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WOMBS FOR RENT?Gestational Surrogacy and the New Intimacies of the Global Marketby Rachel BlattSubmitted in partial fulfillment of the requirements fora Bachelor of Arts with Honors in AnthropologyBrown UniversityApril 2009First Reader:Lina Fruzzetti, Ph.D.Second Reader:Sherine Hamdy, Ph.D.1

Wombs for Rent? Gestational Surrogacy and the New Intimacies of the Global MarketExcerpt from the website of the Malpani Infertility Clinic in Bombay, India:“Infertility, Artificial Insemination & Surrogate Mother in Hindu Mythologyby Dr. Devdutt PattanaikIn the Bhagvata Purana, there is a story that suggests the practice ofsurrogate motherhood. Kans, the wicked king of Mathura, had imprisonedhis sister Devaki and her husband Vasudeva because oracles had informedhim that her child would be his killer. Every time she delivered a child, hesmashed its head on the floor. He killed six children. When the seventhchild was conceived, the gods intervened. They summoned the goddessYogamaya and had her transfer the fetus from the womb of Devaki to thewomb of Rohini (Vasudeva’s other wife who lived with her sister Yashodaacross the river Yamuna, in the village of cowherds at Gokul). Thus the childconceived in one womb was incubated in and delivered through anotherwomb.”2

IntroductionIntroductionIn the spring of my junior year at Brown I enrolled in Sherine Hamdy’sBioethics and Culture class, an introduction to medical anthropology thatengaged the social and ethical implications of medicine and biotechnology. Icouldn’t have known when I registered how important the class would be forme. It changed my understanding of this discipline, of the anthropologist’srole in society, of the intersections of our bodies, policies and economies, andmore than most classes at Brown, it left me hungry to read, witness and learnmore. That semester, I was introduced to many of the contemporary medicalanthropologists you will see cited in this thesis. I realized that identifyingbioethical problems is important not only for one’s understanding of scientificand medical realms, but also for one’s understanding of society as a whole.Questions surrounding abortion, amniocentesis, disability, conceptions ofmotherhood, conceptions of the body, as well as the commodification of thebody, were central to our in-class discussions. During the final project for theclass, I became particularly interested in women’s health, the global trade inhuman body parts, and the transnational inequalities on which reproductivepolicies and practices increasingly depend. It was during my search for abioethical problem that encompassed these issues that I first learned aboutinternational commercial surrogacy and the burgeoning surrogacy marketin India. “India Nurtures Business of Surrogate Motherhood,” an article3

Wombs for Rent? Gestational Surrogacy and the New Intimacies of the Global Marketprinted in the New York Times in March 2008, was the jumping off point formy research.India’s rapidly expanding commercial surrogacy industry isdependent on “gestational carrying” arrangements, in which the surrogatemother is not genetically related to the child she carries. Rather, the spermof the intended father fertilizes either the ovum of a donor or the ovum ofthe intended mother, and the resulting embryo is implanted in the gestationalcarrier’s womb.This type of surrogacy is made possible through in vitro fertilizationtechnology (IVF)—literally “in glass” fertilization— where an embryo iscreated outside of the womb. Before the introduction of IVF procedures in1987, however, surrogates were impregnated with the sperm of the intendedfather through artificial insemination. In this arrangement, called “traditionalsurrogacy,” surrogate mothers contributed their own ovum and did bear agenetic connection to the child they bore. The anthropologist Rayna Rapphas pointed out that even this so-called “traditional” surrogacy is “surely aplausible oxymoron” (Ragoné and Twine 2000: xv). In this particular sociocultural context, any third-party form of reproduction, requires individuals toreconceptualize procreation, reproduction, kinship and family.Before my introduction to Indian surrogacy and the anthropologicaldiscourse on reproductive technologies in the U.S., I had, of course, beenexposed to the surrogacy business through other popular media outlets,including the work of American comedians. Recently, Tina Fey’s film BabyMama, featured a successful, single businesswoman who discovered she wasinfertile and hired a working class woman to be her surrogate. The arrangement,as well as the class/education differences intrinsic to it, initially strained theirrelationship, but they eventually became friends when they learned they bothhad the potential for “natural” mothering, after all. The film simultaneously4

