Surrogacy
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2008-07-16T02:58:15Z
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/* Terminology */ Natural Insemination
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'''Surrogacy''' is a method of [[reproduction]] whereby a woman agrees to become [[pregnancy|pregnant]] for the purpose of gestating and giving [[birth]] to a child she will not raise but hand over to a contracted party. She may be the child's [[Genetics|genetic mother]] (the more traditional form of surrogacy), or she may be, as a '''gestational carrier''', carry the pregnancy to delivery after having been implanted with an [[embryo]]. In some cases surrogacy is the only available option for parents who wish to have a child that is biologically related to them.
==Terminology==
A '''surrogate mother''' is the woman who is pregnant with the child and intends to relinquish it after birth.<ref name="gloss"/> The word [[surrogate]], from [[Latin]] ''subrŏgare'' (to substitute), means appointed to act in the place of.{{Fact|date=January 2008}} The intended parent(s) is the individual or couple who intends to rear the child after its birth.<ref name="gloss"/>
In '''traditional surrogacy''' (aka the ''Straight'' method) the surrogate is pregnant with her own biological child, but this child was conceived with the intention of relinquishing the child to be raised by others; by the biological father and possibly his spouse or partner, either male or female. The child may be conceived via home [[artificial insemination]] using fresh or frozen sperm or impregnated via [[IUI]] (intrauterine insemination), [[ICI]] (intra cervical insemination) which is performed at a fertility clinic, or NI (natural insemination) which can also be performed at home.
In '''gestational surrogacy''' (aka the ''Host'' method) the surrogate becomes pregnant via [[embryo transfer]] with a child of which she is not the biological mother. She may have made an arrangement to relinquish it to the biological mother or father to raise, or to a parent who is themselves unrelated to the child (e. g. because the child was conceived using [[egg donation]], [[sperm donation]] or is the result of a donated embryo). The surrogate mother may be called the gestational carrier.
'''Altruistic surrogacy''' is a situation where the surrogate receives no financial reward for her pregnancy or the relinquishment of the child (although usually all expenses related to the pregnancy and birth are paid by the intended parents such as medical expenses, maternity clothing, and other related expenses).<ref name="gloss">{{cite web|title=Assisted Reproductive Technology (ART) Glossary|publisher=[[Reproductive Technology Council]]|accessdate=2008-01-06|url=http://www.rtc.org.au/glossary/index.html}}</ref>
'''Commercial surrogacy''' is a form of surrogacy in which a gestational carrier is paid to carry a child to maturity in her [[womb]] and is usually resorted to by well off [[infertile]] couples who can afford the cost involved or people who save and borrow in order to complete their dream of being parents. This procedure is legal in several countries including in [[India]] where due to excellent medical infrastructure, high international demand and ready availability of poor surrogates it is reaching [[industry]] proportions. Commercial surrogacy is sometimes referred to by the emotionally charged and potentially offensive terms "wombs for rent", "outsourced pregnancies" or "baby farms".
== Rationale ==
Intended parents may arrange a surrogate pregnancy because a woman who intends to parent is [[infertile]] in such a way that she cannot carry a pregnancy to term. Examples include a woman who has had a [[hysterectomy]], has a [[uterine malformation]], has had [[Habitual abortion|recurrent pregnancy loss]] or has a health condition that makes it dangerous for her to be pregnant. A female intending parent may also be fertile and healthy. but unwilling to undergo pregnancy.
Alternatively, the intended parent may be a single male, or a male [[homosexual]] couple.
== Surrogates ==
Surrogates may be relatives, friends, or previous strangers. Many surrogate arrangements are made through agencies that help match up intended parents with women who want to be surrogates for a fee. The agencies often help manage the complex medical and legal aspects involved. Surrogacy arrangements can also be made independently. In compensated surrogacies the amount a surrogate receives varies widely from almost nothing above expenses to over $30,000.{{Fact|date=March 2008}} Careful screening is needed to assure their health as the gestational carrier incurs potential obstetrical risks.
