of smart questions about how socioeconomic disadvantage encourages women to "altruistically" carry another woman's child:

This family may be an isolated example, but, I wonder: are working-class and middle-class women and girls being driven to sell reproductive services in order to get themselves and their children through college? If so, what does it say about what we value in women–their brains or their bodies? Are women who use the latter to improve the former with the goal of finding work that doesn’t involve their reproductive organs being canny, or are they being used?

(Read the rest of Historiann's post for more.)

Historiann locates a lot of unconscious class-based elitism in Kuczynski's essay, and I don't think she's wrong. But I think Kuczynski is equally driven by her unconscious embrace of the ideology of good mothers/bad mothers and her puzzlement at where she and her surrogate, Cathy, fit into it. She's also nagivating a fraught line between commerce and intimacy. Of course, these tensions are profoundly rooted in social class, too, but they can't be reduced to elitism. Here's the money paragraph:

WHEN WE CAME ACROSS Cathy’s application, we saw that she was by far the most coherent and intelligent of the group. She wrote that she was happily married with three children. Her answers were not handwritten in the tiny allotted spaces; she had downloaded the original questionnaire and typed her responses at thoughtful length. Her attention to detail was heartening. And her computer-generated essay indicated, among other things, a certain level of competence. This gleaned morsel of information made me glad: she must live in a house with a computer and know how to use it.

Historiann sees a patronizing "splendid isolation" here, and I agree. It's not quite on a par with Bush 41's awe at supermarket scanners, but yeah, Kuczynski's apparent surprise that Cathy lives in a house with a computer reflects the limits of a life spent shuttling between her Idaho vacation home and their little nest in Southhampton. It's hard not to see Kuczynski as a poor little rich girl who needs to brush shoulders with the hoi polloi more often.

But I think this paragraph - much as it made me cringe, too - reveals other dimensions of surrogacy and, more broadly, American attitudes toward maternity.

One of Historiann's commenters mentions that she'd considered becoming a surrogate, and that it felt to her like becoming "a reproductive whore of sorts." (She didn't do it.) I can see her point (though I've never been either a surrogate nor a prostitute). Both of these forms of work - and they are work, which should not be stigmatized - seem to me as though they entail selling an intimate aspect of one's corporeality. As I wrote a while ago, I don't see a problem with women choosing to sell these services, especially in a labor market where their other options may be quite bleak; I do see the buyer's position as hard to defend ethically, in part because the client is almost always in a strong position to exploit the seller.

I'm still struggling to work out why surrogacy and prostitution seem so qualitatively different to me than selling one's hard physical labor as a coal miner, say, or one's intimate thoughts as a professor (which Martha Nussbaum claims is in fact at least as ethically problematic). Maybe because surrogacy and prostitution would involve letting others have use of the interior of my body? Maybe because they seem to imply a different, physically and psychically deeper sort of vulnerability than other occupations? Maybe because both surrogacy and prostitution would be far less attractive if women had other lucrative possibilities at their disposal? Yes, I know that there are many sex workers and surrogates who claim to love what they do, and I don't dispute that. I'm still sure that their numbers would drop dramatically if the financial incentives evaporated.

At any rate, Kuczynski's arrangement with Cathy is both contractual and highly intimate. This is not so different from prostitution, either, viewed from the john's side. Susannah Breslin's Letters from Johns collection is rife with examples of men who want much more from a prostitute than just an orgasm. Ditto for Peridot Ash's wonderful blog on the charms and burdens of being a paid escort (here, for example).

To drive the sex work parallel just a little further into the ground: Escorts are generally better paid when they're educated and bright. Clients pay a premium for the privilege/illusion of social intercourse with someone who appears to have something in common with them. Why should surrogacy be any different? From this angle, it's not at all surprising that Kuczynski would look for someone she felt she could connect to, emotionally and personally. The lines that follows the paragraph quoted above are revealing on this point:

In our conference call with Cathy and her husband, Mick — the vice president of marketing for a credit union — we felt immediately comfortable. They had three children, two of whom were in college. Cathy and Mick sounded compassionate and intelligent. ...

I appreciated Cathy’s warmth and straightforward manner. But there was something else that drew me to her — the same thing that caused me to see her computer-generated essay in a different light from the other women’s hand-scrawled applications. She and her husband were college-educated. Her husband graduated from William and Mary. Her daughter Rebecca, then 20, wanted to be a journalist. They lived in a renovated mill house on a creek in a suburb of Philadelphia. They seemed, in other words, not so different from us. Later, during the election season, she and I were unaccountably pleased to learn that we were both planning to vote for Obama.