Introductionpoked fun at, but reaffirmed, the “traditional” ways to make a baby, and therewas a clear favoring of “natural” childbirth over surrogacy. As Fey’s characterrealized that she, too, could biologically have her own child with the manshe loved, her absolute joy implied that the other way would have been less“legitimate.”Before Baby Mama, Larry David, in an episode of his HBO sitcom Curb YourEnthusiasm, had made a mockery of himself and American kinship ideologywhen he attended a baby shower for a child being born through surrogacy andupset everyone by bringing two gifts—one for the intended parents and one forthe surrogate mother. “What?” he said, looking at the surrogate. “You’re theone carrying the baby. That’s your baby.” By suggesting that the surrogatecould have formed a legitimate parental connection to the child through theact of “carrying” it, David had made a social faux-pas. Like Baby Mama, thisscene depicted a cultural ambivalence about the way surrogacy has askedpeople to reconceptualize notions of family, parenting, and relatedness.I had off-screen encounters with new reproductive technologies as well.Alongside notices for pizza delivery and spring break specials, Brown’s campuspublications regularly print ads soliciting college-age egg donors. A 60,000pitch goes: “Pay off your student loans, covergrad (sic) school tuition, studyabroad or get a head start on your career goals” (Kay 2004). Another, for 75,000, lists characteristics of the desired donor: “Attractive, intelligent,Jewish, SAT score of at least 1370, 21-29 years of age, at least 5’4” tall andno more than average weight” (Kay 2004). These ads provide another exampleof cultural ambivalence toward new reproductive technologies.Donatedeggs could be used for gestational surrogacy, but they could also be used forsomething that seems its reverse. An intended mother could be implantedwith someone else’s egg and therefore be able to “carry” a child that is not5

Wombs for Rent? Gestational Surrogacy and the New Intimacies of the Global Marketgenetically her own.Selling human ova is prohibited in America, but it is legal to “donate”eggs in this manner and be “compensated” for the invasive hardship. WhileI’ve read the ads for four years now and occasionally fantasized about what 75,000 could do for me (cover my loans, fund my wildest travel and researchprojects, the list continues) I had never allowed myself to imagine howbecoming an egg donor might change my perceptions of my self, my bodyand of life and birth, in general. But then this fall, perhaps only to rouse me,a close friend asked if I would be interested in donating my eggs to his uncle,who had been trying to conceive a child through surrogacy for some time.He and his partner had decided they were looking for “Brown eggs.” Due totheir perceived superiority, a female Brown student’s eggs are highly-covetedgenetic material. If it didn’t work out, my friend told me, his uncle was alsolooking into the “less-expensive Oberlin eggs.”They didn’t get their first or second choice eggs, but months later, theyfound a donor from a bank in California and a gestational surrogate in Texas tocarry a child for them. I had the opportunity to talk to them throughout theirsearch and their experiences informed my questions and ultimate conclusionsin this thesis. I also conducted interviews with the counselors at the NewEngland Fertility Institute in Stamford, CT, one of the East Coast’s leadingclinics for third party reproduction. In March 2009, I attended one of theInstitute’s information seminars on gestational surrogacy and there, I metand conducted short interviews with four infertile American couples who wereconsidering hiring surrogates within the U.S.As my research turned to the burgeoning transnational surrogacyindustry, the Internet proved a valuable resource for finding news sourcesand conducting interviews. Through email I was able to interview a young6