==History==
Having another woman bear a child for a couple to raise, usually with the male half of the couple as the genetic father, is referred to in antiquity. For example, chapter 16 of the book of [[Genesis]] relates the story of [[Sarah]]'s servant [[Hagar (Bible)|Hagar]] bearing a child to [[Abraham]] for Sarah and Abraham to raise.
Attorney Noel Keane is generally recognized as the creator of the legal idea of surrogate motherhood. However, it was not until he developed an association with physician Warren J. Ringold in the city of [[Dearborn, Michigan]] that the idea became feasible. Dr. Ringold agreed to perform all of the [[artificial insemination]]s, and the clinic grew rapidly in the early part of 1981. Though Keane and Ringold were widely criticized by some members of the press and politicians, they continued and eventually advocated for the passage of laws that protected the idea of surrogate motherhood. [[Bill Handel]], who is a partner in a Los Angeles, Surrogacy firms, also attempted to have such laws passed in California, but his attempts were struck down in the State Congress. Presently, the idea of surrogate motherhood has gained some societal acceptance and laws protecting the contractual arrangements exist in eight states.<ref>[http://www.surrogacy.com/legals/map.html Map of laws by jurisdiction] from The American Surrogacy Center (TASC)</ref>
In the [[United States]], the issue of surrogacy was widely publicised in the case of [[Baby M]], in which the surrogate and biological mother of Melissa Stern ("Baby M"), born in [[1986]], refused to cede custody of Melissa to the couple with whom she had made the surrogacy agreement. The courts of [[New Jersey]] eventually awarded custody to Melissa's biological father William Stern and his wife Elizabeth Stern, rather than to the surrogate Mary Beth Whitehead.
==Legality==
There is a default legal assumption in most countries that the woman giving birth to a child is that child's legal mother. In some jurisdictions the possibility of surrogacy has been allowed and the intended parents may be recognized as the legal parents from birth. Many states now issue pre-birth orders through the courts placing the name(s) of the intended parent(s) on the birth certificate from the start. In others the possibility of surrogacy is either not recognized (all contracts specifying different legal parents are void), or is prohibited.
=== Australia ===
In all states in [[Australia]], the surrogate mother is deemed by the law to be the legal mother of the child as well, and any surrogacy agreement giving custody to others is void. In addition in many states arranging commercial surrogacy is a [[criminal offence]], although [[New South Wales]] has no legislation governing surrogacy at all.<ref>{{cite web
| last = National Health and Medical Research Council
| title = Reproductive technology: Legislation around Australia
|date=2007-05-09
| url = http://www.dh.sa.gov.au/reproductive-technology/other.asp
| accessdate = 2008-01-04 }}</ref>
In [[2006]] Australian senator [[Stephen Conroy]] and his wife Paula Benson announced that they had arranged for a child to be born through egg donation and gestational surrogacy. Unusually, Conroy was put on the [[birth certificate]] as the father of the child. Usually couples who make surrogacy arrangements in Australia must [[Adoption|adopt]] the child rather than being recognised as birth parents, particularly if the surrogate mother is married.<ref>{{cite news
| last = Coorey
| first = Phillip
| title = And baby makes five - the senator, his wife and the surrogate mothers
| language = English
| publisher = [[The Sydney Morning Herald]]
|date=2006-11-07
| url = http://www.smh.com.au/news/national/surrogate-mothers-for-mps-baby/2006/11/06/1162661615860.html
| accessdate = 2008-01-04 }}</ref><ref>{{cite news
| last = Nader
| first = Carol
| title = Senator wins paternity battle
| language = English
| publisher = [[The Age]]
|date=2007-12-03
| url = http://www.theage.com.au/articles/2007/12/02/1196530480979.html
| accessdate = 2008-01-04 }}</ref>
After the announcement, Conroy's home state of [[Victoria (Australia)|Victoria]] announced that they were reconsidering the Victorian laws that make surrogacy within the state almost impossible.<ref>{{cite news
| last = [[Australian Associated Press]]
| title = Surrogacy laws being reviewed, says Premier
| language = English
| publisher = [[News Limited|news.com.au]]
|date=2006-11-07
| url = http://www.news.com.au/story/0,23599,20715087-2,00.html
| accessdate = 2008-01-04 }}</ref>
=== Canada ===
Commercial surrogacy arrangements were prohibited in 2004 by the Assisted Human Reproduction Act. Altruistic surrogacy remains legal.<ref>[http://laws.justice.gc.ca/en/showdoc/cs/A-13.4///en?page=1 Assisted Human Reproduction Act]</ref>
=== New Zealand ===
Commercial surrogacy was banned by the Human Assisted Reproductive Technology Act 2004. Altruistic surrogacy is allowed.
