Tag Archives: health

Mother’s Day

On Mother’s Day we celebrate our own mothers and our children celebrate us. It is a day to acknowledge the sheer hard work of raising children, how we come to have them and family units in different sizes and forms, but the focus is on mothers.

Only women can be mothers. Only women can become pregnant, give birth and breastfeed and ‘mother’ is both a social term and a legal one. The legal definition was in response to scientific developments in IVF, where egg donor conceived pregnancies created the question of what a mother is. Subsequently, two sub-categories or ‘gestational’ and ‘traditional’ surrogacy were also created. Prior to this there was no confusion about the meaning of the word ‘mother’.

The 1990 Human Fertilisation and Embryology Act (Section 27) defines ‘mother’ as

“the woman who is carrying or has carried a child as a result of the placing in her of an embryo or of sperm and eggs, and no other woman, is to be treated as the mother of the child”.

In other words, the woman who gives birth has legal rights and responsibilities and the woman who provides the egg for that embryo does not. Before this law, the word mother had one meaning which everyone understood. The only deviation and subsequent sub-subcategory was when legal rights and responsibilities were transferred from a birth mother to an adopting mother. IVF of this nature created an additional sub-category; genetic mother.

The definition of the noun ‘surrogate’ is:

a substitute, especially a person deputising for another in a specific role or office

For me, in surrogacy, the person deputising or standing in for the mother is the commissioning parent; an adult – male or female – who not only commissioned the child into being but is the social parent caring for and raising the child, as a result of an arranged pregnancy, with or without a contract. This person – as single people can obtain a child through surrogacy in the UK – or couple, later become the legal parent/s when a parental order is granted by the family court. A parental order cannot be applied for, under the current law, before the newborn reaches 6 weeks old. So these people are not the legal parents from birth and there is always (as with adoption) a birth mother, regardless of how invisible they might want her to be.

Proposed law reform would see a seismic shift with the introduction of a ‘new pathway’. This would allow for parental rights for the commissioning couple to be transferred during the pregnancy, with a pre-birth order (like that seen in commercial surrogacy arrangements, a model we are told is rejected by the Law Commission and pro-surrogacy lobbyists). That’s right, whilst the woman is still pregnant, the baby inside her doesn’t belong to her and in fact someone else has legal parental rights to the child she has not yet given birth to.

The idea that a child you have within your body belongs to someone else has lead to what I consider to be dangerous and deceptive discourse around surrogacy. Euphemistic language begins with ‘surrogate’, where the word mother doesn’t feature at all, (or worse ‘gestational carrier’) and ends with the claim that the mother is ‘giving the baby back’. Back to where, where the original order was made? The baby is not returning to the place they began. With IVF that would mean taking the child to a lab where they were conceived. No, this claim refers to handing the baby over to the strangers they may or may not be related to. (Under current UK law and reform proposals, the requirement for one commissioning parent to be genetically related to the child remains.)

The dominating theory here is that the genetics are equal to ownership and that pregnancy and birth are minor details. This denies the reality of how babies are made, with or without a Petri dish. It dismisses the mother baby bond, something agencies and proponents of surrogacy, denies exist. Academics will downplay the sharing of cells in the womb as “a mere fantasy of romanticism”.

Some supporters of surrogacy prefer to dehumanise the woman, reducing her to an electrical appliance, calling women ‘ovens’ and the baby a ‘bun’. Or they consider having a baby for others to be ‘extreme babysitting’ – like Ultra Marathons or Free Solo climbing. Something that is impressive in the danger and fraught with risk. (I’m not convinced that the medical risks are fully explained to surrogacy candidates prior to conception or implantation.) Saying a pregnant woman is simply ‘babysitting’ is an insult to motherhood and it seeks to separate the mother and baby and reduce pregnancy to a bodily function or a paid role. There may be more truth in this than was intended.

In surrogate motherhood, a genetic is unimportant, whilst the genetic link between the baby and the commissioning parent/s is paramount. In surrogacy, the natural maternal bond is dismissed as emotional and romantic and known science of maternal-foetal microchimerism is waved away, but the legal definition remains – even if a woman becomes pregnant with an embryo made from another woman’s egg, she, “and no other woman”, is the mother.

We wish every mother, whether she wants to be thought as one or not, a Happy Mother’s Day.


Words from a Midwife: Part Three – The Unspoken

There has been an interesting response to the Royal College of Midwives (RCM) webinar on Surrogacy. Perhaps it’s not surprising that those ‘with women’ wanted to offload their or share what they themselves have witnessed when supporting patients through pregnancy, birth ‘and beyond’.

Midwives got in touch with us to tell us of their shock at when they heard their union was considering hosting a webinar on surrogacy. We later heard from the women who attended that it was far from a the ‘neutral’ presentation they were promised.

Parts One and Two of this short blog series are direct accounts from RCM Members who attended and who remain anonymous and other midwives gave us permission to share their personal perceptions of surrogacy in their day-to-day jobs.

A Community Midwife noticed how the glossy images a surrogate mother posted online which promoted surrogacy as a wholly positive experience hid the very raw and real realities of her birth injuries.

Another midwife said something similar about a woman who had a baby for a family member. The commissioning mother was posting on social media about how amazing her ‘journey’ was, but this midwife knew the reality for the birth mother. It was filled with gestational diabetes (which can lead to higher risk of diabetes in future), obstetric cholestasis which is a liver condition (that can causes liver disease and other issues in the future) and high blood pressure. This risky pregnancy ended in a C section. The truth was this woman was devastated after the birth as she would never have another child of her own due to these complications. It put a strain on her own marriage as her husband, while initially supportive, didn’t realise the enormous negative affect this had on his wife’s health and the future of their own family. This desperately sad reality was not shared on social media.

Another midwife commented on the late maternal age of two surrogate mothers she cared for and she expressed concern that there are no upper age limits in proposed reform. Both of the surrogate mothers she supported were in their 50s. She felt that as the pool of women available for surrogacy was ‘slim pickings’, women with a complex obstetric histories may be considered by the commissioning parents as their options were limited. This was nothing to say of the risk to the baby.

And finally there was one patient that stayed in the mind of a midwife we spoke to by phone. She told us how she supported this woman through four surrogacy pregnancies. The midwife knew she had lost touch with all but one of the families she was pregnant and gave birth for. During these pregnancies the commissioning parents were her “best friends” but once the baby had been delivered, the surrogate mother was “ghosted” and she then grieved the loss of the lifelong friendship she was told she could rely on.

In sharing their experiences these midwives has a sense of release, as if they had to keep to the official line outwardly, but inwardly there was worry and anger building as they were unable to talk freely. In our conversations these women were able to air their concerns about the direction of travel of surrogacy in the UK. Several felt badly let down by their union as women and as midwives.

We were left with a distinct observation that midwives are on the ‘front line’ of surrogacy. Any legal disputes may end up in the court room but they begin on a maternity ward. It is the midwives and other healthcare professionals who will have to navigate the practicalities on the ground around consent, the removal of the newborn and ongoing mental and physical health problems as a result of surrogacy births.