What questions are raised by globalizing surrogacy?

I just can't help myself. I find these articles and read in awe at how much the world has changed in the 10 years since I started swimming in the sea of surrogacy. Now, when speaking of surrogates and surrogacy the words "globalization" and "outsourced" are used. How about medical tourism as a term? The world is a much smaller place for sure when you are talking about frozen sperm being flown from one continent to the next and International surrogates being referred to as incubators in the 'market place'.

Sharon
www.InfertilityAnswers.net

What questions are raised by globalizing surrogacy?
Ellen Goodman, ellengoodman@globe.com
Saturday, April 12, 2008 (Please note that this is over a year old but still relevant today)



By now we all have a story about a job outsourced beyond our reach in the global economy. My own favorite is about the California publisher who hired two reporters in India to cover the Pasadena city government. Really.

There are times as well when the off-shoring of jobs takes on a quite literal meaning. When the labor we are talking about is, well, labor.

In the last few months, we've have had a full nursery of international stories about surrogate mothers. Hundreds of couples are crossing borders in search of lower-cost ways to fill the family business. In turn, there's a new coterie of international workers who are gestating for a living.

Many of the stories about the globalization of baby production begin in India, where the government seems to regard this as, literally, a growth industry. In the little town of Anand, dubbed "The Cradle of the World," 45 women were recently on the books of a local clinic. For the production and delivery of a child, they will earn $5,000 to $7,000, a decade's worth of women's wages in rural India.

But even in America, some women, including Army wives, are supplementing their income by contracting out their wombs. They have become surrogate mothers for wealthy couples from European countries that ban the practice.

This globalization of baby-making comes at the peculiar intersection of a high reproductive technology and a low-tech work force. The biotech business was created in the same petri dish as Baby Louise, the first IVF baby. But, since then, we've seen conception outsourced to egg donors and sperm donors. We've had motherhood divided into its parts from genetic mother to gestational mother to birth mother and now contract mother.

We've also seen the growth of an international economy. Frozen sperm is flown from one continent to another. And patients have become medical tourists, searching for cheaper health care, whether it's a new hip in Thailand or an IVF treatment in South Africa that comes with a photo safari thrown in for the same price. Why not, then, rent a foreign womb?

I don't make light of infertility. The primal desire to have a child underlies this multinational Creation Inc. On one side, couples who choose surrogacy want a baby with at least half their own genes. On the other side, surrogate mothers, who are rarely implanted with their own eggs any longer, can believe that the child they bear and deliver is not really theirs.

As one woman put it, "We give them a baby and they give us much-needed money. It's good for them and for us." A surrogate in Anand used the money to buy a heart operation for her son. Another raised a dowry for her daughter. And before we talk about the exploitation of the pregnant woman, consider her alternative in Anand: a job crushing glass in a factory for $25 a month.

Nevertheless, there is - and there should be - something uncomfortable about a free-market approach to baby-making. It's easier to accept surrogacy when it's a gift from one woman to another. But we rarely see a rich woman become a surrogate for a poor family. Indeed, in Third World countries, some women sign these contracts with a fingerprint because they are illiterate.

For that matter, we have not yet had stories about the contract workers for whom pregnancy was a dangerous occupation, but we will. What obligation does a family that simply contracted for a child have to its birth mother? What control do - should - contractors have over their "employees' " lives while incubating "their" children? What will we tell the offspring of this international trade?

"National boundaries are coming down," says bioethicist Lori Andrews, "but we can't stop human emotions. We are expanding families and don't even have terms to deal with it."

It's the commercialism that is troubling. Some things we cannot sell, no matter how good the deal. We cannot, for example, sell ourselves into slavery. We cannot sell our children. But the surrogacy business comes perilously close to both of these deals. And international surrogacy tips the scales.

So these borders we are crossing are not just geographic ones. They are ethical ones. Today the global economy sends everyone in search of the cheaper deal, as if that were the single common good. But, in the biological search, humanity is sacrificed to the economy, and the person becomes the product. And, step by step, we come to a stunning place in our ancient creation story. It's called the market place.

Ellen Goodman is a columnist for The Boston Globe. Her column is distributed by the Washington Post Writers Group. Her e-mail address is ellengoodman@globe.com.