Saturday 22 January 2011
Surrogacy: the brave new world of making babies
As actress Nicole Kidman becomes the latest star to take delivery from a surrogate mother, the social and moral boundaries of reproduction are becoming increasingly blurred. Hollywood stars are good at paying tribute to the production teams who helped them create their latest masterpiece. But last week, when actress Nicole Kidman and her musician husband announced the birth of a baby girl – and thanked the “gestational carrier” in whose womb she grew – they conjured up a Brave New World indeed.
In Aldous Huxley’s chilling dystopia, natural reproduction has been abolished, with children created in bottling factories and decanted, to be brought up in hatcheries and conditioning centres.
Issuing a statement on Monday, hours after shimmering tautly at the Golden Globes, Kidman said no words could adequately convey the gratitude that she and husband Keith Urban felt to those who supported them through the process, and in particular to their gestational carrier.
Yet it was precisely this inelegant euphemism for surrogate mother – perhaps an attempt by baby Faith Margaret’s biological parents to assert their authority – which calls to mind Huxley’s vision of 2540.
The pronouncement came days before singer Sir Elton John, 63, and partner David Furnish, 48, shared the first images of their baby son, born via a surrogacy arrangement on Christmas Day. The celebrity pair said they had “no clue” which of them was the father of Zachary Jackson Levon, both having contributed sperm samples to be mixed with eggs donated anonymously.
Is this just the stuff of Hollywood – or a glitzed-up mirror to a new world of reproduction, where traditional social and moral conventions are quickly changing?
Natalie Gamble is one of this country’s leading fertility lawyers, specialising in surrogacy. A lesbian mother of two children (both born via donor insemination), she won a landmark legal case last year, in which two British parents were allowed to keep a child who had been born via commerical surrogacy.
Since Britain’s first official surrogate birth, in 1985, laws have limited payments to cover only what is described as “reasonable expenses”, such as loss of income. Women cannot make a profit by “renting out” their wombs, nor can infertile couples pay such rates to surrogates, even if they live in countries with different laws.
But, last month, Mr Justice Hedley explained how he had allowed a British couple to keep their child, despite the fact that they made higher payments to a surrogate living in Illinois, in the United States, where there is no ceiling on amounts.
In making the ruling, he went further, saying that the welfare of the child was the paramount consideration,
and future cases would be rejected only in the “clearest case of the abuse of public policy”.
Ms Gamble, a partner at Gamble and Ghevaert, says: “The ruling was pretty important. It doesn’t change British law, but it shifts the focus within it, so that people know that, if they do go abroad and pay more than expenses, the chances are that those deals will be ratified afterwards.”
Support groups for surrogacy believe many women who want children but are unable to carry them will feel they have no alternative.
In October, Surrogacy UK, which brings together potential surrogates with intended parents, was forced to close its waiting lists for those seeking surrogacy, such is demand.
Kim Cotton, Britain’s first surrogate mother, was paid £6,500 when she had a child for an infertile Swedish couple, using her own eggs and the sperm of the father, 26 years ago.
Estimates suggest that, since then, about 750 children have been born in this country of such arrangements, with “expenses” payments averaging about £15,000.
Soon after the birth, Mrs Cotton, who had already had two children with her husband, said: “You can cut off all maternal feeling if you try hard enough.”
She has never met her child, nor the couple who brought her up. Now a grandmother, aged 54, she does not regret her place in British fertility history, but she believes it was both wrong and damaging that a relationship was never forged between the parties involved. A later happier agreement saw her carry twins – unpaid – for a friend with fertility problems.
Yesterday, details emerged of a surrogate mother allowed to keep her baby girl after refusing to hand her over to the prospective parents.
Explaining his ruling, Mr Justice Baker said on Friday that the woman – the biological mother of six-month-old child T – was better able to meet the girl’s needs than were the married couple, who were alleged to have a violent relationship. Surrogacy support groups insist that such disputes remain rare.
Jayne Frankland, 45, from Herefordshire, tells perhaps Britain’s most unusual surrogacy story. She is bringing up a child born via surrogacy, has acted as a surrogate three times – and in between has had four children who were conceived naturally.
She and her husband Mark had been married for more than 10 years and had undergone repeated fertility treatments in their attempts to start a family when they decided to contact a surrogate agency. After four months of insemination with Mark’s sperm, the surrogate, Susan, a mother-of-two, became pregnant with baby Abigail, who is now 14.
