Gay Americans scored a huge victory in June when the Supreme Court, in a 5-4 decision, declared same-sex marriage a Constitutional right.But will this historic win for homosexuals inadvertently translate into a setback for American women? Anyone who studies third-party assisted reproduction trends, more specifically surrogacy, will tell you it’s inevitable, unless something is done about it. Payments from wealthy prospective parents to poor women for surrogacy services were surging before Obergefell v. Hodges. Now they’re set to explode.The gay rights movement has realized astonishing success in the past two decades, not just in advancing legislation but in normalizing homosexual relationships in American culture. According to Gallup, just 38 percent of Americans believed that gay and lesbian relationships were “morally acceptable” in 2002. A decade later that number stood at 63 percent. Sixty percent of Americans support gay marriage today, almost twice the 35 percent that supported it in 1999.In other words, gay and lesbian households are going mainstream, and with that change comes a demand for traditional features of the married household, including, foremost, children. The growing number of adoptions by same sex couples speaks to that nesting trend: In 2000, the Census reported 8,310 adopted children living with same sex couples in the U.S. In 2009—five years before the Supreme Court decision—it was 32,571.Consider another fact: The Census Bureau estimated that there were 252,000 gay and lesbian married couples in America in 2013, when just 14 states allowed same sex marriage. Now that all fifty states allow it by the Supreme Court’s decree, the number of married same sex couples is poised to shoot up in short order. It’s not a stretch to say that the baby market going forward could reach into the low millions, as gay couples turn to Third Party Assisted Reproduction rather than adoption to build families.Paid surrogate pregnancies are one of those things that sound like a win-win upon first hearing but become more and more problematic, for all parties involved, the closer one looks. There’s a reason countries like France, Germany, and Spain prohibit all surrogacy, and that Canada has banned paid surrogacy. They understand what the surrogacy market can do to women and to the children they bear.In the United States, though, the laws are still a patchwork quilt that has effectively allowed a lightly regulated, multibillion-dollar business to take hold. A quick Internet search reveals baby brokers who aggressively market surrogates especially, in the wake of Obergefell, to same sex couples. They sell the idea of the American family by renting out the wombs of struggling American and foreign women. Agency websites are rife with dehumanizing terms, with patients referred to as “clients,” surrogate mothers as mere “carriers,” and pregnancies referred to as “sales.”Brokers also provide prospective customers with a veritable menu of features to bequeath children. Eye color, athleticism, Ivy League genes? It’ll cost you more, but they have it all. Tall, short, blonde, brunette, Asian, European—whatever you’re looking for can be arranged, for the right price. Unregulated, the business of egg and sperm “donation” run the risk of eugenic commodification. Ads commonly specify racial, physical, and intellectual characteristics—giving parents the opportunity to create custom-tailored children and pressuring surrogates to terminate pregnancies if the “product” doesn’t fit the customer’s desired outcome.For £1,800, couples can now get a blood test in England that will reveal in thirty days if their genetic combination could—could—result in one of more than 600 heredity diseases. A single potential flag will no doubt send some to the egg and surrogacy markets.Because surrogacy frequently depends on the exploitation of poorer women, the lack of regulation on these unequal transactions often results in “uninformed” consent, low payments, coercion, poor health care, and severe risks to short- and long-term health. As the European Parliament stated in a resolution, surrogacy and egg sale constitute an “extreme form of exploitation of women.” The New York State Task Force on Life and the Law under former New York Governor Mario Cuomo stated that commercial surrogacy “could not be distinguished from the sale of children and that it placed children at significant risk of harm.”Still, the practice is being regularized, glamorized even, by the American media. Time listed pregnancy as one of the “Top Ten Chores to Outsource” a couple of years back. Glamour glowingly noted this May a group of A-List celebrities, including Nicole Kidman, Sarah Jessica Parker, Elton John, and Neil Patrick Harris, who have hired surrogates to produce children for them. Wealthy, figure-conscious Americans are in on the game as well. Why endure the pains and risks of pregnancy when you can pay help to do it for you?But what about that help? Who are they? What are these surrogate pregnancies doing to them, psychically, spiritually, and psychologically? And what does it do to the children?These are the questions not being asked because the surrogacy industry doesn’t want to know the answers, and there are almost no government studies on paid surrogacy. The National Institute of Health spent $666,905 to study the benefits of watching television reruns but doesn’t seem to care that scenes from Margaret Atwood’s dystopian novel, The Handmaid’s Tale, are playing out in delivery rooms every day.What we do know from limited private research is that the health and psychological risks to women serving as egg vendors or surrogates often go untold. Those risks include Ovarian Hyperstimulation syndrome (OHSS) due to superovulation, loss of fertility, ovarian torsion, blood clots, kidney disease, premature menopause, ovarian cysts, chronic pelvic pain, stroke, reproductive cancers, and in some cases, death.In October, a paid surrogate mother from Idaho died from placental abruption while carrying twins, reportedly for a Spanish couple. The twins died, too, just days before they were scheduled to be delivered by cesarean section. The mother had been a paid surrogate multiple times.Military wives are being heavily targeted to act as paid surrogates. And “targeted” is not too strong a word: These woman, mostly young and mostly poor, may not be able to hold down full-time jobs while balancing responsibilities to children and household—not to mention the stress of having a spouse in harm’s way overseas.Here’s what one recruiting website writes:
Embraced by independent ways, military wives are a good match for couples looking to build a family through surrogacy.They truly understand the commitment and the self-sacrifice—which comes full circle in their own lives.Today, military wives are helping intended parents, as well as gay singles and couples, both in the US and abroad. It is a suitable fit, with their solid supporting cast, more and more of these courageous and loving women are taking action. They see it as a way to help unlucky couples build a family, not an exclusive montage of money.
