Economic Inequality and Babies

02babymaking-t_CA2-articleLarge Melanie Thernstrom writes about her experiences with using egg donors and surrogates to produce her kids. If she had written a "just the facts" sort of story, I would have read the first paragraph or two and then moved on. Instead, she wrote a long rationalization for her method of producing kids and completely ignored the risk and the economics of child-birth, which caused me to read the whole thing and run to the computer on this Saturday — a non-blogging day.

In early her 40s, Thernstrom was unable to make a baby on her own, and adoption wasn't an option. She said that it's harder to adopt children today, because of abortion and international restrictions. Actually, she could have adopted a kid with special needs pretty easily, but she failed to mention that. Friends of ours recently adopted a little girl from China who had a cleft palate, so it can be done. 

She received eggs from a donor and used two surrogates to produce two babies. My usual reaction to surrogacy is that these are consenting adults, who should be allowed to do whatever stupid-assed thing that they want to do, as long as we don't pretend that they are making good decisions.

In 1986, Mary Beth Whitehead, a surrogate mother, gave birth to Baby M and then refused to hand it over to the Sterns, a couple from my home town. Whitehead agreed to have the baby for the Sterns, because she needed the money. However, she bonded with the child during the nine months pregnancy and couldn't give her up. After a long legal battle, Baby M went to the Sterns, and New Jersey no longer allows surrogates to accept cash.

Thernstrom says that her children were born out of the generosity of other people. No, they were born out of economic inequality. Thernstrom had the money to pay for their services, and these people needed the money.

Harvesting eggs is a lot harder than getting a sperm donation. There is much more involved that an old issue of Penthouse and a plastic cup. Egg donors have to take fertility pills for a while, so they produce more eggs. Eggs are removed during an operation. There are risks that accompany this procedure, including infertility. Nobody in their right mind would go through the hassle of egg donations for free. That's why women are paid about $4,000 for this service.

Egg donation is a breeze compared with pregnancy and birth. While some women truly love the experience of pregnancy, it does horrific stuff to your body. Death is always a possibility during birth. Giving up a child that you carried for nine months is a traumatic experience.

The only reason that a woman would deal with the enormous physical pain of pregnancy and birth and then the emotional pain of handing over a child, while she's lactating, is money.

Thernstrom mentions that one of the surrogates provided her with breast milk in a cooler every week. The surrogate's milk would drop when she heard the baby cry. Thernstrom then rambles on about that she generously let the surrogate breast feed the baby, but was unable to understand the physical pain of having engorged breasts with no relief of a baby.

Thernstrom fails to give us the dollar amount for her children. In a long story that provides us with every other minor detail (a doula is dismissed for being insensitive), she leaves out the dollar amount for her kids. I don't need a degree in psychology to recognize repression and denial when I see it. I feel like I should I sit down next to her, hold her hand and tell her the truth.

Listen, honey, I know that you must have been in a lot of pain when you realized that you couldn't have children on your own. Some people really, really need to have children, and it's earth-shattering when you are denied something that you wanted a lot. However, you have to recognize that the egg donors and the surrogates provided a service for you, because of CASH. They needed it and you had a whole lot of it. If they had enough money, they would have never gone through with the physical and emotional hardships and the social stigma of egg harvesting and pregnancy. They might have had a baby on their own and kept it. Please be honest about the cash relationship between you and the donors.

As I said in the beginning, I think child surrogacy should be legal (though heavily regulated), but I'm really uncomfortable with these white-washing stories that fail to recognize the hardships and economics of childbirth.


37 thoughts on “Economic Inequality and Babies

  1. Two of my children came to us through open adoption. Neither one of their birth fathers are involved much. My daughter hasn’t seen hers in over a decade, yet she still has thoughts, questions and his absence causes her grief sometimes. I don’t know how people who have children through donation don’t realize their children are adoptees. They are likely to have the very same issues. Rather than voice those issues and have them validated, they are told “there is no biological mother.” Um, that’s semantics. The woman who donated her eggs is their mother, just like both of my children have other mothers.
    I have no problem with surrogacy or donation, I just think we need to look at the complex realities for the children, donors and surrogates and really face them. At one time we were all told that a birth mother in adoption “just gets over it, moves on, and forgets.” We know now that doesn’t happen. I doubt it happens for those in third party reproduction either.

