Catholic Medical Quarterly Volume 68(1) February 2018


A case against surrogacy

Agneta Sutton

AuthorThe Economist recently carried a leader article in support of gestational surrogacy.[1] The leader recounts the story of Natalie Smith, who was born without a uterus but with working ovaries. It tells how ‘with the help of in vitro fertilisation (IVF) and gestational surrogate – a woman willing to carry a baby for someone else - she and her husband were able to have children genetically related to both of them’. Mrs Smith is described as ‘lucky to live in Britain, one of just a handful of jurisdictions where surrogacy is governed by clear (though restrictive) rules’. And we are told that the surrogate, Ms French, ‘was motivated by her own experience of infertility between her first and second children. The experience created a lasting link: she has stayed friends with the family she helped to complete and is godmother to the twins.’ The story is by all appearances a happy one.

Nobody would begrudge Natalie Smith the happiness of motherhood. But the rosy picture of surrogacy given above is but a snapshot of one apparently happy family. The controversial aspects of surrogacy are left out. The Economist leader fails to take note of the ethical considerations that surrogacy commodifies and depersonalises woman and children, and that by fragmenting motherhood it places children in an ambiguous familial position.

The article in The Economist refers only to gestational surrogacy, so no distinction is made between traditional and gestational surrogacy. Traditional surrogacy is like that described in the biblical story of Hagar and Sarah. Hagar was impregnated by Abraham, Sarah’s husband. In the case of traditional surrogacy, the surrogate is the genetic mother of the child, not so in the case of gestational surrogacy. Today gestational surrogacy is the most common form of surrogacy, because it allows heterosexual couples to have children who are genetically their own. In the case of the gestational surrogacy the surrogate carries a couple’s IVF baby to term. On the other hand, in the case of traditional surrogacy the female party of a heterosexual couple is in a similar a situation to that of an adoptive mother inasmuch as she becomes the social mother of a child who is not genetically her own.

Adoption is, however, very different from either kind of surrogacy. The adopted child is not normally commissioned and brought into the world for the purpose of being given away. By contrast, surrogacy arrangements, whether gestational or traditional, are contractual arrangements whereby a woman undertakes to carry a child and hand it over to the commissioning party (or parties) after birth. Since the child is created specifically for the purpose of being transferred from one party to another, it is treated as a commodity. That the child might be greatly welcomed and dearly loved does not alter this.

The wrong of treating the child as a commodity is especially obvious in the case of commercial surrogacy. As Michael Sandel, Professor of Government at Harvard, says: ‘Even if buyers did not mistreat the children they purchased, a market in children would express and promote the wrong way of valuing children. Children are not properly regarded as consumer goods … ‘.[2] Indeed, so to treat them is degrading. Whether the surrogacy is of the gestational or the traditional type and whether it is of the commercial or the altruistic kind, the child is treated as a commodity, since it is gestated by one party for another.

Not only do surrogacy arrangements commodify children, they also commodify women. Again this is most obvious in the case of commercial surrogacy. If the surrogate is hired for a fee to carry a child to term, she is hired simply as a gestational incubator. Today rich couples from industrialised countries may travel to Asia or Africa where, with the help of an agency or clinic, they hire a woman to carry a child for them. The health of the surrogate may be of interest to them, but only because they want a good baby-making machine. Most probably the couple want no further contact with her once she has delivered the desired goods, the child.

Undeniably, the commercial surrogate might need and welcome the money. But the fact remains that she is selling room in her womb and thus allowing her womb, and thus herself, to be used as an incubator, which is self-degrading. And if is she is in dire need of money, the commissioning couple is taking advantage of her disadvantaged position. They are exploiting her.

It might be less obvious that an altruistic surrogate is allowing her body to be used in a way that amounts to self-degradation. But she too is allowing others the use of her body as a gestational incubator. Like Ms French who carried twins for Natalie Smith, she might be befriended by the couple, and as such treated as a person. But this does not alter the fact that the surrogate allows her body, and thus herself, to be treated as property that might be sold, hired or given away.

