Unit 10: Molly Nestor

This week we read ‘Knowing’ the Surrogate Body in Israel by Elly Teman and Gestational Surrogacy in Iran: Uterine Kinship in Shia Thought and Practice by Shirin Garmaroudi Naef. Through interviews and participant observation field work, both ethnographic works take a look at surrogacy and its place in Israeli and Shia cultures, respectively.

The goal of Elly Teman’s work is to analyze surrogacy as a “cultural anomaly” in Israel and how it has made its own place in Israel’s pronatalist society.  She uses the concept of ‘authoritative knowledge’ to convey how “surrogates, intended mothers, and health professionals attempt to solve the anomaly of surrogacy in practice” (263). Through intuitive, medical, and technological knowledge, Teman provides insight on the surrogacy process women experience in Israel. Intuitive knowledge refers to the situation in which the intended mother ‘knows’ the pregnant body of the surrogate, providing a way for the intended mother to claim maternity. Statements from both surrogates and intended mothers mention how each woman knew she had chosen the ‘right woman’ to go through this process with her as soon as the women had met. This intuitive knowledge also served to minimize the connection between the surrogate and baby while emphasizing the intended mother’s ‘meant to be’ relationship with the unborn child through an equal partnership in the pregnancy.

Teman uses ultrasound experiences to convey another way in which surrogates extract themselves from the pregnancy and allow the intended mothers to go through the pregnancy experience as if they were pregnant. During ultrasound screenings, the surrogate “symbolically becomes a silent participant, a transparent medium,” allowing intended mothers to view the fetus as an “individual entity, alone on the screen, as if removed from the surrogate’s body” (268). Doctors and ultrasound technicians would address the intended mother and father during the screenings, reemphasizing the removal of the surrogate from the situation, both emotionally and physically, while simultaneously allowing the intended parents to feel more connected to the pregnancy process.

Doctors and other medical practioners play an important role in the surrogacy process through their “effort to designate the intended mother’s status” by addressing her as “the mother” and directing all medical knowledge to her instead of the surrogate patient (271). Along with the equal partnership between the two women, medical practioners work to create a unitary patient construction, treating the intended mother the same way they would the surrogate, providing her with all the same care. The concept of a ‘hybrid patient’ address the abnormalities that surrogacy presents (i.e. having two separate patients) and allows for normal practices to ensue after birth.

The 3 different forms of knowledge confirm the intended mother’s maternal identity and serve to “confirm, rather than challenge, the Jewish-Israeli cultural belief system” (276). I found the emphasis of an equal partnership between the surrogate and intended mother to be a very interesting experience. Also, the emphasis from the doctors and medical staff of the intended mother’s maternal identity played a very important role throughout the process, a role that I  was previously unaware of.

Questions:

• Do you think Teman’s analysis effectively addresses the “anomaly” of surrogacy in a pronatalist society such as Israel?
• Do you think all societies should promote an equal partnership approach between the intended mother and surrogate? Does this help surrogacy fit a more culturally norm framework of pregnancy?
• What type of relationship should exist between a surrogate woman and the child that is born? Should such a relationship exist at all?

In our second reading, Shirin Garmaroudi Naef explored surrogacy in Shia thought and practice and the relationships established through surrogacy and uterine kinship. Through analysis of Islamic legal texts, consultations with Shia scholars, and ethnographic field research, Naef attempts to “show how juridical meaning ascribed to physiological facts and bodily substances. . . leaves room for the legal permissibility of gestational surrogacy” (160).

In the first part of her chapter, Naef mentions that the “notions of contact and transfer of bodily substances has become an approach for studying kinship and assisted reproduction in Muslim societies” (161). Naef argues that the definition of incest in Shia thought does not depend on the transfer or contact of bodily substances, but rather on, “the illegitimate physical act of illicit sexual intercourse, and not on the act of conception itself” (163). With this notion of kinship relation, she conveys why and how Shia thought and practice define surrogacy and assisted reproduction as acceptable.

