In a slim new volume, Outsourcing the Womb: Race, Class, and Gestational Surrogacy in a Global Market (Routledge, 2011), France Winddance Twine provides multiple accounts of the ways in which racism, classism, and colorism permeate the international market for wombs and gametes. For example, Twine cites the story of a Japanese woman who backs out of a surrogacy arrangement when she learns that the gestational mother, whom she had selected on the basis of her profile and skin color, is Korean. And there is the case of the black woman seeking IVF services who is "policed" in her choices by white doctors who insist it would be "inappropriate" for her to use "white" sperm if "black" sperm were available in the bank. Or the admission of the white, would-be surrogate who tells a researcher that she would carry "a Japanese baby or a Chinese baby because they are white to me," but says that "to give birth to a Black child would add one more controversial aspect to my life and I'm not ready to be on the front page of the National Enquirer" (p. 25).
Twine, a University of Santa Barbara sociologist who has written extensively on whiteness, gender, and racism, argues that such stories have too often been neglected by the press and even by scholars who engage in analyses of gestational surrogacy, and takes it as her brief to reframe the study of this global enterprise in terms of the concept of "stratified reproduction" first advanced by ethnographer Shellee Cohen in her study of West Indian migrant workers in New York. Twine sees gestational surrogacy as "embedded in a transnational capitalist market that is structured by racial, ethnic, and class inequalities and by competing nation-state regulatory regimes" (p. 3). Only some women and couples can afford surrogacy, and in most countries, it is only poor women who are the providers of the desired commodity.
Drawing on the work of other sociologists and of anthropologists, legal scholars, and philosophers including Gillian Goslinga of Wesleyan University, Anita Allen of the University of Pennsylvania Law School, Susan Kahn of Harvard University, Amrita Pande of the University of Cape Town, Kelly Oliver of Vanderbilt University, and Rene Almeling and Marcia Inhorn, both of Yale University, Twine provides an overview of international surrogacy with special focus on the U.S., Egypt, Israel, and India.
In the U.S., she argues, it is impossible to consider gestational surrogacy outside the context of chattel slavery, a historical legacy too often neglected. She writes,
For almost 300 years women of African ancestry worked as slave laborers and produced children who were commodities in a stratified system. As the mothers of children who constituted a form of wealth for their owners (and sometimes their biological fathers) they did not possess what [Northwestern University law professor] Dorothy Roberts calls reproductive liberty (p. 8).
Ongoing racism and economic inequalities in the U.S. continue to shape the attitudes of both whites and blacks toward surrogacy, yet these forces have largely gone unstudied. Twine laments the "dearth of ethnographic studies of gestational surrogacy that illuminate the experiences of Black, Mexican-American, Puerto Rican, Latina, and other women socially classified as members of racial or ethnic minorities who are oppressed..." (p. 47). Such studies might reveal the ways in which standard arguments regarding reproductive liberty, including the right to privacy, have been "used to reinforce and restore the privileges of the racially dominant groups to reproduce while restricting or denying the poor and ethnic minorities those same rights" (p. 49).
Twine does a quick review of what she terms "constrained occupational choices" of American women and finds that there is near parity between the highest payment for a singleton surrogacy pregnancy — in the $20- to $25,000 range — and the wages earned by women working in retail sales, or as nursing home or home care aides. So while women in such professions might appear to be exercising agency in choosing to serve as surrogates, Twine sees their choices as structured by their class and economic situations. The same holds in an international context, where women suffer even greater wage discrimination and limits on employment. There is choice and there is choice, and women in higher paying occupations in any country do not typically view gestational surrogacy as an option carrying much benefit.
The book also looks at surrogacy in India from class and ethnic perspectives, and in Egypt and Israel from a religious point of view. (Interestingly, in Israel, where the government subsidizes surrogacy as well as other assisted reproductive technologies, rules prohibit unmarried or gay Jewish men from using ARTs, while granting lesbians and unmarried heterosexual women access.) Twine also documents acts of systematic religious and ethnic segregation in the fertility business in Israel, as when Orthodox Sephardic and Ashkenazi clients at fertility clinics are matched to rabbis of the same heritage, whose approval for procedures is essential due to "the potential social stigma that could attach to a child conceived via ART."
In the end, Twine sees that at least some of the inequities could be eliminated via policy shifts and echoes Dorothy Roberts's call for state support for the procreative decisions of all women, regardless of class, including removal of economic barriers via subsidies.
Note: At 50 pages, and with discussion questions included, this volume would serve well as an introduction to surrogacy for college and advanced high school students.
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