Surrogacy, Kinship and the Social Dynamics of Reproductive Behaviour

Reproductive behaviour is rooted in social relationships as well as political and cultural circumstances. Creating settings that facilitate behavioural change necessitates a careful examination of these situations. However, the prevalent conceptual framework for analysing reproductive behaviour is strongly individualistic, drawn from Becker and Easterlin's fertility cost-benefit models, with the individual or ‘reproductive' couple as the unit of decision-making. Ethnographies have shown that such a paradigm is inadequate in its knowledge of human behaviour as well as its assumptions about the core units of reproductive decision-making. Reproductive behaviour is impacted by social relationships and institutions at the local level, such as familial groupings, informal social networks, local political organisations, and religious and spiritual counsellors, which are influenced by and are the product of larger social, political, economic, and historical processes.

Many reproductive health interventions and policies show a disregard for context. For example, the reproductive rights rhetoric frequently concentrates on individual rights to the neglect of the larger social and economic contexts in which rights are established and fulfilled. This viewpoint minimises the extent to which the poor and disadvantaged are unable to exercise their rights to economic and social resources critical to their health and well-being. Social analysis is required to produce a knowledge of  numerous contexts of reproductive health, the methods by which needs and priorities are recognized and addressed, and the social dynamics of exclusion and vulnerability. Ethnographies show how social, cultural, economic, and political variables influence reproductive behaviour in four major areas: fertility, culture, gender, and sexuality.

New Reproductive Technologies

Since the birth of Sweden's first in-vitro fertilisation (IVF) baby in 1982, the country's laws governing assisted reproduction have steadily expanded and grown more comprehensive. Today, heterosexual couples, lesbian couples, and single women are all allowed to participate in gamete donation and IVF. Additionally, embryo donation is about to be approved, which will significantly enhance the likelihood that involuntarily childless individuals may become parents. The potential of permitting surrogacy has been under more and more intense discussion in recent years, with arguments for and against it being sharply divided. Recent findings by the Swedish National Council of Medical Ethics and a government study concurred that there should be more opportunities for those who are childless involuntarily, but they arrived at contrasting conclusions about surrogacy. The former advocated for it (under specific conditions), whilst the latter argued against it (under all conditions). One point of contention between them concerned the question concerning bodily autonomy and self-determination in surrogacy. These two diametrically opposed results raise important queries regarding the implications of the idea of reproductive objective for queries relating to reproductive autonomy in surrogacy. With respect to autonomy and self-determination in surrogacy, does it matter at what point in the reproductive process the declaration of intent is made? What happens if we consider the potential of changing intentions? What conditions, if any, make the mater est rule compatible with an intersectional, queer, and non-discriminatory approach to reproductive justice? Are there any alternatives to the "either/or" thinking between these two principles?

Surrogacy, Kinship and Motherhood

Helena Ragone, in her study based on ethnographic fieldwork in the US in the late 1980s, has examined the changes in American kinship ideology in the backdrop of surrogate motherhood.

The fundamental characteristics of kinship have long been up for debate, even before surrogate parenting emerged as an unconventional practice. Although it may seem as though surrogacy would have challenged the widely held American ideas of kinship, Ragone finds it to not be entirely true. However, surrogacy does add a contemplative aspect to this discussion. Despite the fact that surrogacy is an uncommon method of childbirth, it appears that the established ideas of American kinship dominate the majority of discussions around it. Therefore, it may not be accurate to assume that a new reproductive technique would fundamentally alter how a community views kinship. Ragone observes that while surrogacy may have impacted how kinship is currently conceptualised, the American focus on the biogenetic component and the notion of family has not changed.

While the biogenetic aspect is highlighted by the father who is genetically related to the child (even if through surrogacy), in the end, the couple and the child comprise the family. In the case of the surrogate mother, the biogenetic component is downplayed. As a result, motherhood is redefined as being divided into two categories: social motherhood and biological motherhood. The notion of social motherhood is used to conceive surrogate motherhood; in this type of motherhood, the biogenetic component is deemed less important than the element of choice, and caring is emphasised. The continuance of the existing familial norms is aided by this concept of social motherhood in the context of surrogacy, which greatly downplays the biogenetic component. It does so by downplaying the importance of the surrogate mother's and the child's biogenetic link and by lessening any potential indication of a relationship between the surrogate mother and the child's father.

However, Ragone also identifies the following three significant changes in conception, reproduction, and parenthood in the western context: First, the introduction of birth control technologies separated intercourse from reproduction. Then, with modern reproductive technology, pregnancy could be separated from intercourse. Subsequently, the third shift is the distancing of motherhood from a bodily connection between the mother and the foetus. This separation of motherhood and pregnancy has created three categories of motherhood. The biological mother, who has conventionally been regarded as the true mother, is the one who supplies the biogenetic factor in the form of the ovum; the gestational mother, who carries the embryo but is not related to the child genetically; and the social mother, who raises and cares for the child. In each of these three cases, the background surrounding the mother's separation from the kid is different: 1) A biological mother who could place her child for adoption 2) A surrogate mother who would give the child away to the father and his wife 3) The social mother is the child's mother by virtue of law even though she is not the child's biological mother. The first of these three is "biogenetic substance" motherhood, and the third is "legal" motherhood. The second kind of motherhood, however, does not follow either of the two recognized paths in the American kinship system. One argument would be that since gestation is a biological process, this is a situation in which the mother is related to the child biologically in some way. However, it is not entirely clear because the surrogate mother's aim is only to create the biological environment necessary for the baby to develop. The biogenetic component is absent, and any other intention outside supplying that environment is also absent. Therefore, this cannot easily be compared to one type of parenting because it is primarily thought of as a facilitating one. 

