Human Nature: Science, Technology, and Life.

Surrogacy and the State

Is the global market in womb rentals out of control? Does it need regulation?

I wondered about that three weeks ago when I saw this Reuters story: "Poverty Makes Surrogates of Indian Women in Gujarat." The $4,000 to $8,000 paid to successful surrogates in India is "a huge sum of money in a country where many live on less than $2 a day," Rina Chandran reported. But compared with U.S. rates, it's cheap. That's why foreigners have begun

to flock to [Nayna] Patel's clinic, drawn by the lower costs, relaxed attitude toward surrogates and lack of legislation. A draft bill on surrogacy is pending before parliament, and meanwhile, hundreds of clinics have mushroomed across the country, with critics saying touts promoting this "reproductive tourism" care little for the health or rights of the surrogates. ... Patel has a list of nearly 200 [would-be surrogates] and is seeing more women walk in everyday because they are feeling the pinch of the slowdown.

And yet, Chandran noted, Patel "draws the line at gay couples."

Cheap reproductive labor for wealthy foreigners, but no gay parents allowed? For the usual incoherent combination of lefty reasons—not enough private discrimination in working conditions, too much private discrimination in family values—I felt the urge to support regulation of the industry.

Then, yesterday, Reuters published another investigation of overseas surrogacy conditions, this time in China. "With China's rising affluence, increasing numbers of infertile couples have been seeking surrogate mothers," James Pomfret reported. "Surrogacy agencies have been recruiting girls, often from poor villages, to have babies on behalf of prospective parents."

Should the government do something about this? Actually, authorities are already on the case:

In the southern Chinese city of Guangzhou, three young surrogate first-time mothers were discovered by authorities hiding in a communal flat. Soon afterwards, district family planning and security officers broke into the flat, bundled them into a van and drove them to a district hospital where they were manhandled into a maternity ward, the mothers recounted to Reuters. "I was crying 'I don't want to do this'," said a young woman called Xiao Hong, who was pregnant with four-month-old twins. "But they still dragged me in and injected my belly with a needle," the 20-year-old told Reuters. ... Another of the surrogates, who said she'd come from a village in Sichuan province, recounted how officers made her take pills then surgically removed her three-month-old fetus while she was unconscious.

This isn't the kind of policing liberals have in mind when they call for tighter regulation of the fertility industry. But the tricky thing about official intervention is that once the state gets its foot in the door, you don't necessarily get to dictate what it can and can't do.

Every time the global market in human body parts and rentals looks ugly enough to regulate, I'm reminded how much uglier things can get when the government steps in.

Lady Parts

Yesterday I wrote about an awful story in California. A number of couples hired gestational surrogates through a fertility brokerage. They were directed to put money in trust accounts to pay the surrogates throughout their pregnancies. Now the money is gone. Andy Vorzimer, an attorney involved in the case, told the New York Times, "We've got couples in the midst of pregnancies with no ability to pay the surrogate." I ended the piece this way:

I hope the women carrying these pregnancies will see them through, even if the company that hired them doesn't. But that financial burden shouldn't fall on them alone. Here's the contact page for an attorney working the case. If you'd like to prevent abortions, help pregnant women, and facilitate reproductive choice at the same time, now's your chance.

Yesterday evening, Vorzimer sent me an e-mail to clarify the situation:

The article has obviously resonated with your readers as my inbox has been flooded with concerned people offering to donate funds so as to avoid possible abortions. I am happy to inform you that there are no situations in which a surrogate has elected to abort because of this financial scandal. While many of the surrogates will not be reimbursed for their out-of-pocket expenses lost wages or even have their medical bills paid, every single one of them has committed to moving forward.

That's great news. I'm impressed with the surrogates. I'm also impressed with all of you who contacted Vorzimer and offered your support so they wouldn't have to end their pregnancies. Pro-lifers are often accused of moralizing and interfering but not helping. You disproved the caricature. And I hope you'll stand by your offers even if no abortions are at stake.

In recent days, I've had a few curious exchanges with friends, readers, and bloggers who wonder why I keep writing about this stuff: abortions, pregnancies, IVF, surrogates—what some of my critics jokingly call "lady parts." What's my agenda? Do I have a problem with women controlling their bodies? Am I a frontman for the religious right, a useful idiot who pretends that compromise on these issues is possible when, in fact, it isn't? Even Vorzimer, in a tweet posted on his blog, initially responded to my article by remarking, "The lengths (or depths) abortion foes will go to make a point."

Vorzimer and I have had some back and forth since then, so we've come to understand each other better. But the misunderstanding was my fault, not his. I need to do a better job of explaining myself.

This may sound strange, but I don't consider myself a real abortion foe. I have friends and sparring partners who think abortions should be illegal or at least heavily restricted. To me, that's the chief dividing line in the debate. I don't feel comfortable crossing that line. I don't think a regime of abortion restrictions enacted in the name of life would make this world a better place. I think it would cause a mess—hypocrisy, deceit, interrogations, amateur home surgery, moral crudity backed by the force of law—as ugly as any war fought in the name of peace.

I don't equate abortion with murder. I don't even think it's the worst option available to a woman facing unintended pregnancy. Every abortion dilemma is different, because every situation is different. The person best situated to make the right decision is the pregnant woman. A few years ago, I wrote a whole book on this point.

So why do I keep bringing up abortion as a moral problem? Because it is a moral problem. It's the destruction of a developing human being. For that reason, the less we do it, the better. When I say abortion is bad, I'm not saying it's necessarily worse than bringing a child into the world in lousy circumstances. I'm saying it's worse than avoiding unintended pregnancy in the first place. That's why I keep pushing contraception. If you cause an unintended pregnancy and an abortion because you didn't want to wear a condom, you should be ashamed.

But that's the conventional life/choice debate. The reason I keep you posted on developments in IVF, surrogates, and embryo screening is that they're transforming the debate. They're changing the conditions on which our moral positions rely. Were you pro-choice because the embryo was in a woman? Now we have embryos in dishes. Did you support embryo screening for fatal diseases? Now we're talking about screening embryos for eye color. Does the value of an embryo depend on what its mother thinks? Now we have embryos with two mothers: a genetic one and a gestational one. Should they at least consult each other?

I got into this field because the moral questions are enduring but the facts are always changing. Technology is transforming culture. And I write about the value of unborn life because that's the problem my fellow pro-choicers don't like to talk about. I want to challenge you. Keeping the government out of these sticky moral questions doesn't make them go away. It just puts the burden on you to face them responsibly.

Defaulting on a Surrogate Pregnancy

What if you delivered the money to a broker, and the broker lost, stole, or squandered it? You did your part, but the surrogate is no longer being paid. And she has every legal right to end the pregnancy.

That's the scenario unfolding in California.

More here.