US surrogacy: An interview with Zsuzsa Berend
10.7340/anuac2239-625X-3836
Questo articolo è una parziale trascrizione di una lunga conversazione tra la sociologa Zsuzsa Berend (Università della California, Los Angeles) e l’antropologa Corinna Sabrina Guerzoni (Western Fertility Institute, Los Angeles) sulla surrogazione di gravidanza (SdG) negli Stati Uniti. È il risultato di un’intervista avvenuta il 6 ottobre 2017 a Los Angeles, trascritta e rivista da entrambe le autrici. Il testo analizza alcuni concetti fondamentali che Berend esplora nel suo libro The Online World of Surrogacy (2016) e offre spunti di riflessione per leggere la SdG statunitense con nuove lenti rispetto a quelle generalmente utilizzate. Lo studio di Berend è un’analisi approfondita della SdG commerciale negli Stati Uniti che mira a comprendere le esperienze ed i punti di vista delle donne direttamente coinvolte in queste pratiche riproduttive.
application/vnd.openxmlformats-officedocument.wordprocessingml.document
2239-625X
3836
2
en
Corinna Sabrina Guerzoni
Anuac
US surrogacy: An interview with Zsuzsa Berend
Text.Serial.Journal
https://ojs.unica.it/index.php/anuac
8
Interviews
2019-12-29
2019-08-19
2019-12-29
2019-12-29
255-263
1
Corinna Sabrina Guerzoni
2019/12/29
10.7340/anuac2239-625X-3836
255
Western Fertility Institute, Los Angeles, United States
2239-625X
2
en
263
US surrogacy: An interview with Zsuzsa Berend
https://ojs.unica.it/index.php/anuac/article/download/3836/3661
8
                                        2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263




                                                                            INTERVISTE

US surrogacy
An interview with Zsuzsa Berend

Zsuzsa BEREND
University of California, Los Angeles
Corinna Sabrina GUERZONI
Western Fertility Institute, Los Angeles




ABSTRACT: 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.

KEYWORDS: SURROGACY, ANTHROPOLOGY OF REPRODUCTION, PREGNANCY, ONLINE COMMUNICATION, GIFT.




This work is licensed under the Creative Commons © Zsuzsa Berend, Corinna Sabrina Guerzoni
US surrogacy: An interview with Zsuzsa Berend
2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263.
ISSN: 2239-625X - DOI: 10.7340/anuac2239-625X-3836
256                                             ZSUZSA BEREND, CORINNA SABRINA GUERZONI




   The Online World of Surrogacy, book by Zsuzsa Berend (sociologist of the
University of California, Los Angeles), is an ethnographic exploration of the
largest online information and support forum for US surrogates. SMO,
founded in 1997, it is a self-regulating group operated by surrogates; a public
forum that also wants to educate people about surrogacy. From around 2014,
discussions have largely relocated to Facebook groups, but SMO is still a rich
source of in- formation for potential surrogates and other interested parties.
Berend read and analyzed SMO discussion threads during the forum’s most
vibrant years between 2003 and 2014.
   Many critics of surrogacy focused on the commodification of life, the
patriarchal exploitation on women’s reproductive capabilities, and the idea
that babies are snatch from the womb of the surrogates (Gross 2012) as the
main problems. Rather than exploring these much-rehearsed and not
particularly fruitful questions about ethics and moral risks of assisted
reproduction, in The Online World of Surrogacy, Zsuzsa Berend pays attention
to what Fourcade and Healy called “moral markets” (Fourcade, Healy 2007).
Berend builds and expands on her previous work, providing an updated and
extended analysis of her continuing research on US surrogacy. 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.
Also, while the author situates her analysis within the rich literature of
artificial reproductive technologies, her attention is not focused on the
politics of reproduction but on documenting how surrogates, through online
discussions, have fashioned a collective and social meaning of US surrogacy.
   The main socio-anthropological studies that have investigated the topic
of surrogacy have analyzed the developments in various socio-cultural
contexts such s India, Thailand, Russia, etc. (Deomampo 2013; Pande 2014;
2015; Radruppa 2010; Twine 2015; Vora 2013). Despite a lot of criticism of
this practice, few studies focused on US surrogates. The Online World of
Surrogacy offers a unique perspective and a timely analysis of compensated
surrogacy in the United States. Berend’s book, focusing on their online
communications and collective definitions, represents an opportunity to
learn more about the thoughts, experiences, and points of view of women
directly involved in surrogacy. The Online World of Surrogacy deconstructs
some preconceptions related to surrogacy. Based on a decade of empirical
data, the book documents and analyzes US practices and negotiated
meanings and shows how the practice can only be understood in its socio-