Once they sign a contract, these and other women are injected with risky hormones to produce as many eggs as possible for cultivation. Egg providers are enticed through ads in online classifieds, social media, and college newspapers offering anywhere from $5,000 to $100,000 per extraction. The better the school these young women attend, the more money they are offered. Ads directly appeal to college-age women’s financial need without any mention of the potential health risks involved—essential information to enable informed decision-making and consent. Universities do nothing to block these advertisements, even though their students are being recruited to accept medical risks for money.Lupron, a drug commonly used on egg donors to medically induce menopause, for example, is not approved by the FDA for use in fertility treatment; thus it used off-label in surrogacy. This drug has a Category X rating, which means if a woman gets pregnant while taking it there will be harm to the developing fetus. This is extremely concerning in egg donors who are very fertile and may not be compliant with instructions not to be sexually active during ovarian stimulation. The use of Lupron in preparing a gestational surrogate to receive transferred embryos has been documented to put a woman at risk for increased intracranial pressure.Most concerning is that there is little to no peer-reviewed medical research on the long-term safety effects of egg procurement on the health of the young women who provide their eggs. This makes it impossible for fertility clinics to provide the information about health risks necessary for informed consent. Students are praised, paid, and left in the dark about what might happen to their bodies.Due to the high costs involved in surrogacy and the strong desire to boost success rates, multiple embryos are often implanted in a surrogate mother. In addition to the increased risk of caesarian sections and longer hospital stays, the British Journal of Medicine warns, “multiple pregnancies are associated with maternal and perinatal complications such as gestational diabetes, fetal growth restriction, and preeclampsia as well as premature birth.”Surrogate mothers who carry multiple embryos can be pressured to abort one or more. Couples can separate or divorce during a surrogate pregnancy, complicating the process. Serious moral dilemmas can arise over disagreements about unborn babies found to have deformities or other medical difficulties. One party might insist on terminating while the other wants full-term delivery. Our laws are chaotic and unsettled when it comes to determining what is in the best interests of the child when surrogacy arrangements go wrong.In addition, egg and sperm donors often regret their decision later in life. A 2014 study in Human Reproduction found that many donors later in life seek to gain information about their child and sometimes seek to establish relationships with these donor-conceived persons. The biological link between parent and child is undeniably intimate and, when severed, has lasting repercussions on both parties. A 2013 study in Reproductive BioMedicine surveyed 108 parents of children conceived via oocyte donation and found that 50 percent regretted using anonymous donation for these very reasons.There are also clear health and psychological risks to the children born via third party reproductive arrangements. Children born through assisted reproduction are much more likely to suffer from low and very low birth weights, according to a study published in the New England Journal of Medicine. Children conceived via IVF (as are all children in gestational surrogacy) also suffer from significant increases in preterm births, stillbirths, low birth weights, fetal anomalies, higher blood pressure, Beckwith-Wiedemann and Angelman Syndromes, and cesarean sections according to studies published in the American Journal of Obstetrics & Gynecology, the Journal of Perinatology, the American Journal of Human Genetics, and Fertility and Sterility.Equally concerning is the fact that surrogate pregnancies intentionally sever the natural maternal bonding that takes place during pregnancy. A June 2013 study released in the Journal of Child Psychology and Psychiatry found that “surrogacy children showed higher levels of adjustment difficulties at age 7,” and that “the absence of a gestational connection to the mother may be more problematic.” The study also reported that the child’s difficulties “may have been under-reported by reproductive donation mothers who may have wished to present their children in a positive light.”Young adult children born via anonymous gamete donation also suffer serious genealogical bewilderment according to both empirical studies and first-person testimonies. A 2001 study in the journal Human Reproduction concluded, “Disclosure to children conceived with donor gametes should not be optional.”The more one looks, the more ones sees serious moral, ethical, and medical problems associated with the commercialization of conception. Teresa Erickson, a reproductive attorney convicted of baby selling, has stated that she was just “the tip of the iceberg.” Rudy Rupak, founder of Planet Hospital, a global IVF industry provider of services, stated in the New York Times: “Here’s a little secret for all of you. There is a lot of treachery and deception in I.V.F./fertility/surrogacy because there is gobs of money to be made.”The problem of the exploitation of poor women—the renting of them for childbearing duties—was coming to a head long before June’s Supreme Court ruling. But now it threatens to pit women’s rights advocates against LGBTQ advocates in profound ways.The pressure on state governments from the paid surrogacy industry to widely legalize the practice is growing. In New York State, for example, Governor Andrew Cuomo is using the same task force his father convened to outlaw paid surrogacy, the Task Force on Life and the Law, to reverse course and allow it once again. It raises the question: When in the intervening years between father and son did the commodification of children become morally acceptable?Some perspicacious gay leaders are joining with feminists of all political persuasions to demand a stop to the growing paid surrogacy industry in this country. It is a brave and lonely fight at present, but it’s one that has to be waged.