Thursday, December 4, 2008

So What Do You Think of Surrogate Mothers?

Well, back from Manhattan today where I met my new agent for the first time. Yes, I am working on a memoir about my quarter-century relationship with my daughter. Heard about dismal publishing milieu today. Editors will be fired, some companies not even looking at new manuscripts. (Sounds like the auto industry, no?) Check. How this can't be just "another birth-mother memoir." Well, okay, I'll do my best. How I can't come across as still a victim...at that point, the years of frustrations from being victimized by the closed records system back in 1966 pinged inside and tears welled up...I felt like Hillary Clinton when she became glassy-eyed after being asked, "How do you get up and do it every day?" When I told the agent I'd never cried on television, she said, "Well, that isn't always bad...."

So all I can do is the best that I can do.

Though I had no idea before I submitted my partial manuscript to her, she was the agent who sold the best book on being adopted: Being Adopted: The Lifelong Search for Self by Brodzinsky (adoptive father) Schechter (married to an adoptee) and Martanz Henig (good writer who put it all together). Meanwhile, let's get to Sunday's (11/30/08) New York Times Magazine piece: Her Body, My Baby. Adventures of a rich girl who tried to have babies at age 34 and up and after eleven attempts with IVF and four failed pregnancies, she gave up and for $25,000 hired a womb from a nice 43-year-old woman in Pennsylvania who needed the money to help put her kids through college...

New York Times Magazine Cover In the end I didn't actually hate the writer (Alex Kuczynski) and mom-with-the-perfect-body (though many if not most of the hundreds of people who commented on the New York Times website did). Eleven IVF cycles is a hell of a lot, and from what I've read, they are not pleasant, the miscarriages must have been devastating, and so I have some sympathy for this woman. How can you not?

Almost Baked
Cathy Hilling at home
in Harleysville, Pa.
Gillian Laub for The New York Times

But what is galling is how the statistics for infertility were treated in the piece, that is, as if infertility was an illness--not a normal reality of advancing age. I'm 66--and pretty sure I'm infertile. Should I be counted in this statistic? Here's the letter I fired off to the Times magazine Monday.

To the Editor:

While the writer of Her Body, My Baby (November 30), Alex Kuczynski, notes that infertility affects 7.3 million people in the United States, this is an erroneous figure, for it equates infertility among older women as abnormal, as if they all had the flu. There is no difference today between fertility rates of the past and today--what is different is the age at which women and men try to conceive. According to the Mayo Clinic, a woman's fertility peaks between the ages of 20 and 24, begins slowly declining until the early 30s, after which fertility declines quite rapidly. At age 30 to 35, fertility is 15 to 20 percent below maximum. From age 35 to 39, the decrease is 25 to 50 percent. From 40 to 45, the decrease is 50 to 95 percent. The writer of the piece did not try to conceive until she was, at best, 34. Savvy marketing of fertility services often makes no mention of these facts, and many men and women today are lulled into believing that technology can easily help them get pregnant when they are ready.

However, according to the American Society for Reproductive Medicine, age affects the success rates of infertility treatments as well as your natural ability to get pregnant. According to a 2003 booklet put out by the organization, a healthy 30-year-old woman has about a 20 percent chance per month to get pregnant. By age 40, however, her chance is only about 5 percent per month. In many cases, these percentages are true for natural conception as well as conception assisted reproductive technology.

Although Ms. Kuczynski, best known for her exhaustive research into numerous anti-aging treatments and surgeries, treats the realtionship with the surrogate mother candidly, pieces such as this one further encourage the wait-too-long mentality and then, the somewhat yukky trade in rent-a-womb. Lorraine Dusky

Let me know what you think about surrogate mothers--I really am interested how this plays with adoptees and other birth mothers. As the piece in the Times makes clear, its a lot less complicated emotionally (quel surprise!) when the egg isn't the surrogate's. But it still makes me queasy. I have less trouble with a relative having the baby since there is usually no exchange of filthy lucre. I saw one case where a mother did it for her daughter.

