This is the first in a three-part series of articles on the global surrogacy trade.

UPDATE: Subsequent to the publication of this article, MLJ , a firm cited below, changed their website to delete any reference to Mark Reder’s expertise in “surrogacy arrangements,” text originally cited in this piece.   This change occurred roughly 72 hours after publication.

Since the turn of the Millennium, approximately 200,000 children have been adopted from abroad by U.S. families. Success stories include positive outcomes for children who make significant developmental gains as compared to children left behind in institutions in their home countries. However, one down-side has been what some call a “baby trade” in which some adopting families have paid at least $25,000 and upwards to $50,000 to be matched with very young and healthy children.

The most alarming and systematic problems in recent times were in Guatemala. While there were legitimate adoptions, especially of older children, it is believed that payments to birth mothers for their infants became routine. It was estimated that at the peak of this practice, Guatemala sent 17 children a day to other countries as inter-country adoptees. Under these conditions, the demand for infants became such that Claudia Rivera, a child rights advocate, asserts that “children were manufactured” in the nation to supply the system. Another Guatemalan women’s health advocate, speaking on the grounds of anonymity about her assistance to sex workers, underscored the contribution of inter-country adoption pressures to the grave situation of human trafficking in the nation.

She recounted the experience of a 17-year old girl who was sold by her parents into prostitution; when she later became pregnant, her infant was sold into inter-country adoption. That particular child most likely lives in the United States today as an adoptee.

Coercive child relinquishments are also a problem in an environment of extreme poverty where there is no attempt to provide the birth mother with counseling to insure informed consent and to protect her basic rights. In Guatemala there have been allegations of child theft to supply the adoption industry and today several kidnapping cases remain unresolved. During a recent US speaker’s tour on violence against women, Guatemalan human rights defender Norma Cruz recently reminded audiences that this form of child kidnapping is the cruelest kind of violence against a mother, describing the experience as an “eternal suffering.”

Cruz’s advocacy efforts include legal actions on behalf of women who have experienced this pain and she has been seeking international legal resolution without satisfaction. Cruz further underscored that these alleged kidnapping crimes took place in an environment already characterized by the highest rate of violence against women in the Western Hemisphere and, as such, seeking legal advocacy to exercise rights is a dangerous act in and of itself.

In response to concerns for child sales and theft, a new era of reform has been underway in both Guatemala and the United States, in accordance with the Hague Convention on Intercountry Adoption. Both nations, along with over 70 other countries, have ratified the international agreement which was developed to prevent child sales and theft and ultimately promote the best interests of the child. Practically speaking, the Convention has cooled the international adoption industry with regulations that set forth standards for agencies to act with financial transparency and improved child placement practices, and with obligations to prevent child sales and theft. This is a tall order in sending nations where bribery, corruption, and human trafficking are known problems. Still, for those concerned about adoption practices and ethics, this has been an important step forward in curbing abuses and raising standards of care.

With this new system, combined with problems like the recent adoption scandals in Russia and other nations, inter-country adoption has undergone radical decline and it is no longer the opportunity it once was for building families.  In the US, the practice peaked in 2004 with 22,990 children sent to the nation as adoptees as compared to only 12,753 in 2009.

As adoption has become more difficult, the global surrogacy industry has begun to surge to meet the fertility demands of individuals and couples seeking to secure healthy infants.

A handful of adoption agencies and service providers with prior significant interests in Guatemala have been shifting to meet this need. For example, attorney Mark Reder of MLJ Adoptions based in Indianapolis boasts international surrogacy as a practice area of expertise, calling the activity “surrogacy arrangements.” Because Guatemala is recognized by the UN to have the greatest gender inequality in the Western hemisphere and the nation has no regulatory laws on surrogacy, “expertise” on such matters is more about the how to, where to, and with which vulnerable woman to contract the service. In the current environment, the information and service that will be offered will undoubtedly be tailored to meet the needs of those who have the privilege to pay for surrogacy.  One has to wonder how information will be imparted to Guatemalan women who may well be illiterate and lack the legal savvy to truly understand the contracts they will be required to sign.

Armed with information from his agency’s previous adoption work in the nation, Reder has the knowledge and networks to be well-positioned in this emerging market. North American and European families are now looking to him and other entrepreneurs to supply healthy infants but at the societal level, there is no real discourse about the inherent ethical dilemmas and human rights concerns involved.

Desperately poor, Guatemalan women will inevitably find themselves being offered an opportunity to earn a wage to birth a baby in this dollar-a-day nation—not unlike previous underground adoption activities. The financial payment for surrogacy in Guatemala is unclear, but inter-country adoption experts estimate that some women earned approximately $1,500 for child-relinquishment signatures in the old adoption system, which amounts to just over $5 a day for a normal 280 day gestational period. For a woman of privilege in the United States looking for fertility alternatives, this is a bargain-basement price, but extreme poverty is the only reason why any Guatemalan woman would agree to such an arrangement. It is a reminder to all of us that poverty is coercive and the fertility choices that are made, on both sides of the global surrogacy arrangement equation, will be determined by both economic opportunity and oppression. 

Those developing surrogacy services in this desperately poor nation should take caution as they pioneer in this area of global fertility practice. As a business model, they are stepping into a grey area of human rights which will challenge us all to consider what is right and wrong and how far to take the privilege of purchasing power. Developing an expanded or more precise definition of human trafficking and a new area of regulatory control will become important considerations in this next wave of the global baby business.

It should be noted that very little is currently known about the exact nature of Guatemalan surrogacy services and the mechanics of such arrangements–how women get impregnated, by whose sperm and with whose eggs and so on. However, in a follow-up report by Dr. Nicole Bromfield, the case of surrogacy in India will be investigated, shedding light on these practices elsewhere.