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10/10/2007
Et tu, TiVo?
Oprah's gotten it wrong before — bad wrong, quite wrong, really, really wrong — so it was with great trepidation that I set my DVR to record Tuesday's show. I halfway expected the TiVo to tell me, "I'm sorry, Julie, I'm afraid I can't do that," and then vengefully fill its hard drive with back to back episodes of Deal or No Deal. And then, since I simply can't have 18 pounds of hyperintelligent plastic trying to kill me like that, I'd have to unplug it, and then some other stuff would happen with big flying monoliths and whatnot, and I'd hurtle unchecked through time and space, and some other stuff would happen — I'd fast-forward through this part if I hadn't already disconnected the TiVo, but you're my witness: it was him or me — and then I'd be all old and wrinkly, and then I would mysteriously become a fetus, orbiting the earth, bathed in light, mellowing out to Also sprach Zarathustra. Or maybe watching Oprah. (I've kind of lost control of this metaphor.)
But, yes, I did watch Oprah, because she was doing a show on infertility. Since her last foray was so disappointing, I fully expected this one to be just as bad: a carnival of finger-wagging. A festival of sanctimony. A 44-minute-long make-your-peace-a-ganza. A veritable let-go-and-let-God-a-go-go. (I've kind of lost control of this one, too.)
Anyway, you know what? It...wasn't...all...that...bad.
Wait, wait, this is even worse. It was almost...kind of...good?
Great. Now y'all are going to try to kill me, too, just like my treacherous DVR.
I began my viewing with great trepidation, especially since Oprah opened the hour by promising to reveal "why they will stop at nothing to have a baby," and asking her viewers in an ominous voiceover, "How far would you go?" This didn't bode well, especially when she revealed that the answer for one couple, Jennifer and Kendall, was "Innnndiaaaa," in a tone one might normally reserve for "halfway up the ass of Satan himself."
Lisa Ling, as it turned out, would travel there with Jennifer — to India, I mean, not the Devil's Duodenum, which is, I believe, a breathtaking rock formation somewhere in the American desert — to report on one clinic's surrogacy program, where poor Indian women carry babies for women from the U.S. and elsewhere. And to witness, according to Oprah, "her...dessssperate...pursuit of motherhood." (At this point I decided to count how many times "desperate" was used during the broadcast. I can call myself desperate, but you, Ms. Winfrey, may not. That's one.) And to figure out "why Jennifer and Kendall chose a developing country like this" — wrinkled nose from Lisa Ling, as if assaulted by the unholy vapors of Beelzebub's bunghole even within the soothing beige confines of Oprah's stateside studio — "to try and have a child of their own."
So this was not, in my opinion, beginning well.
But it got better fast. Jennifer, age 34, told us a bit about their struggles thus far. She and Kendall have been married for five years and trying to conceive for three. "On all the infertility procedures over the three years," she estimated, "we've probably spent about $25 or 30 thousand — basically, everything we had saved up." (Hearing this I tried not to compare the total unfavorably to my own tab at Schraft's, or to calculate the cost of the cycles endured by my friends inside the computer, because however you look at it, Jesus, that's a lot of money.) "How does it feel not to be able to get pregnant?" Oprah asked. To her credit, Jennifer did not roll her eyes and tell her it was a sunny stroll down motherfucking Fifth at the goddamned Easter Parade — how does Oprah think it feels? No, she was sincere, and said it exactly right. She talked about having believed that she could do anything she put her mind to, that if she put in enough effort and time and heart, she would eventually be successful. Infertility, she said, gives the lie to that belief. Simply, "it's the worst kind of failure."
So as soon as she started to talk, I knew I liked Jennifer. I liked her even more when she ignored Oprah's inevitable "Why didn't you adopt?"
Unable to afford surrogacy in the U.S. — which can run up to $70 to 80 thousand, according to Lisa Ling, whose numbers I cannot vouch for — Jennifer and Kendall turned to a program in India, where "healthy embryos could be implaaaanted into a surrogate." (Here I paused the recording to titter, imagining the heads of countless infertiles simultaneously exploding at Oprah's clumsy choice of words. One.)