Yet, the argument is far from over -  Britain's Warnock report and Australia's Waller committee both concluded that a surrogate mother should be legally recognized as the child's mother. Looking at the case of a surrogate mother, the New Jersey Supreme Court ruled that the mother had visiting rights over the child since she had biological links to it. Some feminists have argued against this essentialist view of motherhood, arguing that a biological bond should not automatically imply motherhood, especially when a sperm donor has no connection with the concept of fatherhood. In another instance of gestational surrogacy, the California Supreme Court ruled that both women have claim over the child, one through the donation of the ovum and the other via gestation. This implies that the payment for surrogacy services is a payment for her biological services, but this does not imply that she has given up her rights as the child's mother. 

Intent and Sisterhood

In the case of surrogacy, since the surrogate mother is responsible for the entire experience of conception, pregnancy, one of the tactics employed by adoptive mothers to feel at ease about the thought of surrogacy is to emphasise the intentionality of their desire to have a child. They made the mother's wish to have a child - the central notion that finally led to the surrogate birth arrangement, thereby elevating the mother's desire to have a child above the arrangement that made it feasible. The surrogate mother tends to extend this argument by stating that she is able to serve this position because of someone's desire to be a mother. When a surrogate mother expresses choice and nurturing as the primary purposes of her job as a surrogate, she is also downplaying the possibility of infidelity or illegitimacy. Such a statement makes it simpler for her husband and family to accept her function as a facilitator for a childless couple, and nothing else. A potential allusion to the commercial side of maternal facilitation is also avoided by pointing at the warmth inherent within this position - the commercial aspect is secondary.

Ragone observes that the majority of surrogate mothers are married women, and any suggestion of connection with the child's father / or formation of any tie with the child's father in this capacity - would threaten not only their own marriage but also the marriage of the other couple. As a result, the emphasis is always on the concept of motherhood and the sanctity of motherhood, followed by the sisterly tie between the adoptive mother and the surrogate mother. 

Surrogacy-related dilemmas are difficult to address, although attempts to conventionalize or simplify the situation and understand challenges pertaining to motherhood and fatherhood in surrogacy have been frequent. The assumed relationship between marriage and parenthood is clearly challenged. 

The Indian Context

In her book Transnational Reproduction: Race, Kinship, and Commercial Surrogacy in India, Daisy Deomampo explores the global surrogacy industry in India, focusing on the ways in which surrogate mothers, parents, egg providers, and doctors navigate their relationships formed through gestational surrogacy. In the early 2010s, India was one of the world's leading providers of surrogacy services. Transnational Reproduction contends that, while the surrogacy industry in India provides a clear example of "stratified reproduction"—the ways in which political, economic, and social forces structure the conditions under which women carry out reproductive labour—it also complicates that concept as the various actors work to understand their relationships to one another. The book focuses on the racial implications of transnational surrogacy, examining how race is constructed among the numerous people involved. 

Deomampo explains how specific notions of race and difference intersect with notions of kinship and relatedness, and how racialization practices shape kinship and family formation, arguing that racial reproductive imaginaries underpin the unequal relations at the heart of transnational surrogacy. Actors create racial reproductive imaginaries through a variety of transnational reproductive behaviours, including those that Other, articulate difference, and produce and reproduce power and hierarchy.

Deomampo also emphasises how a lack of an effective law affects surrogates' health and wellbeing. Medical professionals over-medicate births, perform routine caesareans, continuously and oppressively discipline pregnant bodies, and transfer multiple embryos in order to give commissioning parents the greatest possible return on their investment. Other methods include making surrogates live apart from their own children in independent housing and withholding payment from them if the foetus does not acquire weight. Considering that the Surrogacy Regulation Bill forbids commercial surrogacy, non-standardized payment considerations are no longer applicable. However, as the Bill makes no specific mention of the health of surrogates, concerns concerning excessively medicalized pregnancies continue to exist. The Bill restricts surrogacy to married, heterosexual Indian nationals, and also stipulates that the surrogate must be a "close relative" of the intended parents, notwithstanding the lack of a precise definition of this term in the law or in society.  It compels prospective parents to 'prove' infertility with a 'certificate of essentiality,' with exceptions for families with disabled children.  Additionally, it requires surrogates to have been married at some point in their lives and have at least one surviving child.

Written by -

Gauri Dhosiwal,

Content Head