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While surrogacy practices are on the rise in various countries, the terms used to designate the woman who gets pregnant and carries a baby for another person or couple remain ambiguous and controversial. In this contribution, while not intending to reject the term ‘surrogate mother’ itself, I argue that its usage needs to be rethought and nuanced. Drawing on a total of fifteen months of ethnographic fieldwork in Saint Petersburg, Russia, I will demonstrate that—at least in that context—the term ‘surrogacy worker’ more accurately captures the actions and intent of women engaged in this form of work for four main reasons.
Firstly, surrogacy agencies only accept women who can demonstrate that they are financially motivated. Altruism is rejected. Secondly, surrogacy workers themselves perceive carrying a commissioned pregnancy as a complex job. Thirdly, the absence of genetic relatedness with the gestated child is operationalised to suppress feelings of affinity and to present it as care work rather than as ‘mothering’. Finally, the temporality of identifying as a surrogacy worker renders evoking the allegory to ‘mother’ inappropriate.
Expanding the terminology that we use when we talk about women who work as gestational carriers is overdue and necessary, because such expansion helps us understand and accommodate the complexity and diversity of experiences that women who gestate children for others to raise have. The term ‘surrogacy worker’ highlights the women’s commercial considerations and articulates the performance of reproductive work.
The business of surrogacy
Commercial surrogacy arrangements are legal in Russia. Since the birth of the first surrogacy-gestated twins in Saint Petersburg in 1995, surrogacy has developed into a lucrative business. However, Russian legislation only permits gestational surrogacy. This means that the pregnancy is conceived from the gametes (egg and sperm) of the intending parents or a third-party donor, but the surrogacy worker cannot share a genetic link with the child she gestates. This in contrast to ‘traditional surrogacy’ (also termed genetic surrogacy), wherein the surrogacy worker provides her own egg and is thus the genetic mother of the child. As the market of surrogacy services in Russia has expanded, more and more women are now considering carrying a surrogacy pregnancy for money—most commonly to invest in an apartment. They perceive the work as carrying a child to term in exchange for compensation, as opposed to performing a form of mothering.
In Russia, the Euro-American cultural framing of surrogacy as a ‘labour of love’ or a ‘gift’ is generally absent. Instead, surrogacy is a commercial enterprise and framed as an economic exchange. On respective websites, where intended parents and surrogacy workers upload their requests and offers, both sides haggle over the price. Commercial surrogacy agencies reject prospective surrogacy workers who appear too altruistically motivated, instructing their gestational carriers to be financially orientated and to regard surrogacy as work and not as a gift. They ground their policies and rhetoric on the notion that money-oriented women make better workers, as they will do whatever is necessary to maximise their profit. Emotional involvement and a friendly relationship between the intended parents and the surrogacy workers are considered messy and as having the potential to spoil both process and outcome.
Many of surrogacy workers I spoke to in Russia used this same framing, portraying carrying a pregnancy for someone else as solely a job. The following exchange exemplifies the perception of many surrogacy workers. “How do you do this, to give away the child? And what do you feel?” an inquisitive IVF nurse asked Alyona, an experienced surrogacy worker. She answered: “What you do is your job, and what I do, is mine”. Similarly Yuliana described her commissioned pregnancies as “nothing particular, just work”.
Pregnancy, though not a pathology in itself, entails risks. Carrying a surrogacy pregnancy requires preparatory hormonal treatment and the preservation of the artificially induced pregnancy in the first trimester. Depending on the respective contracts between intended parents and surrogacy workers, it may also exclude seeking other medical treatment in order to foreclose the possibility of harming the unborn child. Anna, for example, was instructed not to treat her inflamed tooth and subsequently lost it. She commented: “There are those who say you are selling your child. I am saying that I am working. That means, indeed, I am putting my health at risk to gestate for [the intended parents].” In another instance, Inga told me that she accepted the nausea and the liver pain that she believed were caused by the required medications as part of being a surrogacy worker. Those experiences are exemplary of how the surrogacy workers I met in St. Petersburg frame their commissioned pregnancies as work and negative side effects as accompanying work hazards.
Besides capturing the self-perception and self-description of the women, the term ‘surrogacy worker’ provides the opportunity to analyse and verbalise the complexities of surrogacy work. These are not confined to the physical labour of gestation and giving birth, but also include communicating with intended parents, managing their requests, and coping with emotional labour. Frequently, surrogacy workers said that they find carrying a surrogacy pregnancy more demanding than having been pregnant with their own children. They worried more about things going wrong during the pregnancy and harm befalling the unborn or them. In such cases, not only is the intended parents’ possibly last chance of having a genetically-related child at risk. So is the health of the surrogacy worker and the wellbeing of their families, as in most cases financially dire situations gave the incentive to opt for surrogacy.
Lack of a genetic link
It is also important to emphasise that surrogacy workers in Russia strongly reject the option of keeping the child they are gestating for others because of the absence of any genetic link. Preparing to gestate her first commissioned pregnancy, Anyuta declared that one option would remain for her if the intended parents did not take the child: to place the child in an orphanage, as she neither has the means to raise it nor can imagine feeling affectionate towards a stranger’s child. The absence of genetic relatedness makes gestational surrogacy, once again, employment rather than motherhood.
Nadya, who gestated twins, researched IVF and surrogacy for hours online to verify that the procedure would not pass on any of her genes. “The only thing I did was giving the babies blood. The foetuses were attached to my placenta. That was the only link to my organism, the only thing that was mine!” Her friend Karina, who had carried three surrogacy pregnancies, explained how strangers’ presumption that she might change her mind and keep one of the children amused her. “Why should I take a stranger's baby home?! If [my husband and I] wanted another child, we could make one of our own ourselves.”
While surrogacy workers clearly state that they do not cultivate maternal feelings and have no intention of keeping the children, they were nonetheless not indifferent towards the life growing inside them. Often women drew parallels to being child-minders and nannies, such as Daria: “I was like a nanny, a good nanny at the time of the pregnancy. But those [twins] were entirely [someone else’s] children”.
Finally, the temporality of the experience and identity of being a surrogacy worker underlines my argument to rethink the terminology. To develop this example necessitates briefly outlining the sociocultural setting within which commercial surrogacy in Russia evolves. Surrogacy workers in Russia often cloak themselves in silence over their work, fully aware that others might repudiate them on moral grounds, deprecate them as breeders, or discriminate against their own children. Opting for surrogacy, as many emphasised, was seen as the only concrete and honest opportunity to earn potentially enough money to purchase a long-desired own apartment, provide their family with material security, or resolve other pressing financial problems.
Yet, hiding the commissioned pregnancy is not easy. To do so effectively requires an alternative narrative of how they got their money. It may also require a story about where they have been, for example in cases when surrogacy workers temporarily leave their social and family environment by choice or because of a stipulation in their contract. Surrogacy worker Alexandra strikingly delineated these challenges when she expressed worries about having to undergo a caesarean section. The scar remaining after such a surgery would leave a permanent mark on her body and thus on her life. Having given birth to her own children vaginally, she would be forced to hide this scar indefinitely. “[But] if there won’t be a scar, I will forget about this all. It will be over.” This example highlights how the occupation and the women’s self-identification with surrogacy work is temporary. Once the transaction is completed, the women refer to this identity as something lapsed or of the past.
The experiences of surrogacy workers in Russia substantiate the need for expanding the terminology when analysing and discussing the growing global surrogacy business. I contend that the term ‘surrogacy worker’ allows greater accommodation of the complexity and diversity of experiences of women who do not see themselves as mothers, but as workers who gestate a child for others in exchange for financial compensation.