The program they chose was Dr. Nayna Patel's Akanksha Infertility Clinic, which was profiled in Marie Claire a few months ago. Shots of Jennifer and Lisa's arrival in the small city of Anand were heavy on the shantytown poverty, editorial cinematography if ever I saw it, with Dr. Patel explaining that Indian women choose to become surrogates to provide better lives for their children. Seeing the footage, I was moved, and could only hope they'd succeed. (Then Lisa threw out another "implanted," so I was back to being amused. Two. And not a moment later, again! Great Lucifer's vent, that's three.)
Amid all the abject poverty, Lisa explained that the surrogates stay at the clinic after transfer — get it, Lisa? Transfer? — at least until a positive pregnancy test. This is a big investment, she pointed out, and the stakes are high, not only for the foreigners who hope to have a baby, but for the surrogates, whose hopes for improving the lives of their own families hang on whether they're successful. With the total cost of a surrogate cycle at Patel's clinic running approximately $12,000, the surrogates themselves make between $3,500 and $6,000, an amount it would take a lifetime for these women to amass otherwise.
Then Oprah asked whether this constitutes exploitation. It's the most important question she would ask all day, one Lisa would later repeat. Jennifer's answer spoke volumes. She pointed out that the critics who'd charge exploitation haven't walked in her shoes — unable to have children — or the shoes of her Indian surrogate — unable to pay for her children to be educated, or to provide them a decent home — and therefore shouldn't judge. "We are able to give each other a life that neither of us could achieve on our own." Lisa added that couples from other countries commonly employ surrogates in the U.S., and claimed that no one says that American women are being exploited. (This is, of course, not necessarily so, but that is the subject for another day, and thousands more cranial explosions.)
And then Oprah misused "implanted" again. Four.
But back to the question of exploitation. I found that my earlier inclination — how could it not be? — was not an easy position to maintain when watching Jennifer's emotions as she described receiving news of the positive pregnancy test. Her husband was just as visibly moved. And when I saw Jennifer present for her surrogate's first ultrasound, and watched her hold up the cell phone so that her husband back in California could hear the embryonic heartbeat? Well, in the moment it was easy to agree with Jennifer's stance on the deal Dr. Patel has brokered, which benefits two families enormously: "I don't see what's wrong with that."
Even more incredibly, so did Oprah. In her habitual holy tone. Right before she cut to commercial.
But the issue isn't nearly as clear-cut as that, and I confess I was pleasantly surprised that their coverage acknowledged it. In the final part of the report, Lisa visited a home for surrogates provided by Dr. Patel. Many surrogates stay in seclusion during their pregnancies because of the enormous stigma attached to surrogacy. Lisa asked the women whether they miss their homes during their long absence. Many of the women cried because they miss their own young children. They worry about surrendering the child after the birth, and the sense of loss they may feel: "It is [the parents'] choice to remember us or not but we will be remembering the child to the end of our life." And they are well aware that their decision to carry another woman's baby could have enormous social consequences, so they plan their stories carefully: "If someone sees them pregnant, they'll say it's their own child." Upon returning to their villages without a child after the birth, they'll say the baby died.
A sobering note, and one they chose not to end on. After this, the focus swung again, back to the positive changes in the surrogates' lives made possible by the fees they collect. Lisa visited one former surrogate in the new house she and her husband have built, an ugly concrete edifice that seems like a palace next to the rickety tarp-roofed shacks that surround it. And then a cut back to Jennifer and Kendall, whose surrogate was 10 weeks at taping, and then the segment ended.
Despite my wanting to grab Oprah by her shoulders and give her a good firm shake, and despite how vapid Lisa sounded when she described couples like Jennifer and Kendall as "cultural ambassadors" instead of "people who only want what the rest of us get to have easily," and despite the repeated disgusting jokes about how the 4'6" surrogate would surely need a C-section to deliver the child of 6'5" Kendall, because, people, it's surgery, and we don't take that shit lightly, okay?...I thought it...wasn't...that bad. I appreciated the window into the surrogates' lives; and I really related to Jennifer, enough to question my own convictions; and I was glad for the discussion of the ethics of the situation, as far as it went.
Frankly, I'm surprised. I was...not overly offended..., when I'd expected to be enraged, particularly since I started Lupron this morning. Lupron, as you'll know if you watched the remainder of the broadcast with Alexis Stewart, is a drug given during IVF cycles "to make sure you don't develop endometriosis." Wait, what? You didn't know that? You didn't know that's what it's used for in IVF? You've done umpteen cycles yourself and you never heard that?
