Abstract
A Critical Approach to Surrogacy by Damien Riggs and Clemence Due is a rigorous empirical analysis of surrogacy as a fast-evolving social issue in human reproduction today. After laying out their conceptual framework in the first two chapters, the subsequent five empirical chapters focus on each of the main role-players invested in the surrogacy discourse, including: (1) the women who act as surrogates, (2) the intending parents who initiate surrogacy processes, (3) the children born through surrogacy, (4) the medical clinics that facilitate the arrangements, and (5) the media and politicians who engage in the surrogacy debate. In the final chapter, the authors briefly recap the ground covered in the previous analytic chapters and discuss possible ways forward. Their goal, they maintain, “is not to provide guidelines as to how countries should proceed in relation to surrogacy legislation, or to dictate as to whether or not surrogacy should be viewed as acceptable by individuals” (p. 117). Rather, they present more fruitful ways of thinking about surrogacy that foreground “operations of health (in)equity and wellbeing within the context of surrogacy arrangements” (p. 117).
The various subthemes on surrogacy are evidently amplified through references from both critical and grey literatures on surrogacy, hence emphasizing that this subject must be understood from a broad perspective and be cognisant of how the main players are situated socio-economically. There is also the central question of the role of capitalism in shaping modern society’s view of surrogacy against the backdrop of increasing cases of infertility and liberalisation of sexual relationships.
Riggs and Due aver that surrogacy “evokes multiple forms of disorientation” based on varied “experiences of disadvantage and privilege” (p. 2). The book therefore opens with a chapter entitled “Becoming (dis)oriented” in which readers are introduced to the contentious debate surrounding surrogacy through the eyes of the various stakeholders. The authors’ orientation to the topic is also detailed in this chapter, with nuanced difference of opinions evidently manifest in the stances held by key players, such as religious enthusiasts, surrogacy agencies, and the media, among others.
At the centre of the controversy surrounding surrogacy are the reproductive desires of those intending parents who cannot genetically reproduce, and the ambivalence of surrogate mothers torn between keeping the babies and handing them over in exchange for money. The disorientation, further highlighted in Chapter 2 of the book, deepens when the surrogate mothers’ bodies are, albeit in a veiled manner, treated as vessels for making money. The exploitation of women in surrogacy arrangements is sanitized, especially in the context of capitalism, despite some women being compelled to take up the role of surrogates by the promise of financial rewards and the desire to raise their families’ economic standing.
In Chapter 3, the authors turn to consider the women who act as surrogates. They delve deeper into the reasons why Indian women engage in surrogacy arrangements and examine the advertisement websites used by prospective surrogate mothers in North America. The contrast between Indian and North American experiences in this chapter illuminates the dilemma of “money or love” as Indian women embark upon surrogacy agreements. Although the authors’ stated intention is to advance a balanced debate on surrogacy for the sake of a “more equitable discussion of health for all involved” (p. 118), the differential power and status between the women who act as surrogates and the intending mothers may mean such a discussion is simply not possible.
The juxtaposition between the experiences of the surrogate women and the intending parents also underscores an “inferior-superior” power relationship between women who act as surrogates and intending parents, in which surrogates must demonstrate high levels of morality and virtue in order to be contracted. This unequal power relationship is further highlighted in Chapter 4, which examines the advertisements placed by intending parents on websites that prescribe the desired moral qualities of potential surrogates. Although the question of the commercial nature of surrogacy arrangements is covert, it is not lost on the reader that the explicit specifications on the advertisements are those that would be expected in commercial transactions.
Chapter 5 highlights the dilemma of children born out of surrogacy arrangements. From a young age, the children are supposed to view surrogate mothers as “agents of reproduction” or “kindly strangers” (p. 20), while intending parents are considered protagonists who have only been denied full reproductive privileges due to natural inadequacies. The portrayal of the weaker demeanours of women who wish to act as surrogates compared to intending mothers who are projected as domineering when it comes to making decisions regarding surrogacy may clearly bring out the socio-economic dynamics underlying the symbiotic relationship between the two sets of women involved in surrogacy arrangements. The picture created is that intending parents are ready to pay money to have pregnancies carried for them by surrogate mothers, and yet at the same time appear to be asking the latter to do it out of altruism. In my view, the complex orientations to the idea of “love or money” displayed by intending parents in surrogacy arrangements portray them as neoliberals – and this standpoint may leave surrogate mothers more vulnerable, as demonstrated by their dilemma when it comes to handing over the children to the intending mothers.
In subsequent Chapters 6 and 7, the paternalistic tendencies of the media and surrogacy clinics are clearly brought to light where they are featured as vigorously marketing the “trade” and controlling the images of surrogate mothers as they entice wide-ranging clientele including gay intending parents. Same-sex couples are assured by surrogacy agencies that they will be assisted in “their family building journey by offering services that are not only accessible to them, but structured with them in mind” (p. 88). Yet, in my view, the “equality” discourse is watered down through objectification of women who act as surrogates.
Gay men intending to have children through surrogacy are furthermore expected to project themselves as accomplished individuals in varied socio-economic domains in order to attract potential surrogate mothers. Based on the advertisements placed by intending parents on websites that describe their reasons for surrogacy arrangements, the question of payment of money prominently features at the initial stages of this conversation. However, later a “narrative of love and desire” (p. 71) by intending parents seems to slowly dominate while women wishing to act as surrogates are treated as employees who must act at the whims of their employers – the intending parents.
As Riggs and Due point to the narrative of neoliberalism in current surrogacy debate, we are perhaps reminded of the fact that the surrogacy discourse revolving around money, business deals, and love should be viewed from a broader perspective. Nonetheless, the authors present a very successful rendition, portraying surrogacy as a critical subject matter in the broader human reproductive health dialogue. However, there are some areas of weakness. Firstly, while the marginalization and commodification of women who act as surrogates manifest throughout the book, their critical voice is relegated to the back burner. Including their active voice in the surrogacy debate would have given readers a more balanced view of this subject.
Secondly, the role of the media as an objective purveyor of truth is also put into question where, perhaps intentionally, potential surrogate mothers are predominantly portrayed as vulnerable, contrary to the image of intending parents who appear to be dictating more on how things should be done. Also, throughout the book, save for highlights of same-sex couples, the voice of intending fathers in heterosexual relationships is almost completely left out in the surrogacy discourse. This imbalance may water down the book’s overriding theme of the role of surrogacy in gender and social parity and health equity. Despite a few weak areas, Riggs and Due successfully managed to deftly present a compelling read for all social scientists keen on the subject of surrogacy and its role in social justice and health equity.
