A Tale of Two Surrogates

Zsuzsa Berend (PhD in Sociology, Columbia University) teaches courses on economic sociology and the sociology departmental honors thesis seminar at the University of California, Los Angeles. For over a decade, she did ethnographic research on an online surrogacy support forum and published on surrogacy-related topics leading sociological and anthropological journals, including Medical Anthropology, Sociological Forum, and American Anthropologist. Her book, The Online World of Surrogacy, was published by Berghahn Books in 2016.

Zsuzsa Berend presents a methodologically innovative ethnography of SurroMomsOnline.com, the largest surrogacy support website in the United States. Surrogates' views emerge from the stories, debates, and discussions that unfold online. The Online World of Surrogacy documents these collective meaning-making practices and explores their practical, emotional, and moral implications. In doing so, the book works through themes of interest across the social sciences, including definitions of parenthood, the symbolic role of money, reproductive loss, altruism, and the moral valuation of relationships.

 

"Berend's insights here both contribute to and are consistent with the newer school of thought in economic sociology that views economic relations as socially embedded… Her work fills a crucial oversight in sociological knowledge about surrogacy and the connections between economic and personal relations…Scholars from diverse backgrounds will likely find this a useful and intriguing read." -- Contemporary Sociology

 

 

Link to purchase The Online World of Surrogacy on Amazon

• Berend, Zsuzsa. "The romance of surrogacy." Sociological forum. Vol. 27. No. 4. Oxford, UK: Blackwell Publishing Ltd, 2012.

 This article seeks to demonstrate and analyze the cultural and emotional work surrogate mothers collectively engage in on the largest surrogacy support website, http://www.surromomsonline.com. Surrogate mothers' online stories and discussions frame contract surrogacy as a "labor of love." Women often describe their surrogacy as a "journey" of shared love; they hope for a lasting relationship with the couple they carry for. This article explores how the language of love, learned and internalized through online communication with other surrogates, creates both a cultural conceptualization of surrogacy and a ground for action. Love and altruistic giving are consistent with close interpersonal rather than market relationships; surrogates hope for a long-term friendship with their couple. Surrogacy journeys, however, not infrequently end in disappointment; surrogates feel betrayed when couples cut ties. As a result of collective learning, surrogates' discussions increasingly articulate the position that love, even when unreciprocated, can lead to repeated giving; love is noble and ennobling. Surrogates find appreciation and support in their online surrogacy community where they agree that giving life is a moral good. This stance has contributed to a renewed enthusiasm to bear children for others.

 Keywords: assisted reproduction; love; motherhood; online communication; online support; surrogacy

 Link to full text of the romance of surrogacy

 

• Berend, Zsuzsa. "Surrogate losses: understandings of pregnancy loss and assisted reproduction among surrogate mothers." Medical anthropology quarterly 24.2 (2010): 240-262.

I explore surrogate mothers' narrative construction of pregnancy loss on surrogacy support websites. Communicating via the Internet, women construct the public online world of surrogacy. Drawing on anthropological and sociological literature I investigate the connections between conceptualizations of loss and understandings of technological practices and the consequences of these understandings for assisted reproduction. Surrogate mothers define loss broadly, ranging from failure to conceive to miscarriage and stillbirth; loss means the failure to give a baby to the intended parents. Assisted reproductive technologies contribute to loss by raising expectations of success, by attempting to maximize results through the transfer of multiple fertilized ova, and by early monitoring and testing. However, surrogates collectively understand technology as a positive force and advocate for reproductive technology. Surrogates' resolve to "give the gift of life" makes them vulnerable to failure and loss, yet also informs repeated efforts to bear children for others with technological assistance.

  Keywords: surrogate mothers, pregnancy loss, reproductive technology, communication technology

  Link to full text of surrogate losses

 

• Berend, Zsuzsa. "The social context for surrogates' motivations and satisfaction." Reproductive BioMedicine Online 29.4 (2014): 399-401.

 This Commentary takes up two of the main findings by Imrie and Jadva's study, namely surrogates' satisfaction with the post-surrogacy contact with intended parents and their motivation for surrogacy. It argues that the findings are in keeping with other qualitative research on surrogacy and that this similarity is not the result of the similarity of surrogates' psychological makeup. The Commentary highlights the centrality of social meanings and definitions, and following Howard Becker, insists on taking into account the collective doings that inform and shape individual feelings and behaviour.