Well, in that case, come back tomorrow morning and I'll clue you in on what else Stewart had to say. That is, if my TiVo doesn't kill me in my sleep.
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I am a Gestational Surrogate and I have to say.. I was somewhat disappointed in this whole show.
This is not exploitation, and just that assumption makes a mockery of the Womens movement. Most often, the word exploitation is used to refer to economic exploitation; that is, the act of using another person's labor without offering them an adequate compensation. Not the case here. In political economy, economics, and sociology, exploitation involves a persistent social relationship in which certain persons are being mistreated or unfairly used for the benefit of others. This corresponds to one ethical conception of exploitation, that is, the treatment of human beings as mere means to an end — or as mere "objects". Also not the case. The IP's (Intended Prents) are very aware and grateful for the service that their surrogates perform. In many cases they maintain close contact as friends well after the surrogacy contract is fulfilled.. In fact, I have a friend who is currently pregnant with her THIRD child for a couple she met through a surrogacy agency 5 years ago. She goes to all birthday parties, gets regular phone calls and pictures mailed...There is no exploitation involved. I'm not "pressured" to do this because I have no other way of making money... That's ridiculous.
Some people have a calling as a surrogate. Others don't. [b]The money plays very little part for either of them.[/b] Some wouldn't do it for 10 years salary, but I'd do it for free for the right people.[i] Being of a lower income doesn't make you unethical.[/i] No one is accosting strangers on the street corner offering the sale of their uterus in order to feed their starving children. As stated above, some people wouldn't do it for any amount of money. That sentiment isn't reserved for the wealthy. And being a compassionate surrogate isn't reserved for the poor, either. How insulting. I think, if Oprah is going to do a show like this one, she shoul focus more on what REALLY happens to the majrity rather than what might happen to the minority.
Long time reader here, who has been stalking (um I mean, checking) your blog every 5 minutes since I saw the show yesterday and was wondering what you thought about it.
I blogged about the show and couldn't quite find a way to describe Lisa Ling's horror at going to India... your characterization ("halfway up the ass of Satan himself.")nearly killed me.
It isn't clear to me whether the surrogates are being exploited or not - to be honest I have a hard time figuring out where I stand. Mostly my discomfort centers around the notion of *adequate* compensation (as referred to in Bumps comment) and what/who defines compensation as being adequate...
But did you catch them cackling over 'Sperm on a rickshaw' ??
I wondered if you'd watched the show. And I briefly, wondered how you'd feel about it. There is a deep seated part of me that still feels its exploitation - How safe is their medical care? Do they really have a choice when the money is needed so badly? Is it better than prostituting out your body?
Except.... these are babies for people who might otherwise have empty arms. And its a chance for a better life for entire families. The good it does cannot be ignored on any level.
Good luck with the lupron.
Fascinating. I didn't watch (didn't even know about it), so I'm interested to read what Oprah did on her show. Thanks for the recap.
I am waaay too exhausted right now to comment on your very interesting post, so forgive me if all I can say is: I plan to work "halfway up the ass of Satan himself" into conversation no fewer than three times today. Tomorrow, I'm all about "Beelzebub's bunghole." Let me know where to send the royalty check.
At first I thought Devil's Duodenum would be an awesome band name, but Beelzebub's Bunghole is the definite winner.
Great post!
I can't wait to hear your thoughts on Alexis. I am still wondering how IVF costs her 28k per month. Maybe 14-15k per cycle. Would donor sperm really make up the other 14K?
I wondered about prenatal care? I mean, I don't think India is the satan's ass that Lisa does (you've termed that perfectly) but it can't be the healthiest place if you are poor and living in that horrific poverty?
I mean, the one woman didn't even have a kitchen until *after* she delivered.
I still don't like Oprah. You're right, she was less judgmental than last time...but still is pretty heartless about IF. Oprah's next show should be about where it is she (apparently) thinks you can go and just pick babies off of the shelf when she constantly insists that we "just adopt." (and then we can take those babies that we "just adopted" to dr.phil to undue the emotional harm of being "just adopted.")
Louise...i think IVF could very easiliy get that $$$.
She's doing PGD ($5,000-6,000), ICSI and donor. She also said that she does other things that people with less $$ wouldn't do. I also think that includes other things such as accu? Or, no?