In his Second Treatise of Government, published in 1690, John Locke speaks of two different concepts of property or ownership. One relates to the Biblical concept of stewardship and life as a gift from God. It refers to the gift of life and limb. The other is that of an exchangeable commodity. With reference to the former Locke writes that ‘we are all the work of one omnipotent and infinitely wise maker and that therefore ‘everyone is obliged to preserve himself’ and that ‘no one may take away or damage anything that contributes to the preservation of someone else’s life, liberty, health, or limb…’[3] Our ownership of this gift from God is not to be sold or given away. By contrast, as Locke tells us, property in the sense of a commodity is linked to human production and labour and is of a kind that is marketable.[4] You can sell it or give it away to someone else.

Whichever the kind of surrogacy, the surrogate allows her body to be treated as a commodity, rather than as a gift over which she has been granted stewardship. The surrogate may, however, seek to alienate herself from her body and from what goes on within it. Indeed, the surrogate is obviously not supposed to think of the child as hers. That the surrogate is meant to dissociate herself from what happens in and to her body supposes a dualistic understanding of the human person. But our bodies are integral parts of ourselves. What happens to or within your body intimately concerns yourself.

The Economist leader claims that ‘recent studies show that it is extremely rare for a surrogate to change her mind and seek to keep the baby’. There is no reference to the studies in question. But the leader suggests that the separation between the surrogate and the child is unproblematic. This is to deny the bonding that normally takes place between mother and child during pregnancy. It is to brush over the pain that might be felt by the surrogate when she is severed from the child she has carried to term.

But why do some surrogacy agencies charge for the counselling of surrogates,[5] if surrogates find the separation from the child easy? Indeed, according to the Iona Institute, a Catholic think-tank in Ireland, ‘not only do surrogates need to tell themselves from the beginning that the pregnancy is merely a business relationship in order to ease their pains of relinquishment, they need the aid of a support group to constantly psychologically condition and affirm the mindset throughout the pregnancy’.[6]

It should also be added that there have been a number of legal disputes between surrogates and commissioning parents. The most publicised one is the American case of Baby M. In 1986 Mary Beth Whitehead, a traditional surrogate, gave birth to a baby, Baby M, for William and Elizabeth Stern. Following its birth the baby went backwards and forwards between Mary Beth Whitehead and the Sterns for two years until the Sterns eventually were granted custody of the child, while Mary Beth Whitehead was granted unsupervised visitation rights.

Of course, on the traditional understanding of motherhood, a woman who, like Mary Beth Whitehead, gives birth to the child is the child’s mother. However, both traditional and gestational surrogacy severs social motherhood from birth motherhood. Both kinds of surrogacy fragment motherhood. It might be argued that social motherhood is of greater significance than biological motherhood. But the very observation that couples prefer gestational surrogacy, which gives them a child who is genetically their own, shows the importance attached to the biological links established by genes. Is the biological link between mother and child established by birth any less important? Surely not! And both gestational and traditional surrogates are birth-mothers.

As birth-mothers both gestational and traditional surrogates give life. What can be more significant? No role is more important for the provenance of the child than that of its birth-mother. It is to her - more than to anyone else - that the child owes the gift of life. The birth mother is no mere incubator, and the child is not a mere chattel.

Dr Agneta Sutton (PhD)


  1. The Economist, 13/05/2017
  2. Michael Sandel, What Money Can’t Buy: The Moral Limits of Market, Penguin Books, 2012, p. 10.
  3. John Locke, Second Treatise of Government, 1690, ch.2, para.6.
  4. Ibid. paras. 36 and 48.
  5. According to the Iona Institute in Ireland, the Center for Surrogate Parenting, which arranged the surrogacy of Elton John’s sons, charge its customers over $5000 for the counselling of surrogates. See, the Iona Institute, The Ethical Case Against Surrogate Motherhood: What can We learn from the Laws of Other European Countries, The Iona Institute, 2013, 1, A, 2.
  6. The Iona Institute, 1. A. 2.