01 Feb The Law of Unintended Consequences
For those like us, who value the family, the inability to have a child is a heavy burden. Infertility is a very real challenge for many couples. In the US alone, one in eight couples have difficulty conceiving or sustaining a pregnancy. Many of you reading this may be dealing with or have dealt with this trial in your life. Certainly we all have friends and love ones who have. The pain and suffering associated with infertility is truly heartbreaking.
Many have been blessed by medical technology that has made the dream of parenthood a reality. And while we rejoice with those for whom science has given this gift, we cannot be blind to the damage being done to women and children in the effort to overcome infertility. The law of unintended consequences dictates that the actions of people always have effects that are unanticipated or unintended. In this case, surrogacy has unintended negative consequences that couples, and the society that wants to alleviate their despair, are ignoring in the pursuit of their desire to have a child.
At UFI, we know that all life is sacred, so issues that affect its beginning and end must be handled with care and respect. Let’s make sure our compassion and concern extends beyond helping the couples that battle the sorrow of infertility and includes safeguarding the sacred nature of childbearing.
In December of 2017, Trent Franks, a pro-life conservative representative from Arizona, resigned from congress because he had approached female aids to act as gestational surrogates. Franks and his wife have twins that were carried by a surrogate. The reaction to his inquiries and the resultant resignation have been met by a mixture of delight on the left and disappointment on the right due to his pro-life stance, but bewilderment on both sides due to the reason for his departure. After all, surrogacy, and its companion artificial reproductive technologies, is a common means of overcoming infertility among both liberals and conservatives. In the US, approximately 9 children are born through surrogacy every year in every state. Between 2011 and 2014, there was an 89% increase in the number of gestational surrogacies in the US. During that same time frame, there was a 180% increase in the number of couples seeking surrogacy in the UK.
For many, the desire to have children is as primal as the need to breathe. When one’s body cannot create or sustain a pregnancy, the pain and disappointment can be excruciating. Adoption used to be the means by which infertile couples realized their dream of a family, but a combination of factors has made adoption a less reliable alternative. With the advent of in vitro fertilization, couples that have difficulty conceiving have another method that can help them have a child. Since 1978, there have been 5 million babies born through IVF. Last of all, there is the expensive option of surrogacy, when a third party carries a child for an infertile individual or couple. Because adoption is so difficult and many countries won’t allow children to go to gay couples, gay men increasingly turn to surrogacy. Surrogacy has the added benefit of allowing them to have a child with some of their “own genetic material”.
A modern take on an ancient practice
Surrogacy, however, is not new. Some of the most compelling stories in the Old Testament recount the sorrows of infertile women and the desperate means they employed to obtain children through other women. Modern surrogacy gives couples, which otherwise cannot conceive, the ability to create the child of their dreams. The most medically technical interventions will produce a baby using donor sperm and donor eggs nurtured in a donor womb. A Google search regarding surrogacy and why couples choose this means to acquire a child, as well as why women choose to be surrogates, returns overwhelmingly positive results: with the use of IVF, a couple can have their “own” child; and women who have easy pregnancies and love parenthood can give the gift of family to a despairing couple. The question is, can a practice that is used to create a family, something that is fundamentally good, be anti-family? When women and children are essentially commodities, the answer is a resounding “Yes”.
In 2005, Lisa Fitzgerald acted as a surrogate and gave birth to a little boy for her older sister who had struggled with infertility for years. When the implantation of one of two embryos created through IVF took, Ms. Fitzgerald, a mother of three, realized she would need to tell her children why the baby in her belly didn’t belong to her. She explained it was like a “hen keeping the eggs warm in the nest.” Women like Ms. Fitzgerald, who are motivated to act as surrogates for a family member for the most benevolent of reasons are the exception. Most women, even those motivated by altruism, admit that the financial compensation is a factor. But there is a still darker side to the transaction as well. When it comes to the business of babies, the wants of adults who can spare no expense take precedence over the needs of vulnerable women and children.
Wealthy women aren’t surrogates for the poor
Except in those cases where a family member or friend acts as a surrogate without compensation, surrogacy preys on vulnerable women. Throughout history, poor women have resorted to selling their bodies for basic survival. Whether the business is prostitution or pregnancy, a woman’s body is the commodity. Like the prostitute who is left alone to deal with the health and psychic repercussions of selling her body for sex, gestational surrogates must also live with the always unintended, negative consequences of selling their fertility. What happens when it is discovered that an unborn child has a defect and a woman is ordered to abort the child she is carrying or be left with all of the medical bills? Or when IVF creates triplets and the intended parents want the surrogate to selectively abort one or two of the children? Or when intended parents divorce and no longer want the baby they contracted a woman to carry?