Our IVF would have cost about $20-22 and we're in GA not using donor, so I don't think an extra $6,000.00 is too much?
Bump-
I have heard the question of exploitation in terms of going to a third world nation as opposed to useing a GS here in the US. Not that all GS's are exploited.
Julie-
This was a really good recap. I enjoyed reading your views...
I didn't mind the Wests' portion of the program, but I sort of wanted to throttle Alexis as she sooo calmly described the injection protocol.
It's 'easy'? Really? And the IM shots don't hurt at all? Really? And even when you 'don't have a much fat' like her?!? (THAT just added insult to injury thank you very much.)
I was glad they at least showed five seconds of an audience member about to start her cycle who looked terrified and overwhelmed and said her husband would have to give her the shots. It showed a much more realistic version of how most (not all, but most) women experience the stress of the injections.
Was Alexis so smug, or is that just me being totally judgmental?
Oh, I am so sorry I missed this episode of Oprah! But I loved reading your take on it. Can't wait to see the review of the rest of the show.
Do you imagine that Martha has made some syringe cosies for Alexis? Perhaps some clever matching microwavable bean filled bags that you can hold up to the injection site? Decopauge (spelling) of the hazardous waste containers? I'll check future editions of her magazine to see if it's included in Crafts 101!
Julie- best of luck on this cycle.
First off: Bump, that was a really intelligent, articulate view you recapped for us. Thank you.
The Oprah Show: Aside from the constant use of "implant", I wasn't really that offended. I was pleased how they handled the exploitation issue because I was just imagining all the anti-infertile accusations that would come later. I think they did an excellent job of preventing exploitation (making sure the Indian women already have a living child, making sure the money is invested in her name, and screening so that women are doing this by their own free will.) It was hard to see the women get emotional over the surrender of the child, but just because a situation is emotional does not mean it's exploitive.
On the infertility, I think there will need to be alot more shows about infertility and the emotional toll of infertility until the general public gets it (and even after alot of press there will still be people who can't get it.). But overall, I did not feel the urge to throw the remote at Oprah.
Loved you're recap Julie! I too counted the amount of times the word 'implanted' was misused.
I liked Alexis. I have no idea about the accuracy of her statements, and I could see she was probably not going to be well received by Oprah's audience, but I really liked her. Especially at the end when doltish Oprah opined that the next generation of women are going to be saving their eggs.
Every time someone said that the embroyo was 'implanted' I felt my (one remaining) ovary scream.
I also felt it was rather well done altho' I wish they could do an infertility/ART show without the 'Oh my gosh! She's renting her womb!' garbage.
I also couldn't figure out how you could spend $28,000 on one IVF cycle. My cycle (using ICSI and donor eggs) was only about that much...granted that was 5 years ago, but still...
I think she uses gold-plated needles.
Ah well, it's CD1 for me (again) despite the best efforts of ART and there is no way in hell I'm watching Oprah butcher IF.
The only ranting around this house would be mine!
J
You know, I could totally see how you could spend $28,000 a cycle, but not necessarily $28,000 a month. Plus, if Ms. Stewart's doctors are telling her that Lupron is given "to make sure you don't develop endometriosis," then...um, I would argue that she could probably be getting better medical advice for her $28,000 a cycle.
For those that missed the Oprah show, you can watch it on her website if your computer has the capability to show video up to speed. Don't know how long old episodes are able to be viewed, but it is on there now.
thanks for this insightful (and hilarious as always) recap of part one of the Oprah episode. halway up the ass of satan himself indeed! i can't wait to hear your take on the alexis stewart portion.
i had seen the Marie Claire article a few months back and was interested in seeing more about this Indian clinic. i really enjoyed jennifer and her husband - she did a great job of deflecting Oprah's condescending and ignorant questions. personally, i didn't necessarily see exploitation - i saw a situation difficult on both sides, with a chance for each side to give the other something they couldn't achieve on their own. i am not in that position and can't presume to know what "adequate" compensation could possibly be.
About the whole Alexis Stewart spending like $28,000 a month, she comments that she also does "extra things" since she has the money to do so, what those "extra things" are, no one can really be sure.
