Surrogacy is touted by some celebrities, including Kim Kardashian West and Kanye West, who have had two children via surrogates. But is it as safe as the media coverage suggests? Jennifer Lahl of the Center for Bioethics and Culture breaks down the medical risks the procedure has, as well as some of the legal and personal consequences surrogacy and egg donation have had for some. Read the interview, posted below, or listen to it in the podcast:
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Kate Trinko: Joining us today is, Jennifer Lahl, who is the president of the Center for Bioethics and Culture. She’s also produced several documentaries on third-party reproduction, including “Eggsploitation” and “Breeders: A Subclass of Women?” as well as “Big Fertility.”
Jennifer, thanks for joining us today.
Jennifer Lahl: Thank you, it’s good to be with you today.
Trinko: First off, let’s talk about the health risks. What are the health risks to the woman, when she is a surrogate for pregnancy, and what are the health risks to the baby?
Lahl: You know, it’s funny, because most people just think all pregnancies are equal, and that’s not the case.
When you think of surrogacy, the woman is pregnant, carrying somebody else’s baby, so if you equate what’s happening to organ donation, we don’t just take a kidney from somebody and put it into somebody else’s body because we know that body will probably reject it. That’s what’s actually going on with surrogacy.
When the woman has the embryo, or embryos transferred into her womb or her uterus, her body immediately undergoes a rejection. This is foreign, this is not my baby.
In the medical literature, you’ll see that a surrogate mother is going to be at higher risk for pre-eclampsia, maternal hypertension, gestational diabetes, and of course, if the mother is at risk, and in a high-risk pregnancy category, that also stresses the baby or babies that she’s carrying, so that they are also at risk.
Daniel Davis: This is something that people know about rejecting kidneys, and that kind of thing, but we don’t often think about this.
I almost think that surrogacy is not talked about. People don’t really think about it, but it’s increasingly common, right?
Lahl: Yeah, and people don’t talk about it, and all they see mostly is the covers of People Magazine, where you’ll see celebrities—Jimmy Fallon, Kim Kardashian, Elton John—all these people that are having babies in this new way.
Since this is a relatively new practice, we’re only now starting to get data in the medical literature. The data is showing that these are high-risk pregnancies because a woman’s not carrying her own child.
Trinko: Just out of curiosity, obviously, they can test for kidneys and which ones would work better or worse for you. Is there anything like that possible for embryos?
Lahl: I suppose they could, but you have to get back to the question, why would you want to do this?
Because, in the case of organ donation, even if you have a really good match, the person’s who’s receiving that organ is going to have to take all these extra drugs, anti-rejection drugs for the rest of their life.
Why would you take a healthy woman, who’s not a patient, put her into a medically risky situation, and then say, “But, that’s OK. We’ll just give her more medication in managing these risks.”
You have to come back and say, “Why would we even want to do this in the beginning? Because surrogates are overwhelmingly young moms, busy at home, taking care of their own children, and why would we want to put them in a compromised pregnancy situation that may jeopardize their ability to mother their own children?
Davis: Your organization is waving a red flag here, saying, “Let’s actually look as a society at what this is and the risks.” Have you gotten much interest from the media in covering and bringing that to the surface?
Lahl: … We’ve actually been silenced by the media. The media has adopted the big fertility industry narrative that everybody wins. Otherwise, these wonderful couples couldn’t have children, and the children are all fine, and the surrogate mothers are all fine. It’s a narrative that’s very strong and powerful. And the media, so far, has not wanted to report on the full story.
I lamented in my remarks at The Heritage Foundation today that we have a surrogate mother in the United States who died carrying twins for a couple in Spain. The twins died and we could not get any media interest whatsoever in three people losing their lives.
Trinko: I assume her death was connected to carrying the twins?
Lahl: It was definitely connected to being pregnant. She had placental abruption, and you don’t get placental abruption if you’re not pregnant.
Trinko: So tragic.
Lahl: There’s no placenta.
Trinko: You just mentioned the big fertility industry. Tell us a bit about it. I think a lot of Americans know it’s extremely expensive to use IVF or involve a surrogate, but is this a profitable industry?
