The Handmaid's Tale - Revisited

Just in time for Mother’s Day (May 10th this year - mark your calendars!), the Women’s Bioethics Project Book Club has released its next selection: The Handmaid's Tale by Margaret Atwood. Download the book club kit developed by WBP advisory board member Sue Trinidad and join us as we explore the bioethical implications of commercial surrogacy, the role of genetic relatedness, redefining concepts of motherhood and the commodification of women's bodies.

Read and discuss with your Mom, your daughters, and friends – let us know what you think – join the conversation!

Gestational surrogacy in the NYT

I'm surprised none of my fellow bloggers has posted this yet, so here goes. The cover story of last Sunday's NYT Magazine was "Her Body, My Baby," style reporter Alex Kuczynski's account of her experience hiring a gestational surrogate to bear a child conceived with Kuczynski's own egg and her husband's sperm.

The story has raised quite a flap in the blogosphere. On one side are ardent defenders of Ms. Kuczynski. Their comments tend to express sympathy for the writer's struggle with infertility, IVF, and miscarriages; support the absolute right to self-determination in matters of reproduction, assisted reproduction included; gratitude for the author's open and honest description of her experiences; and encouragement of the "you go, girl" type. On the other side are sharp critics, who question Kuczynski's motives and values, seeing her decision as driven by "narcissism" and fueled by "too much money," and in some cases, drawing parallels with Kuczynski's adventures in cosmetic surgery.

What should we make of all this? And what accounts for the vehemence of the commentary, on both sides?

The most obvious answer, in my mind, lies in the featured photos. The one on the left is of the author, babe in arms (not facing the camera), and the baby's brown-skinned, uniformed nurse, standing outside the author's well-appointed home. The one on the right is of Cathy Hilling, the gestational surrogate, barefoot and pregnant, sitting with her dog on the front porch of her home, which could use some new paint and maybe some landscaping help. The images clearly juxtapose differences in class and race.

I don't want to start (yet another) flame war about the article--there are enough of those out there already. (Maybe this is why the NYT has shut down comments on the article, having received 404 since Sunday.) I do think there is still room for civil discussion of some more important questions, though ... Anybody game?

Due April 25th - Surrogacy goes Hollywood

[Hat tip to R. Alta Charo for alerting us to this this!]





Can't wait to hear the reviews...

"Reproductive outsourcing" taking off in India

Today's NYT reports (again) on the growing practice of "reproductive outsourcing" in India. For about $25,000 -- about a third what it would cost in the US -- would-be parents can get the whole enchilada: donor egg, the services of a pre-screened gestational carrier, medical expenses, plus travel and accommodations to pick up their little bundle of joy. And none of those pesky legal hassles that can sometimes crop up domestically, as the only names on the birth certificate are the customers'.

Interesting semantic note: Back when this practice was still called "surrogacy," there was at least some intimation that there was some relationship between the would-be mom and the gestational carrier. The would-be mom couldn't carry the pregnancy herself -- usually for health reasons -- and the gestational carrier was essentially pinch-hitting. "Outsourcing," on the other hand, is a business term, in which one "hires out" for unprofitable, dirty, or inconvenient labor.

If you haven't yet read Margaret Atwood's novel, The Handmaid's Tale, perhaps this is an opportune moment. (There's also a movie version, but as I haven't seen it, can't vouch for it. In the film The Island, clones are used to carry pregnancies ... and they are killed once they've served that purpose.)

A Modern Day "Handmaid's Tale"?

In the latest and, in my opinion, grotesque twist on medical tourism, Judith Warner, author of “"Perfect Madness: Motherhood in the Age of Anxiety" and host of "The Judith Warner Show" on XM Satellite Radio, writes about the commercialization of surrogate motherhood in India. Her report can be found on the New York Times “Domestic Disturbances” blog, located here.

Many of us have talked, debated and written on the topic of surrogate motherhood, but all too often in the academic abstract. For someone like myself, who has thought about surrogacy in terms of commodification and exploitation, it is interesting to read Ms. Warner take on the issue, especially when she states “Our rules of decency seem to differ when the women in question are living in abject poverty, half a world away. Then, selling one’s body for money is not degrading but empowering.”

Surrogates from India, the WBP and the Huffington Post

Our founding director, Kathryn Hinsch is quoted on the Beth Kohl's Huffington Post blog, voicing her concern over the exploitation of women in India, ending up on the short end of the surrogacy stick. Kohl writes about "reproductive tourism" at the The Akanksha Infertility Clinic located in Anand, India in the Gujarat State: "To be clear, these are professional surrogates, local women who receive decent medical care and detailed contracts...Using a gestational surrogate in the U.S. can cost $50,000 and up. But an Akanksha surrogate costs only $5,000. The surrogates at Akanksha earn more than 100,000 rupees ($2,250 U.S.) per pregnancy, a massive amount compared to the average daily income of five dollars. Some people consider this a win-win situation..."

After speaking with Hinsch, Kohl writes: "Hinsch also voiced concern over the long term health implications of carrying another person's genetic matter, pointing to the fact that women who gestate even genetically-related multiple boys have increased risks for autoimmune problems, the genetic difference between the male and female of the species being enough to upset our natural physical make up. So what is the physical impact of carrying a non-related fetus? How is that risk compounded when carried out repeatedly which may happen at a place as well-managed as Akanksha in a developing region like Gujarat, India?"

Kohl has immense stores of sympathy for infertile couples and recognizes that there is a cost-effectiveness that is appealing to these couples -- I like the way she concludes, proceeding with caution, taking nothing for granted: "The act of bringing forth life, no matter whose constituent parts, no matter whose uterus or birth canal, is far too complicated to isolate it from history or the world as it is."