She kinda seemed like a robot, no emotion at all. Her face stayed the same the entire segment, I don't know if she uses botox or what. I mean, I didn't expect a smile, but maybe a hint of emotion, even sadness or anger about it, but I got nothing.
Alexis Stewart had all the personality of a sour dishcloth. She has a TV or radio show? Why would anyone listen to her? She bordered on condescending, droned in a monotone and made light of the pain and side effects associated with ART.
I suggest she spend all her money on a personality IMPLANT.
As another gestational surrogate, I also couldn't wait to hear what you said about yesterday's Oprah episode. The general surrogacy community is cold-shouldered towards Oprah also. "Womb for Rent" is damned near the equivalent of a racial slur to surrogates, and Oprah has used the phrase before in her Dec. 2003 issue of O magazine (in which she completely offended a personal friend with the spin she put on her story).
I was equally guarded when I watched yesterday, and like you, I ended up thinking, "It's not *that* bad"; my surrogate and intended parent "friends inside the computer" felt the same.
We're still not thrilled with the angles Oprah usually uses to approach infertility and surrogacy. If she really wants to tell the world about surrogacy and ART, why go to India? Why only discuss the oddball cases of surrogacy? Why not do some research HERE and report factual information about alternative paths to parenthood when a "whoops, look what we did" baby isn't possible? Oprah would have done her viewer base a far greater service with a more straightforward approach instead of going for the shock factor value.
Just for the record, $70-$80 for a typical gestational surrogacy is a little on the high side of average, but is a reasonable estimation. Costs can be cut in certain ways. It should be noted, though, that average base compensation for a first-time surrogate is around $18K-$22K and for an experienced surrogate, $20K+ is average base compensation. Most of the rest goes to the clinic and to legal, medical, and psychological fees. My IPs spent a total of around $60K from start to finish.
Thanks for the perspective — I didn't even know whether Lisa was in the ballpark on her estimate. (The Marie Claire article also used "Womb for Rent." Offensive and reductive, I agree.)
Now I want to seek out the magazine article you mention just to rekindle some of my high-level Oprah umbrage.
Just curious about something I've wondered about for a while. I know that "implant" is not technically correct and that the embryos are "transfered", but why is it that the misuse of "implant" causes infertility bloggers to get so upset? It doesn't seem like a huge deal to me - what am I not getting?
Your telling me that Alexis doesn't have health insurance that does IVF coverage? Doesn't she work in her mom's company? Also, I'm with Akeeyu, I think Alexis' doctors really saw her coming. Either that or she is dumb as a post. Doesn't she read ANY of the stuff that comes with her meds? As far as the "extra stuff" goes...she doesn't know what that stuff is? Or does she think it's just an extra special secret she can't share? I've done ICSI and assisted hatching and yadda yadda yadda...and it still doesn't come close to that much a cycle.
Boy, listen to me bitch today, and I haven't even started my Lupron yet. I guess it's a good thing I didn't watch Oprah.
everything i know about infertility, i learned from you guys, so i am pleased to report that i, too, cringed at all that "implanting." and i was pleased to hear alexis remark that the impressions we glean from all the celebrities having babies in their 40s are false--that those women are likely using all manner of ART, including donor eggs, to have their babies. that is a point i think i've heard julie make herself on this blog.
overall, tho, i found alexis a little bizarre and off-putting. i mean, really, she delayed having a baby because of her mother's legal troubles? and now her mother is kicking in for the $28,000 a month? perhaps my maternal relationship is dysfunctional (ok, there's no "perhaps" about it) but that just strikes me as weird. i look forward to hearing your thoughts, julie, on that portion of the episode.
it's hardly surprising that oprah revealed herself to be an idiot yet again on this show. a couple of weeks back, when she did the show about intersex people, she repeatedly described them (in a tone of naked incredulity) as individuals having the organs of BOTH sexes, despite her experts repeated admonitions that it wasn't so. i'm willing to admit that she does a lot of good with her show and her money, but damn she can be stupid sometimes.
The "implant" bit doesn't bother me, either, not when there are so many other, bigger, juicier nits to pick when it comes to media coverage of infertility treatment.
But as I understand it, the argument goes something like this: Misusing "implant" implies that achieving a pregnancy is as simple as putting embryos inside a woman's uterus. Ignoring that there are two distinct steps in the process — the act of transferring and the process of implantation, over which we have no control — leads laymen to the incorrect assumption that all you have to do to create a pregnancy is to "implant" them.