Gotta go--having my annual visit to the gynecologist in an hour. Delightful. I'm sure I put on a couple of pounds since the last weigh-in. Too much whipped cream on my pie.
--lorraine

PS: Yes, Kippa, Mairaine is right about which mothers were actually visiting with their children, and who was in touch only through communication at a distance, i.e., phone call, email, a written note. (See previous post and comments.) Although my daughter Jane periodically cut off communication for some reason or another, we basically had a relationship for a quarter of a century. At the end, it was close and great, but I couldn't save her from her demons. Next week it will be a year since she committed suicide, and though it's on my mind, I'm certainly not marking the day in any way special. That would just exacerbate what is already a river of grief.

33 comments :

  1. Surrogacy has so many ethical dilemmas it's hard to know where to begin.

    In the NYT article the baby was genetically not of the "mother" (surrogate/host). But the baby does not know this while in the womb and after birth. Primal wound, anyone?

    The host must take on all the risks of preganancy and childbirth, including the risk of death. What about post-partum depression? Who pays for treatment for complications pre/post delivery. What if there is a need for total bedrest - who pays the rent and buys the grocery if the host is out of work? Can they demand she eat certain foods, do they monitor her lifestyle choices while she is pregnant?

    What about genetic problems discovered during pregnancy - can the intended parents force the host to have an abortion? What if she refuses? Can the couple "decline" the product if it is born defective?

    As for infertility as an illness, I can't subscribe to that notion since most reproductive failure is caused by aging-out. I also would be interested in knowing how many of these "infertile" women had abortions when then were young and fertile?

    Women simply have to realize that pregancy is meant for young women. Mother nature ordained it.

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  3. I'm SO not a fan of surrogacy, especially anonymous gestational surrogacy.
    Even in cases where the surrogate is a family member, I think there's a lot of room for confusion for the child.

    But what do I think of surrogate mothers?
    I don't know any in person, but from what I've read it seems that that in most cases they do it out of need or greed. The former elicit my pity - including those poor women in India (where surrogacy has recently been confirmed as legal - here's a link: http://www.straitstimes.com/Breaking%2BNews
    /Asia/Story/STIStory_286442.html) whose husbands pressure them into renting out their wombs, but who have to pretend they're pregnant by said husbands in order to hide the social shame - and the latter I think are horribly misguided. I think what they're doing is fundamentally anti-woman and unfair to the child.

    Besides, I can't imagine anyone would actually *want* to be brought into the world via a surrogate arrangement. In fact I'd put my money on that, given the choice, they'd opt not to.

    Yes, Maireanne's explanation made sense of that conundrum. Ta, both.

    I understand why you wouldn't mark the anniversary of your daughter's death, Lorraine. I'm sure there is nothing that could be done to adequately address the depth of your sorrow.
    I am so sorry.

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  4. Agreeing with Maybe and Kippa on surrogacy....too many ethical dilemmas to count. Also too many health risks for the woman carrying the pregnancy, not to mention the confusion for the child.

    The whole thing is just weird and distasteful. The situation in India is heartbeaking; the ultimate outsourcing. With our economy biting the dust, I think we will see more desperate women in this country selling their eggs and renting their uterus so the rich and biologically over the hill can still buy and have a kid. Just sad.

    The whole thing where the woman who carries the baby is not genetically related to it at allis doubly strange. Will these children have the same curiousity about these women as a biological mother, or will it become just like having had a wet nurse, a very common practice before infant formula was widespread, especially among the wealthy.

    Lorraine, there are no words for the depth of your loss. My thoughts and prayers are with you at this dark time.

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  5. I have been a gestational carrier twice (carrier is a better word then 'host' in my humble opinion because being a host' sounds like you are carrying a parasite). First I have to comment on the following statement.

    "THE WHOLE NINE MONTHS THE SURROGATE IS CARRYING THIS INFANT, HER BLOOD IS RUNNING THROUGH THIS CHILD. I mean literally. Technically. It is amazing how people thionk of surrogate women like they are nothing more than a hole in the ground where a baby is filling it up. Being carried inside of a Mother, you are a part of that Mother, and the child should never be denied the fact that that Mother is a part of him or her."

