Following months of infertility treatments, Meg Watwood cried in joy when her first ultrasound revealed healthy twin babies. At the doctor’s office three years later, when a scan showed she was pregnant with twins again, there was another mom in the room celebrating.
This time, Watwood was carrying the babies for her.
Amid all the waiting, testing, and praying for her own twins, Watwood had developed a deep compassion for families stung by infertility. She felt called to help, so much so that she offered up her womb to two little embryos from a fellow couple struggling to conceive.
Then last year, she did it again for another couple.
Doctors had deemed that hopeful mom-to-be unable to carry a pregnancy after several failed rounds of intrauterine insemination (IUI) and in vitro fertilization (IVF). The couple, a pair of Texas lawyers who shared Watwood’s pro-life convictions, wanted to give the additional viable embryos they had produced a chance. They were connected to Watwood, a Southern Baptist, by a local surrogacy agency.
“God called me to seek out what seemed like unconventional ways to serve others,” said Watwood, now a 39-year-old mother of four. In the surrogacy process, “Some things will be hard … but you’ll be blessed so far beyond what you could even imagine.”
Watwood is part of America’s rapidly growing surrogacy movement. The number of babies born through surrogacy in the United States, though still relatively small, has quadrupled in just over a decade. And despite ethical questions surrounding the practice, demand isn’t slowing.
According to the American Society for Reproductive Medicine, surrogates gave birth to 2,807 babies in 2015, up from 738 in 2004. Nearly all were conceived by IVF and carried by women with no genetic connection, a process called “gestational surrogacy.” (In “traditional surrogacy,” the only option prior to IVF but one rarely used today, the carrier would also be the genetic mother of the baby.)
IVF and surrogacy are becoming more normalized in the US just as other countries have shut down foreign surrogacy enterprises, dual trends that have made the US a top surrogacy destination. High demand for surrogates, who typically earn more than $20,000 per birth, has attracted many evangelical women, who often fit the profile of the “ideal” surrogate and are drawn to the idea of using their fertility to bless others.
But laws and ethical discussions surrounding surrogacy haven’t kept up with the industry’s growth, and pastors and churches appear largely ill-equipped to guide women and couples through the high-stakes decisions involved in third-party reproduction.
A moral and legal patchwork
There is no federal law governing surrogacy. Couples seek out carriers across state lines to navigate the patchwork of laws allowing or banning surrogacy—or, in more than half of the country, a lack of legislation on the issue altogether.
With no agreement over—and sometimes no acknowledgment of—the serious ethical questions that come with new ways of creating and carrying life, neither advocates nor critics see imminent reform ahead for the unregulated surrogacy landscape.
Within the church, even those who share positions against abortion may disagree or simply not have the answers for scenarios that arise with assisted reproduction and surrogacy. But Christians on both sides urgently want their communities to pay more attention to the possibilities and problems emerging as the surrogacy industry continues to expand.
Protestant churches have been largely silent on the issue, said Scott Rae, a Biola University ethicist whose expertise is in assisted reproduction. “Most churches that I’m aware of either have nothing to say or want nothing to say.”
Couples approaching their pastor to discuss surrogacy as an option have often already begun the IVF process, leaving him or her to consider the welfare of the existing embryos even if the pastor would have advised against creating them in the first place. And church leaders have few ready answers for women interested in serving as surrogates; their guidance may vary with the particular situation.
“The pastor is never called to be a medical expert, but he is certainly regarded as a moral expert,” said Paige Comstock Cunningham, the executive director of The Center for Bioethics & Human Dignity at Trinity International University (TIU). “Some of these things are simply not appropriate for the pulpit on a Sunday morning, but they do need to be addressed.”
Last year, former Arizona congressman Trent Franks—a Republican, pro-life Baptist—resigned following allegations that he had asked female staffers if they would serve as surrogates for him and his wife, who had struggled with infertility.
The news launched a bigger conversation among evangelicals over whether gestational surrogacy was even a moral option in the first place—a debate that rarely makes its way into the national pro-life conversation.
A Christian heart for surrogacy
A bubbly mom with a social work degree, Watwood knew how bittersweet the surrogacy process would be for the women whose babies she carried. After years of expenses and treatments, the intended mother had a baby on the way—except Watwood was the one who would deal with the morning sickness, bust out the maternity jeans, feel the first little kicks, and ultimately go through the pain of labor.