  2. Not that I disagree with your take — at all — but this shows that it can be different: not a fraught economic transaction, but an act of selfless love for a close friend.
    Sara, the surrogate, is a literary agent, and I first heard about this through her co-agent’s blog. It sounds like the real deal.
    Again, I don’t think that it changes the usual equation. Just shows that there can be exceptions to every rule.

  3. I was just waiting for you to write about this essay…
    I felt the same way. How can Thernstrom write an article without disclosing the cost of the services and, most importantly, the financial state of the people involved? Someday, her kids are going to find out that they were created, in large part, because of someone’s financial disadvantage in this world.
    How will she explain this to them?
    Also, I have a really hard time believing that she and her husband spent nine months dealing with two very hormonal women– with no tension. Did they really get along so fabulously the whole time? There was NO regret? Did they pay for their breastmilk? Did she ask her surrogates whether they would do it all over again if their finances were not a consideration? Did either of the surrogates have nightmares? Psychological issues? Grieve? Have trouble with their relationships with their own partners?
    The whole thing was so self-absorbed.

  4. I think Thernstrom is unlikely to be a sympathetic advocate for surrogacy, since she’s precisely the type of navel-gazing, self indulgent writer who thinks everything is about her. Her literary career started with a book about how her friend’s murder affected *her.* I knew the people affected by that murder (not intimately, but as colleagues) and remember being horrified by the exploitation then. The book is “dead girl” and tells the story of Bibi Lee’s murder in 1984 and the subsequent trial of Bradley page for her murder. Thernstrom writes the story about herself.
    So a self-centered look at surrogacy is exactly what I’d expect from Thernstrom.
    Regarding surrogacy and gamete donation, I’d beok with both with two conditions that are wildly different from current practices: 1) no payments at all to the surrogate or gamete donor. 2) an absolute right of all offspring to know who their genetic parents are.
    I do not believe that no woman would be a surrogate if not for the money. One might agree for a loved one, or a woman might truly enjoy pregnancy enough to take on the task for a friend. No money changing hands would make it a lot harder for infertile women, but it would prevent money from corrupting the risk assessments and motivations.
    I’m particularly worried about current trends to use surogates from other countries — India and South Africa are current hotspots.
    I, personally, might have considered being a surrogate for someone I loved (since I’m the eldest of my sisters, this wasn’t likely to arise). But I can’t imagine donating my gametes under any circumstances. I don’t think my views should color another woman’s decisions, though, once we’ve considered the economics and the interests of the offspring.

  5. It takes understanding to both sides. This is a complicated issue to think about. I am just glad and thankful I could bear a child my own:)
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  6. I agree with so much of what you’ve written. Just a note – we adopted an amazing and beautiful daughter with a cleft lip and palate. “Hair-lip” is actually “Harelip” and considered a pejorative term. Just fyi.

  7. Ack. Didn’t know, B mama. Will fix it. Sorry.
    Yes, I think deep love for a friend or a family would be a non-monitory motivation to be a surrogate parent. I would give one of my kidneys to my sister, but probably not to a random stranger.

  8. ha! For the first time ever (OK, first time that I can recall in the short years since I’ve been reading your blog 😉 I read something before you commented about it here! I will try to find the time to blog about this too because I was fascinated by the article (and not in a good way — I agree with everything you wrote). I particularly like what Lisa V. wrote above — that people who use donated gametes do not realize that they are really “adopting” someone else’s child. The other comments are GREAT too.
    I often wonder what those poor kids that Michael Jackson had feel like. It must be awful now to know your biological parents and to have been grown in the body of someone who is not related to you and raised by yet another person. Yikes!

  9. Thernstrom has WAY overshared here. I can’t imagine that the kids will be wholly thrilled to find this, when they start weenieing around on the intertubes in ten-twelve years.
    There’s a common thread, I think, in the Alex Kuczinsky article, also about donor egg, and the recent wedding article featuring the spouse swap. Besides, I mean, catching our gracious host’s attention and getting blogged here. The Times is running a lot of narcissistic Problems Of The Wealthy articles, they get our horrified fascination, and they postpone the day when folks don’t bother to look at the Times. It’s a reasonable strategy for the Times, but it’s hard for me to imagine that it’s good for the people – moths to the flame – who volunteer to be subjects.
    More money than good sense, that’s what my grandmother used to say.

