How Surrogacy Arrangements Fail Children

Seow Hon Tan
February 16, 2021
Reproduced with Permission
Public Discourse

Surrogacy arrangements are in the spotlight again. Recently, Chinese actress Zheng Shuang was accused by her former partner of abandoning two babies conceived through surrogacy in the United States. Apparently, she wanted the surrogates to undergo abortion when she broke up with him. But abortion was not feasible, as the surrogates were in the third trimester of pregnancy.

Surrogacy supporters tend to emphasize how much children are desired and valued by commissioning parents. Such arrangements can be win-win for all parties, they think, as long as surrogates are not exploited and commissioning parents are suitable parents. It might seem pedantic to claim that surrogate children are objectified when they are much valued. However, Zheng Shuang's change of heart highlights how the desires of commissioning parents drive surrogacy arrangements, with the value of surrogate children fluctuating as those desires change. The problems presented by cases like this are just the tip of the iceberg. By definition, surrogate pregnancies involve separation between the surrogate and the newborn and the substitution of new primary caregivers.

It is surprising that the best interests of the child have been so neglected in debates over the ethics of surrogacy. After all, adoption and custody decisions focus on the best interests of the child. The truth is, surrogacy undermines the human flourishing of surrogates and children. In this essay, I will lay out a few reasons why such separation is not in the best interests of the child, focusing particularly on what we can learn from relevant scientific data. These reasons suggest that lawmakers should not legalize surrogacy.

The Epigenetic Effects of Surrogate Pregnancy

In recent years, there has been growing interest in epigenetics - the study of heritable changes in gene expression that affect how cells read genes, without actually changing DNA - in the context of pregnancy. The expression of our genes can be affected by environmental factors, including prenatal factors. Surrogate pregnancies present special challenges that ought to be matters of concern because of their negative impact on surrogate children.

Part of the challenge arises from the surrogate's anticipation of separation. It has been known for decades that early attachments between an infant and a caregiver are important for the child's development . Researchers have also studied the connection between poor maternal attachment before birth and later behavioral problems of children. Surrogates have been found to be less attached to the children they carry, compared with non-surrogate mothers. This may be a coping mechanism to achieve "affective isolation," which helps these women to relinquish the newborn later on. Some surrogate mothers may consciously choose to focus on their transactional obligations , resolving not to form emotional attachments to the child. Whatever the reason, evidence of poorer attachment in surrogate pregnancies should make us uneasy, as it can lead to problems for the children later on.

It is surprising that the best interests of the child have been so neglected in debates over the ethics of surrogacy. After all, adoption and custody decisions focus on the best interests of the child.

Another matter of concern is the peculiar stress that surrogates may go through. While some surrogates speak positively of their experience, others face social risks from the lack of acceptance by those around them, as well as the stigma of having served as a surrogate out of financial need. Some face the stresses of living in special housing facilities with restrictions on movement and activities. The surrogacy industry has also been known to manipulate and trivialize the affective lives of surrogates, who may already be suffering from the anticipation of having to give up the children. Such additional maternal stress, on top of the normal stresses of non-surrogate pregnancies, is cause for concern, as maternal stress in general and adverse prenatal environments are known to have effects on the development of the fetus.

Given what we know about weaker emotional maternal-fetal bonds and additional stresses faced in surrogacy, as well as possible epigenetic effects of these on the fetus, lawmakers thinking about whether to legalize surrogacy should not ignore the risks to the future well-being of surrogate children.

Separation from the Gestational Mother

Then there is the potential trauma for the newborn when separated from the surrogate, who is the gestational mother and sometimes also the genetic one. Newborns are handed over to commissioning parents upon birth. Their primary caregivers in the prenatal phase - the surrogate mothers - are replaced with the commissioning parents. The effects of separation of a newborn from a surrogate mother are yet unstudied . Fetuses do have some memory , though the exact workings of fetal memory are not fully known. However, the substitution of primary caregivers in the early post-birth phase is known to constitute a loss or hindrance to the child's formation of early attachments, which is to the child's well-being. Whether a similar loss is experienced in severance from primary caregivers in the prenatal phase is a concerning question that must be researched further.