=== France ===
{{Refimprovesect|date=July 2008}}
In France, Since 1994, surrogacy, commercial or not is considered as unlawful and sanctioned by the law (art 16-7 du code civil). In 2008 a new bill passed french senate and surrogacy will be allowed.
===Georgia===
Since 1997 ovum and sperm donation and surrogacy is legal in [[Georgia (country)|Georgia]]. According to the law a donor or surrogate mother has no parental rights over the child born. In Georgia the compensation of the surrogate mother does not exceed EUR 9 000 during the pregnancy period and after the birth of a child (post-natal rehabilitation period). The major part of the surrogate mother's compensation shall be paid after the seventeenth week of pregnancy and in the post-natal rehabilitation period. [http://www.surrogacy.ge/]
=== India ===
Commercial surrogacy has been legal in India since 2002.<ref>{{cite news
| last = The Associated Press
| title = India's surrogate mother business raises questions of global ethics
| language = English
| publisher = [[Daily News]]
| date = 2007-12-30
| url = http://www.nydailynews.com/news/us_world/2007/12/30/2007-12-30_indias_surrogate_mother_business_raises_-2.html?page=0
| accessdate = 2008-07-14}}</ref> India is emerging as a leader in international surrogacy. Indian surrogates have been increasingly popular with fertile couples in industrialized nations because of the relatively low cost. Indian clinics are at the same time becoming more competitive, not just in the pricing, but in the hiring and retention of Indian females as surrogates. Clinics charge patients between $10,000 and $28,000 for the complete package, including fertilization, the surrogate's fee, and delivery of the baby at a hospital.
===Israel===
In March 1996, the Israeli government legalized gestational surrogacy under the "Embryo Carrying Agreements Law." This law made Israel the first country in the world to implement a form of state-controlled surrogacy in which each and every contract must be approved directly by the state<ref>Teman, Elly. "The Last Outpost of the Nuclear Family: A Cultural Critique of Israeli Surrogacy Policy,” forthcoming in: Birenbaum-Carmeli, Daphna and Yoram Carmeli (eds.), Kin, Gene, Community: Reproductive Technology among Jewish Israelis, Oxford: Berghahn Books.
</ref>. A state-appointed committee permits surrogacy arrangements to be filed only by Israeli citizens who share the same religion. Surrogates must be single, widowed or divorced and only infertile heterosexual couples are allowed to hire surrogates.<ref> Weisberg, D. Kelly. 2005. The Birth of Surrogacy in Israel. Florida: University of Florida Press</ref>
===Japan===
In March 2008, the Science Council of Japan proposed a ban on surrogacy and said that doctors, agents and their clients should be punished for commercial surrogacy arrangements. <ref>http://www.japantoday.com/jp/news/430424 Kyodo News</ref>
=== United Kingdom ===
{{Refimprovesect|date=July 2008}}
{{cleanup tone}}
Commercial surrogacy arrangements are illegal in the [[United Kingdom]].{{Fact|date=February 2008}}
Whilst it is illegal in the UK to pay more than expenses for a surrogacy, the relationship can be recognized under S 30 of the Human fertilization and Embryology Act 1990 under which a court may make parental orders similar to adoption orders. How this came about is one of those occasions when an ordinary person can change the law. Derek Forrest was a family solicitor in a Preston law firm who was approached by a couple facing proceedings by their local authority. The wife had no womb but did have ovaries which could be fertilized by her husband’s sperm. This they did and a surrogate gave birth to their child. When they took the child home to their Cumbrian address the local authority insisted that they should go through the procedure for registering as foster parents for their child even though genetically it was their own child. It was quickly realized that there was no defense to these proceedings and the only possibility was to adopt their own child. Derek Forrest wrote to The Times setting out the predicament his clients found themselves in and elicited a lot of favorable response. Then chance took a hand because the barrister acting for the parents knew the Member of Parliament who represented the parents. It just so happened that the Human Fertilization and Embryology Bill was going through Parliament at the time and the Barrister spoke to the MP to see what could be done. The MP then got things moving and got s 30 drafted and passed as an amendment through parliament. The result was that the couple was the first to obtain parental orders under the new Act.