 Keywords: expectations, motives, relationship, surrogacy

 Link to full text on surrogates' motivations

 

• Berend, Zsuzsa. ""We Are All Carrying Someone Else's Child!": Relatedness and Relationships in Third‐Party Reproduction." American Anthropologist 118.1 (2016): 24-36.

 In this article, I explore surrogates' rich, diverse, and collective negotiations of relatedness and relationships on the largest U.S. surrogacy support website. Surrogates reconfigure existing kinship understandings and maintain that intent and love are firmer bases of parenthood than biogenetic connection. Increasing use of donor gametes contributes to the emphasis on desire to be parents. In gestational surrogacy, genetic relatedness between the child and the intended parents strengthens claim to parenthood but lack thereof does not call parenthood into question. Traditional surrogates' biogenetic connection to the child they carry is never considered to be grounds for claims to motherhood. Surrogates and intended parents "do kinship" and consider the actions of kinship more consequential that its biological facts. In their accounts, desire for children is "natural" and the choice to raise them is understood as morally positive. Genetic facts, however, are understood as morally neutral. Surrogates and intended parents contend that surrogate babies belong to the parents who want them. Surrogates' emphasis on chosen solidarity works to diminish the importance of genetic relatedness and helps them uphold the traditional boundaries of their own nuclear family and that of the intended parents.

Keywords: kinship, assisted reproduction, U.S. surrogacy, family

 Link to full text of article on surrogacy relatedness and relationships

 

• Berend, Zsuzsa. "'Surrogates All Make that Choice to Help': Surrogacy in the Neoliberal Reproductive Market." Italian Sociological Review 10.3 (2020): 537A-559.

Recent scholarships on neoliberal practices document how, in varied settings, people who would benefit from regulation embrace the neoliberal logic. Drawing on ethnographic research on the largest US online surrogacy support forum I explore surrogates' discussions of choices and responsibilities. Surrogates maintain that infertile couples, whom they see as emotionally vulnerable, have no choice but to turn to surrogacy. Surrogates claim to be well-informed, intelligent, independent, and empathic woman who assume responsibility for the legal, relational, and medical aspects of pregnancy and reject standardization of 'surrogacy journeys'. They want more oversight of fertility clinics and surrogacy agencies but ultimately argue for individual accountability. Surrogates' discussions provide insights into the reasons why practitioners are, in many ways, in alignment with neoliberal ideas and practices: because they are compatible with collective definition of surrogacy as a private rather than a business relationship.

Keywords: neoliberalism, assisted reproduction, online communication

Link to full text on surrogacy and neoliberalism

 

• Berend, Zsuzsa. "Surrogate losses: failed conception and pregnancy loss among american surrogate mothers." Understanding Reproductive Loss. Routledge, 2016. 93-104.

Surrogates talk of pregnancy loss as a painful and traumatic experience even though they emphatically disclaim any attachment to the foetus they carry. There are no available statistics of surrogate miscarriages and stillbirths, or on the effects of the extensive medication many surrogates take, on reproductive outcomes or long-term health of surrogates. This chapter explores cyber-ethnography as a research method because the Internet is central to the recent flourishing of American surrogacy. The medicalisation of pregnancy and advances in reproductive technologies, together with a range of sociopolitical developments, has led to a new public elaboration of the personhood of the wished-for child. Emotional loss is sometimes aggravated by lack of financial compensation. In the case of reproductive loss, the loss of attention is accompanied by additional complex feelings. The relationship between couple, surrogate, and foetus magnifies loss; failure to conceive or carry a pregnancy to term means failure to deliver the promised gift.

 

• Berend, Zsuzsa, and Corinna Sabrina Guerzoni. "Reshaping relatedness? The case of US surrogacy." Antropologia 6.2 NS (2019): 83-100.

This article compares three different research projects on US surrogacy, covering a period of about fifteen years. We will reconsider processes scholars call kinning (Howell 2006) and de-kinning (Fonseca 2011) as we aim to capture notions about relationships outside of binaries and standard kinship categories. We set out to answer the following question: how and for what purposes do surrogates evoke kinship categories when they do, and what does it mean when they do not? Our findings show that surrogates do not imply that there is actual kinship created through surrogacy, nor do they imply that pregnancy and birth create kinship. On the contrary, they reaffirm the boundaries of the two nuclear families, theirs and the intended parents (IPs).

