Undercover as a surrogate mother


Kajsa Ekis Ekman


Photo: Holly E Clark

In the US agencies declare that potential surrogates are carefully investigated, and that only women who are determined to be appropriate candidates are approved. They must, for example, have had children before, their spouses must approve of the arrangement and they must pass psychological tests.

How this actually comes about was revealed by journalist Susan Ince when she went undercover as a potential surrogate mother in the USA.

Ince answered an ad in a local newspaper. The agency had a good reputation and was well established. At the first meeting, the female director told moving stories about childless couples: 

“The director did most of the talking. I was touched by her stories of infertile couples—the woman who displayed the scars of multiple unsuccessful surgeries creating a tire-track pattern across her abdomen; the couple, now infertile, whose only biological child was killed by a drunk driver.”

Ince was told that she would be interviewed and would speak with a psychologist and have a physical examination by a doctor. To become a ‘traditional surrogate’, she would be inseminated twice a month for six months. During this time, she would not be allowed to have intercourse. If she


did not become pregnant, she would be removed from the program and would not receive any compensation beyond her expenses. Even if she did become pregnant but miscarried, there would be no compensation. If she were to give birth to a stillborn child, however, she would receive full compensation.

The director explained that they were really looking for married women with children, because if a woman has already given birth, the chances of a positive outcome are higher. Still, the fact that Ince was single and childless did not pose a problem.

In the ‘psychological test,’ Ince was asked about her religious beliefs, her age, her eye colour, her hair colour and whether she had relatives in the area.

“I was surprised to find he had no more questions. ‘I just needed to be sure you’re still positive 100 percent. You are, aren’t you?’”

“Without a nod or a word from me, he continued, ‘You seem like it to me’ ... Because I was ‘obviously bright,’ there would be no IQ testing. I was never asked whether I had been pregnant before, whether I was under medical or psychiatric treatment, or how I would feel about giving up the baby.” 

Once the surrogate has signed the contract, she finds herself in the hands of the agency. She may not have intercourse, smoke or drink. She has to submit to all of the physical examinations and treatments the program prescribes.

She has to have an amniocentesis, and in some cases, the buyers have the right to demand that she have an abortion if the results are abnormal—but not based on the sex of the child. If the surrogate herself changes her mind and wants to have an abortion, she can be accused of breach of contract and have to pay damages of 25,000 dollars.

While Szpigler assures us that ‘everything is properly handled by lawyers and a supportive medical team’, it was clear to Ince that the agency’s lawyers are on the side of the agency and its clients—if the surrogate wants to have her own lawyer, it will be at her own expense, as will any litigation expenses.

All actions that “can be seen as dangerous for the health of the unborn child” are deemed a breach of contract and the agency has the right to sue her. The medical team is not on her side, either: if the doctor prescribes a Caesarean section, the surrogate has no right to refuse it.

The meaning of all of this is that the foetus that grows inside her is not hers—it is the buyers’. She is simply taking care of it for them.

Susan Ince began to ask questions, irritating the director who “admonished me for asking too many questions”

Ince’s conclusions about her undercover investigation were that anyone would be accepted as a surrogate just as long as she was fertile and seemed compliant.

Scholar Olga van den Akker challenges the “reliable psychological tests,” saying that they continue to be a myth. Women are not tested to see if they are psychologically stable but rather to see if they can be counted on being tractable about giving up the child.

In terms of ‘work’, surrogacy is not particularly lucrative. An American surrogate earns less than $1.50 per hour, and her Indian sisters earn barely half as much. The physical process which surrogates must undergo is complicated. In gestational surrogacy, they are subjected to multiple drug treatments. They have to inject themselves with hormones 2 to 3 times a day for 3 to 4 months.

To maximise the chances that a child will result, the doctor often implants more than one fertilized egg at a time, usually between 4 and 6. Because surrogates are younger and more fertile than other women who undergo in vitro fertilization, it is not uncommon for the result to be twins. Twins often necessitate a  Caesarean section.

Women have become infertile as a result of serving as surrogates. One woman tells of her attempt to become a surrogate mother:

“I’ve experienced things that I never wanted to experience. My body has been pumped full of medications and poked and prodded. I’ve had a D&E and a natural miscarriage. And now, I’m done. I can’t do it anymore no matter how much I love my IPs [intended parents] because my body just isn’t working. I have lost tangible things like money and jobs that I didn’t take because they wouldn’t have been conductive to pregnancy. I have lost intangible things like time and days of my daughter’s life when I was traveling or too wrapped up in hormonal meds to pay attention.”

Surrogacy, whether altruistic or commercial, is no solution to the desire for a child. As Elizabeth Kane, Americas first legal surrogate mother who changed her mind after she gave birth, put it succinctly: “One woman is in anguish because she cannot become a mother, and another woman may suffer for the rest of her life because she cannot know the child she bore for someone else.”

Kajsa Ekis Ekman is the author of Being and Being Bought. Prostitution, Surrogacy and the Split Self (Spinifex Press 2013). She will be in Australia as a guest of the Sydney Opera's Festival of Dangerous Ideas (August 30 and 31).