2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263
US SURROGACY                                                                     257


cultural context. Rather than having universal characteristics, as normative
analyses often argue, assisted reproductive practices develop and change in
relation to different socio-cultural contexts.

   CORINNA SABRINA GUERZONI – In your book, you paid a lot of attention to the
contract. Can you explain the reasons of this choice?
   ZSUZSA BEREND – The contract grew as a chapter because I realized as I was
writing how significant it is in surrogates’ own discussions, not just legally
but also in terms of the relationship with intended parents. Surrogates often
say that it is through contract negotiations that they figure out the
relationship, to make sure they “are on the same page” with the intended
parents, that it is going to work. And they said that such a negotiation is just
so difficult that if people survived that, they come out of it as stronger
partners in the “journey”, as they call the surrogacy arrangement. But what I
also found throughout my ten or so years doing this research is that
contracts became more and more sophisticated, and they added more and
more provisions and specifications. Legal professionals became more
specialized in this field and contracts have gotten much longer, much more
elaborate, often with more restrictions on the surrogates, and more detailed
specific reasons for termination of the pregnancy, for example. Many of
these changes were initiated by surrogates so as to make sure they are “on
the same page” with their couple, especially in terms of embryo transfer,
selective reduction if multifetal pregnancy, and termination of pregnancy in
case of abnormalities. Surrogates are quite adamant that they want to give
life, not take it, so they insist that reasons for termination should be
specified ahead of time. Money issues are important, too, especially items
such as lost wages and childcare in case of complication during pregnancy.
Women may lose money if lost wages are capped, for example.
   C.S.G. – People who are generally against surrogacy, depict the contract
as a tool designed to force women to accomplish a “task”, based on the fact
they have signed it. What does your long research reveal about US surrogates’
experiences?
   Z.B. – From all the discussions I’ve read, surrogates see the contract is a
binding manifestation of a mutual agreement that honorable and
responsible people should all work out anyways when they want to
collaborate. And even if the contract is not legally binding, they always
encourage everyone to have such a detailed contract, knowing that it is not
going to be good for legal purposes. They agree that it is still certainly worth
going through the contract negotiation for the purposes of the journey, the
purpose of clarifications, and the purposes of knowing exactly where you

                                   2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263
258                                             ZSUZSA BEREND, CORINNA SABRINA GUERZONI


stand and what you want and what you agree to. So, in that sense they are
just as adamant that contracts are important as the intended parents are. No
surrogate on the support forum I researched ever said that people force
contracts on them; in fact, they advise newcomers to take the contract very
seriously, make sure they understand what contract entails and make sure
they have everything clearly specified so as not to be surprised later. They
also often advised that surrogates should not agree to provisions they don’t
agree with, hoping such things won’t happen, and should not work with
couples with whom they are not on the same page.
   C.S.G. – In relation to the contract, many critics describe the surrogate
pregnancy as an exploitative practice, as a commodification of life. What is
your opinion on that, having done research for more than ten years with US
surrogates?
   Z.B. – Surrogates very often discussed the value of giving life, the value of
creating families. Women on this online support forum generally said that
family is the most meaningful and most important institution and that
infertility is one of the most devastating misfortunes. In this context, we can
understand that they considered helping people have a family an altruistic
action. But they also said that it was not reasonable to expect anyone to do
such a thing for free when pregnancy involved risks and hardships.
Surrogates considered the arrangement a “win-win”, a reciprocal agreement
in which couples have the baby they wanted, and the surrogate and her
family receive money that helps them “achieve their dreams” (down
payment for a house or saving for their children’s education). Surrogates
emphasized that being informed and knowledgeable were crucial for
mutually beneficial outcomes and that all surrogates “should do their
homework” before matching with IPs. What’s more, US surrogates often said
that it is intended parents who have no choice but do surrogacy while
surrogates do have a choice whether to help such couples and which couples
to help. This choice and knowledge are central in surrogates’ understanding
of the practice.
  C.S.G. – And what do US surrogates think about this idea of surrogacy as
exploitative practice?
  Z.B. – Ironically, surrogates consider surrogacy in India exploitative. But
once we read their discussions, we understand the reasons: from what they
had read, they considered Indian surrogates poor, even destitute women who
do not understand the legal and especially the medical complexities.
According to US surrogates, these Indian women are oppressed by family or
necessity and “have no choice”, no real autonomy – as opposed to US