The exploitation of poor women is even more pronounced in places like the Ukraine, India and Mexico. In the United States, surrogacy costs, including IVF, can reach upwards of $170,000. Couples can spend approximately one-third that amount by using a surrogate in India. Surrogacy in Mexico will cost a couple 70% less than it will in Canada. Some enterprising individuals used lax regulations in countries like the Ukraine to implant women with embryos created without surrogacy agreements. Babies were then advertised to potential adoptive parents as a surrogacy that fell through. The women in these cases were literally baby making machines. Poor women in under-developed countries are also frequently uninformed regarding the health risks that accompany gestational surrogacy. To save costs for the intended parents, gestational surrogates are typically implanted with more than one embryo and are therefore more likely to carry multiple children. This increases the likelihood of pre-eclampsia, gestational diabetes, and hysterectomy in the surrogate.
Jennifer Lahl, president of the Center for Bioethics and Culture, would like to see surrogacy banned. “These mostly low-income women are injected with powerful hormones and other drugs to maximize chances of pregnancy, virtually without government oversight. Women didn’t get this far to be treated like breeding animals.”
Even benevolent, familial arrangements like the Fitzgeralds’ can carry an element of exploitation. During a second surrogacy for her sister, 45-year-old Lisa was put on bed rest when five months pregnant with twins. Recognizing the need to keep those babies in as long a possible, she “thought a lot about what could go wrong.” “They always said, ‘If something’s wrong, it’s not your fault,’ but there isn’t anyone else to blame. I was aware of that every day.” And at a certain point, the older sister’s desire for healthy children took precedence over the well being of her surrogate sister. “I’d be such a liar,” said the older sister. “If the doctor said she could get up to do something, I’d say, ‘Well, get up.’ But I was thinking: ‘Those idiots — how could they let her? We have to keep them in as long as we can. Thirty-five weeks is better than 34, 36 better than 35.’”
The babies were born at 34 weeks, and while seemingly fine, the older sister worried about their size and inability to suck. There isn’t much room for imperfection when it comes to these surrogate births. As Ms. Fitzgerald’s sister remarked, “If there’s something wrong, I’m the one bringing home the babies. I don’t want to hear ‘almost fine.’ I want ‘fine.’ I want what everyone else has.”
I want. That’s what it comes down to. Adults want, so money and medicine and the market responds, but is it ethical to buy and sell life like it’s an accessory? The United Nations Convention on the Rights of the Child declares that there are certain rights to which every child is entitled, and from which surrogacy deprives them – rights involving identity and family relationships. These rights protect children from exploitation and abuse. They ensure that life has inherent worth and that a child does not exist to satisfy the wants of an adult.
Those who employ surrogates claim their status as parent through DNA and financial power. This is why IVF has transformed surrogacy. A gestational surrogate has no DNA link to the child she carries, and even if the intended parents have no biological tie to the child, the fact that they have footed the bill to bring the child into the world establishes their parental rights. Science, however, is never static, and is changing the way we understand the link between a woman and the child to whom she gives birth.
Epigenetics is the study of changes in organisms through modification in gene expression as opposed to changes in genetic code. Research conducted at the National University of Singapore and the University of Southampton found that “fixed changes in a baby’s genes have only a modest influence on its epigenetic profile at birth and that most of the variation between babies arises from interactions between the environment experienced in the womb and the genetic information inherited from the parents.” The uterine environment, meaning what a mother eats, how she feels, and her lifestyle “have long-lasting effects on the health of her children.” The neonatal microbiome is also determined by the mother and microbial exchange between surrogate and child can influence the future health of a child. There is a physical bond between a surrogate and the child she carries that will last forever. In a process called microchimerism, fetal cells pass into the body of the mother and maternal cells pass into the body of the child. These cells become part of the tissue in which they settle; yet they are still distinct from the carrier. Even though a surrogate may not share any DNA with the child she carries, these two individuals are linked and affect each other for life.
A double-edged sword
Science and technology is a double-edged sword. It has the ability to alleviate so much of pain and suffering. But science and technology has no ethics. It is up to us to determine what is moral and just. Money, desperation and pity obscure our understanding of right and wrong, healthy and harmful. Martin Luther King, Jr. once said, “Our scientific power has outrun our spiritual power.” The very real sympathy we have for those who struggle with the heartache of infertility, has blinded us to the harmful effects of surrogacy. This form of family creation exacts too high a cost from women and the children they carry, as well as the society that sanctions their exploitation.