Surrogacy Is Good for Women and Good for Families

A few years back, when a relative was struggling to conceive even with in vitro fertilization, a mutual cousin of ours offered to serve as her gestational surrogate. It ended up being unnecessary, as the relative eventually got pregnant on her own. But it highlights how—far from being “deplorable” and “exploitative,” as Pope Francis recently called it—surrogacy can be an act of compassion and love. 

Surrogacy is good for families. 

Ironically, we live in a timeline where fertility rates are plummeting, and yet a seemingly growing number of people who want to have children simply cannot. In surveys of childless adults, infertility routinely ranks high among reasons for not having kids (though it often lags behind simply not wanting to).

Only a few thousand U.S. births per year result from gestational surrogacy, so even seriously boosting this number isn’t likely to cause some big boost in birth rates. (The main driver of the fertility rate dip isn’t childlessness, anyway, but smaller family sizes among those who do have at least one child.) But more surrogacy—combined with other fertility innovations, like IVF and things yet untold—could at least slightly raise the number of children being born. 

More importantly, it could help individual families who want children to fulfill this goal. Heterosexual couples struggling to conceive. Same-sex couples without the machinery to make it happen independently. Women for whom medical issues make pregnancy dangerous. All are situations where surrogacy could help. And helping those who desperately want children to have them is something worth celebrating, even if it doesn’t lead to a dramatic baby bump. 

Surrogacy is good for women. 

It probably goes without saying that surrogacy is good for women who want children and can’t have them on their own. But it’s also good for the women who serve as surrogates. For one thing, it helps these women—who may already have children of their own to support—earn a substantial amount of money for doing something that simultaneously benefits other women and families. 

There’s nothing inherently crass or ruthless about that. And surrogates see value in their work far beyond financial remuneration. 

Research shows that “surrogates are primarily motivated by altruistic reasons [rather] than monetary gains,” noted a 2020 study published in the Journal of Patient Experience. A commercial surrogate named Audrey told the researchers: “I am able to see the family have their biggest dream come true. And I was able to help them do that. I know that I helped make this family whole.” 

People get very hung up on the fact that money is often involved in surrogacy. You’ll hear some argue that women shouldn’t have to “rent out their wombs” to achieve financial security. But that framing—that this is an exploitative last resort for people with few other options, perhaps even a form “of human trafficking”—imposes on surrogates a framework that surrogates don’t necessarily share.

A survey of Canadian surrogates, published in the May 2020 issue of Women and Birth, found many “viewed surrogacy as a positive experience and as something meaningful and impactful to other people’s lives.” 

Surely some surrogates do it mainly for the money. (And if we want surrogacy to benefit the widest pool of people—including surrogates and intended parents—we must allow both commercial surrogacy and purely altruistic arrangements.) But it doesn’t follow that these women literally had no other choices. Just because some can’t imagine serving as a surrogate doesn’t mean that no one would find it an appealing option. To me, a year’s salary for taking care of myself and a growing fetus seems a whole lot better than, say, a year of working retail. (But I enjoyed being pregnant, and I hate customer service. To each his own.) 

In any event, banning surrogacy doesn’t magically make women with financial struggles fiscally sound. It just means they have to turn to less lucrative or less appealing alternatives (or become surrogates anyway, but in a riskier black market). 

Whatever their reasons, surrogates largely report positive experiences and concerns from people outside the process about their mental health appears paternalistic and unjustified. Contrary to “concerns about objectification of women’s bodies and disembodiment from the pregnancy experience,” systematic reviews of decades of research have “concluded that many surrogates were well-adjusted emotionally and psychologically,” note the authors of the Canadian surrogate study. Another study, published in Human Reproduction, looked at 20 surrogate mothers 10 years after the process, finding they “scored within the normal range for self-esteem and did not show signs of depression” and “none expressed regrets about their involvement in surrogacy.”

Yes, pregnancy can be risky. But lots of legal endeavors and lots of jobs are risky, and we still allow people to do them.

If we accept that women are mentally capable and morally culpable—and I hope we all do—then we must allow them to decide for themselves whether their personal ethics permits surrogacy and whether the risks involved are worth it. It’s insulting to suggest women need big government to protect them from making their own decisions. 

Surrogacy is good for humanity. 

It’s not hard to conceive of surrogacy as a feminist system—a sisterhood of women helping other women fulfill their dreams of motherhood. Surrogacy is also simpatico with conservative or religious emphasis on the importance of family. In a saner world, surrogacy would be embraced by both devout feminists and devout Christians. 

And yet opposition to surrogacy is an issue that unites many on the left and the right. Culturally conservative moms who decry casual sex and lefty moms who decry capitalism and baby formula. Devoutly religious types who see it as an offense against the natural order, and radical feminists who say it commodifies women. Both sides can be found arguing that surrogacy destroys something essential about mother and child bonds. 

In a New Year’s address, Pope Francis advocated for a universal ban on surrogacy, calling it “a grave violation of the dignity of the woman and the child.” Catholics are joined in such calls by prominent feminist groups, like Italy’s Se Non Ora Quando, which has described surrogacy as “incompatible with human rights and with the dignity of women.”

Words like dignity and humanity come up often from surrogacy opponents. But what’s humane about preventing people from having children they want with the help of people who want to help them? What’s undignified about being so wanted that your parents went to great lengths to bring you into the world? What’s demeaning about choosing to help bestow the great gift of parenthood upon someone else? 

I (and many others) don’t see shame in any of this. 

Some do, and that’s OK. I’m not trying to argue anyone out of their personal spiritual beliefs against surrogacy. I just don’t think those beliefs—which a substantial majority of Americans do not share—should dictate universal policy. We can’t ban things just because some find them icky or against their church’s teachings. 

Free to choose.

Nor should we try to separate “good” reasons for surrogacy (like infertility) from “bad” ones (like someone simply not wanting to bother with pregnancy). In a free society, we have to accept that if we permit a particular action, some people will engage in it for reasons we may not respect or like. 

Which brings us to Paris Hilton. The heiress and TV personality welcomed not one but two children via surrogacy last year, a move that some have criticized as yet another example of the rich exploiting the poor. Hilton has said that abuse she suffered as a teenager left her too traumatized to give birth herself. 

Maybe you find it a valid reason to employ a surrogate and maybe not. But while personal judgments of these sorts are fine, they cannot carry over into policy. And any kind of infertility requirement would be impossible to enforce without highly invasive and expensive interventions. The causes of infertility are not always apparent, and how to define infertility  how long would one have to try before being deemed legally infertile (and how ow would one prove it)?—are unclear. 

In any event, there are far more ordinary people struggling with infertility than there are chihuahua-toting heiresses afraid of pregnancy. We shouldn’t let the Paris Hiltons of the world distract us from this fact. 

As I write this, I’m staring at a beautiful and peacefully sleeping baby boy whom I gave birth to in September. When asked about having children, I used to quip (mostly jokingly) that I would do so only if I became rich enough to hire a surrogate. I feared pregnancy and labor—the responsibility, the bodily changes, the pain. Now, having had two boys, I’m so grateful to have had the experience and even more grateful to have these amazing little people in my life. But not everyone is fortunate enough to be able to conceive and carry a pregnancy to term naturally. There’s nothing undignified about helping these people experience the sublime joy of parenting, too. 

Editor’s Note: This article is part of a Dispatch debate series. Last week, Emily Zanotti made the case against surrogacy.