Three years later, to her amazement, Mrs Frankland discovered she was pregnant. Her fertility had spontaneously recovered and she was now producing eggs. Four children – Sam, 11, Charlie, 10, Elisabeth, seven, and Scarlet, three – followed.
Because of their experiences, the couple had become members of support group Surrogacy UK. Soon after Elisabeth was born, they got to know a couple who were desperate to have a child. It was their eldest child Abigail, then seven, who asked Mrs Frankland if she could have a child for somebody else “now that your tummy is mended”.
Mrs Frankland has now done that twice, giving birth to Isaac, now six, and Hector, five, for two more couples. She is currently three months pregnant for another couple. In the 14 years since Abigail was born, she belives that the stigma attached to surrogacy has almost evaporated.
“When we had Abigail, I was afraid of what people would think. I wondered how they would treat us – would they accept her? Would we be outcasts or be seen as buying a baby? Compared with how it used to be, people really don’t bat an eyelid any more.”
She acts as surrogate, she says, because of her empathy for those struggling to have a family. She believes that no one would enter lightly into surrogacy, or choose it for convenience, or to maintain a figure: “I don’t think anyone who wanted children would choose this as an option over anything else.”
But it is the ethics for the surrogate mothers and the risks of exploitation that most concern fertility experts.
Dr Gillian Lockwood, a fertility doctor and vice-chairman of the Royal College of Obstretricians and Gynaecologists’ ethics committee, believes the current British laws restricting payments are hard to justify.
In response to a national shortage of eggs and sperm donated for fertility treatment, the Human Fertilisation and Embryology Authority (HFEA) is currently consulting on proposals to raise the amount donors can be paid.
But the rules on surrogacy remain mired in controversy, and, so far, watchdogs and Parliament have shown little appetite to relax the current restrictions, which say payments should not overtake expenses.
Dr Lockwood says: “If you can pay for egg and sperm donors, it starts to look ridiculous that a woman can agree to carry a child for nine months and all they can get is a bit of money to buy a few maternity frocks. It would have made good sense to include this in the HFEA review rather than doing law on a case-by-case basis, which introduces a lot of uncertainty.”
The difficulty, as the fertility doctor acknowledges, is that, if the rates are too high, “temptations can become irrestistable for those living on the margins”.
Looking abroad, the global economy in surrogacy makes it almost impossible for “fair rates” to be set.
Since 2002, when India legalised the practice, it has become a world centre for surrogacy tourism, expected to generate £1.5 billion for the country annually by next year.
Dr Lockwood says: “If you have a woman in India with two children who she is struggling to bathe and feed, and one surrogacy arrangement means she can send them to school and build a house, is that exploitation? Renting a womb out might seem a much better option than a year of breaking rocks.”
Dr Allan Pacey, a fertility lecturer at the University of Sheffield, says the ethical issues are different but just as complex on home turf. “I worry particularly about the cases involving family members, who might feel under intense pressure to act as a surrogate. Areas like that are a great concern,” he says.
While media commentators have been in turn vitriolic and squeamish about the latest cases, with Sir Elton John accused of treating babies as the latest “must-have” accessory in an extravagant lifestyle, some religious figures express a deeper unease.
The Rt Rev Michael Nazir-Ali, the former Bishop of Rochester recently told The Sunday Telegraph of his concerns that the introduction of a “third party” into parenthood would affect the child psychologically. He also highlighted the age of Sir Elton, who turns 64 in March. “It is very important for a child’s parents to be of an age that provides the child with a fair chance of being brought up by them without unnecessary disrupution,” he said.
Naturally, where ethical commentators see an issue that is divisive and explosive, popular entertainment sees a ratings opportunity.
Barely recovered from the furore over its controverisal cot death/baby swap storyline, BBC soap opera EastEnders is reportedly planning to dramatise a surrogacy plot, involving gay characters Christian Clarke and Syed Masood.
It wouldn’t be the first time that the dramatic potential of reproductive technology had been detected. In 1946, Aldous Huxley reconsidered the futuristic satire – or prophecy – he had penned 15 years earlier.
“Technically and ideologically, we are still a long way from bottled babies,” he concluded – 32 years before the birth of Louise Brown, the world’s first test-tube baby.
And what of the rest of his brave new world? He looked again at the picture he had painted for 2540, with its widespread promiscuity and babies being decanted, hatched and then conditioned to live in a state that was almost free of emotion.
His verdict: “Today it seems quite possible that the horror may be upon us within a single century.”
By Laura Donnelly, The Telegraph