IntroductionIndian filmmaker who is currently at work on an animated documentaryabout surrogacy in India. I also emailed with three graduating journalismstudents from the Wee Kim Wee School of Communication and Informationin Singapore who recently published a 45-page book based on their firsthandinvestigations of the surrogacy industry in Mumbai and Gujarat, India inDecember 2008.I supplemented these interviews with secondary sourcematerial from American and international newspapers as well as ethnographyand medical anthropology roductiveoutsourcing” and “rent-a-womb” by popular media, provides a rich terrain fordebate in the U.S. and elsewhere because it provokes yet another disturbanceof the imagined public/private sphere divide. Commercial surrogacy, likecommercial adoption, abortion, or sex work, places things that are normallyrelegated to the private sphere (procreation, the maternal body, the femininebody) into the public sphere (the capitalist market). When an element ofreproduction becomes a commercial service, issues of bodily exploitationand economic opportunity are immediately called into question. And whenthe service crosses national borders, as gestational surrogacy has in the lastdecade, with transactions between women and families of different culturesand vastly unequal social and economic statuses, questions of power, consentand opportunity are even further complicated. It is impossible to disentanglequestions of culture, politics, and biology from the topic of reproduction.However, my goal in this thesis is to develop some kind of analytical frameworkto examine their intersections, specifically as they pertain to surrogacy.In the 1980s and 90s, surrogacy stretched and contested the definitionsof biological relatedness and parenthood in the U.S. Today, as surrogacyextends into the global economy, it raises many of the same ethical issues7

Wombs for Rent? Gestational Surrogacy and the New Intimacies of the Global Marketthat are present in the U.S., but it also presents new contexts for examiningchoice, empowerment, social worth, and personhood. In the article DisplacingKnowledge: Technology and the Consequences for Kinship (1995), anthropologistMarilyn Strathern wrote that “there is no vacuum in people’s practices andhabits of thought; there are only existing practices and habits of thought onwhich the new will work” (Ginsburg and Rapp 1995: 346) Keeping in mindthat the past informs the present, my goal in this thesis is to explore andunderstand the bioethical uncertainties and cultural logics surrounding thegenealogy of surrogacy, from its onset through artificial insemination in theU.S. in the late 1970s to the newly emerged transnational surrogacy industryin India.In what follows, I address these questions as they pertain to surrogacy’spresent and past. What is the genealogy of surrogacy in the United States? In the U.S., how has third party reproduction altered, but alsobeen altered by, American kinship ideologies? What happens when these biotechnologies leak into the porousboundaries of the new global economy? What are transnational surrogacy’s implications for gender, class,and conceptions of “personhood”? What global dynamics are involved? What new contexts have beenraised for the judgment of what is right and what is wrong? How can earlier works by feminist anthropologists shed light onthese issues? What are the obstacles to regulating the transnational surrogacyindustry? What is the role of anthropology in such a task?8

IntroductionA Road Map for ReadersThe first chapter of this thesis will follow the genealogy of the Americansurrogacy industry, from the onset of informal “traditional” surrogacyarrangements through artificial insemination in late 1970s to the emergenceof gestational carrying through IVF technology in the late 1980s. I will lookat the ways medical advances worked in tandem with “traditional” Americankinship ideologies to enable, justify, and sustain gestational surrogacy, tothe point where this type of arrangement has all but replaced “traditional”surrogacy as the main form of surrogacy in the U.S.The second chapter will explore gestational surrogacy in transnationalcontext. In the wake of legal controversies over “traditional” surrogacy inthe U.S., gestational surrogacy arrangements, which offered infertile couplesmore options for having a genetic connection to their child, proved more inline with American kinship ideologies. As the gestational surrogacy industrydeveloped its own bureaucratic machinery in the U.S., it became heavilyregulated and normalized. In the last decade, however, gestational surrogacyarrangements have proliferated into the global economy, accompanied bya dearth of regulations and a whole host of new ethical concerns. In thischapter, I will discuss the development of the surrogacy industry in India, withconsideration of the tensions and uncertainties raised by new global flows ofpeople and technology in the twenty-first century.The final chapter of this thesis will look closely at a recent controversyin India that has highlighted the need for transnational surrogacy regulation totake specific