Birthing a Mother: The Surrogate Body and the Pregnant Self (review)

Elly Teman’s Birthing a Mother begins by describing the generally negative, at best highly suspicious public attitude toward surrogacy. Academic scholarship on the topic has “raised concerns about the commodification of women and children, class and gender-based exploitation of women’s bodies, the distortion of nature, and the devaluing of human life and of women’s reproductive labor” (pp. 1–2). This “sense of uneasiness” is also evident in popular accounts of the practice and in media coverage, which are rife with stereotypes of wealthy women lightheartedly “renting” poor women’s wombs in order to preserve their figures.

As for surrogates themselves, their very agreement to relinquish the babies they have carried apparently positions them as the threatening underside of the notion of the “good mother.” Such “unnatural” behavior tends to earn them a host of derogatory, demeaning or at the very least condescending adjectives, ranging from poor and desperate to greedy, emotionally unstable or pathologically altruistic. They are seen as almost definitively untrustworthy in terms of carrying out their obligations, though in practice it appears that such problems arise in less than one percent of cases.

It is here, then, in the breach between public uneasiness, stereotypes and misinformation, on the one hand, and apparent reality, at least statistically speaking, on the other, that the anthropologist enters—“to think against the grain of what we believe ought to be true” (p. 3). Specifically, Teman sets out to “take a fresh look at surrogacy and attempt to completely rethink what we know about this reproductive practice by taking the experiences of persons immediately involved in it at face value and trying to understand what surrogacy means for them, in their own words” (p. 3).

The result, Birthing a Mother, has been hailed as the first ethnography to explore the intimate experience of gestational surrogate motherhood. Based on the author’s doctoral research at the Hebrew University of Jerusalem, it culminates eight years of in-depth ethnographic fieldwork conducted among (Jewish) gestational surrogates and intended parents throughout Israel, putting particular focus on the relationship that develops between the two women involved.

Why Israel?

In many ways, Israel is the ideal location for the relevant research. First, the country is geographically small, which greatly enhances the possibilities of contact between the surrogates and the intended parents. Second, a shared language and culture help unite them; under Israel’s 1996 Law of Surrogacy¹ (henceforth: the Law), the host and the genetic mother must be of the same religion.

According to Carmel Shalev, “The guiding principle of the Law, which was dictated by political considerations, is preservation of the rules of kinship according to Jewish halakha.”² Hence, for example, the same-religion limitation mentioned earlier. In addition, to avoid the infringement of incest prohibitions, surrogates must be women who are currently unmarried. As for the intended parents, the Law limits the option of surrogacy to married or legally paired heterosexual couples, and only the intended father’s sperm may be used in fertilization.

Not all legal limitations are religiously motivated, however. For example, in a bid to make it easier for surrogates to relinquish the babies they birth, the Law allows only gestational surrogacy, that is, a pregnancy conceived through in-vitro fertilization rather than through artificial insemination (“traditional surrogacy”). In addition, the surrogate must be raising at least one child of her own. On the part of the intended parents, surrogacy in Israel is restricted to couples with serious infertility problems. The intended mother must provide medical evidence that she has tried IVF at least eight to ten times, has repeatedly miscarried, suffers from prolonged infertility or the absence of a uterus, or that pregnancy poses a severe risk to her health (p. 16). In addition, although the process enjoys significant state coverage, the couple must be able to pay a good percentage of the costs.

Most significantly, the Law sets up an official committee (henceforth: the Committee) that must approve every...