    I disagree...The placenta is the organ that attaches the developing embryo or fetus to the uterus (womb) and is composed of maternal and embryonic tissue, it links the blood supply of the embryo to the blood supply of the mother, allowing the exchange of oxygen, nutrients, and waste products. Please note that the two blood systems are not in direct contact, but are separated by thin membranes, with materials diffusing across from one system to the other. The placenta also produces hormones that maintain and regulate pregnancy. It is shed as part of the afterbirth.

    Having cleared that issue up, the emotional aspect of being a Gestational Carrier ( as opposed to Traditional Surrogacy in which the surrogate is also biologically related) is vastly different for most women who carry a baby for someone else. Speaking from experience, I had my own children and so felt prepared to carry a baby for another couple knowing that my own family was complete. I ended up carrying two sets of twins for two separate couples. I never had any issues with postpartum depression although it is possible with hormonal changes to be emotional after a birth. The Intended Parents are the ones responsible for any costs connected to bed rest or medical treatments that the insurance does not cover. You visit to the two sites that I am listing below to learn more about Surrogacy. As a side note....I suffered from secondary infertility which is why my son is 22 and my daughter is 12 so I do understand how it feels to want to have a baby and it just isn't in the cards (at the time when YOU want it to happen) and my own father was adopted so I know from my grandmother how it feels to go through that particular process as well.

    Thank you for allowing me to post....I just wanted to educate those who are a bit confused as to what happens during a surrogacy and I would be more then happy to answer any questions that you may have.

    Sharon LaMothe
    Infertility Answers, Inc.
    http://infertilityanswers.org/
    http://infertilityanswers.typepad.com/surrogacy_101/

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  6. Thanks for your comments, Sharon. Some of us here DO know that blood does not cross the placental barrier, having passed basic biology:-)And the emotional disconnect from children not biologically yours is not surprising. But I have to admit I still do not understand why any woman would do this, especially for strangers.

    So you carried twins twice for other people. How much were you paid? I assume you were paid, so it was a commercial transaction, a job, not just a good deed, no matter how much sympathy you have for the infertile and those who waited to long to conceive wanting a child "when they want it." Were you "freelance" or did others setting this up get a cut as well?

    Compared to other jobs you could have had for 9 months, was it worth it, really? Were you really aware of the long-term health risks of surrogacy? Two sets of twins must have been pretty rough on a nearly middle-aged body, no matter how in-shape you were.

    Would you reccomend this type of work for your daughter if she needs cash in the future?

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  7. I wonder too how many of these little buns cooked in ovens other than those of their biological mothers, will be told about the process by which they were brought into the world, and the identity of the non-family contributer. I'd guess in situations like Sharon's probably most - maybe - but there's no legal obligation to give the children that part of their history.

    As Marianne said, when money is exchanged surrogacy becomes a commercial transaction. So how would such an employment contract be enforced?
    I assume it varies state by state, but in any case, what if the surrogate changes her mind?
    What if the IP dudes change *their* mind? What happens then?

    Who will monitor the surrogates behavior? What if she decides to go on a drinking binge or whatev? Even where trust exists, not everyone behaves predictably, and she can't be supervised for wholesome behavior for 24 hours a day.

    I'm glad you didn't suffer post-partum depression, Sharon, but according to the statistics, between 10 and 20% of new mothers do, so it is not an inconsiderable risk.

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  10. Um, Improper. People in chateaux shouldn't throw tomateaux.
    But I guess it's different when you do it.

    Heidi Hess Saxton must have been delighted with the ammunition you gave her. Of course, she's under no obligation to make allowances for your obvious psychological problems.

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  12. Actually, what prompted my response about people in chateaux was yours to Mairaine.
    I just tossed Heidi in for good measure.

    Your definition of stalking is just about as off-beam as your understanding of what 'devil's advocate' means. But whatev.

    I'm off now, to buy groceries, and cut down a few innocent Adoptees while I'm about it.