Watwood saw herself as part of a bigger plan for these couples and their little ones. When the mother of her most recent surrogate baby teared up in the delivery room, she said to her, “This is almost over. You are going to praise God that you didn’t get pregnant those four years . . . because you’re fixing to meet this baby that God has for you. You’re going to be grateful for all of the nos he gave you that led up to this yes.”
The demands of surrogacy—emotional, physical, and spiritual—go well beyond what gets written up in surrogacy contracts. Watwood said she worried more about her surrogate babies than her own, avoiding medication, caffeine, and as many other risk factors as possible to ensure a healthy outcome.
A friend and fellow surrogate, Melissa O’Hare, was admitted to the hospital to give birth to her surrogate baby at the same time as Watwood. She felt the pressure, too. “I’m so glad I have a peace about this being God’s plan,” O’Hare said. “I don’t know how non-Christians do this.”
Watwood and O’Hare worked with an agency called Surrogate Solutions, one of dozens of networks in the US that recruit surrogates. Candidates are typically active women in their 20s and 30s with at least one kid of their own and a solid financial background. They can’t smoke, do drugs, or take antidepressants and must pass a psychological review. And they must live in a state where surrogacy is legal.
New Jersey has long known the risk of surrogacy-gone-wrong since its courts handled the first surrogacy dispute in the US. In the 1986 “Baby M” case, the surrogate (and genetic mother) famously fought for custody, forcing the intended parents to sue for the rights to their baby.
New Jersey, along with states like Washington and Indiana, will not enforce commercial surrogacy contracts. New York, Arizona, and Michigan prohibit all contracted surrogacy arrangements.
Jurisdictions with restrictions deem the practice “injurious to the public” or “contrary to public policy,” because such agreements, according to some lawmakers, amount to “baby-selling,” which is illegal.
Meanwhile, favorable laws in places like California and Texas provide a relatively smooth legal process for commercial surrogacy if everything goes right.
The industry is unregulated, so every agency has its own approaches and standards. “The compatibility factor is huge,” said Gayle Garrett, director of Surrogate Solutions, which oversees 55 births a year through gestational surrogacy.
Most agencies recognize that pregnancy is not a compartmentalized side task and ask that a surrogate’s spouse agree to support her through the process. Demographics like Christian stay-at-home moms and military wives, with big hearts and a deep appreciation for family, prove to be a good fit for the job.
Garrett, a Christian who studied nursing at Oral Roberts University and founded the agency over a decade ago, first carried babies as a surrogate for a couple in Europe, where commercial surrogacy is largely illegal. From her experience, she learned that the relationship between carrier and intended parents “helps make the process easier all the way around.”
Surrogate moms and parents also have to be on the same page about two of the touchiest social issues: marriage (whom they’re having the baby for) and abortion (whether they will end the pregnancy under any circumstances). Agencies can help both sides enter into agreements designed to avert worst-case scenarios, such as surrogates fighting to keep a baby found to have a genetic condition or surrogates refusing to hand over a baby upon learning the parents are gay.
In a high-profile example last fall, the Supreme Court declined to hear what would have been its first-ever surrogacy case, a petition from a California surrogate who refused to abort two of the triplets she carried for a 51-year-old single man in Georgia, babies conceived with his sperm and donor eggs.
After having the babies, Melissa Cook sued for custody, alleging that the man who hired her, Chester Shannon Moore Jr., was unfit to raise them. Moore said he was not in financial or physical shape to care for three babies when he had tried to convince her to “reduce” the pregnancy. Lower courts did not grant her custody, even as she drew support from the Family Research Council as well as certain feminist advocates.
Christian surrogates like Watwood avoid the possibility of such a scenario by making their preferences clear from the start and only meeting with couples who share their views. “I’m not comfortable under any circumstances having an abortion,” she said. It means “you just might have to wait a little longer for intended parents to select you.”
Garrett said her agency has had “very, very few” disagreements between intended parents and surrogates—and no litigation come up. “We’ve not ever had an instance where a surrogate was asked to terminate a pregnancy.”
In most states where surrogacy is commonly practiced, surrogacy agreements are not necessarily binding: Intended parents don’t have much say over the baby before it’s born, and surrogates cannot claim rights to it after.
“In the state of Texas, even if the surrogate says, ‘Sure, I’ll terminate a pregnancy if you want me to,’ when it comes right down to it, Texas law looks at that surrogate as this is her body, and she makes the final decision,” Garrett said. “Legally she has the right to say no, even though she signed a contract with the couple.”