=== Netherlands and Belgium ===
Surrogacy is legal in Netherlands and Belgium.
=== United States ===
Compensated surrogacy arrangements are illegal in [[Washington (state)|Washington]], [[Michigan]], [[Utah]], [[Arizona]], [[New Mexico]] and [[New York (state)|New York]]. Additionally, four states in the US have held that such contracts, while not illegal, are unenforceable. [[California]] is widely recognized as one of the most friendly jurisdictions for parties desiring to enter into a surrogacy arrangement.<ref>[http://www.surrogacy.com/legals/article/calaw.html California Surrogancy Law] from TASC</ref> There are many states at the present time that issue pre-birth orders placing the correct parent names on the baby's birth certificate.
Compensated surrogacy is legal in Oregon, Texas and Arkansas. Texas requires the surrogate mother to be a resident of Texas. Arkansas does not require surrogates to be residents. Intended parents and surrogates resident in any state of the USA can enter into a legal surrogacy arrangement in Arkansas. Provided the child is born in Arkansas and that financial considerations are dispensed from Arkansas the contract will be recogized by Arkansas courts and upheld.
Fertility treatment in Texas and Arkansas is a fraction of the cost in California. California is the US state closest for infertile couples from Europe and Australia who wish to enter into third party reproduction arrangements to travel.
==Ethical issues==
=== Mother Child Relationship ===
A study by the Family and Child Psychology Research Centre at [[City University, London]], [[United Kingdom|UK]] in 2002 concluded that surrogate mothers rarely had difficulty relinquishing rights to a surrogate child and that the intended mothers showed greater warmth to the child than mothers conceiving naturally.<ref>MacCallum, Fiona et. al. 2003. Surrogacy: The experience of commissioning couples Human Reproduction, Vol. 18, No. 6, 1334-1342; Vasanti Jadva et. al. 2003. Surrogacy: the experiences of surrogate mothers. Human Reproduction, Vol. 18, No. 10, 2196-2204; Golombok, Susan et. al, 2004. Families Created Through Surrogacy Arrangements: Parent-Child Relationships in the 1st Year of Life. Developmental Psychology, v40 n3 p400-411</ref> Anthropological studies of surrogates have shown that surrogates engage in various distancing techniques throughout the surrogate pregnancy so as to ensure that they do not become emotionally attached to the baby. <ref>Teman, Elly (2003) “The Medicalization of ‘Nature’ in the Artificial Body: Surrogate Motherhood in Israel,” Medical Anthropology Quarterly 17 (1):78-98.[http://mslula.googlepages.com/maq.2003.17.1.pdf]</ref> Many surrogates intentionally try to foster the development of emotional attachment between the intended mother and the surrogate child. <ref>Teman, Elly. 2003. “Knowing the Surrogate Body in Israel,” in: Rachel Cook and Shelley Day Schlater (eds.), Surrogate Motherhood: International Perspectives, London: Hart Press, pp. 261-280[http://mslula.googlepages.com/knowingthesurrogatebody.pdf]</ref> Instead of the popular expectation that surrogates feel traumatized after relinquishment, an overwhelming majority describe feeling empowered by their surrogacy experience.<ref>Ragone, Helena. Surrogate Motherhood: Conception in the Heart. 1994. Westview Books; Teman, Elly. 2001. “Technological Fragmentation and Women’s Empowerment: Surrogate Motherhood in Israel,” Women’s Studies Quarterly, 31 (3&4):11-34.</ref>. However, this has been widely critizised by feminists who claim that surrogate motherhood is a form of commodifying and dismemebering the female body and thus a patriarchal form of violence, not unlike prostitution.