I have to make a leap of empathy, but in Kuczynski place I think I'd feel the same. Consider daycare providers, an area where I do have some direct experience, and which substantially parallels surrogacy in that you're entrusting your child's care to another person. Personally, I valued the fact that our long-time provider was intelligent in every way - emotionally and intellectually - and well educated. She had good common sense, excellent problem-solving abilities, and an intuitive understanding. Oh, and she supported Obama too! That's not as superficial as it might first appear. It was just one more indication that our values harmonized well.

Now, Kuczynski's situation was different in that Cathy would not be teaching, disciplining, and playing with her child; she wouldn't be molding his character or values. Kuczynski writes:

I know all this should have been irrelevant. Political preferences aren’t passed along through the umbilical cord. Strictly speaking, she was a vessel, the carrier, the biological baby sitter, for my baby, or as she put it in her essay, “I will serve as the ‘foster mother’ to the baby until it is born.” But it was easy to think of her as carrying my baby. She wasn’t desperate for the money, so our relationship wouldn’t have to feel like a purely commercial enterprise, or a charitable one.

In fact Cathy mentions that she's become part of the extended family for another couple whose child she carried. In an ideal world, every surrogate contract would morph into a real relationship, just as birth mothers would find a comfortable relationship with everyone involved in open adoptions. In reality, an awful lot of factors militate against this happening: social and economic differences; the parents' desire to move on with their lives or even deny their neediness; the fact that the arrangement was always about business, first and foremost.

While Kuczynski's desire for someone like herself to carry the baby is perfectly understandable, it also has a shadow side: the desire to control the surrogate as if she were, indeed, "a vessel." This reflects the near-paranoia that has taken hold in middle-class America about women's conduct in pregnancy ever since the publication of the original What to Expect When You're Expecting, with its endless lists of virtuous and evil foods. These paranoid tendencies seem to intensify toward the top of the socioeconomic food chain, where Kuczynski is located. For her, since self-control wouldn't ensure a healthy baby (no matter how many yoga classes she attended), she directed this controlling impulse toward Cathy:

Later in the fall, Cathy went to Las Vegas with her husband, who was attending a conference. I took the news badly. My tiny child — now that there was a sex, an identity, I could think of him as a child — was out there in Vegas at a craps table. I worried about the flight and whether the pressure would harm him. The thought crossed my mind to ask Cathy if it was really necessary to go, but I knew I couldn’t. I had given her my baby, and I would have to give her my trust as well. I hated giving up control, but experience had proved that I had even less control over my own uterus, and trying to exercise any measure of authority over Cathy would cause both of us only grief.

Yikes! I can imagine that making this leap of trust would be hard. I'm not totally unsympathetic. And yet - does Kuczynski really think she would have foregone her trips to Boise if she's been the "vessel"? Pregnant women routinely fly. If they're not experiencing complications or within a few weeks of delivering (or leaking amniotic fluid!), flying is no big deal.

Kuczynski recognizes that she can't control Cathy in any practical sense. What she fails to acknowledges is that her desire to do so isn't just likely to retraumatize herself; it's just plain unreasonable. Why does she object to Cathy playing a few rounds of the craps? Is the baby going to be born with a gambling addiction as a result? Or is it just that Kuczynski has bought into the mythology that a good mother forgoes all pleasure?

Instead of reflecting on how overblown these control issues had become, both in her mind and in our culture, Kuczynski laments her inability to live them out. Given the reflective tone of her essay, I wish she'd found a way to break out of this insanely exacting Good Mother paradigm. Given the control freakery around pregnancy in modern America, it's not surprising that she didn't.

Kuczynski's control issues culminate in her reaction to the baby's delivery, which sounds like a classic case of couvade - the practice in some cultures of the baby's father emulating symptoms of pregnancy and/or labor:

Birth is not a tidy business. As Cathy went into labor, my husband stood respectfully by her head to avoid being on the more visceral end of things. I found my son’s birth to be a terrifying event. When the baby crowned and the top of his skull appeared, my brain did back-flips. There was the mind-bending philosophical weirdness of it all: there is our baby — coming out of her body. And then there was the physicality of it: the torture of childbirth, of being split open, of having your body turned, it seemed, inside out to produce this giant, beautiful baby. Cathy vomited; I vomited.

Watching someone else birth your baby has got to be a profoundly weird experience, indeed. What's missing, of course, is an account of Cathy's experience. That essay - written by the mother who nurtures the baby, then hands her over in an act of blinding generosity - has yet to be published in the New York Times. What are the odds of that ever happening?

Photo by my husband.