Hi Betty–thank you so much for your perspective on the documentary and more. I especially appreciate your unique perspective on the issues surrounding surrogacy. I think there are still a lot of stigmas today surrounding infertility issues that may help lead to one of your points on the rising prices of healthcare. Though I am in no way an expert, I think that rarer diagnoses end up costing much more, and despite infertility being not as rare as we expect, it still costs those suffering from it thousands of dollars for just one kind of treatment. In regards to the documentary, you bring up a good point about how it is difficult to figure out who to blame for what happened. Each party was in part responsible for what occurred and the difficulties faced by the biological parents. Regulation is absolutely needed in this regard to avoid what happened in the documentary, but the question remains about what kind of regulations are needed. How are the contracts going to be drawn up so no one is being taken advantage of? Can we ensure the rights of the biological parents regardless of location? Culture also may pose a problem, because this process of surrogacy could be stigmatized depending on the dominant belief in the area, causing additional issues to be dealt with.
Hi Betty Frances! Thank you for your exceptional summary of the film as well as your vulnerability in your response. I appreciate in particular your honesty about your “clouded” view of the ethics surrounding gestational surrogacy, given that you are a product of it.
However, I want to affirm that the questions you pose are quite insightful. Additionally, you started from framing Aasia or the Switzers as victim and enemy, which I think the film itself does to some extent as well. But when reflecting on the ability to frame narratives, I am led to wonder about the relationship between framing and change. In some way, we do have to frame someone, or some community, as a victim so that we can create change. Does this mean that ethical debates over reproductive technology, for example, have to be framed in an us vs. them context?
The film did a fine job of giving both Aasia and the Switzers the airtime to give their two cents on the matter, including their emotions, concerns, and restraints. Individual interviews gave glimpses into not only their innermost thoughts, but also the larger ethical questions at hand.
In my own work within my IDS major, I do a lot of research on narratives. It has been scientifically proven that defining our story increases our self-efficacy, resilience, and confidence. When I think about this research in tandem with Aasia’s interviews, I wonder as to how she frames her narrative throughout this film. Her story, in many ways, was narrated for her by her impoverished conditions. But one could also argue the same about the Switzers and their view of their emotional poverty.
This was a great summary and analysis of the film, and even plus points for you adding your own backstory to highlight your own biases when assessing this situation. Anyway, this is a great look. In our lecture when we looked at this film, it seemed that no one really focused much on the fact that a surrogacy in the US is a whopping 70-100k. That is very important. I think something equally important that would be interesting to look at is the difference between low-income Americans who can not afford the expensive surrogacy of the US, versus Indian elites (or really elites of any other poor country which could be put on the international surrogacy market) and how they may be more well off than some American upper class even, but could stay domestic and have a surrogacy for much cheaper. Either way, there are structures around this system that raise serious ethical questions.
It is especially elevated when we are talking about someone’s body. Aasia basically let a couple rent one of her organs for 9 months (although it became 7) for what was a lot to her, but cheap to the couple. It is one thing if I rent out my house to someone and they could leave the house a mess and I do not get compensated much. But when it involves the body, the values associated can sometimes become seem to put a worth on different people. This must be reflected upon greatest as to ensure respect for all in these processes. I believe that your reflection touches on this perfectly. It i not a matter of if surrogacy should be around, but how it should be implemented-GREAT JOB:)!
Hi Betty Frances, thanks for your incredibly thoughtful and thought-provoking reflection on the film. It is always so interesting to see how these topics personally affect those around us and I very much appreciate you included your personal connection to the topic of surrogacy–it helps to remind us that we are not just discussing concepts, but concepts that are deeply personal and life-altering for many people. I found myself thinking less about the ethics of surrogacy itself, but much more about the exploitative nature that comes as a result of the unaffordability of fertility treatments in the U.S. Because of the economic dynamics involved with this global surrogacy transaction, that leaves impoverished women underpaid for their surrogacy services, I think that is where the real ethical conversation comes in. It is pretty clear that Aasia was exploited for her service here, but I do not think that is because surrogacy is exploitative in nature, but because of the economic and social power dynamics at play in these types of scenarios. Again, thank you for your very insightful reflection and I look forward to discussing more in class!
Hi Betty. Thank you for such a well-written summary of the film and for sharing so much about yourself. I find it really interesting that you note how your view of surrogacy is clouded. It made me think of my own personal anecdote—even though she was adopted by a (very loving) mom, and has said how her life is probably better here than it would’ve been in Korea, my mom has still expressed to me discomfort with adoption (specifically, I think, transnational adoption, which seems applicable in the case of this film.) In my research on transnational adoption, I’ve also found that there are many anti-adoption adoptees. Maybe this is kind of an absurd point of view, but I was really surprised to find that it’s out there. Just as we saw in the film, there’s maybe something different about transnational adoption or surrogacy versus “domestic” adoption or surrogacy, though maybe the transnational also magnifies issues of belonging and displacement that exist on a smaller level in the domestic.
