Contributed by Kathleen Sloan
The worldwide use of reproductive technologies has grown exponentially in recent years. While these developments have brought benefits to many by successfully treating some types of infertility, deep regulatory divides – or their complete absence such as at the national level in the United States – have fueled growing national and international markets in which privileged individuals and third party intermediaries, who benefit financially from the commodification of reproduction, exploit vulnerable, uninformed, low income and poor women for their reproductive capacities. Surrogacy and the trade in human eggs in particular have become pervasive national and international phenomena in which women’s poverty and subordinate status everywhere increase their exposure to gender-based exploitation and physical harms.
Unequal relationships between the buyers (intended parents) and the women who rent their uteri, favor the needs and desires of the buyers. These unequal transactions, in the absence of regulation of the fertility-industrial complex, result in “uninformed” consent, low payments, coercion, poor health care, and severe risks to their short and long-term health. In addition, both the children conceived through commercial transactions and the intended parents may suffer as a direct result of these arrangements. While the full magnitude of the harms resulting from reproductive exploitation is unknown due to lack of regulation, documentation and oversight, reports of egregious harms continue to mount.
Unless her own eggs are used with intrauterine insemination, women recruited to serve as surrogates are subjected to the many risks of synthetic hormonal stimulation in order to synchronize their menstrual cycles with those of the egg provider. Hormones and drugs used include Lupron which is not FDA-approved for this purpose; estrogen, which is linked to breast and uterine cancers, blood clots, heart attack and stroke; and steroids which can produce high blood pressure, glaucoma, cataracts, peptic ulceration, and an impaired immune system. High rates of multiple births and infection resulting from Invitro Fertilization (IVF) place both surrogates and babies at high risk for complications. When problems arise during the pregnancy, the wellbeing of the fetus tends to be given precedence over the health of the woman serving as a surrogate since the intended parents are paying large sums of money for the baby being produced. Care of the surrogate ends with the birth of the baby even when the woman who bears the child suffers lasting effects.
If the intended parents’ circumstances change during the pregnancy, or if the child is born with health problems or disabilities, the infants may be left to the surrogate or abandoned. Intended parents may find that they face unplanned financial costs and inadequate legal protections. The practices of reproductive organ, tissue and cell commerce, particularly surrogacy and ova sale, infringe upon several basic human rights under international law, and are violations of international agreements on health and medical standards. Policy makers and the public at large must recognize reproductive commerce as a unique kind of human exploitation. As the European parliament stated in a resolution, surrogacy and egg sale constitute an “extreme form of exploitation of women.”
It is estimated that nearly half of surrogates in the U.S. are “military wives” who represent an ideal supply source for agencies and brokers. They often survive on low incomes and tend to marry and have their own children at young ages, so the prospect of doubling their income by serving as a surrogate is a powerful incentive. These women have few legal or regulatory protections, making them sitting ducks for exploitation and fraud. It is no coincidence that surrogacy brokers and clinics are concentrated in areas where there are large military bases. One could also point out that while the military heavily recruits from the working class and poor demographics to provide their cannon fodder for endless wars and occupations, these people are doubly exploited for their reproductive capacities by profit-driven private enterprise.
Society has barely begun to grapple with the issues surrogacy raises. In many countries, most notably in Europe, surrogacy is an illegal medical procedure. But in the U.S. there is no national regulation, earning its title of the Wild West of third party reproduction and its status as second world-wide only to India in the supply of surrogates.
Surrogacy is a stark manifestation of the commodification of women’s bodies. Surrogate services are advertised, surrogates are recruited, and operating agencies make large profits. The commercialism of surrogacy raises the specter of a black market and baby selling, of breeding farms ala The Handmaid’s Tale, turning impoverished women into baby producers. Surrogacy degrades a pregnancy to a service and a baby to a product – an entitlement for those with the financial means to procure one.
For millennia, women’s human rights have been abused and ignored with impunity. As developments in biotechnology facilitate the commodification of reproduction, alarm bells should be sounding about the new door that has been opened for yet further disregard and degradation of women’s humanity, wholeness, physical and emotional inviolability. Simply put, if you care about women’s human rights, you cannot allow their exploitation as commodities and their health endangerment for others’ profit and gain.
Kathleen Sloan is a member of the Board of Directors of the National Organization for Women (NOW), a consultant to the Center for Bioethics and Culture, and the former Program Director of the Council for Responsible Genetics.