2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263
US SURROGACY                                                                     259


surrogates who do. They generally insisted that if a surrogate gets exploited
in the US, it is her own fault because she could and should have researched
surrogacy before “jumping in without thinking”.
  C.S.G. – Many critics say that money is the most important resource to
analyze this practice. What is your opinion about it?
  Z.B. – A lot of people think that money is the most relevant resource
because it does cost a lot for couples to pay the surrogates, pay clinics and
doctors and lawyers. But what is missing here is that money by itself can’t
buy babies and there is a lot of truth in surrogates’ point of view which is
that couples may spend a lot of money on treatments, IVF, and various
procedures and experts and still have no baby. So, money is clearly not the
only resource, not the only important resource. Obviously, it is a resource
because people that don’t have the money can’t probably start the surrogacy
process, but also people with money cannot end up with a baby if the
surrogate doesn’t put her resources, her generosity, all the other skills that
they are so proud of into providing the baby for this couple. And in their
understanding, the IPs should see the surrogate as a key player, maybe even
the most important person, during the surrogacy process.
   C.S.G. – So, which are the other different forms of power that play a role
during the journey?
   Z.B. – Surrogates consider their ability to gestate and give birth, to be able
to follow all the rules and all the medical protocols as a kind of a resource, as
a skill, not something that is given but as achieved, like a combination of
skills and abilities that is pretty valuable and pretty impressive. Their
fertility is a biological fact but using it to carry other people’s children is a
purposeful activity. The fact that they will do that, the fact that they will
follow medical protocol even when it means shots, medication, and various
invasive procedures, and it takes time to go to medical appointments, they
think of all those things as resources that most intended parents don’t have.
This is an interesting reversal: the surrogate can do things for this couple
that the couple can’t do themselves and surrogates are very proud of that,
and they take their agency very seriously. And they would say: “I know my
body, I know I can do that. The doctor said this, but I know my body better”.
So, they have a lot of stories in which they emphasize their agency, as well as
their ability and their resources. They do not think of themselves as
powerless at all. They also say that surrogates need to be informed and
knowledgeable and be their own advocates, rather than simply rely on
doctors’ or other professionals’ advice or opinion.
   C.S.G. – There is a complex meaning around the concept of the gift-
giving. Often, the common sense tends to describe just the baby as the gift of

                                   2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263
260                                             ZSUZSA BEREND, CORINNA SABRINA GUERZONI


