Surrogacy Raises Some Hard Moral Questions

“The psycho-social ramifications of surrogacy have yet to be explored”   Says Winsome Thomas.

  4/02/2012 by Winsome Thomas

Nicole Kidman and Keith Urban recently employed a ‘gestational carrier’ so that they could have a child. Psychologist Winsome Thomas explores the ethics of surrogacy.

Surrogacy seems to be receiving greater attention as more couples can choose this means of becoming parents. The procedure may be chosen when the biological mother is too old to carry a child or cannot conceive on her own (for example, due to a hysterectomy) or, as in the case of Elton John and his partner David Furnish, a female is required to produce a child for them.

"Some emotively call the process “rent a womb” but that is also the precise nature of the contract established between the surrogate mother and those who will raise the child."

Surrogacy, however, is not an easy route to take. All surrogacy in Australia must be altruistic or non-commercial. The alternative is to purchase a surrogate, usually in the United States of America or India. The cost is likely to be anywhere between $20,000 and $90,000. For some in our society, however, the idea of surrogacy shakes the accepted and long-held understanding of conception, birth and parenthood, even in a society where IVF is commonly undertaken and gay couples now raise children.

Gestational surrogacy is the medical term used when the surrogate mother has no genetic link to the child she is carrying, thereby becoming the gestational carrier. The term “birth mother” is still mostly reserved for the biological mother of a child who is then adopted. Traditionally surrogacy was the term used when the female carrying the child was also the biological mother. The term “gestational carrier”, however, is seen by some as implying detachment and the notion that the surrogate is somehow stripped of her humanity and becomes the equivalent of an incubator.

Of course that is exactly what the surrogate mother agrees to do, notwithstanding her intimate connection with the child over nine months. Some emotively call the process “rent a womb” but that is also the precise nature of the contract established between the surrogate mother and those who will raise the child. Put bluntly, it is a commercial transaction ostensibly carried out for the benefit of both parties. One might pause, however, and consider some of the ethical and moral questions raised in this contractual undertaking.

In the past surrogate mothers have been portrayed as women who have chosen to use their bodies in this manner in order to provide financial support for their own families. Others state that they blossom during pregnancy and delight in bringing joy to another family, notwithstanding the fact that they are paid for the part that they play. One wonders how they explain the pregnancy to their own children, what the effect is upon their spouse and children during the pregnancy and after yielding the child to another couple. Does the family become attached? Does it mean that women in India where the practice is growing and where it is much cheaper than in the USA could be exploited due to poverty? If so, how can the vulnerable be protected whilst allowing women to do with their bodies whatever they please? Is the reduction of a woman’s uterus to that of a commodity for which one receives payment akin to that of prostitution where payment is received for sexual services provided? And if prostitution is legal, why not commercial surrogacy? Are the future parents buying a baby or buying a gestational carrier? Is surrogacy providing the gift of life or demeaning women and co modifying children?

The research is very limited but reveals that surrogate mothers are carefully screened and manage to cognitively distance themselves from the baby throughout the pregnancy, making the child’s release much easier. What happens, however, if she is unsuccessful in distancing herself from the child? What if the baby is deformed or disabled? Who chooses to terminate a pregnancy? What if the surrogate mother decides not to hand over the child? These are but a few of the very difficult questions to be answered. To my knowledge no longitudinal research has been carried out on the effect(s) of being born to a surrogate mother has on the child in question. One may hypothesise that the results may be similar to those of adopted children but we have yet to be presented with good, sound evidence.

As yet we do not know what percentage of society accepts the notion of surrogacy, nor does there appear to be any longitudinal research on the number of satisfactory/happy versus unsatisfactory/unhappy outcomes for the child’s parents and surrogate mother alike. Anecdotal evidence suggests that both exist. The full extent of the psycho-social ramifications has yet to be explored. Given the public’s mixed response to the arrival of celebrities’ children born through surrogacy it is clear that much more work needs to be carried out in this area, one that is an ethical and emotional minefield.

Thus the landscape of issues linked with surrogacy range from legal to ethical & social. Although the socio-ethical aspects will undergo a transformation in understanding, interpretation & execution, it should be ensured that the legalities laid down by the laws of the land are strictly followed. There various healthcare agencies like “Wyzax Surrogacy Consultants (WSC)” that give due importance to socio-ethical issues besides legal issues very seriously. Such agencies are required to take care of the interest of both the parents & the surrogates & help in bridging gaps & overcoming the lacuna in this sector. Such agencies which take their social responsibilities very seriously and play a significant role in optimising the surrogacy sector in India & across the world.  

Winsome Thomas is a registered psychologist in private practice. She is a member of the Social Responsibilities Committee for the Diocese of Melbourne and worships at St John’s Camberwell.