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  13. Kippa will you stalk me instead then, because I really appreciate your sense of humor, and I promise not to throw tomateaux, well not too often anyway.

    The thing that scares me about surrogacy is we don't really know what the consequences are.

    We know that mitochondrial (sp?) DNA from the children a mother carries stays in her body for at least 38 years, and that her DNA does mix with the growing babies.

    So we don't really know what we are doing, and we are willing to find out by using the lives of innocents. That makes me very sad for us.

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  14. I'm willing to stalk you instead, Joy.
    But are you innocent enough for me to bother?
    That is the question.

    You're right about the mitochondrial DNA. I'd forgotten about that. I've read that women and their fetuses exchange cells during pregnancy, leaving mother and child with fragments of the other in their systems. I've also heard that this can trigger autoimmune diseases in the mother.

    How about this one then?
    http://www.dailymail.co.uk/news/article-1091907/Hampstead-intellectual-seeks-egg-donor-mother--Oxbridge-students-considered.html

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  15. I can certainly act innocent and violently claim innocence. That has to be worth something...

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  16. I wish that women/couples who cannot conceive would just accept that as their fate and find something else to devote their lives to. We can't all be sports stars, actors, rock stars, rocket scientists... parents. It is what it is. Accept it, for crying out loud!!! Stop trying to subvert nature and/or take children from their families of origin.

    IMHO, surrogacy (as well as using donor eggs and sperm) is as wrong as adoption, perhaps more so, because there are situations where adoption is a viable solution (children in foster care or who would otherwise not have families). Using others' bodies and reproductive pieces/parts for personal gain is plain wrong.

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  17. Never understood why surrogates and recipients (and donors) seem to use any rhetoric that they can to win on-line debates - this in spite of the donateds and adoptees best efforts to talk to them about the degrees of unhappiness that donorship brings.

    The adults invloved wwant to buy nine months gestation.

    But since some donateds get very unhappy over that transaction as well as surrogacy itself, it is time to stop donorship.

    In poor families the adults invloved go without to feed their young, and so I ask here where is that self-scrifice to be found in in donorship?

    Love does not win the donateds round, as is seen if anyone looks at what the donateds have to say.

    As the poster called maybe states that infertlity is an illness, let me state that the donorship process does not cure it, which is what donor-conceived themslves say.

    And since donorship is about them, and is failing, it should be banned.

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  18. Yes, surrogacy, even more than adoption, is all about what the buyer wants and can pay for, and never mind the feelings of the child so created; he or she is first and foremost "the product". Products don't have feelings or opinions. They exist to please the consumer.

    We have heard from plenty of artificial insemination products, since that practice has gone on for many years. They are not delighted. And of course we know the problems many adoptees face.

    In my opinion surrogacy is just another form of prostitution, taking it one step further and selling not the sexual experience but the product. Women with either few other options due to desperate poverty, or pure greed using their reproductive organs to make money.

    And of course we have the pimps, as ever, those who arrange and profit from egg donation, surrogacy, and embryo sales. The terchnology may be new but the dubious ethics, exploitation and greed undelying the whole mess are very old. The "oldest profession" with a high-tech twist.

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  19. Improper, you said "THE WHOLE NINE MONTHS THE SURROGATE IS CARRYING THIS INFANT, HER BLOOD IS RUNNING THROUGH THIS CHILD. I mean literally. "

    What your doctor told you, which is true, does not back up this statement, which is what I was responding to. Mother and child have separate circulatory systems, and may have different blood types that would be incompatible if they came in direct contact with each other. Like getting the wrong blood type in a transfusion. You die.

    That is why RH positive babies of RH negative mothers could have serious problems unless the mother is given a Rogam (sp?) shot after her first delivery, in case some blood got mixed during delivery.

    Nutrients and other things are filtered and passed through the placenta. That is not the same as "her blood running through the child." I very much doubt that your doctor would back up that statement because it is not true.