Keywords: US Surrogacy, Motherhood, Kinship, Relationship, Friendship

Link to full article on US surrogacy and relatedness

 

• Berend, Zsuzsa. "Two families helping each other: Children's books and surrogates' discussions about surrogacy." Reproductive Biomedicine & Society Online 7 (2018): 80.

The three most recent children's books about surrogacy, A Turtle's Tale, Sophia's Broken Crayons, and Grown in Another Garden, depict couples without children as sad and surrogacy as a kind, helpful act that makes "the sadness go away". A Turtle's Tale, for example, is characterized as "a heartwarming tale of love and family". Love and family, empathy and altruism are indeed central themes in all three books. In this essay I discuss the three books, written by women who are themselves surrogates, in the context of critics' evaluation of surrogacy, on the one hand, and my ethnographic research of surrogates' debates about practices and meanings on the largest public moderated online surrogacy support forum, www.surromomsonline.com (SMO), on the other.

Link to full text of review of children's books about surrogacy

 

• Berend, Z. and Guerzoni, C. (2019) "US surrogacy: An interview with Zsuzsa Berend", Archivio Anuac, 8(2), pp. 255-263.

This paper is a partial transcription of a long conversation between the sociologist Zsuzsa Berend (University of California, Los Angeles) and the anthropologist Corinna Sabrina Guerzoni (Western Fertility Institute, Los Angeles) on US surrogacy. It is the outcome of an interview occurred on 6th October 2017 in Los Angeles, transcribed and revised by both the authors. The text analyzes some fundamental concepts that Berend explored in her book The Online World of Surrogacy (2016) and offers some food for thought to read the US commercial surrogacy with other lenses. Berend's study offers an in-depth analysis of compensated surrogacy in the US and unique perspective for a better understanding of the experiences and points of view of the women directly involved in this assisted reproductive practice.

Link to full text of interview with Zsuzsa Berend

 

• Berend, Zsuzsa. 2018.  Ethnographic Fieldwork Online: Studying a Surrogacy Support Forum. Sage Research Methods Cases Part 2.

This case discusses the ethnographic challenges that the increased prominence of online interactions represents. Sociologists need to reflect on the nature of online forums and adjust their methodology if they want to understand new forms of social interactions. In my own work, I took up this challenge by exploring an online surrogacy support and information forum, www.surromomonline.com, as my fieldsite. I spent a decade immersed in this online world, reading discussion threads on numerous sub-forums in which women discussed a wide range of topics, such as relationship with their couple, contract negotiations, embryo transfer practices, termination of pregnancy, and even non-surrogacy issues, including family, work, news, and more. I also contacted surrogates by posting on the forum; their responses helped me understand www.surromomonline.com discussions and stances more accurately. I found that understanding the history and context of online discussions is important for comprehending the meanings people create together. Treating discussion threads, rather than individual posts, as the unit of analysis helps provide context for understanding data from online forums. Much as in physical life, meanings inform actions, and people never construct meanings alone. Long-term immersion in www.surromomonline.com enabled me to see change over time; surrogates modified and renegotiated previous conceptualizations and notions. Looking for negative cases is just as important in analyzing online data as it is in any other ethnographic work. This case exemplifies the implementation of the interactionist insight that feelings, practices, and meanings are formulated collectively in interactions even in the context of online forums.

Link to article on surrogacy methodology

 

• Teman, Elly, & Berend, Zsuzsa. 2022. Individual responsibility or trust in the state: A comparison of surrogates' legal consciousness. International Journal of Comparative Sociology, 63(5-6), 265-284.

 Drawing on ethnographic research in the United States and Israel, two countries that have long-term experience with surrogacy, we compare surrogates' understanding of, approaches to, and expectations about regulation. Women who become surrogates in these two countries hold opposite views about regulation. US surrogates formulate their rejection of standardized regulation—including standardized screening and contracts—by emphasizing their own responsibility for the legal, relational, and medical aspects of surrogate pregnancy. They want more oversight of fertility clinics and surrogacy agencies but ultimately argue for individual accountability. Israeli surrogates, conversely, support centralized government regulation of the practice and even defend Israel's centralized regulation of surrogacy; many advocate for the extension of the law and the state to assume more responsibility for these arrangements. We discuss these differing formations of legal consciousness in terms of Engel's conceptualization of "individualism emphasizing personal responsibility" versus "rights-oriented individualism."