  10. Dave forgot the link to the article about people who outsource their Christmas traditions.
    Read Thernstrom’s article about her discussion about buying a Lexus after her husband sold his start-up for even more self-indulgent fun.
    I do not think kids who are the result of innovative reproductive technologies will be irreparably damaged. I do think they’ll be damaged by lies and lack of information and cluelessness.
    The child-specific tidbit that struck me was the decision to create twins in two different uteruses. Really clueless, kind of like buying matched sets of dolls..

  11. I don’t remember my gestation. I don’t think the children have been damaged by that. Now, lab-assisted reproduction may lead to a greater chance of certain health problems down the road, but I haven’t read any definitive reports as to the scale of the effect–if any.
    A few generations back, large families seem to have been the norm. Women died in childbirth for many reasons, but also because they were pregnant more often. I don’t think that money is the only reason to become a surrogate or egg donor. I think it’s possible that some women are happy to be pregnant and bear children, even if they can’t afford to support them. For many of our ancestors, deciding to limit family size to one or two children would have been irrational.
    In some Darwinian sense, the egg donors or sperm donors are able to produce more offspring who live to adulthood than they could support. In some sense, the milkman who has eighty grandchildren when he dies has out-competed the billionaire whose daughter dies childless.
    I know too many women who’ve had to come to terms with childlessness to judge. The urge to bear your own children isn’t necessarily rational, but it stems from the sort of selfishness which has allowed the human species to survive.

  12. “I do think they’ll be damaged by lies and lack of information and cluelessness.”
    I have a hazy recollection that there’s a study that says it actually works the other way around–lies are good. As I recall, children may have better relationships with their non-biological fathers if they aren’t told that they were the product of donor sperm.
    The supply of donors may dry up if there are requirements that donor children be able to access information about the identity of biological parents, as I believe has already happened in the UK.
    It is definitely a weird area of the law. Normally, the good of the children is considered paramount, so a woman who conceives via donor sperm should not be able to waive her child’s right to financial support from his biological father, and yet we’ve created this large loophole whereby a sperm donor is not considered legally liable.

  13. “The supply of donors may dry up if there are requirements that donor children be able to access information about the identity of biological parents, as I believe has already happened in the UK. ”
    That’s OK with me. I see the right to know the identity of your genetic parents as a civil right that the state should not be allowed to subvert. I wouldn’t actually mandate genetic testing, so it’s true that I don’t see a way to avoid putting down “unknown” for the father, if no one but the mom knows. But, if a health professional (or a lawyer, or anyone else who participates in these new ways of baby making) knows, they shouldn’t be permitted to withhold the information from the child.
    Assisted reproduction is a wild area of law. Laws are different in different states, private money and contracts abound, and regulations are slow coming because the people who care deeply are on very very different sides and the people in the middle don’t worry about it unless they read NY Times articles.
    In Michigan, paid surrogacy is illegal and surrogacy contracts are unenforceable (a woman can choose to keep the children she gives birth to, even if they are not genetically related to her). In California, the private contracts are enforceable. I have no idea what laws govern bringing children born of surrogacy into the US Presumably immigration & adoption laws would apply, but who knows?

  14. I see the right to know the identity of your genetic parents as a civil right that the state should not be allowed to subvert.
    The old way, wine and giving the wrong name, still work for dad.

  15. I was one of three finalists for one of those $50k-egg-donations-advertised-in-college-newspapers that got so much attention a decade ago. I still ended up with $2,000 for my very minor trouble, which involved sending a picture and a family health history.
    A few thoughts:
    – I was completely, totally in it for the money. I was in the midst of my fiercest years of doing everythign possible to prevent pregnancy, so the idea of seeking out motherhood was so foreign to me at the time that I don’t think I even saw myself as potentially helping anyone. It was just a transaction.
    – If I had met the couple, and sensed that they wanted me to talk a good game like Thernstrom’s did, I’d do it in a heartbeat. Faking altruistic tendencies to pay off my college loans and then some in one fell swoop? Sure.
    I was also approached about being a surrogate for my SIL. It was a similar situation to the one that Tamar linked to — SIL was on a medication, had to go off it for pregnancy, and they weren’t sure if she could safely handle being off it for a year.
    Luckily, she was off it for two months with no problems and decided to forge ahead, right as I had decided to say no (but before I told her!). Ultimately, it would require just way too much sacrifice — not just my body and maybe some new stretch marks, but what with two kids of our own at that point, we’d definitely need more household help at quite an expense. And what if I had to go on bedrest? Could I ask to get out of service obligations due to bedrest for what was essentially a volunteer project, when my colleagues don’t get to do the same because they want to spend more time, say, working with their daughter’s Girl Scouts troop? Would that be fair to anyone?
    It was a horrible spot to be in. I was the only one in the family who was both under 35 but could be trusted to be a responsible vessel (although, to Thernstrom’s horror, we do occasionally order Pizza Hut…). If I had said no, MIL would never have forgiven me, and likely wouldn’t speak to me for years.