    Nor is any fetus "part of the mother's body". It is a separate being, able to be supported by the mother's body because of placental and hormonal actions that turn off the body's natural immune response to reject a foreign body. This response is a big problem in organ transplants. Any fetus, including those carried by the real mother, not an unrelated surrogate, is half the father's genes, so is not identical to the mother's body or a part of it. Yes, the fetus is affected by the gestational mother's nutrition, substance abuse, illnesses and emotions while being carried by the mother,and nobody is disputing that.

    None of this ie either wrong, tactless or arrogant. It is just the accurate science, which you seem not to care about if it does not fit your beliefs. Aren't you the person who believes schizophrenia is caused by demonic possession?

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  20. It's worth a lot, Joy.
    As Oscar Wilde said, it's only shallow people who do not judge by appearances.
    If you can look innocent, that's good enough for me.

    You may call me Herod.

    Mairane is absolutely correct about babies having separate circulatory systems from their mothers. It's a fact.
    And I agree with her that surrogacy for money is a form of prostitution.
    As far as the altruistic argument is concerned, some prostitutes use it too, that they are just performing a social service.
    I have big trouble with the truthiness of such a statement. Although I'm sure they find it comforting to believe it.

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  22. Whoops-typo
    There has never, ever been any medical test to prove that the *lack of dopamine causes schizophrenia-
    too much dopamine causes schizophrenia rather.

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  23. No comment needed, IA. Nobody else could destroy your credibility better than your own words. I wish you were on our opponents' side!

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  24. Well, you must be making money somehow off of psychiatry mairaine or the drugs used and what I say threatens that. Lorraine said to cool it, so please stop the juvinille insults. Ty

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  25. This is a can of worms.
    "Military wives find a new mission with service as surrogate mothers"
    http://www.signonsandiego.com/news/
    military/20080629-9999-1n29surro.html

    Apparently Tricare comprehensive medical services for military wives can trim about one-fifth off the surrogacy price tag.

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  26. Hi again!

    I am very interested in this debate that Surrogacy and even adoption is "wrong". The people making these comments, do they have their own children? If so, I can certainly see that you have no idea how a barren woman (Or infertile man) would feel as its a natural instinct to want to pro create and be a parent. Considering that Infertility is a life sentence lets compare that to people needing a blood transfusion or a kidney or bone marrow..should they, too, just "accept their fate"? Should they not use a donor? I think it's very closed minded of all of you who believe that people should not use science to complete their families when their own bodies has somehow failed them. Very Sad.

    As for me...My expenses were paid for...all my ins policies, living expenses and maternity clothing. Any medical co-pays and travel expenses and, yes, even the child care for when I had to give birth. Why should my family pay to have another person's baby to be born? Remember it is against the law in every state to sell a baby! Compensation is for the expenses above. When you hear of a surrogate "getting 20,000 dollars" it is for more then a year of her life. Is it worth it? YES because its a gift that will keep on giving....not only making parents but grandparents, great grandparents aunts, uncles, and perhaps brothers and sisters etc. Human nature wants to pro create...people become couples most often to share their love with their children....everyone should have that choice if they can. No one should be able to take it away from them.

    JMO!
    Have a great week!

    Sharon LaMothe
    http://infertilityanswers.net/
    http://infertilityanswers.typepad.com/surrogacy_101/

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  27. Dear Sharon,

    What I think is sad is that you don't even seem to be aware of the fact that these babies that infertile people need, are actual human beings themselves.

    Those little babies that infertile people need might not want to lose their identities and families just to meet the gaping hole in someone else.

    Have a great week!

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  28. Sharon, you say "Why should my family pay to have another person's baby to be born?" Then you refer to surrogacy as" a gift that will keep on giving." So I assume you would not give this "gift" if you were not paid, which makes it not a gift but a commercial transaction, even if
    the pay isn't great for 9 months work and wear and tear on your body. You did not answer my earlier question as to whether you would recommend this line of work for your daughter.Nor how this differs from prostittution; just another way of selling your body to provide a service to someone else.

