Monday, April 8, 2019
YES! Magazine (Apr. 2, 2019): For Black Women, Reproductive Justice Is About More Than High-Risk Pregnancies, by A. Rochaun Meadows-Fernandez:
Recently, journalists, medical professionals, and advocates have been emphasizing the discrepancy in medical care between White women and women of color. The maternal mortality rate is already abysmally low in the United States; this rate is even worse for Black women. These reports have largely focused on the medical risks of pregnancy and childbirth for women of color, but there is another, lesser-reported area of reproduction that also disproportionately burdens women of color: infertility.
"While infertility affects roughly 12 percent of the population, Black women are twice as likely to experience challenges achieving or sustaining a pregnancy—and less likely to seek assistance." Infertility can also severely harm the mental health of someone wishing to get pregnant.
Options to prevail against infertility often include the use of assisted reproductive technologies, including surrogacy.
Surrogacy has been met with controversy from many angles over the years. Those against the practice express concerns of stigma, exacerbated classism, commodification of women's bodies, and exploitation. "Some countries, including Mexico, have banned commercial surrogacy under the guise of protecting low-income women and children from exploitation."
Advocates, however, argue that surrogacy is a viable option for many people to pursue their dreams of parenthood they otherwise have trouble achieving.
Black women in particular are less likely to pursue surrogacy, among other reproductive technology, and are less likely to be surrogates as well.
According to the Centers for Disease Control and Prevention, from 1999 to 2016, gestational carriers resulted in 13,380 deliveries and the birth of 18,400 infants. Although the current figures are unknown, surrogacy is helping to counter infertility struggles.
Still, the number of Black surrogates and Black intended parents remain low.
This could possibly be because of the stigma from slavery that historically frames enslaved Black women as surrogates for their White female owners. But is most likely because of the high costs normally associated with surrogacy (about $100,000, which includes medical and health care expenses for the carrier and agency or finder fees)—although some may turn to family or friends where there is no compensation—called altruistic surrogacy.
Surrogacy can occur in two ways: the traditional way in which the surrogate is impregnated by either the intended father's sperm or that of a donor, while using her own eggs; or, gestational surrogacy in which the surrogate is impregnated using the eggs of either the intended mother or an egg donor. In the former, the surrogate is genetically related to the child and the in the latter, she is not. Gestational surrogacy requires a few additional interventions, like IVF, and is generally more expensive.
Many intending parents prefer gestational surrogacy, though, in order to lessen the likelihood that the surrogate will develop an emotional connection and assert a biological claim of custody over the resulting child. "This is an intended parent’s worst fear."
"Juli Fraga, a psychologist who specializes in women’s health, including pregnancy-related depression...suggests that it is especially important for all members of the surrogacy contract to be open to seeking mental health services."
In re Baby M is one of more famous cases illustrating potential legal battles that may arise over surrogacy. In this case, intended parents William and Elizabeth Stern fought for custody after their surrogate, Mary Beth Whitehead, invalidated their contract and attempted to claim custody over "Baby M." The court ultimately held that the surrogacy contract was entirely unenforceable, likening it to the "sale of a child." The court also held that William Stern, the child's biological father, retain custody according to the best interests of the child, but that Whitehead, the surrogate and also the child's biological mother, also retain visitation rights with the child.
Similar cases have continued to arise between surrogates and intended parents. Baby M influenced a shift in the legal protections and parameters for surrogacy, though. "It’s now suggested that intended parents prioritize entering contracts in states that support protective surrogacy legislation. But only 17 states and the District of Columbia have laws governing the conditions of surrogacy."
It is important to ensure that Black women are receiving the same medical care and equitable access to reproductive services, including reproductive technology and protections in cases of surrogacy (either as the intending parent or the surrogate), as White women. Equally as important is removing the stigma around infertility and opening conversations to all women about their reproductive options.
In once recent case, GloZell Green, a Black woman and YouTube star, was told by a fertility specialist that she'd waited too long to have children at age 39. Green began searching for the best way to enter motherhood and ultimately had a baby girl through gestational surrogacy. Green shared her surrogacy journey with her millions of subscribers, hoping to break the stigma and open conversations. She highlights that "above all else, she doesn’t want Black women to be embarrassed about infertility."