Exploiting Pregnancy Surrogacy

"Did I feel like an employee? Damn straight I did. Like a piece of trash. They used me and just threw me away like I was nothing."
"Once you become a surrogate and something goes wrong, there's no support. There's no support for you whatsoever."
Nancy, 47, Ontario

stock.xchng   Carrying triplets for complete strangers, the Ontario woman developed first high blood pressure, then congestive heart failure, before she was put into a medically induced coma last fall to save her life — and that of the infants.

"At what point are we just using these women? Women didn't get this far to be treated like breeding animals."
Jennifer Lahl, Centre for Bioethics & Culture, California

Evidently in Canada there is a surging trend toward surrogates volunteering to carry a pregnancy for other women who cannot do so themselves, according to statistics compiled by the Canadian Fertility and Andrology Society. Over 400 in vitro-fertilization cycles were carried out on surrogates in 2013, a vast increase over a five-year period.

Surrogacy is not without its complicating factors. Although most women who opt to act as pregnancy surrogates for others don't experience problems, there are those who do, and age is certainly a factor. While risk of maternal death in childbirth is low, with six to 11 per 100,000 deliveries, surrogates are faced with an elevated risk of dangers involved in the process.

And those risks include a higher rate of pregnancy-induced high blood pressure, pre-eclampsia (hypertension/protein in the urine), and gestational diabetes, as an example. The need for hysterectomies associated with the outcome of surrogate child-bearing is significantly higher for women carrying twins, triplets, quadruplets; with IVF, multiple pregnancies are higher than otherwise.

Postpartum hemorrhage or hypertension is more certain to be caused by contract surrogacy with pregnancy involving donated eggs. A consultant who specializes in making contact between surrogates and those who seek their aid, has seen an increase in complications, and she assumes that this is the result of demand outstripping the supply of young women willing to become surrogates, with older women taking their place.

It is certainly not for profit, since although surrogacy is not illegal in Canada, paying someone to become a surrogate is illegal. Only expenses related to the surrogacy may be reimbursed, although it is common for the contractor to offer to the surrogates some form of recompense, under the table. Women who volunteer to become pregnancy surrogates do it for reasons other than pecuniary. Some multiple times, even though they often have the burden of caring for their own children.

Sally Rhoads-Heinrich, the consultant, described a woman in cardiac arrest while giving birth in 2013, and another woman who developed a blood clot in her lungs and two others who lost their wombs to surgical removal as the complications arising in some of these instances. And then there is the report of an Idaho woman who suffered a rare complication called placental abruption, who died. She had been five times a surrogate.

Nancy, quoted above, signed with an American surrogacy agency to aid a Canadian couple as a surrogate. Her expenses related to the pregnancy were paid, as well as slightly more. She had two embryos inserted in her womb in Mexico, at a clinic. The use of more than one embryo at a time is common, since multiple embryos increase the chance of the IVF succeeding. In the same token should more than one embryo succeed, risks for complications rise.

She became aware of the heightened risk of pre-eclampsia with triplets for the first time when she was diagnosed with the condition late in the pregnancy, when she ended up carrying triplets for people with whom she had contracted. She had first experienced high-blood pressure, then congestive heart failure, requiring that she be placed in a medically induced coma to save the life of four; her own and those of the babies her body was nourishing.

With doctors concerned that her impossibly high blood pressure might trigger a stroke, the coma was induced, then a Cesarean section conducted. Her uterus was finally removed, as a result of excessive bleeding. Her own aspiration to have another child of her own, was brought to an end when spontaneous menopause occurred.

Her experience and those of others women acting as pregnancy surrogates has led some experts in the field to argue that surrogates should receive commercial payments for their enterprise. The experts suggest other rules to protect surrogates. According to Karen Busby, a law professor and human rights expert at University of Manitoba, the "vast majority" of surrogacy arrangements work out well, and serious, life-threatening complications are scant, but standards should be put in place to make the industry safer.

Limiting the age of surrogates to begin with, and the number of times they should be permitted to carry other people's babies for starters. There should be medical assurances that they experienced previous healthy pregnancies, and that their own families have been completed before they embark on surrogate pregnancies. And finally, that no more than one embryo be used in the treatment process leading to a successful pregnancy.

All of which reflect common sense.

Tim Sloan / AFP / Getty Images    Some experts argue it is more reason to allow surrogates to receive commercial payments, others that new rules are needed to better protect them.