Katharine Dow: Can surrogacy ever escape the taint of global exploitation?

making the good life jacket dowSurrogate motherhood has a bad rep, as a murky business far removed from everyday experience – especially when it comes to prospective parents from the West procuring the gestational services of less privileged women in the global South. So while middle-class 30- and 40-somethings swap IVF anecdotes over the dinner table, and their younger female colleagues are encouraged by ‘hip’ employers to freeze their eggs as an insurance policy against both time and nature, surrogacy continues to induce a great deal of moral handwringing.

The Kim Cotton case in 1985 was the first attempt to arrange a commercial surrogacy agreement in the United Kingdom. It set the tone for what was to come. Cotton was paid £6,500 to have a baby for an anonymous Swedish couple, and her story provoked sensational press-fuelled panic. British legislators, too, saw surrogacy as likely to lead to exploitation, with poorer women coerced into acting as surrogates out of financial need, and with intended parents taken advantage of by unscrupulous surrogacy brokers. Their action was swift: within just months of the Cotton story breaking, a law was passed banning for-profit surrogacy in the UK.

With the growth of an international surrogacy industry over the past two decades, worries over surrogacy’s fundamentally exploitative character have only intensified. Worst-case scenarios such as the Baby Gammy case in 2014, involving an Australian couple and a Thai surrogate, suggest that surrogacy frequently is exploitative. But that’s less because paying someone to carry and bear a child on your behalf is inherently usurious than because the transaction takes place in a deeply unequal world. The Baby Gammy case was complicated by other unsavoury factors, since the child, born with Down’s Syndrome, seemed to be rejected by his intended parents because of his condition. Then it turned out that the intended father had a previous conviction for child sex offences, which rather overshadowed the potential exploitation experienced by Gammy’s surrogate – and now de facto – mother.

I am not arguing for a laissez-faire approach to regulating surrogacy, but for thinking more deeply about how surrogacy reflects the context in which it takes place.

We need to step back and think critically about what makes people so driven to have a biogenetically related child that they are prepared to procure the intimate bodily capacity of another, typically less privileged, person to achieve that. We should also listen to surrogates, and try to understand why they might judge surrogacy as their best option. Intended parents are not always uncaring nabobs, and surrogate mothers are not just naïve victims; but while the power dynamic between them is decidedly skewed, each is subject to particular cultural expectations, moral obligations and familial pressures.

As for the larger context, we increasingly outsource even the most intimate tasks to those whose labour is cheap, readily available and less regulated. If we think of surrogacy as a form of work, it doesn’t look that different from many other jobs in our increasingly casualised and precarious global economic context, like selling bodily substances and services for clinical trials, biomedical research or product testing, or working as domestic staff and carers.

And surrogacy is on the rise. Both in the UK and in the United States, where some states allow commercial surrogacy and command the highest fees in the world, increasing numbers of would-be parents are turning to the international surrogacy industry: 95 per cent of the 2,000 surrogate births to UK intended parents each year occur overseas. With the age at which women have their first child increasing, more women are finding it difficult to conceive; and there’s now greater access to fertility treatments for single-sex couples and single people. In addition, surrogacy has become the option of choice for gay couples, transgender people, and single men wanting a biogenetically related child.

For me, as someone who has studied surrogacy, the practice is problematic because it reveals some of our most taken-for-granted assumptions about the nature of family. It also tells us much about work, gender, and how the two are connected. This is why it is so challenging.

At a time when parent-child relationships often appear to be one of the few remaining havens in an increasingly heartless world, surrogacy suggests that there might not be a straightforward relationship between women’s reproductive biology, their capacity to produce children, and their desire to nurture. The usual debates that focus simply on whether or not surrogacy is exploitative sidestep some of these uncomfortable truths, and make it difficult to ask more complicated questions about the practice.

There is a parallel here with abortion debates. Trying to define and defend the sanctity of life is important, but this also obscures highly problematic issues, such as the gendered expectation that women should look after children; the fact that women typically bear responsibility for contraception (and the disproportionate consequences of not using it); the prevalence of non-consensual sex; and the pressure on women to produce children to meet familial obligations.

Surrogacy is a technology. And like any other technology we should not attribute to it magical properties that conceal its anthropogenic – that is, human-made – character. It’s all too easy to blame surrogacy or the specific individuals who participate in it rather than to ask why surrogacy might make sense as a way of having children at all. We should give credit to intended parents and surrogate mothers for having thought deeply about their decisions, and we should not hold them individually responsible for surrogacy’s ills.Aeon counter – do not remove

Katharine Dow is a research associate in the Reproductive Sociology Research Group at the University of Cambridge. She is the author of Making a Good Life.

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This article was originally published at Aeon and has been republished under Creative Commons.
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Katharine Dow on the complex ethics of assisted reproduction

making the good life jacket dowAlthough many don’t know the full scope of current reproductive technologies, opinions and judgments on the ethics involved abound. Katharine Dow explains the intrigue and controversy in Making a Good Life: An Ethnography of Nature, Ethics, and Reproduction. Touching on fears about environmental degradation and the rise of the biotechnology industry, the book offers a new approach to researching and writing about nature, ethics, and reproduction technologies, from IVF to surrogacy. Dow recently agreed to answer a few questions on understanding the impact these technologies have had on our culture.

How did you first become interested in assisted reproductive technologies?