  16. I have never commented before but think it’s worth adding that her comments about the difficulty of domestic adoption should have specified that she is talking about WHITE babies. As a 44-year-old single (white) mother, I had no trouble (and no wait) adopting a healthy newborn African-American boy. It’s fine that not everyone is up for transracial adoption, but I wish they were more honest about it.

  17. Thanks, hab. My husband made the same point after he read my post. I wasn’t sure if some states had barriers to make it harder for white parents to adopt non-white babies. I read something about that somewhere, but I guess I was wrong.
    Siobhan, what a story!

  18. I have followed Thernstrom’s career from her early days. She’s like Joyce Maynard but with better credentials and more connections. This latest contribution (Meet the Twiblings) adds to her vast body of work.
    As a former au pair, CNA, and nursing student, I empathize with the numerous doulas, nurses, medical professionals, and unenlightened individuals who must endure Thernstrom’s demands. I await their literary efforts, however puny they will be in comparison to Ms. Thernstrom’s.
    Oh, Ms. Thernstrom. I know you. I hope your two innocent twiblings are up to fullfilling all your desires. I pray that they will live up to all your expectations. Heaven forbid that they should ever become fat, unpopular, surly, zit faced, quarrelsome, selfish, opinionated, too tall, non-musical, low SAT scorers, bad at soccer. In other words, I hope they are able to resist the terrifying tendency of children to grow up into independent human beings.
    But then you will have so much to write about! So it’s all good.

  19. “The only reason that a woman would deal with the enormous physical pain of pregnancy and birth and then the emotional pain of handing over a child, while she’s lactating, is money.”
    Laura, is this what you really think? My spouse and I adopted a newborn baby, whose birth mother didn’t want either a child or an abortion. She chose us to have the child. We didn’t pay a penny to her, not even for medical coverage (she had insurance, and we did pay a lawyer). I didn’t like Thernstrom’s article much, either, but you paint with too broad a brush here when you dismiss the possibility that some surrogates do what they do for reasons other than money.

  20. ix, honestly, I can’t imagine why someone would have a baby for a random stranger, unless BIG money was provided or because of a religious conviction that the world needed more babies. Pregnancy and childbirth is a full year process with life-long scars, long term economic repercussions, and the potential for death. All that and you don’t even get a mother’s day card? I don’t know your surrogate’s motivations, but she is an extreme outlier. (Though I am totally happy for you that you found this person. I adore my kids and am happy when other people find a child that they can love and adore, too.)

  21. sounds like the birthmom of the baby ix adopted was not a surrogate but a woman with an unplanned, unwanted pregnancy who chose to bear and give the baby up for adoption rather than have an abortion.

  22. Marta–you’re right; our daughter’s birth mother had an unplanned pregnancy and was not a surrogate, and Laura, I expect you are right that there are mighty few surrogates who would choose to do it solely from the goodness of their hearts. My point, which I could have put better, is that there are some women who choose to see a pregnancy through and then “hand over” the child to others without payment–birth mothers who choose adoption. (And yes, there are no doubt many more women who either choose abortion, or at least seek financial help from a child’s adoptive parents.)

  23. Regarding transracial adoptions, a number of African American groups, including the National Association of Black Social Workers, have vehemently denounced such adoptions. I don’t agree with them, but it seems very unfair to criticize Thernstrom or anyone else for not choosing to wade into that melee, or setting up her own judgment about what is good for black children over an organization of knowledgeable black professionals. Anyone who wants to display his or her political courage can surely find a more challenging target than Thernstrom.

  24. y81,
    I have this awful suspicion that we’re in for a forklift-full of “I was an adopted Chinese baby raised in an upper-middle class white family” memoirs, starting in about 15-20 years. Maybe they’ll even turn up in the NYT.

