Read more about surrogacy.

The rising trend of global surrogacy and the troubling implications leaves one to consider how the idea of outsourcing pregnancy to poor women in nations like India, Eastern Europe, and Guatemala is perceived by ordinary Americans. When one considers the fact that the countries where the practice is taking off have infamous reputations for human trafficking, the practice is not without complications. It is important to begin careful discourse and policy planning for regulation.

We must begin with looking back when surrogacy first emerged as a concept, it was pitched as a technological solution to infertility. However, the press followed the famous “Baby M” case in which custody of the child in question was fought over in the courtroom when the surrogate mother changed her mind about the original contract. Between this sensationalized story and the fact that surrogacy can cost from $50,000 upwards, it has not been a strategy used en masse by middle class individuals or couples.

However, Oprah Winfrey presented global surrogacy as a promising practice, spotlighting a US family that had successfully obtained their infant through medical tourism in India.  The Oprah factor inevitably raised the general consciousness about using a woman/surrogate in developing nations to carry out the pregnancy and it was potentially a catalyst moment—marketing the idea as an extraordinary opportunity and win-win for all involved.

Unfortunately, Oprah’s discourse did not include the complexity and intersections of the social realities involved, especially the reality of poor and vulnerable women. Oprah failed to explore ideas of informed consent or if women living in oppressive conditions of poverty can even make such consent when enticed with money. And, one has to wonder if Oprah is aware of the fact that women who act as global surrogates often live under lock and key while pregnant—in pregnancy camps of sorts—and they face shame and stigma in their home communities. Pande (2009) interviewed surrogate mothers in India and identified the practice as “dirty work” and found that the technology is not truly understood by most people, including the surrogate mothers themselves.

Oprah also failed to acknowledge that many surrogate mothers in India deliver children by C-Section. This medical procedure is not carried out without significant risks, especially from infection in the short term. In the long term, it creates problems for women in subsequent pregnancies—especially natural delivery of future babies. Take that fact and think about the average Indian and poor surrogate mother who will not have such easy access to future C-section care due to poverty. Who knows how many women have suffered the fate of significant health problems and even death in India after they deliver their surrogate babies. Of course, nobody is counting because at the end of the day poor women die in developing nations every day from reproductive health problems—and now surrogacy will further complicate this unfortunate reality.

Without a doubt, Oprah Winfrey has been a champion of women and the rights of women and children—shining the light on sexual abuse and other issues, often confronting stigma. She has also been an important voice in development of opportunity for women, a symbol of success herself. She has committed to girl’s education in Africa and her generosity runs deep, taking interest in the young women attending her school in South Africa. However, on surrogacy she got it wrong. I have a fantasized idea that she may actually reconsider her position and document the other side of the story with careful attention to women in developing nations and the aforementioned complexities. This could be a good documentary for her new television network.  Then, the Oprah Factor can be used to truly explore the issue, from all sides, and help move along the discourse about the need for international regulation to insure prevention of human rights abuses in the emergent global surrogacy marketplace.