Lahl: It’s a huge profitable industry, and of course, the surrogate mother is the low person on the receiving end, if you will, of the economic gain.
We say often that the person, the buyers, the intended parents who get a take-home IVF baby through surrogacy, it’s a six-figure baby, so this is clearly a very wealthy, lucrative industry.
It’s a growing industry, it’s in the billions and billions of dollars, it’s a global industry, because embryos are tiny and egg and sperm are tiny. They can be frozen and shipped all around the world. So it’s definitely a big, big industry.
Davis: Here in the United States, what is the regulation like? You mentioned a Spanish couple having their child here. What’s the regulation like?
Lahl: The United States is a peculiar country in that we have 50 states, which means we have 50 different pieces of legislation, if you will. Of course, some states have the same laws, but commercial surrogacy is all illegal in New York state.
My state of California, where I live, it’s literally a reproductive tourist destination zone, so people from all around the world will come to California because it’s very friendly to surrogacy.
The global south has just recently, over the last several years, closed their borders, shut down commercial surrogacy, because women and children have been harmed and exploited, which makes the market just move and shift to more surrogacy-friendly places like the United States.
Right now, we’re fighting a very tough uphill battle to keep commercial surrogacy illegal in New York state, and Gov. Cuomo is poised to legalize commercial surrogacy there. It’ll be interesting to see if we’re successful or not because that’s an active piece of legislation right now.
But, in the last few years, because of the work I do, I’ve been involved in Washington state, in Louisiana, in the District of Columbia, where we’ve lost. These are states that normally, in the past, did not permit surrogacy, and have now become surrogacy-friendly states.
Trinko: You mentioned the instance of the mom with the Spanish twins, but you also discussed at the event a woman who ended up having both a child she was carrying as a surrogate, but also her natural child.
You said she faced legal obstacles in getting the rights to her own child back. Can you talk about that? Also, are there other stories of things like this, where things have gone wrong?
Lahl: Oh, there’s so many stories. …
I remember sitting in my office the moment Jessica Allan contacted me. She’s a young woman in Southern California, who literally gave birth to a Chinese baby and her own baby, and did not realize that at the time.
The whole time she was pregnant, she thought she was pregnant for this Chinese couple with their two Chinese babies.
Most surrogates do not see the babies when they’re born. They’re immediately taken away. That was the case with Jessica, so she didn’t immediately see these two babies that came out of her body.
It was only within the hours and days later that she could sense that there was something amiss. The Chinese mother came in and on her phone showed Jessica a picture of the two twins, and said, “What do you think about these babies?”
Jessica said, “They don’t look like they’re brothers and sisters. They don’t look the same.”
Jessica Allan is a white women, who is married to an African-American man, and in fact, what happened was, through a rare occurrence called superfetation, she got pregnant about a week to 10 days after the embryo transfer.
Throughout the pregnancy, they thought she was carrying Chinese twins, when in fact, she was carrying one Chinese baby and then got pregnant with her own child.
It took her two months to get her baby back because immediately, her maternal rights were already severed when the children were born, and the Chinese mother and the Chinese father were the parents on the birth certificate.
Then, it took her another about 10 months to get the Chinese name off of the birth certificate of her son, and to put the name they gave their son, and herself and her husband listed as the birth mother and birth father of their own child.
I could tell stories like that all day long. In my film, “Big Fertility,” I rattle off a couple of very provocative cases that I personally know of, and I say, “How many? How many more of these kind of stories are the media going to not tell, or not listen to, or our government officials not step in, and act, before … ”
Are we going to just keep letting women be harmed, and children be harmed, before good laws are passed?
Davis: It seems like surrogacy is closely related nowadays to gay couples, the issue of gay couples wanting to have their biological kids.
Trinko: Although, I would just point out also, more and more older straight couples as well.
Davis: Yeah, fair. But it seems, at least to me, that a lot of people think, “Oh, well, surrogacy, that’s just enabling these couples to have full equality in society, enabling them to have access to what everyone else has access to.”
How would you speak to those who maybe support gay couples being able to marry and that kind of thing, but aren’t sure how to think about surrogacy? Because it seems like what you’re saying is it’s not just about the parents’ rights. There’s a lot more involved here.