KD: It’s funny because when I first started looking at these issues, during my doctoral studies, a lot of people in my cohort were studying things that they had some personal connection to, and I had no personal experience of IVF, surrogacy or egg or sperm donation. Though, as I discuss in the book, I do have experience of having some rather complicated family relationships like my father’s adoption and discovery of long-lost sisters! I first became interested in assisted reproduction when I was an undergraduate and I had a few lectures on it. I found the thorny philosophical and ethical issues that they raise completely fascinating and so when I came to think about what I would like to research myself, my thoughts turned to assisted reproduction.

Initially, I was particularly interested in surrogacy and I think the reason for that was firstly that it is so obviously to do with gender, which is a perennial interest of mine, and secondly, that it touches on so many taboos and I suppose I’ve always been fascinated with those kinds of things that set off people’s ethical antennae, because then you know you’ve really hit a cultural nerve. I think these sort of taboo subjects can be a great way of digging deeper into how people think. But, as you can tell from the book, I’ve also come to realise that reproduction is often treated as being marginal, yet it is absolutely fundamental to how we think, whether or not we have children – it’s so closely linked with ideas about life, the future, ethical values and even complex concepts like nature, and that’s really one of the overarching points I want to make with the book.

Making a Good Life is unusual in that it looks at what people who are not using assisted reproductive technologies themselves think about these technologies. What do you think that brings to our understanding of assisted reproduction?

KD: Well, first of all, I should make it clear that I think there is enormous value to all the clinic-based ethnographies of assisted reproductive technologies out there, which were instigated early on by feminist theorists wanting to better understand what it was like for people – mostly women – to undergo IVF and so on. That is so important.

Having said that, I am also very aware that most people aren’t personally involved in assisted reproduction, but they are frequently exposed to it through media coverage and public debates and so I felt like a really important part of the puzzle was missing – which is what people think about assisted reproduction and how they respond to it as an ethical ‘problem’. As I say in the book, it’s not that I think patients aren’t objective enough or anything like that, but it’s about recognising that reproduction has very important effects and implications for life more generally and that asking people to really discuss in detail what they think the ethics of assisted reproduction are is a way of getting at some deeper cultural assumptions, which might well be different if you’re not personally invested in the technologies.

So, from an empirical point of view, it’s about filling in a gap in our understanding of these technologies, which are actually crucial to the time we’re living in, in terms of how IVF has provided the platform for a whole biotech industry and what that has done to forms of labour and medical treatments, how they’ve opened up parenthood to gay, lesbian and single parents and so on. But also, it’s questioning the received wisdom about how we social scientists learn about medical technologies. So, I was also interested in playing with the ethnographic method and trying something different.

A sense of place seems to be an important aspect of your book. Can you describe what it was like to do ethnographic research in Spey Bay, this small village in northeast Scotland?

KD: Oh, I often think about Spey Bay, even though it’s quite a few years since I left now. What immediately comes to mind when I think of the place is the look and feel of it – the crunch of pebbles underfoot, the feel of the wind in your face. I think of shared laughter, the scent of woodsmoke and the scrunching sound that Gore-Tex jackets make while you walk. It’s certainly quite different from London, which is where I lived before fieldwork and where I live now.

I started fieldwork as a shy 23-year-old and constantly worried that I wasn’t doing it right. I thought I would hate fieldwork, because it would mean having to be obtrusive and not worrying about whether I looked like a fool if I asked the wrong questions. And of course there were moments like that, but I found an incredibly warm and open group of people there who never seemed to mind me asking them questions or challenged my right to live amongst them. Of course the close – and genuine – friendships I cultivated with people in Spey Bay meant that it was quite difficult to write about them afterwards and I wonder whether they will object to how I’ve represented them, but thanks to them, I really enjoyed fieldwork in the end.

Do you think we are in an age of heightened attention to ethics?

KD: Yes and no. I think we are currently in the midst of a really exciting repoliticisation of public life. I particularly see it amongst students and especially in relation to questions of gender, race and sexuality. In the book, I am writing about people who explicitly think about ethics every day, especially in relation to the environment and I think the ethical living movement has been a really important way of mainstreaming environmental concerns. I accept the criticisms about it not doing enough to challenge capitalism, which is what is really required if we are to prevent catastrophic climate change (as well as ameliorating the myriad inequalities that capitalism is responsible for). But, I also think that there is an ideological move at stake in assuming that a movement or campaign that presents itself as primarily ethical has nothing to do with politics. So I am wary of the idea that an ethical turn is necessarily a turn away from politics. Also, while I’m all for overturning the central assumptions of neoliberal capitalism, I think climate change is tricky because, pragmatically, it requires a global effort and so radicals do have to bring more conservative and moderate people on board and framing the argument in terms of ethics can be a really powerful way of doing that.

So, what’s next for you after completing Making a Good Life?

KD: I’ve been at the University of Cambridge for a couple of years now, where I work in a fantastic research group of people who all work on reproduction and assisted reproductive technologies. In terms of my current research, I’ve been taking some of the themes from Making a Good Life in two different directions. Firstly, I am in the middle of a research project on how the British media represented IVF, particularly focusing on the 1970s and ’80s. It’s been really rewarding to broaden my experience by doing research from more of a cultural studies angle and to do historical and archival research. The public debates about assisted reproduction were a very important backdrop to Making a Good Life, so it’s great to get the chance to look at them in more depth. Secondly, I am working on a new collaborative project with my colleague Janelle Lamoreaux, which looks further at connections between reproduction and the environment. Related to that, I’m currently developing a new multi-sited ethnographic project that looks at informal seed saving and seed swapping in the UK, which I’m really excited about pursuing over the next few years.

Katharine Dow is a research associate in the Reproductive Sociology Research Group at the University of Cambridge. She has written Making a Good Life: An Ethnography of Nature, Ethics, and Reproduction.