Table of Contents for My Body, Their Baby
Introduction
Though growing in popularity and usage, surrogacy remains the most controversial path to parenthood. I begin by describing the reactions people have had to my once having carried and delivered a child for my involuntarily childless friends. I next explain why surrogacy as a method of family expansion generates strong reactions among three discrete but overlapping communities of which I am a part and this book especially engages—feminists, Christians, and the general public. To facilitate my goal of constructing a progressive Christian vision for surrogacy and a framework of seven principles to guide the formation of ethical surrogacy relationships, I provide a chapter-by-chapter outline of how the book's argument will unfold. I conclude with several disclaimers about my terminology and about writing about my collaborative reproduction with my friends without attempting to speak for them.
1.A Primer on Surrogacy: Logistics, Laws, and Trends
This primer covers the "nuts and bolts" of surrogacy in four parts. The first covers language surrounding the practice, different types of arrangements, and what it takes for someone to become pregnant for others, including the decisions intended parents must make during the embryo creation and in vitro fertilization (IVF) process involved in gestational surrogacies. The second describes surrogacy's other mechanics, including the parties needing to clear medical screening and psychological evaluation and formalize their contracts or preconception agreements. The third provides a snapshot of diverse surrogacy laws and customs across the U.S. and the world. The final section attempts to account for surrogacy's surging global popularity, including why some persons cross borders to meet their reproductive healthcare needs.
2.Does Surrogacy Cause Psychological Harm?
After rehearsing the reservations people have had to my surrogate motherhood for my friends, I examine popular concerns that surrogacy extracts high psychological costs on the "surrogacy triad": the surrogates, intended parents, and any child born of their arrangements. I also describe popular suspicions that persons proximate to them will also experience collateral damage (the surrogate's own children, parents, and spouse or partner, if any). I then present key findings from four decades' worth of ethnographic and social scientific studies on surrogacy families to show how many of these concerns, such as surrogates experiencing anguish at journey's end because they will have bonded with the baby in the process, are not substantiated by the data.
3.Does Surrogacy Violate Distinctive Feminist or Christian Commitments?
This chapter focuses on distinctive concerns about surrogacy among feminists who mostly operate out of a secular framework and Christians not necessarily committed to feminism. The first section unpacks feminist misgivings that surrogacy redefines and fragments motherhood, diminishes women's bodily autonomy and rights, undermines the case for abortion rights, and perpetuates negative gender stereotypes. The second section explains common Christian objections that surrogacy runs counter to God's will for marriage, sex, and the family; involves marital infidelity, mistreats embryos in the IVF process involved in gestational arrangements, and is inferior to adoption. The final section offers initial rejoinders to these concerns while noting which of these I wrestled with in my surrogacy journey with my friends.
4.A Progressive Christian Vision for Surrogacy: Advancing the Argument
I advance in this chapter a progressive Christian argument and vision for surrogacy in three parts. The first identifies seven simplifying assumptions about the type of surrogacy initially under consideration, including the arrangement being gestational, non-commercial, and intrastate. The second describes how my account engages the four traditional sources of Christian ethics. The third offers a vision of surrogacy as a practice that serves, not impedes, flourishing and relationships by affirming the sharing of traditionally maternal roles between two or more persons, showing how plural motherhood among surrogacy families can be compared to the "maternal multiplicity" that is already found in other family composition types (e.g., children who have both adoptive moms and birth moms, moms and step-moms), and analogizing to the examples of altruistic wet-nursing and milk-sharing to show how reproductive generosity and embodied solidarity could be extended to gestation and childbirth, too.
5.A Progressive Christian Framework for Surrogacy: Seven Principles
The chapter opens by describing how the uncertainty about abortion figured in my surrogacy journey; specifically, which party (surrogate or intended parents) should have the final say. Prompted by my wish we could have had a framework of principles for guidance, I address what ethical norms and best practices should be in place to steer the formation of surrogacy relationships. My first two out of seven principles are intended for those contemplating the feasibility of collaborative reproduction for themselves: "discernment without haste" and "covenant before contract." The next three are for the members of any given surrogacy triad as their arrangement unfolds: "empathy, care, and stewardship," "medical self-determination," and "disclosure, not secrecy." The final two are for the general public regarding the posture they would ideally take toward the surrogacies of others: "social justice" and "trust women."
6.Assessing the Ethics of More Complex Surrogacy Arrangements
This chapter considers three more complex types of surrogacy arrangements: those that are financially compensated, involve interstate or intercountry travel, and/or traditional. In the first case, after examining the popular charges commercial surrogacy exploits and commodifies, I defend the good of surrogate compensation under certain parameters by showing the co-existence of altruism and self-love, among other arguments. In the second, after acknowledging the increased risks involved in cross-border surrogacies and identifying particular difficulties that arose after certain natural and man-made disasters and during the Covid-19 pandemic, I recommend several ways to mitigate these risks. In the third, after explaining why traditional surrogacy poses distinctive challenges, I also note conditions when this type of surrogacy might even be preferrable. My framework, in short, does not judge these more complex types of surrogacy as beyond the moral pale.
Conclusion
I conclude by offering final thoughts about my surrogacy arrangement with my friends. I also acknowledge the common ground I nonetheless share with commentators who have reached different ethical judgments about surrogacy. I clarify that my support for collaborative reproduction does not mean "anything goes" in the name of science or reproductive freedom, but that my firsthand experience with what is currently the most controversial method of family expansion has primed me not to reject without thoughtful consideration other reproductive techniques that, at the time of this writing, still remain more in the realm of science fiction than real life