Relatedly, I found it interesting that you discuss how the film portrays the power dynamic between Aasia and the Switzers. For me, what was uncomfortable about the film was not necessarily or centrally the surrogacy, but the relationship between the Switzers and Aasia, and (I think, as the film argues) by extension, America and India. I’m not quite sure what to say about this, only that it seems to have to do with issues of post-colonialism and empire that maybe extend beyond what we’ve talked about so far in this class—though of course these conversations have to be complicated, too.
Betty, thank you for your detailed, and well versed blog post. As you mentioned, the film adopts a positive perspective towards the whole surrogacy process suggesting that all parties involved had a “happily ever after”. However, I strongly do not believe that was the case. The obstacles undergone by all the parties involved suggests leaks in the system that should be address in order for it to be just. One of the most obvious obstacles, that stuck out to me because I believe it is a simple yet harmful discrepancy, is the fact that Lisa and Brian Switzer did not have a direct line of communication with Aasia due to cultural differences. The Switzers and Aasia did not share any common ground: they have different beliefs, speak different languages, and lead very different lives. Even though these discrepancies do not sound grave, they do cause a significant ethical dilemma. Lisa and Ben are involved in the surrogacy process because they desperately want a child of their own, while Aasia is involved due to a severe lack of money and a dire need to provide funds for her children. Therefore, both parties have their own separate motives that drive their desire to undergo the surrogacy process. In addition to their separate motives, the dissimilar cultures causes a disconnect between the 2 parties. No one involved really “cares” for the other. This lack of interest leads to further ethical issues as no party is truly being accounted for (no one has anyone’s best interests at heart, and wants to fight for a just process); whether it is the couple trying to get the child, the donor undergoing the pregnancy, or the actual organizers of said transaction. The point I am trying to get at is that the setup of the surrogacy service is already flawed, and there are already ethical concerns to begin with. After the process initiated, more setbacks presented themselves, like Aasias preterm labor and the birth certificate complications at the hospital. Not to mention the fact that none of the promises made by Planet Hospital, the organizers, were upheld. The Switzers had to present DNA testing in order to be able to take their children back to the US, Aasia was not fully informed of what could happen to her if she underwent the process of being a surrogate (like carrying twins), and, also, she did not receive the money she was promised (Aasia even asked the Switzers for money, which they agreed to give – although we don’t really know if they actually did). All the actions in this situation were out of the norm. Lisa and Brian sought to find a reproductive technology to assist them to have children of their own outside their home country due to lack of funds. In the meantime, a young, innocent Hindu mother had to undergo a body taxing experience of carrying the American family’s embryos in order to make a small amount of money to provide for her family. That is why surrogacy is such a delicate issue: it involves the creation and growth of a human life, while also putting another human life at risk. It is clear that the system in India for international surrogacy is flawed, and needs serious ethical norms and regulations to provide a more scrupulous process. The further questions I have regarding this situation are: “Do the ethical concerns observed in India also happen in other 3rd world countries?” “Is there really a way to set protocols in place to make surrogacy a problem-free process?” “Was Aasia abused by Planet Hospital because they misinformed her, or by Lisa and Brian who underwent an arguably “unnecessary” treatment to have children, putting her life at risk?” I hope we are able to address some of the questions in class and try to set up and ideal ethical system were surrogacy harms the least amount (hopefully none) of parties involved in the process.
Thanks so much for your great post and for your willingness to share your close personal experience with surrogacy!
I agree in that I do not think you should question the morality of the surrogacy process itself; your parents’ case of utilizing such a service when they could not carry you on their own is a perfectly reasonable option. With their clear willingness to abide by laws on the matter, it does not seem like there was any exploitation involved. I think the waters get much murkier, though, when the process is done like it was in the documentary.
Your question of how to make sure the process is ethical, to me, is answered simply by paying for the process in your home country. There is a reason for the very high price of surrogacy in the US; the medical care and administrative oversight required to carry a child, let alone someone else’s, is quite extensive. The large price tag ensures that the mother is getting adequate nutrition, medication, and attention, as well as facilitating all of the legal matters required in the process. To try to skirt around this is, in my opinion, very negligent to some very important factors in pursuit of the surrogacy being cheaper. And by going to another country to do so, it signals that the parents acknowledge all these factors and choose to find a surrogate mother who is likely unaware of all these factors due to her being from a poorer background.
