Wombs and Breasts for Rent: What Next?

Published: January 25, 2013

Payment for contract pregnancy (‘surrogacy’) is illegal in Canada. In other countries, including India and the United States, paying women for gestational services is legal, and so Canadians travel to these destinations to purchase what is ‘not for sale’ in Canada. The contract pregnancy industry in India is in such high international demand that recently [...]

Payment for contract pregnancy (‘surrogacy’) is illegal in Canada. In other countries, including India and the United States, paying women for gestational services is legal, and so Canadians travel to these destinations to purchase what is ‘not for sale’ in Canada.

The contract pregnancy industry in India is in such high international demand that recently its government found it necessary to begin to regulate surrogacy commissioned by foreign nationals. As the practice becomes more regulated in India, business elsewhere is likely to expand. For Canadians, the United States is a close destination and now, as recently reported in the New York Times, it appears that if the price is right, the breasts of gestational women are for rent along with their wombs.

With contract pregnancy, typically the rich are paying the poor to gestate their babies, and now, breast milk is being included in pregnancy contracts. In the case of C, discussed in the New York Times article, a rich white couple in their late 50s with three biological sons wanted to experience raising a daughter. They paid C, a poor 39-year-old California woman with five children from two previous relationships, $35,000 to make them a baby and to provide breast milk.

On one hand, the purchase of breast milk can be seen as evidence of loving, caring parents who want to provide the best for “their” newborn.  Breast milk is better than infant formula because it is a richer source of nutrients (e.g. fatty acids essential for brain development) and natural antibodies against certain diseases, and it has been shown to decrease the incidence of allergies in breast fed children.

On the other hand, the benefits of the act of breast-feeding are separate from (and in addition to) the benefits of breast milk. The skin-to-skin contact promotes a loving bond and sense of security. The newborn also gets early exposure to the natural flora of the breastfeeding woman, allowing her to build up resistance to the natural bacteria that she will be exposed to in her home environment. These benefits are lost in cases where gestation and breast milk production are contracted out. If the gestational woman just provides breast milk, then the benefits of breast-feeding are lost.  If the gestational woman does the breast-feeding, then the child will have the additional benefits of breast-feeding, but the emotional (bonding) and physical benefits (resistance to natural bacteria) will be in relation to the gestational mother, not the social mother.

The practice of including breast milk in pregnancy contracts is perhaps an indication of things to come. In the extreme, we can imagine the role of women working under contract for social parents expanding significantly. Their list of contractual duties could include: providing eggs; accepting embryo transfer; carrying the developing fetus(es) to term; doing all that is necessary during the pregnancy to ensure fetal health; birthing the neonate(s) following a birth plan dictated by the social parents; providing breast milk to nourish the newborn infant(s); breast-feeding; providing child care services; and when the child(ren) is/are sleeping or being entertained by the legal parents, perhaps doing a little housekeeping and cooking; and so on.

Indeed, a recent news story about a woman in New York who offered her nanny $30,000 for her eggs, with the assumption that the nanny would then raise the new child along with the existing children, suggests that this scenario is not as far-fetched as it might first appear.

To be sure, in the near term, social parents may be reluctant to extend the contractual arrangements with the gestating woman this far, because of uncertainty regarding legal guardianship. It is not difficult, however, to imagine two or more women together providing this full range of reproductive and childrearing services under contract. This future prospect forces us to ask and answer the following question: Is there anything morally wrong with reducing parenting to merely a legal relationship, while others bear, birth, nourish, and care for the children one claims to parent? Our short answer to this question is ‘yes’.  And, regarding the issue at hand, we worry that the expanding scope of commercial contract pregnancy to include breast milk production is a wrong step in the direction of reducing parenting to a legal relationship, more so than a caring one.

Those who do not share this view may point out that, for centuries wet nurses were paid by women of higher socioeconomic status to provide sustenance for their newborns, either because the women could not breast-feed or because it was socially unacceptable for them to do so. But neither of these factors explains (or justifies) why women today who buy gestational services, also buy breast milk (and more).

Women who have not been pregnant can produce breast milk and nurse a newborn if they are so inclined; all they need to do is take domperidone a few months before the anticipated birth of the child. Domperidone, a prescription medication for the treatment of stomach and intestinal problems, is routinely used off-label to help with breast milk production in women experiencing insufficient lactation. Last year, the Motherisk program at The Hospital for Sick Kids in Toronto reported, on the basis of a meta-analysis of relevant trials, that domperidone increases breast milk supply. There were no maternal safety issues with the use of this drug as compared with placebo, and there were no side-effects in the breast-fed infants. Thus, women who contract with other women to make them a baby (and adoptive parents as well) could breast-feed ‘their’ newborn. We believe they should. Exceptions to this presumption would be women who have had a radical mastectomy and women for whom domperidone is contraindicated.

Where procreation and parenting risk becoming something you just purchase from others, there is a real sense in which important elements of those practices may be compromised, including the bond between mother (parent) and child.

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