  25. Well the genre already exists for Korean babies (who have grown up and written books).
    It’ll be interesting to see if the Chinese adoption stories are different. Certainly they are being adopted into an ever more diverse America. And at least some of the adoptive parents are more culturally aware.

  26. So those who considered gamete donation as young women — have your feelings changed at all after having children? I never considered it as a young woman, but I’ve heard others discuss it.

  27. That’s interesting, I don’t know what the current crop of adopted Asian girls–there are lots and lots of them on the Upper West Side–will say in 20 years. Does it make a difference if the mother is herself of Asian ancestry (a pretty common situation)?
    My sister spent a lot of money to adopt a Russian baby, much more than it would have cost her to adopt a Chinese baby, because she wanted a white child. I guess in some people’s eyes, she was doing the culturally sensitive and politically correct thing, which is kind of funny, if you knew my sister.

  28. I imagine that these girls will be very grateful indeed. Good friends of mine adopted an little Asian girl. Their description of the orphanage in China where their little girl came from is horrific. They’ve made a lot of effort to incorporate Chinese culture into their home and they live in an area, which has a huge proportion of Asian families. They’ve been great parents and this little girl has more love and attention than she would have received in an institutional orphanage.

  29. “I imagine that these girls will be very grateful indeed.”
    Gratitude and good sense is not what gets you a first-person story in the NYT, unfortunately.

  30. “I imagine that these girls will be very grateful indeed.”
    Highly unlikely, if you’ve read the Korean child genre already. As with all of these “traumatic childhood” genres, my suspicion is that they’re a bad statistical indicator, since it is the angst-written who write and publish books. But children of privileged American homes rarely consider the plight of orphans in China when evaluating their own childhoods. Actually being from China might change this dynamic, but not completely.
    If we’ve done the job right, our children are not usually very “grateful” for what we’ve done for them. Most well-adjusted children take their parents for granted.
    I think the generic differences between the Korean and Chinese adoption syndromes will be the diversity of the communities and cultural sensitivity of the adoptive parents. How significantly that changes the adoption dynamic is yet to be understood, I think.

  31. Adoptees should not be any more grateful than any other child. They did not ask to be placed for adoption or abandoned (whichever the case may be). They deserve a loving home just like every person born deserves a loving home. They aren’t any more lucky than the next child. Some will look back on their lives with gratitude to their parents for raising them, and some won’t. Just like kids who are raised by the parents that they are born to.

  32. I completely agree with Laura here. At the same time, I have nothing but sympathy for everyone involved, even rich, indulgent annoying Melanie. I also would never ever judge anyone personally for doing this. I think now that the family exists, we should love an accept them.
    On the subject of adoption the first comment illuminates perfectly why a lucky upper west side Chinese adoptee may not be totally grateful for being adopted and may write a depressing memoir one day. Every kid is different and as wonderful as adoption is, it seems important for everyone to remember and respect that a loss occurred for the child. Even if they don’t happen to remember their mother.

  33. In other reproductive news, an Australian couple with three boys wants to have a girl to replace a baby that died. In the course of trying to replace the dead baby girl, they’ve aborted twin boys. Australia does not permit sex selection in IVF (except to avoid genetic abnormalities), so the couple is suing and may go to the US if they can’t get their way in Australia.

  34. wow… so many that can judge… very sad. I had sons when I was much younger, lost my dh, then remarried in my 40’ a man without any children, and a desire to have a child, the only son in his family to carry on his family name… we tried to get pregnant, then tried embryo donation to try again, then moved on to egg donation and IVF.. with a person I met on the internet that wanted to donate her eggs whether we paid her or not. What I paid to her I didn’t feel would be something I would post for public view..That would be something between my husband/myself and the egg donor. She told me she had 3 chileren of her own, and heard of egg donation and wanted to do something bigger then herself..for someone else. Thanks to this person that we keep in touch with to this day and will probably always keep in touch with her…we have a beautiful daughter that I will always be greatful to this donor for. Our daughter will always be told we had to have help to have a baby since we married older…and she will know who this person was that helped us create her. By the way, I was there the whole time while this donor was going through surgery to retrieve the eggs…I felt so blessed and after so many failed fertility treatments/cycles I will never take any of it for granted and always feel blessed to have met our donor.
    Please be kind and gentle to those that can’t reproduce like others…you have no idea how much heartache we have gone through to have what some take for granted. Unless you have walked in those shoes…be careful of judgement.

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