Naef emphasizes the distinction between directly inserting sperm into a female surrogate’s uterus and implanting an embryo into the surrogate’s uterus, citing it as a reason as to why sperm donation is not entirely forbidden. While it is forbidden in Sunni Islam, Shia scholars argue that, although it is not allowed, fertilization of a women’s egg with donor sperm from a man other than her husband is not analogous to zina (Islamic law concerning unlawful sexual intercourse). Shia authorities authorize such insemination in a lab dish which may then be implanted into the wife’s uterus because, since the sperm is not inserted directly into the wife’s uterus, no forbidden act has taken place. From this, traditional surrogacy is not religiously permissible according to most scholars, but gestational surrogacy is viewed as an acceptable form of assisted reproduction because fertilization takes place outside of the woman’s uterus. Also, this translates into the donation of gametes and embryos. Since the fertilization takes place outside of the woman’s uterus, it is not considered zina and the resulting child is considered legitimate. Thus, embryo transfer and gestational surrogacy are not forbidden according to Shia Islam.

Another distinction made between Sunni and Shia thought is maternal relatedness. Shia jurisprudence “recognizes a bilateral filiation in which maternal filiation acquires the same importance as paternal” (166). Because of this, females play an important role in producing and contributing to the line of descent of a child through ties of uterine kinship. Shia scholars argue maternity is established at conception and, in the case of egg donation or gestational surrogacy, regard the mother as the producer of the ovum. Because of this, a child conceived through gestational surrogacy is not considered to be related to the gestational mother or her family in any way. Likewise, the father is considered to be the man who produces and provides the sperm.

Naef also looks at the issue of breastfeeding and the important position it holds in Islamic legal tradition. According to Islamic customs, the milk bond, “establishes [a] permanent legal realtion[ship] between the child and the milk mother” as well as all members of the milk mother’s kin (173-174). The Shia position on milk kinship states that “kinship relations created by the ‘act’ (and not ‘milk’ as substance, my emphasis) of suckling is equivalent to kinship relations created by nasab” (174). However, according to the viewpoint of Ayatollah Mo’men, a prominent Shia scholar, gestational surrogacy should not be analogous to milk kinship because gestational surrogacy, “does not establish any filiation (nasab) and marriage prohibition (mahramiyat) between the children conceived in this way and the surrogate” (174-175).

The final parts of Naef’s chapter look at the experience of Iranian gestational surrogates and what they think of their experience. While many of the women she interviewed had financial incentives to partake in surrogacy, many of the women also expressed emotional reasons for surrogacy, in order to help friends or family. In both instances, “both groups emphasized the altruistic aspect of the process, helping a woman to become a mother as well as preventing a marriage from falling apart because of infertility” (176). In the end, all women believe that the resulting child does not belong to them, the gestational surrogate, but the contributors of the embryo, the “true parents.” As previously mentioned, no women considered this to be adultery because, according to the Shia notion of adultery, it is only established by the social and physical act of illicit sexual intercourse,” not the biological act, which was an important distinction to be made for many of the women. Also, many women acted as surrogates for siblings who were unable to conceive on their own because they believed it to be better than involving a complete stranger. This wasn’t considered incest because it violated no social or physical illicit act.

One of Naef’s main findings was how surrogates used the language of kinship to “disconnect themselves from the experience of surrogate pregnancy,” while also maintaining “the social order in dealing with infertility” (181-182). She also found throughout her fieldwork that, even in the presence of assisted reproductive technologies, God was still considered to be the divine creator of human life. An important conclusion made by Naef was the importance of women in the establishment of nasab as well as the important place they held in the establishment of kinship ties. Naef showed how Shia scholars applied ancient religious and legal texts to challenge the bioethical dilemmas presented by surrogacy in Iran (183).

Questions:

• As mentioned in the chapter, is motherhood a biological or legal determination? Does giving birth to a child entitle the person to motherhood?
• Do you think having your sibling as a surrogate is considered incest? Or do you agree with the Shia definition of incest, in which having your sibling as a surrogate does not violate the realm of incest?
• Can surrogacy be a truly altruistic act?