    Also, as Joy has pointed out, the "gift" isn't an organ or an object, but a human being. Nobody has a "right" to children by any means possible. In this case science has far outstripped ethics and the commercial model of infant adoption surrounded by secrets and lies under sealed records has become the template for assisted reproduction as well. To put it more bluntly, if you can pay for it you deserve to have it, and the child becomes a sought-after commodity, a product, not a person with rights of his own.

    Perhaps surrogacy has been just peachie for you, but what about women in India who are tempted into earning more money by selling their bodies than they could by any other means, in order to feed their families?Does anyone provide surrogacy and other reproductive assistance for those who are infertile and poor? I don't think so. "Sympathy" for infertile people only goes so far, doesn't it? Only as far as those people can pay.

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  29. ". . . lets compare that to people needing a blood transfusion or a kidney or bone marrow transplant."

    Blech. Let's not. It's not the same at all.
    Nuf' said

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  30. I found it positive that the author of the NYT article emphasized the importance of a genetic connection (her egg and her husband's sperm). I am absolutely opposed to surrogacy where the egg is the surrogate's or purchased from an egg seller (not an egg donor since she is paid.)

    As an aside, one of Oregon's most notorious murderers was a surrogate mother using her own egg. Diane Downs is in the news this week because she is up for parole. Diane shot her three children in 1983, killing one of them. Prior to the murder, she had been a surrogate. I wonder if the "parents" of the surrogate child knew whose genes their child carries. Diane also had a child conceived after the murder who was placed for adoption. True crime writer Ann Rule wrote a book about the Downs case, "Small Sacrifices," which was made into a TV movie with Farrah Fawcet.

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  31. I, like Sharon, am a "surrogate mother." We used the father's sperm and eggs from an egg donor. I gave birth to two beautiful twin babies almost 3 weeks ago, a boy and a girl, to the most wonderful couple, who I and my family have become close friends with. Our "journey" lasted nearly two years, and their attempts at having a family lasted 8 years before I came along.

    Yes, I am/was a compensated surrogate. For all of you who have a problem with that, I suggest you stop tithing your priest as well, or paying your OB, or any doctor who sees you. They should all be putting themselves out for you for free. Stop paying your taxes, too, because that all voluntary military everyone so loves (and I used to belong to) is compensated more than a surrogate is. And nobody dare mentions the fact that all-voluntary is, well, hardly.

    But then again I am someone who is pro-prostitution as well. Much like I wouldn't say some people who desperately want children but can't have them should NOT have them, I wouldn't say someone who is unlucky enough to have a regular sex partner should go without either. We all become so self-righteous when it is something we have no experience with; and even when we do, some of us like to play martyr and think everyone else should abstain just because for whatever warped reason, we did.

    I am currently pumping breast milk for my surrogate twins and am in contact with the parents daily. In two months, my family and I will be moving back home and won't be near our surrogate-family any more, and it will be heartbreaking. The last two years were some of the most emotional yet rewarding years of our lives, and we are now joined forever because of that, in a way most people will never understand.

    Unlike so many babies in this country today, these two babies were desperately wanted and loved, before they were even conceived. I would think the way they were conceived woudl be preferable to those children who find out their mother was drunk and had a one night stand -- where was the love in that?

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  32. Your blog keeps getting better and better! Your older articles are not as good as newer ones you have a lot more creativity and originality now keep it up!

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  33. I would like to make a quick comment. I am an infertile person. I am not in my 40's or 50's like some of you have suggested. I am 30 years old and have been fighting infertility for several years. My husband and I are now looking into surrogacy right now.
    I do not understand why some people are so against it...Do you have your own children, are you able to have your own? Do you not know how it feels to not have the ability to have your own child? I do. It haunts me every day that I cannot carry a child of my own.
    There are not words that I can describe to make you understand how I feel. If I had the money to pay someone a million dollars to have my baby, I would. I would appreciate this wonderful woman giving herself and her families time to give me and my husband a family.
    This is not something that should be battled about. This is not something just for "old people who waited too long to have children". These are real people with real feelings and infertility issues.
    Surrogate mothers are a blessing from God.

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