Lahl: Yeah. … Of course, my position is that I am 100% against surrogacy for anybody—gay couples, heterosexual couples, single people who just want to have a baby and don’t want to be involved, or Mrs. Right or Mr. Right haven’t come along.
It gets back to the point: You don’t have a right to a child and you certainly don’t have a right to another woman’s body.
In the case of gay couples, they overwhelmingly exploit two women. They exploit one woman for her eggs and they exploit one woman for her uterus, so that they can have the child of their dreams.
Now, I’m overwhelmingly sympathetic to people who can’t have children. I don’t ever want my message to be misconstrued of I don’t feel sympathy or have any kind of empathy for people who really want to have children, and for some reason, all the different reasons why people can’t have children can’t.
But I do draw a very bright line between you don’t have a right to put another woman, or in the case of an egg donor, two women in harm’s way. You don’t have a right to intentionally separate children from their birth mother and their biological identities and realities.
I was a pediatric nurse for almost two decades and I say often that the only thing a newborn baby knows at the time of birth is their mother. You don’t have to teach them that. They’ve learned that from being nine months in the womb with this woman. They know her sounds, they know her voice, they know her smell. They know her rhythm and her movements.
There’s a trauma, and that’s in the medical literature, that’s broken when that bond is severed. …
So, Jessica’s son, who was taken away for two months, I wonder what kind of long-term trauma there might be on that child, who was placed in a very undesirable situation. …
He was with intended parents, who knew “this is not our baby,” so they weren’t attaching to this child, and Jessica being clueless that she had given away her own child, and then, only to be reunited with him two months later, you have to imagine that there is some kind of trauma that was happening at that time.
Trinko: You just mentioned that, in cases of surrogacy that involve an egg donor, there are also health risks to the egg donor.
I was wondering if you could get into that because I think it’s becoming more and more popular to encourage young women to freeze their eggs, so if they don’t meet the right guy until they’re older, they can have children then.
But then of course, there are also ads that say you’ll get a lot of money if you donate your eggs right now. Why is that a concern?
Lahl: Well, for one, they’re getting a lot of money to sell their eggs, and it’s all under the guise of donation.
When you think of organ donation, organ donors are truly donors. They’re not being compensated. But egg donors … are being heavily compensated, and especially the more beautiful, and smart, and if they go to an Ivy League school, they can really be compensated heavily.
There’s serious health risks to young women who are being paid to sell their eggs. They take very powerful hormones, super powerful doses, because if you’re going to pay an egg donor $10,000 or $15,000, you don’t want one egg. You want as many as you can get her body to produce.
These women are bombarded with very high doses of powerful fertility drugs that have never been tested on healthy women.
What the medical literature shows is what the drugs have done as far as negative effects on infertile women. So you can’t compare those studies because you’re taking a healthy woman, an egg donor, who has nothing wrong with her fertility, she’s not sick, and then, you’re putting her on high doses.
She’s undergoing surgery, anesthesia, so there’s all those short-term risks associated with the procedure and the drugs. Then, there’s the longer-term risks.
For example, in my film, “Eggsploitation,” two women lost their ability to ever have their own children. So in helping somebody have a baby, these women will never be able to have their own children.
One of the women went on and developed bilateral breast cancer at a very young age, where breast cancer doesn’t normally strike younger women. It’s a much older women kind of a cancer. Women of my age are more at risk.
Two women had massive strokes, massive strokes. They live with permanent damage from the strokes. And you have to think again, back to “Big Fertility,” why for the sake of the all-mighty dollar and somebody else who really wants a child would we be willing to risk the health and well-being of otherwise healthy women, surrogate mothers, or egg donors?
They’re not patients. They’re not doing any of this because they have a medical need to assume risks of drugs and pregnancy. They’re doing it because they need money.
Davis: Wow, it’s pretty sobering. Jennifer Lahl, I really appreciate your time and being on. Where can our listeners find your work?
Lahl: My website is www.cbc-network.org.
Davis: Fantastic, thank you.
Lahl: You’re welcome.