By Jennifer Lahl, originally published on National Review.
I have lost count of the number of celebrities hiring women to gestate their babies.
Elton John and David Furnish set the trend ten years ago and the list just keeps growing: Kim Kardashian and Kanye West; Sarah Jessica Parker and Matthew Broderick; Jimmy Fallon and Nancy Juvonen; Nicole Kidman and Keith Urban. More recently, Andy Cohen and Anderson Cooper became single dads via “third party conception,” meaning they purchased eggs from one woman and rented the womb of another. This arrangement also constitutes “gestational surrogacy,” where a woman enters into a contract, most often for money, to carry a non-genetically related child for another couple or a single person.
Now Amy Schumer, talking about her pregnancy complications, is considering using a surrogate to have her next child. In her HBO documentary, Expecting Amy, her friend Christy Turlington Burns talks about wanting to have another baby, at which Amy exclaims, “Great! I’m looking for a surrogate, because I’m never doing [pregnancy] again.” Schumer suffered from hyperemesis gravidarum during her pregnancy with her now 14-month-old son Gene. While morning sickness is common in pregnant women, hyperemesis gravidarum is much less common and presents as severe nausea, vomiting, weight loss, and dehydration. Women often need to be hospitalized, as in Schumer’s case. Because the risk is high of having this condition in subsequent pregnancies, it appears Amy is thinking about outsourcing her next pregnancy. Time magazine once listed pregnancy as No. 1 in their list of “top 10 chores” to outsource.
Flicking through these headlines while standing in line at the grocery store, many might think that surrogate mothers have undertaken an amazing act of service. However, if you scratch below the gloss of People magazine, you will learn about the serious health risks to women who carry babies for others, as well as the serious risks to the children they give birth to.
Let’s start with the maternal-morbidity and -mortality rates in the U.S. Morbidity trends in the U.S. have been increasing for years. Per the Centers for Disease Control website, the most recent report shows that severe maternal morbidity has increased by almost 200 percent, from 49.5 percent in 1993 to 144.0 percent in 2014. Pre-eclampsia is one of the leading causes of maternal morbidity and mortality worldwide. The U.S. maternal-mortality rate has also been steadily rising. In fact, the U.S. is the only developed country where maternal mortality is on the rise. As the authors of a recent Harvard Business Review report note: “Over 700 women die of complications related to pregnancy each year in the USA, and two-thirds of those deaths are preventable,” “black women in the USA are three to four times more likely to die in childbirth than white women — regardless of education, income, or any other socio-economic factors,” and an additional 50,000 American women suffer from life-threatening complications of pregnancy according to the CDC.
Now let’s extrapolate this data to the pregnancy of a surrogate mother. Fertility and Sterility, a leading fertility medical journal, published a 2017 study comparing “perinatal outcomes after natural conception versus in vitro fertilization (IVF) in gestational surrogates.” Significantly, the study compared a woman’s own pregnancy with her gestational surrogate pregnancy and found that:
Neonates born from commissioned embryos and carried by gestational surrogates have increased adverse perinatal outcomes, including preterm birth, low birth weight, hypertension, maternal gestational diabetes, and placenta previa, compared with singletons conceived spontaneously and carried by the same woman.
Dr. Allen Merritt, a perinatologist at Loma Linda Medical Center in California, published a snapshot of the medical outcomes of surrogate deliveries at Loma Linda in 2012-2013 and found that of 69 infants delivered from surrogates, there was an increase in multiple births, NICU admissions, and longer hospital stays which added to hospital charges. In fact, in the case of surrogate mothers who gave birth to a single baby or twins, hospital charges increased 26 times, and in triplet births, hospital charges increased 173 times. Of course, these increased lengths of stay in the hospital and spiked costs were all because these women were in a high-risk pregnancy category, putting their health and the health of the unborn babies at risk.
The profound consequences of this data are illustrated in the news of surrogate mothers who have died in the U.S. Brooke Brown of Boise, Idaho died in 2015 of pregnancy related complications. The twins she was carrying for a couple in Spain (where all surrogacy is illegal) died too. Crystal Wilhite, a young mother of two in Southern California, also died of complications of her surrogate pregnancy in 2017. And just this year, Michelle Reaves, also a young mother of two, in San Diego, Calif., died from pregnancy-related complications. This was her second surrogate pregnancy for a couple she had already had a baby for
Knowing the bleak maternal-morbidity and -mortality rates in the U.S., and adding to that the high-risk nature of a surrogate pregnancy, why would Ms. Schumer, or anyone else for that matter, want to put a young mother’s life at risk?
Jennifer Lahl is the Founder and President of the Center for Bioethics and Culture in the US.