=== Compensated surrogacy ===
Bioethicists are concerned that Indian surrogates are being badly paid for their surrogacy and that they are working as surrogates in a country with a comparatively high [[maternal death]] rate. <ref>{{cite news|url = http://www.smh.com.au/news/world/indias-baby-farm/2008/01/05/1198950126650.html|title = India's baby farm|publisher = [[The Sun-Herald]]|date = 2008-01-06|accessdate=2008-01-06}}</ref> However, high maternal death rates are found in the poorest sections of the population in India. They may not get access to proper medical facilities in time, or there are those who opt not to access them because of superstition. Surrogate mothers in India enrolled in commercial surrogacy programs are usually cared for with advanced medical, nutritional and overall care.{{Fact|date=February 2008}}
=== Labor Employment Issues ===
{{Original research|date=July 2008}}
Furthermore the relationship that the surrogate mother has with her employers, has been scrutinized by several human rights activists, who argue that it is morally unjust for an employer to have control over the body of their employee.
==Fictional representation==
* In [[Robert A. Heinlein]]'s [[1961]] [[science fiction]] novel ''[[Stranger in a Strange Land]],'' TV reporters exult that socialite Cynthia Duchess has decided to have the Perfect Baby, with the use of a [[sperm donor]], an [[egg donor]], and a surrogate mother.
* The heroine of Heinlein's [[1966]] novel [[The Moon is a Harsh Mistress]] describes herself as a "professional host-mother".
* The character [[Phoebe Buffay]] in US sitcom ''[[Friends]]'' was a gestational surrogate mother for her brother.
* The character Fertility in [[Chuck Palahniuk]]'s novel ''[[Survivor (novel)|Survivor]]'' works as a commercial surrogate, although she is infertile herself.
* In the film ''[[Baby Mama (film)|Baby Mama]]'' starring [[Tina Fey]] and [[Amy Poehler]], Amy Poehler's character is a surrogate to Tina Fey's character.
* The Character Leah Patterson/Baker was surrogate to her friend Sally Fletcher and husband Flynn Saunders in the Australian soap opera Home and Away.
==See also==
* [[In-vitro fertilization]]
* [[Embryo transfer]]
* [[Infertility]]
* [[Fertility]]
* [[Reproduction]]
* [[Artificial insemination]]
* [[Third party reproduction]]
* [[Repugnant market]]
==References==
{{reflist|2}}
==External links==
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*[http://www.surrogacy.ge/index.html Surrogate Motherhood Center of Georgia]
*[http://query.nytimes.com/gst/fullpage.html?res=9D0CE6D81630F931A35755C0A967958260&sec=health&spon=&pagewanted=print French High Court Rules Surogacy Illegal]
* [http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Surrogacy_the_issues?OpenDocument Surrogacy - the issues]
* [http://www.cbc.ca/health/story/2007/12/31/india-surrogate.html Indian women carrying babies for well-off buyers, 'Wombs for rent' pleases women and customers, but raises ethical questions; Monday, December 31, 2007; The Associated Press; CBC News; Canadian Broadcasting Corporation]
* [http://www.cbc.ca/health/story/2007/05/01/surrogates-pay.html Paid surrogacy driven underground in Canada: CBC report; Wednesday, May 2, 2007; CBC News; Canadian Broadcasting Corporation]
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[[Category:Family]]
[[Category:Pregnancy]]
[[Category:Reproduction]]
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