My babies, not my belly
As a young Christian mom, Jenna Miller was an unusual client for surrogacy. She never imagined having another woman carry her children. She also never imagined suffering heart failure at 24 and hearing her doctor issue what felt like a death blow to her family dreams: “You shouldn’t have any more kids.”
Eager to add to their family of three, Jenna and her husband, Mark, looked into adoption—many Christians’ instinctual recommendation for couples who can’t conceive—only to have the process stalled by her health issues. Agencies weren’t eager to place a child with her due to her heart condition (which she now manages through medication).
Eventually, Miller contacted Surrogate Solutions in suburban Dallas, having seen the agency featured in a local family magazine. She felt God finally opening doors for them, particularly with the surrogate they were matched with: a pastor’s wife who became a close friend and “the most godly woman I know.” She prayed for them and their baby every day.
“Our prayer life got real serious,” Miller said. “Once you get into surrogacy and IVF, there’s just an amount of faith that has to go into that.”
Miller was eating breakfast at Shipley’s Do-Nuts when she learned that the first of their prayers had been answered: The surrogate texted a picture of a positive pregnancy test. The good news continued at the ultrasound and then months later when their son Ryan, now four, was born.
The Millers—then in their 20s, the youngest clients ever for Surrogate Solutions—went on to work with the same surrogate, Jennifer Nelson, to carry their remaining embryos. With each IVF process, they transferred two of their four total embryos and ended up with one healthy baby at the end of both rounds. Their daughter Faith was born in 2016.
As Christians who believe life begins at conception, they had to think ahead about the possibilities for the embryos generated in the process. Options like selective reduction, when doctors plant several embryos and terminate higher multiples, or disposing of extra embryos violate many believers’ pro-life convictions.
“I’d like to see significantly better education so people know what they’re getting into before they go down these roads,” said Rae at Biola. “We tell couples, ‘If you don’t have the stomach for implanting every embryo you create in the lab, then don’t go down this road to begin with.’ ”
Rae does see potential improvements and areas of hope in the practice of gestational surrogacy, including IVF options that work alongside a natural cycle to minimize hormones taken and only fertilize a single egg at a time. The rise of egg freezing over embryo freezing also gives Christian couples more options.
“I can’t tell you how many people have called me, and they’ve got twins, but they’ve also got six embryos left in storage,” he said. “I tell them, ‘Those are your children,’ as much as the bouncing baby boys or girls left in their arms.”
Altogether, the IVF and surrogacy process can run at least $80,000, but the Millers agreed that the outcome was worth whatever costs, inconvenient treatments, and awkward conversations they had to endure to get there.
Intended parents end up having to explain that even though they’re expecting, it won’t be Mom giving birth (my baby, not my belly), just like surrogates like Watwood have to clarify to family, friends, and curious strangers that the little one inside them belongs to someone else (my belly, not my baby).
There are even kids’ books, like The Kangaroo Pouch and The Very Kind Koala, to explain this setup to siblings or surrogates’ children. But opponents to surrogacy worry that such metaphors—as well as another common one, “our bun, her oven”—oversimplify the relationship between a woman and the child inside her.
“Since in most surrogacy arrangements it’s not a genetic contribution, some people think that that makes it more morally neutral or acceptable. I think that’s viewing the surrogate in a way that is a stretch,” said Rae, who co-authored the book Outside the Womb: Moral Guidance for Assisted Reproduction.
“They view the surrogate as this human incubator or prenatal babysitter, which I don’t think does justice to what we know takes place in the womb and how formative the gestational environment is to the development of the child.”
Christian bioethicists raise concerns over the commodification of women, women’s bodies, and women’s reproduction (worries also shared by some feminists) as well as the long-term impact on children born via surrogacy. Cunningham at TIU points to research on maternal-fetal bonding, including hormones during pregnancy and the baby’s senses as a newborn, as a crucial question for commercial surrogacy.
“Is the gestational surrogate going to intentionally not bond with the child, knowing that she’s not going to be the mother? There could be harm or at least some loss or deprivation to the growing child if the mother’s intentionally not bonding emotionally,” she said. “But if she intentionally bonds with the child, there is going to be some harm or loss at birth when she’s separated from the baby.”
Watwood and other surrogates said that knowing how much the intended parents wanted a baby helped them from ever seeing the child as “theirs.” “People worry so much about how much you would bond with a surrogate baby when it’s in the womb, then giving it away would be so painful,” she said. “God protects your heart in such a way that it never ever felt like my baby. It was not emotional to give the baby to its parents.”
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Source: Christianity Today