Keywords: Comparative ethnography, neoliberalism, contracts, legal consciousness, regulation, surrogacy

 Link to full text of our comparative article of surrogates' legal consciousness 

 

• Teman, Elly, and Zsuzsa Berend. 2021. "Surrogacy as a family project: How surrogates articulate familial identity and belonging." Journal of Family Issues 42 (6): 1143-1165.

This paper explores how surrogates negotiate the meaning of familial belonging and family identity when they discuss surrogacy with their husband, children, and other relatives. We suggest that surrogacy necessitates reflexive explication of what a family is and how this family is implicated in surrogacy. Our comparative study analyzes ethnographic data on Israeli and US surrogates to illuminate key similarities in surrogates' strategies vis-a-vis their husband and children, pointing to the importance of daily family practices in how people understand family belonging. First, we map out the ways surrogates engage their husbands in order to gain their support and protect their nuclear family unit before entering the process. Next, we look at how surrogates explain surrogacy to their children in efforts to clarify siblingship and the boundaries between the two families, and to make surrogacy into an educational family project. We analyze the metaphors and rituals in surrogates' family-bounding practices.

Keywords: Surrogacy, surrogate mothers, familial belonging, family identity, children of surrogates

Link to full text of Surrogacy as a family project

 

• Teman, Elly and Zsuzsa Berend, 2020. Surrogate Non-Motherhood: Israeli and US surrogates speak about kinship and parenthood, in: Zeynep B. Gürtin, Charlotte Faircloth (eds.), Conceiving Contemporary Parenthood:Imagining, Achieving and Accounting for Parenthood in New Family Forms, London: Routledge. Also printed in: Anthropology & Medicine, 25(3), 296-310.

Drawing on a comparison of two ethnographic research projects on surrogacy in the United States and Israel, this paper explores surrogates' views about motherhood and parenthood, relationships and relatedness. The paper challenges three myths of surrogacy: that surrogates bond with the babies they carry for intended parents, that it is immoral not to acknowledge the surrogates' maternity, and that surrogacy upsets the moral order of society by dehumanizing and commodifying reproduction. Contrasting the similarities and differences in the voices of surrogates from these studies, the authors argue that surrogates draw on ideas about technology, genetics and intent in order to explain that they do not bond with the child because they are not its mother. This is followed by an exploration of surrogates' definitions of what constitutes parenthood, suggesting that in both contexts, surrogates draw clear boundaries between their own family and that of the intended parents. Finally, it is suggested that surrogates expect a relationship, or a bond, to develop with the intended parents and view their contribution as exceptional moral work which involves nurturing, caring, friendship and solidarity. The paper concludes that for surrogates in the USA and in Israel, maternity, bonding and kin-ties are not automatic outcomes of pregnancy, but a choice. Surrogates in both contexts hold that bonding with other people's children as if they were one's own is wrong while bonding with their couple and creating 'fictive kin' ties with them is the logical outcome of the intense and intimate process of collaborative baby-making.

Keywords: Surrogate mothers; bonding; ethnography; maternity; relatedness; surrogacy

Link to full text of our comparative article on surrogate non-motherhood

 

• Teman, Elly, and Zsuzsa Berend. 2021. "Unsustainable Surrogacy Practices: What We Can Learn from a Comparative Assessment." Sustainable Birth in Disruptive Times, pages 115-127.

What are best practices in surrogacy and what are unsustainable ones? Comparing our long-term ethnographic studies of gestational surrogacy in Israel and in the United States, we analytically explore practices and outcomes we have found to be unsustainable in surrogacy agreements. We then outline three key finding that explain better outcomes for babies and surrogates: regulated contracts, standardized screening of all participants, and supportive relationships between participants. By shedding comparative light on practices emergent from the "field," whether sustainable or not, we can better identify the central regulatory mechanisms that may shield surrogacy participants from harm.

Keywords: surrogacy, surrogacy contracts, regulation, screening, intended parents

 Link to full text of our comparative article on Unsustainable Surrogacy Practices

• "Misconceptions about altruism and choice in U.S. Surrogacy" December 15, 2015 
• "The morality of contract surrogacy - U.S. surrogates' perspectives" February 18, 2016
• "Researching surrogacy online: the challenges and opportunities of digital ethnography" May 6, 2016
• Podcast on "Science and Surrogacy with Zsuzsa Berend" on I want to put a baby in you podcast