Hi Betty, thanks so much for all your insightful analysis. Your discussion about the agreements signed between Planet Hospital and the biological parents and between the surrogate and the fertility clinic was particularly interesting to me. It does very much seem like the film framed issues with these contracts as not being a terribly huge issue in the long term and that all parties eventually were satisfied, even if there were issues along the way. The film did highlight the controversies in some ways, showing the difficulties the biological parents faced in trying to take their children home and showing Aasia trying to get the money she was promised. But it felt like the film could’ve gone farther in their analysis. They showed these issues as taking place over a period of at least a few days, but didn’t explain exactly how long it took to resolve. They showed some of the negotiations between parent and hospital and between Aaisa, the clinic, and the biological parents, but it felt like those were limited in scope. I would’ve appreciated if the film went further in depth on these struggles, rather than just focusing on the process as a whole. In response to your question about who bears the blame for these issues, I would personally say that it falls on both the Indian and United States government. Realistically, all of the people involved, Planet Hospital, and the clinic are all small parts in the wider healthcare and welfare systems in both countries. If the United States had more robust assistance for people struggling to become parents, perhaps similar to the system that exists in Israel, biological parents like Lisa and Brian may not have been forced to go abroad and use a system that is clearly beset by ethical issues. If the Indian government had more rigorous protections for surrogates and biological parents, then the surrogacy would, in all likelihood, have gone off without a hitch, and these problems wouldn’t exist. It’s clear to me that these two groups bear the most blame for this situation, and that the film would’ve been better served going further in depth about these issues, rather than following the process as a whole
Hi Betty, thank you for your thoughtful response to this week’s blog. I am so glad you felt comfortable sharing your personal connection to the topic with us. You bring up a really interesting question in your post – who is to blame? I think when we ask this question, the first thing to consider is what are we blaming someone for? Hypothetically, blame could be placed on many of the parties involved. The Switzer’s could be “blamed” for not pursuing adoption, the clinic could be blamed for not making sure Aasia was properly informed, etc. I think the question you are trying to get it is who should be blamed for what we deem the exploitative elements of this situation? You propose your question of blame rhetorically, and I agree with you – pointing fingers is not so simplistic here. However, I do believe the clinic could have done a better job making sure Aasia fully understood what her role as a surrogate entailed. This education piece would allow surrogates to make a more informed decision. Does this solve the problem of poor women renting out their bodies? No, but it does make sure that these women understand the process and potential impacts of doing so. You also say in your post, “we must rework aspects of these systems from the bottom up.” Was there a specific idea you had in mind? What do you think this would look like? As I mentioned before, better education for surrogates (and biological parents) is an element I believe must be reformed, but I am curious what else you have in mind. At the end of your post you discuss that the conversation should not be around “if” surrogacy should be allowed, but “how.” Surrogacy is going to happen whether or not it is allowed, so I think it is important we put better standards in place to make it more ethical and less exploitative.
Hello Betty! I think that your discussion of surrogacy in relation to the documentary that we watched does a great job of examining the issues of medical tourism. Though the response is applicable to this form of assisted reproductive technology, I feel that these concepts can be applied past surrogacy and into other elective forms of medical tourism (including plastic surgery and dentistry). What is most important to understand is that taking advantage of cheaper labor, materials, and environment comes with risks that some people are not aware of when the operation is hid behind a seemingly legitimate facade of an organization. The risks associated go beyond medical and into the legislative territory. It is more difficult to get legal help outside of the country, just as we saw with Lisa’s struggle to gain custody of her biological children. Additionally, the norms and values that are considered when undergoing something like this are not universal and are not yet regulated, making this entire journey incredibly dangerous, challenging, and exploitive. Though the documentary was willing to let us into both sides of the journey, I am sure that there are other stories and aspects that did not have as happy of an ending. That being said, the documentary left many of us with a bad feeling in our mouths after hearing that the story did not have a happy ending with one of the twins dying of sudden infant death syndrome. Your discussion on the second page was especially compelling – with something like child gestation, there are so many unpredictable factors that cannot be controlled, even by a “put-together” agency like Planet Hospital. Though there is science behind it, it is important to acknowledge that every human body is different, every pregnancy is different, and every situation is different with regard to the intended parents and surrogate. People like the Switzers fall into a false sense of comfort during the journey – perhaps it is because they are removed from the situation and thousands of miles away, or perhaps it is because they are leaving all decisions and care into the hands of external forces. Regardless, the convenience of their exploitation is jarring for many reasons. One of the reasons is that they feel they are the ones being altruistic in a sense, giving the surrogate mother a sense of wealth that she would have never encountered. This clouds their judgment as to whether or not what they are doing is truly exploitative. I am also curious about the role of Planet Hospital in exploiting both infertile couples like the Switzers and marginalized women globally.
