Pope Francis this week expressed his hope for a global ban on surrogacy, a practice he described as “deplorable.” The next day, the U.S. Conference of Catholic Bishops echoed his statement saying that surrogacy, in their view, does a “grave injustice” to everyone involved. The denunciations of surrogacy from the pope and the U.S. bishops brought back memories of me navigating the world as a 40-year-old Christian ethicist, and a married mother of two, who agreed to become pregnant for my friends.
The denunciations of surrogacy brought back memories of me as a 40-year-old Christian ethicist, and a married mother of two, who agreed to become pregnant for my friends.
My mom, a conservative evangelical, didn’t articulate the same objections the Roman Catholic Church has voiced for decades (against any practice separating conjugal union from procreation whether or not money changes hands) but she nonetheless pronounced that surrogacy is not the way God wants us to bring children into the world.
She also wondered why my friends didn’t “just adopt.”
The truth is that during their decadelong struggle with infertility, my friends had pursued adoption. They were never picked. Their experience, and those of others, showed me that adoption isn’t universally accessible to those who long for children. Nor is it always morally unambiguous.
So, some eight years ago, I joyously gave birth to their baby girl. And, to the surprise of some, it was my progressive Christian faith that gave me the courage to do so.
The Taiwanese evangelical church in which I was raised had already primed me to associate Christianity with the provision of health care, given that the first Presbyterian missionary to Taiwan also established the first Western medical institution there.
I later joined the Presbyterian Church (USA) largely because of its social witness policy. I have appreciated the PCUSA’s valuation of both science and conscientious discernment in decision-making on sexual and reproductive matters, including its support for IVF in 1985 as a “responsible alternative for couples for whom there is no other way to bear children” and its stance that doesn’t condemn surrogacy, or the use of donor gametes, but encourages study on their “psychological, ethical, and legal ramifications.”
I became a surrogate out of a sense of Christian love and reproductive generosity. In the book I recently published about that experience, I offer a vision for surrogacy that I believe aligns with Christian theological ethics, feminist methodology, social scientific studies on surrogacy-expanded families, human rights and the reproductive justice framework. I also wanted to correct widespread misperceptions many people have about surrogacy.
For instance, four decades of research on surrogate mothers reveal that it’s the exception, not the norm, for them to bond with the child they are carrying. That means that it’s rare that they experience anguish at having to relinquish the child at journey’s end. Instead, surrogate mothers tend to bond with the intended parents as they come to share in their pains, hopes and dreams.
Second, in contrast to the pontiff’s assumption that surrogacy is exploitative because women are looking to improve their dire economic situation, surrogates often report a host of reasons for their actions. Some reasons for themselves and some reasons for others.
I became a surrogate out of a sense of Christian love and reproductive generosity.
To give a sampling: In Israel, surrogates report wanting the money and also wanting to help couples carry on their genetic lineage (“continuing generation”) in keeping with Jewish-Israeli pronatalism. In Buddhist-dominated Thailand, surrogates report seeking financial remuneration and wanting to assist infertile couples, a prospect Theravada Buddhists believe will confer virtue on the person providing help (umbun — “carrying the merit”). In the U.S., the mostly white, Christian-identified surrogates in one study became pregnant for others “for what they gain from it (which is not a baby): the pleasure of pregnancy, the fulfillment of helping others, the relationships cultivated with IPs, and yes, the money.”
I find it insulting that anyone would characterize these women and other surrogates as mere victims of tragic circumstances. To see them as only “exploited” is to deny their agency and self-determination. My feminist and reproductive justice-inspired argument is that anyone who believes it is important to “trust women” to make their own informed decisions about whether to continue a pregnancy or terminate it, should also trust them (and other pregnancy-capable people) to make decisions about whether to undergo a pregnancy for someone else.
Speaking on behalf of the U.S. bishops, Bishop Robert Barron condemned the practice of surrogacy, joining Pope Francis in calling it a “grave injustice” that results in the “commercialization of women and children.” https://t.co/yAW6ek0rWS
— Catholic News Agency (@cnalive) January 11, 2024
To be sure, not all surrogacy arrangements end well. Surrogacy disasters have happened and will likely continue to happen. And some women and intended parents have been exploited (the latter mostly by questionable surrogacy brokers), and children have suffered as a result.
That’s why my support for surrogacy is not unconditional. So much hinges on the particularities and ethical parameters of how each and every agreement is arranged.
I was a child when I witnessed the headlines and public anxieties about “test-tube babies” after Louise Brown was born through in vitro fertilization (IVF) in 1978.
I was a child when I witnessed the public anxieties about “test-tube babies” after Louise Brown was born through in vitro fertilization in 1978.
While ethical and legal questions remain — for instance, about certain uses of preimplantation genetic diagnosis or about the fate of surplus cryopreserved embryos — IVF has gone mainstream. Most Americans (61%) believe health insurance should cover the cost of fertility treatments, 15 of the 21 states that have passed fertility insurance coverage laws include IVF, and 54% of the largest U.S. employers cover IVF.
Michelle Obama revealed that Malia and Sasha were IVF-conceived, disrupting a stereotype that IVF is primarily for older, wealthy white women, and former Vice President Mike Pence revealed on national television that he and Karen Pence had used IVF “many times,” disrupting the popular thinking that IVF was verboten for pious, “pro-life,” evangelical churchgoing folk.
Will surrogacy, which requires IVF in most cases, follow a similar trajectory from widespread controversy to accepted — even subsidized — usage?
Time will tell.
But today, we have not yet reached a global, or even a national, consensus on the good or ill of the practice. For example, New York finally reversed its decadeslong ban on surrogacy through passage of the Child-Parent Security Act (CPSA), though compensated surrogacy is still prohibited in Louisiana, Michigan and Nebraska.
India, once a top surrogacy destination for foreign singles and couples alike, has shut its commercial surrogacy doors for good through its Surrogacy (Regulation) Act of 2021, and has blocked members of the LGBTQIA community, among others, from becoming parents through altruistic surrogacy. Around the same time, in 2022, Israel lifted restrictions that had prohibited same-sex couples and single men from having children through a surrogate.
India, once a top surrogacy destination for foreign singles and couples alike, has shut its commercial surrogacy doors for good.
Instead of calling for a global ban on surrogacy, I wish the pope had realized that diverse social attitudes and laws about this practice are not going to change anytime soon. I wish he instead had supported ongoing efforts by Hague member countries to establish a regulatory framework to safeguard the interests of children born of international surrogacy arrangements.
The international community once did that for intercountry adoption. Surely we could do something similar for surrogacy for the good of everyone involved.
Grace Y. Kao
Grace Y. Kao is Professor of Ethics at Claremont School of Theology and the author of "My Body, Their Baby: A Progressive Christian Vision for Surrogacy" (Stanford University Press, 2023) and of "Grounding Human Rights in a Pluralist World" (Georgetown University Press, 2011).