...I think.
Implant vs. transferred: I too shuddered each time the two were used interchangably on the show yesterday, and even more so when Alexis did it. Oprah could *almost* get by with just not knowing any better, but given the fact that Alexis isn't yet pregnant, well...SHE should at least know.
Transfer simply means that the embryos or blasts have been placed inside the uterus in the HOPES that they one or two will implant. Implantation = pregnancy. Next step, hope for continued pregnancy and beyond.
I didn't see the Oprah episode yesterday, but thanks for the recap and insights. Sounds interesting - I'll have to see if I can watch it from the website... somewhere in my ten minutes of spare time.
I started Lupron yesterday for my FET cycle. Um, my second attempt at my FET cycle. Was all set to transfer in September, when we had a medication mishap and my husband injected me with 1cc of Lupron instead of progesterone. Oops. Transfer canceled.
(He's still alive. It was an honest mistake.)
Anyway, good luck with your cycle, Julie. If you're on roughly the same schedule as I am, you'll be transferring in early November, right? I'll keep my fingers crossed for both of us. =)
I didn't see the Oprah episode yesterday, but thanks for the recap and insights. Sounds interesting - I'll have to see if I can watch it from the website... somewhere in my ten minutes of spare time.
I started Lupron yesterday for my FET cycle. Um, my second attempt at my FET cycle. Was all set to transfer in September, when we had a medication mishap and my husband injected me with 1cc of Lupron instead of progesterone. Oops. Transfer canceled.
(He's still alive. It was an honest mistake.)
Anyway, good luck with your cycle, Julie. If you're on roughly the same schedule as I am, you'll be transferring in early November, right? I'll keep my fingers crossed for both of us. =)
PREFACE: I've been reading your blog for years and all I can say is that, like so many others, I Super Like You. There's a thing I want to *ask* you and no matter how many times I go over it, it sounds *grouchy*. And I don't mean it that way. It's sincere and curious and respectful and I don't write as well as you do. Please read this in a friendly and kind way, ok? Ok.
I'm not the boss of you, but if you're ever feeling blocked or anything and wondering what to write about... I'd be really interested to hear more of your thoughts about surrogacy. (as I assume you've thought about it at great length). This is what I'm having trouble with, this reasoning.... It seems like you're saying it's NOT weird or (whispered: desperate) to go "Innnndiaaaa," to hire another woman to carry a baby because it is, you're saying, just something everyone takes for granted and she's getting paid and so everything is all even steven and understandable and fair. But what's confusing to me is - if having a biological child of yourself and/or your husband is so important that it's reasonable to go to Innnnnndiaaaaaa..... and it's so *deeply* important that - well - this whole blog... how can that *then* jump to the conclusion that for those women who choose to be surrogates, it's just a transaction? (and I think it's fair to say that in this particular india example, there is serious coersion involved in the amounts of money offered). It seems, from everything I've ever read here, that you place a primary and sacred importance on pregnancy and childbirth - to the extent that you're willing to risk your life for it. so how do you square *that* with the idea that it's totally cool to hire a woman to go through pregnancy and childbirth - where she's then forced to hand the kid over? with no rights to the child at all?
christ, upon rereading? that was the worst comment *ever*. I'll just cross my fingers that you can make head or tail of it.
Hope the lupron is not so bad for you. This means you are getting really close. I'll be very interested in hearing your perspective on a DE cycle as they're so different (and easier) than a "regular" one.
Holding thumbs for you.
Julie, I know that "m", the surrogacy question poster, directed her question towards you and would like to hear your perspective, but I'd also like to answer from a surrogate's perspective if that's okay with you. I just didn't want to barge in and a question that was directed towards you. She clearly doesn't understand most surrogates' mentality and is under the impression that we're coerced by money to do what we do.
Very interesting topic - I'm a grad student in anthropology, and have stumbled across a whole area of research in the social sciences that relates to surrogacy, organ transplants, and the like - it seems like we haven't quite figured out how to think about the ethical/moral implications of certain medical innovations. Part of the confusion seems to relate to the ways we think about gifts vs. commodity exchange. We think of gifts as creating social bonds between people - uncoerced and uncoercive. In contrast, we think of commodity exchange (buying and selling of objects) as impersonal and alienating. But these things are always mixed - they are hard to separate. So when people talk about the exchange between surrogate and IP as a gift exchange, this is a move to emphasize the humanity of the interaction. When people use the phrase "womb for rent" (for example), it is a move to emphasize the commodification of the body in an alienating way. Does it have to be one or the other? It all depends on how you think about it.