I really enjoyed reading your summation of the documentary, as well as hearing about you and your parents’ experience with surrogacy. I think the question of surrogacy is a complicated one, and I understand how it would be even more complicated for you. My initial feelings are similar to yours– if the woman carrying the embryo is okay with it, why should it be an issue? However, I do have to think deeper into the cultural and financial factors that could influence a surrogacy decision. In my opinion, Aasia was exploited by Planet Hospital. At the same time, she was impoverished and desperately needed income, so why should she not be allowed to be a consenting surrogate? I think this ties in with your last statement– it’s not about if surrogacy should be legal, but instead how it should be legal. I think medical tourism is a slippery slope, and can often lead to the exploitation of people from other cultures. The best way to combat this, in the case of surrogacy, is for the healthcare system in the United States to improve and become more financially attainable for everyone.
Thank you for this great response! This is the first year that I have learned about surrogacy or met anyone that was a surrogate baby. It is not something that has been really talked about in my circles. Did you always feel so comfortable talking about it? Does anyone treat you differently when they find out?
I have discussed this in class before but my issues with this film came from the mitigating companies. I felt like they did not provide any type of support or services to the surrogate, and instead just took their money from the Americans. Their authority was clearly not very legit, as the babies could not be discharged into the Texan’s care. To me, the idea of using an Indian woman did not start out as exploitation because she did agree to the circumstances. It is interesting to me how people can say her body, her choice and then describe surrogacy as an exploitation of the womb. If she wants to do this, isn’t it her choice? I am not stating my personal opinions as much as I am just raising this question. It raises all the same questions as abortion in my mind- who gets to decide what happens to a woman’s body? What would make someone a good or bad parent?
Hi Betty! I thought it was unethical that the surrogacy brokerage firm, Planet Hospital, painted this process as an easy one. Even though they claimed to have many documents that would protect the Switzers and ensure that they would have their child, those documents meant nothing if hospitals, like the one Aasia gave birth at, did not follow those rules. I was shocked when those in charge at the hospital would not listen to Planet Hospital or the Switzers and claimed to have their own rules and regulations. They would not be influenced by what Planet Hospital had to say. To answer your question about who to blame, I think I would blame Planet Hospital. They did not seem prepared for this situation or have a backup plan. It seemed as thought the Switzers had to resolve the problem on their own. I was also confused on how Aasia did not receive original amount that she was told she would receive, even though there were signed documents as proof. I think to resolve these types of problems, surrogacy firms like Planet Hospital should make themselves more well known at near by hospitals to ensure that hospitals understand this concept. I also agree that we have to resolve this problem from the bottom up because these problems stem from bigger problems such as poverty and incredibly high surrogacy prices that give people no choice but to do this.
I really enjoyed your blog post from this week! I enjoyed reading your opinions following the film, “Made in India.” That film also influenced my opinions on surrogacy. My opinions on surrogacy change like the wind and I have a feeling that won’t stop since surrogacy is such as complicated, and due to recent technologies new and unique topic to address. I too, was very similar to you in the beginning, as I felt that surrogacy is completely ethical, nothing could be wrong with contract and regulation, and and anybody should be able to partake in it. However, during the last couple of years I have slowly changed my mind regarding surrogacy to a more restrictive perspective. A few qualms that made me rethink my original stance eon surrogacy was the obvious disparity between surrogate mother and surrogate parents. However, the film did make me rethink this. A lot of critics complain that surrogacy will create a world similar to the handmaids tale where rich and upperclass women will stop carrying children and just hire women to do it. I can also see this being a future thing. If you see the Kardashians, they have also been known for using surrogacy to carry their children. However, in the film, the Swishers were a normal middle class family, who struggled with infertility. That made me realize that not only do people with he money for surrogacy, such as higher income individuals, but also average income people. Another interesting perspective that critics have brought up is the this concept called the primal wound. The primal wound is based on a book by Nancy Newton Verrier. She addresses that a child in utero has an innate connection to their mother and when this bond is broken, it causes a trauma that can manifest as insecurity, abandonment, and longing in children where this bond has been broken so primarily in surrogate and adopted children. After hearing these critiques, I did switch mindset to be more critical of surrogacy and the film, “Made in India” didn’t help. I still have mixed feelings on surrogacy, but in the end, if the surrogate mother is safe and happy, as long as the child, and biological parents then that is basis for a great process.
Hi Betty, thank you for sharing your experience. Since I’m posting pretty late I’m going to reiterate what I said in class. I thought your perspective on the dynamic between the couple and the surrogate is interesting and made me more sympathetic toward couples who choose surrogacy tourism. Both the couple and the surrogate were in an economic position that led them to seek out less-than-ideal arrangements to accomplish their goals. Their desperation united them. We talked in class about how in ethnography it is difficult to cover both sides of a situation, but in a certain way, the Switzers and Aasia are on the same side while Planet Hospital and the government are on the other side. Though I agree with you that the situation depicted in the film should be avoided in the future by either providing better protection and information to the surrogate or by reducing the cost of domestic surrogacy.
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