With the new movie Baby Mama out and Newsweek's recent article "The Curious Lives of Surrogates", the cultural gaze is on surrogacy in a semi-positive or at least ambivalent way. In my experience, most people who know anything about surrogacy have read news stories about custody disputes, usually in poorly thought out situations where haste was the operating principle. So it's kind of strange to see surrogacy pulled out of Geraldo world and plastered respectably on the cover of Newsweek.
When my husband and I made the decision to pursue surrogacy three years ago, neither of us knew anyone, in real life, who had had children via surrogacy, or had been born that way. There are several wonderful online communities where we got most of our information.
We were almost immediately beset by ethical quandaries. The largest one that most people have to address, either for themselves or their concerned friends and relatives, is "Why not adoption?" We actually did not have to address this one, because we knew adoption could not work for us. A year before, we had been seated on our living room couch with the profile of a 4 month old Russian girl who we had been matched to. Then a Mayo Clinic specialist called and informed me that I had a rare muscle disease. I called the adoption agency. They called Russia. Russia yanked our placement and we were back at square one. Even with a letter from my Neurologist at Mayo stating that my disorder would not affect my parenting ability, I was told no. I was also advised against open domestic adoption - who would pick me? I was in my 30s, not my 20s - count one against me. And I had a medical condition. It wasn't that my condition was so bad, it was mainly that it was unheard of. We tried a few other domestic options, including one agency that was supposed to be disabled friendly. All no. One said maybe yes, if I hired a 24 hr nanny.
But the bigger ethical question to me was how do I make surrogacy a non-exploitative situation? The compensation that surrogate receive, if they receive any, is intended to offset the inconveniences of pregnancies, including visits to the doctors office, increased appetite, etc. But the amount of money they receive, typically $15,000-28,000, is paltry compared to the vigilance and transparency they must maintain. As the Newsweek article points out, most surrogates are in it because they love being pregnant, they know the value of having children, and they find doing it empowering. A significant fraction of the surrogate community are military wives. Surrogates also run the socio-edu-economic gamut. I know a 3x surrogate who is entering a PhD program in the fall.
Another issue that occurred to my husband and I when we started and is even more evident to me now is the financial advantage required to even consider surrogacy. Sure, there are plenty of people who take out a 2nd mortgage or raise funds in other ways, but for the most part you need to be solid financially. Infertility is often demographically attributed to middle and upper-class people, but I assume this is because it requires health-care access to diagnose. Also, because many infertility treatments are not covered by insurance, I expect that without the financial wherewithal, lower income families must accept infertility as a dead end.
It's difficult for me to take a hard-line on any of these issues, though. Since surrogacy made me a mother.