I think the issue gets more complicated when the factor of drastic difference in economic status is instroduced. I agree with Bump's point about altruism - to consider that someone is incapable of acting based on compassion and altruism just because they are impoverished is certainly insulting. At the same time, I also think that the vast wealth disparity is something to think about. I've read more about the issue of organ transplant than surrogacy; some researchers have found really exploitative practices going on with people being recruited to sell kidneys, for example (Nancy Schepper-Hughes foremost) and not being advised about long-term health risks. I'm sure comparable research has been done in the area of surrogacy, donor gametes, and so on (of course the donation aspect puts the transaction squarely in the arena of gift exchange) - even international adoption - I'm just not familiar with it.
It does seem sensationalist on Oprah's part to focus on surrogacy in India, instead of within the US - but I guess that's what gets people talking. I still think it's an important thing to think about - is there a way to ensure that these kinds of transactions be carried out in a humanizing and non-coercive way?
Just to clarify, given Kymberli's comment... I don't think American gestational surrogates are, as a group, coerced or motivated by money. I was referring specifically to the women on the show, who were described here as being paid more than they could conceivably (ha!) acquire any other way. Seems like that kind of *enormous* pay, relatively speaking, very definitely suggests that everyone there may not have made the choice as freely as I assume American women do.
Thanks for clarifying, "m". I'll have to admit that even as a surrogate, I started off on the fence with how I felt about "outsourcing" surrogacy to India. On my online surrogacy community we had a lengthy discussion about it in reference to the Marie Claire article a few months ago. I believe that while typical base comp for an Indain gestational surrogate (GS)is on average 3 to 4 times less than the base comp for a US GS (or traditional surrogate, for that matter), Indian surrogates STILL have just as much free choice in their decisions as US surrogates. Most Indian surrogates use their compensation to build nicer houses and fund their children's educations; many US surrogates do the same. Yes, the Indian standards for homes and educations are paltry in comparision to US standards; this is the wealth disparity that Elizabeth mentions.
To address this question you asked of Julie --
"It seems, from everything I've ever read here, that you place a primary and sacred importance on pregnancy and childbirth - to the extent that you're willing to risk your life for it. so how do you square *that* with the idea that it's totally cool to hire a woman to go through pregnancy and childbirth - where she's then forced to hand the kid over? with no rights to the child at all?" -- I have to say this:
Surrogates enter into the arrangements with the clear understanding that we are helping to build OTHERS' families - not our own. While we do care for the children we carry, we do not form the same maternal attachments to the babies as we do to our own and thereby do not feel "forced to hand the kid over". Comparing how we feel when the babies go from our temporary care to their parents' lifelong care is COMPLETELY different than a child being forcefully taken from his or her biological parents.
In fact, delivery and finally seeing the babies with their parents is the most rewarding part of the whole process for most surrogates. Many a surrogate have missed that very moment for various reasons (difficult deliveries, hospital policy to only have 1 support person in the OR, etc) and not getting to witness the first time their IPs see and hold their baby is a HUGE letdown. We ALL feel a huge sense of relief once the babies have been safely delivered to their parents' waiting arms; we did what we set out to do - we've made it through the cycling, the retreival, the nail-biting while waiting for fert and growth reports, the transfers, the 2ww with testing or not testing (I personally suffer from peestickitis), betas, first u/s, pregnancy, and finally the deliver - we've help build a family, and everything turned out okay.
Pursuing surrogacy is not putting a woman in an emotional checkmate and offering money to soften the blow - not even for the Indian surrogates.
I know that you were asking out of curiosity, "m", and I also know that it's sometimes impossible to detect the tone that faceless commenters use in their posts, so please understand that I'm only trying to give insight into the typical surrogate's mentality. :)
I thought Jennifer was wonderful! And her comment about each of the women giving the other a life she never would have had, brought me to tears.
Now, Alexis, on the other hand, is an idiot.