Of course, similar losses also occur in other circumstances, such as when the mother of a newborn dies. We see those cases as unfortunate, even tragic. How then can it be fair to impose such losses on surrogate children? The essence of surrogacy agreements is to separate the children from their gestational mothers. By design, a child born to a surrogate mother is severed from the woman who bore him, whose own genetic makeup, environment, and behavioral choices influenced the expression of the child's genes before birth.

While the potential trauma of separation has not been thoroughly researched in the context of surrogacy, the known trauma of separation between birth mother and child in adoption is helpful in thinking about surrogacy. The difference is that the act of the adoptive parents is salutary. They step in to serve the needs of a child when birth parents are unable or unwilling to do so. Morally speaking, this is very different from surrogacy. In adoption, a child is not intentionally conceived and born in order to be given up. Separation is not sought by the adoptive parents. By contrast, commissioning parents choose to impose the trauma of separation on surrogate children.

Bonding to Commissioning Parents

After being separated from their surrogate mothers, newborns may face problems in reattaching to new parents, as has been seen in research on children who lose biological mothers. Because the circumstances of loss can affect reattachment, the specific circumstance of surrogacy should be studied. Reattachment problems could be deeply detrimental to surrogate children's well-being.

Moreover, even if the commissioning parents strongly desired children, they may be conflicted and take time to adjust. This can lead to a gap in the child's reattachment to his or her substitute primary caregivers. For example, van den Akker has observed that a "missing genetic link" in surrogacy arrangements can be troubling to the marital relationship if the commissioning mother sees the child as fathered by her husband with the surrogate. If she rejects or finds it hard to bond with the child as a result of emotional struggles, the child can be damaged in a way that exceeds the damage in adoption. In such cases, the surrogate child faces a form of "rejection" by the surrogate - who is his or her gestational and sometimes also genetic mother - followed by rejection by the commissioning mother.

The fight to legalize surrogacy exists to serve the desires of commissioning parents, not to protect the best interests of children.

The possibility of conflicted feelings is not far-fetched. Some commissioning mothers who had employed traditional surrogates - surrogates who are biological mothers, both providing the ova and carrying the child - after legally taking over the children, felt that it would have been easier to accept children who were genetically connected with themselves. But the same study revealed that, among commissioning mothers who were genetically related to their children, the number who believed that it was easier to accept a genetically related child decreased after they actually took custody of their children.

We also need to think about how carrying a child transforms a woman into a mother, a point explored in Cranley's classic work on maternal-fetal attachment. Recent research associates maternal-fetal sensitivity with maternal-baby sensitivity, and attachments in pregnancy are known to be valuable for caring for the newborn. Such attachments are impossible for mothers who commission another woman to carry their child. Disconnecting childbirth from child-raising means commissioning mothers must raise their infants without being able to draw upon the benefit of maternal-fetal sensitivity and attachments in pregnancy.

The Ethics of Surrogacy

As much as supporters like to frame surrogacy as motivated by the altruistic desire to help others who deeply desire children, surrogate children might well fail to appreciate all of those intense desires. At the end of the day, the fact that their gestational, and possibly genetic, mothers conceived them just to give them up - often for payment - may continue to weigh on them. Surrogacy leaves a child wondering about the gestational, and possibly genetic, environment that so deeply formed the person he or she became.

It would be naïve to think that new laws could require commissioning parents to allow future contact between children and the surrogates who carried them or require surrogates to agree to such contact. Many surrogacy arrangements are cross-border. Furthermore , surrogates may not want to be reminded of children they have given up, and commissioning parents may fear interference with their parenting.

The fight to legalize surrogacy exists to serve the desires of commissioning parents, not to protect the best interests of children. Poor prenatal attachments and other epigenetic effects of pregnancy cannot be ignored, as they may affect the future development of children. The trauma of separation and the special challenges in parenting newborns conceived through surrogacy present further concerns. The desire of children to reconnect with birth mothers and their right to know their origins must be considered.

Lawmakers should prioritize the well-being of children - not the desires of adults. Surrogacy should not be legalized, as it is not in the best interests of the child.