Thank you Julie for this lovely recap. I wanted to check out the show but I was unable to so glad to read the jist. Oprah has always pissed me off when it comes to infertility. She is SO misinformed and judgmental about the process and clearly does not know anyone personally that struggles through it the way a lot of us do. I don't understand how the same woman that supports and loves people with mental illnesses or chronic addictions can't see infertility for what it really is.
Great post though. And I'm so glad to see that so many other people feel the same way I do.
Julia, I don't think you've ever been to India, have you? I am sure that Oprah's camera person did wish to get colorful footage, but honestly, in India there is so much overpopulation, wretched poverty, disease, and desperation that simply turning a videocamera on will capture this. Even if you are in one of the wealthier cities, you won't escape the beggars and horrors. So please don't dismiss Oprah's show as having exaggerated this or somehow worked hard to get colorful footage. That's what it's like there. It's a very different world than New England.
p.s. Because that sounded more astringent than it should have (I spent a traumatic month in India once), I must post again simply to say that I Love Your Blog and Think You Are Hilarious.
I'm still pretty uneasy with commercial surrogacy... especially involving surrogates from poor countries and parents-to-be from wealthy ones. The differences in power and choices available is just so wide that the potential for abuse is really high. Plus, aren't there some things that we as a society should just insist aren't commodities? Maybe some things (like organs) just should not be bought and sold and subject to market forces.
Julie, the misuse of the term 'implant' really does get up my nose (hey, maybe that's what we're doing wrong!) for exactly the reasons you wrote in the comment.
However, I can't get too snippy about it because of the medical term PGD - pre-implantation genetic diagnosis. Bastard term should obviously be PTD, but as it's not, I'd just better get used to it.
I do however have help in putting my irritation at this particular misuse of terminology into perspective. Last night, my husband and I were talking about our increasingly possible donor egg cycle, and he absentmindedly refered to the as-yet-hypothetical donor as the as-yet-hypothetical baby's 'real mother'.
Dear God, I almost wept, and then I almost hit him. I mean, if I'm facing this from MY HUSBAND, what the hell am I going to have to face from our families, friends and wider acquaintances? I feel drained even thinking about it.
May I have a sticker too please?
i'm only reading this now, two years after the fact, just going through the archives, but i cannot, can.not, keep myself from commenting on this. i'm practically in tears. i am indian. i have spent time in india. i know exactly what these streets and gullys look like, what these women look like, and i have seen the depths of their desperation. Surrogacy in India and surrogacy in the states are so different one might as well be called charity while the other might as well be called abuse. Three guesses as to which is which, first two don't count.
i'm practically in tears. this is nothing but exploitation, in some ways, human trafficking, at its saddest. let's put it this way. these women are so absurdly desperate, looking for some way to keep their families afloat, that they're willing to produce a child to put up for adoption. that, in and of itself? is heartbreaking. now for the sake of discussion, let's look at the consequences. i can guarantee with 99.925849% certainty that the so-called "prenatal care" they receive is abominable verging on nonexistent. If something goes wrong? If something truly goes wrong? They're on their own. And they'll probably have to pay the bills themselves, possibly putting them in more debt and worse health than when they started. Look into those "kidney donor" type stories. Oh, yes, they donate, but they get NO CARE AT ALL in recovery, and usually, the entire rest of their lives are ruined by the ongoing health consequences. India is the land of corruption. People coming in may hear anything at all about how these mothers are cared for and compensated, i can guarantee that almost none of it happens. It's almost like adoptions here, where agencies take extra money claiming to give it to the mothers to get them back on their feet, but never do. This just happens to be a little worse because of the potential for abject ruin, death, and orphaning of any children she might already have.
I understand where Laura is coming from. I am infertile myself. However. My pain, my desperation, my effort is NO EXCUSE WHATSOEVER for encouraging this type of surrogacy industry of the poorest, most desperate Indian woman. It's telling in and of itself that the only women willing to be surrogates are women of that status and position. Now, if an upper middle class woman was willing to do this? That would be a different story. I fully, completely reserve my right to judge her. She might be desperate, but I cannot believe that she is so desperate that she would so willingly participate in exploiting a fellow female member of the world like this. This is greed, the unwillingness to adopt an older child, and doing anything at all to end up with a newborn.
oops. jennifer, not laura. huh.