life. The critics say that the baby cannot be considered as a gift cause the
interrelation with the money. What did you find that you can add to this
discussion?
   Z.B. – It would be very simplistic to think of the baby as the precious gift,
because when you actually read all the things that surrogates are talking
about, it is a whole long list of things that they include as their gifts. It starts
with the willingness to carry for the couple. Because they always say that the
money itself it is not enough for the hardships and risks, so there must be
some other good motivations, and some generosity, compassion, some other
reasons for wanting to be a surrogate. When they talk about their own
children as a gift, then you also imply that children in general are gifts and
the ability to have them is a gift, meaning that no one can take it for granted
that they can have children. They also say that their generosity to carry for
others is a gift to these people. And once they start the surrogacy, all the
bodily involvement and risks and sacrifices become the surrogates’ gift to
the intended parents. But then they talk about the gift of trust that they are
receiving from their couple, because the intended parents are trusting them
to carry “their baby”, and surrogates are honored to be trusted to gestate the
baby. It becomes very interesting, a mutual kind of gift-giving, a reciprocal
relationship, at least when things go well.
   C.S.G. – Did you analyze the relationship between altruistic and commercial
dimension of surrogacy?
   Z.B. – In these kinds of relationships, where the intimate and the financial
components are so interrelated, I think there is more of a continuum rather
than opposition. In general, altruism coexists with commercial practices.
When money changes hands there is still a space for altruism. I agree with
the definition of altruism that says that people are altruistic if they do things
for others with the intention to benefit them, even if themselves benefit.
Surrogates often say that they feel good when they help others – and argue
that feeling good is a benefit, so would it disqualify the act as an altruistic
one? Of course not – if it did, only mean and callous people who don’t feel
good when they accidentally do good would be able to act altruistically. In
relationships that involve bodily commodities (as some people called organ
donation, surrogacy, etc.) there is always going to be a kind of coexistence of
gift and money, because these are not standard goods, they are not produced
for the market for profit. Thus, it is impossible to calculate “costs” and
“profit”, and money is generally used in ways that are somewhat different
from money practices in commodity exchange. There are all kinds of risks
involved in these kinds of practices that people can’t put a price tag on. This


2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263
US SURROGACY                                                                   261


is not saying that this kind of giving has nothing to do with financial
consideration, just that giving and helping, coexist with monetary practices
in ways that have nothing to do with “profit”. There are economists like
Kenneth Arrow, for example, who write about how certain risks don’t have a
monetary price and can’t be expressed in monetary terms.




                                 2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263
262                                             ZSUZSA BEREND, CORINNA SABRINA GUERZONI


REFERENCES
Berend, Zsuzsa, 2014, The social context for surrogates’ motivations and satisfaction,
      Reproductive Biomedicine Online, 29, 4: 399-401.
Berend, Zsuzsa, 2016, The Online World of Surrogacy, New York & Oxford, Berghahn.
Blyth, Eric, 1994, “I wanted to be investigating. I wanted to be able to say ‘I’ve done
      something interesting with my life’”: Interviews with surrogate mothers in
      Britain, Journal of Reproductive and Infant Psychology, 12: 198-198.
Brazier Margaret, Alastair Campbell, Susan Golombok, 1998, Surrogacy: review for
      health ministers of current arrangements for payments and regulation, CM 4068,
      Department of health, London.
Deomampo, Daisy, 2013, Gendered Geographies of Reproductive Tourism, Gender
      & Society, 27: 514-537.
Pande, Amrita, 2014, Womb in Labor: Transnational Commercial Surrogacy in India,
      New York, Columbia. University Press.
Pande, Amrita, 2015, Blood, Sweat and Dummy Tummies: Kin Labor and Transnational
      Surrogacy in Indi, Antropologica, 57, 1: 53-62.
Strathern, Marilyn, 1999, The ethnographic effect I, in Property, Substance and
      Effect: Anthropological Essays on Persons and Things, Marilyn Strathern, ed,
      London, Athlone Press: 1-23.
Teman, Elly, 2015, My Bun, Her Oven, Anthropology Now, 2, 2: 33-41.
Twine, France Winddance, 2015, Outsourcing the Womb: Race, Class and Gestational
      Surrogacy in a Global Market, London, Routledge.
Vora, Kalindi, 2013, Potential, Risk, and Return in Transnational Indian Gestational
      Surrogacy, Current Anthropology, 54, 7: 97-106.
Zegers-Hoschchild, Fernando et al., 2009, International Committee for Monitoring
      Assisted Reproductive Technology” (ICMART) and the World Health Organization
      (WHO) Revised Glossary of ART Terminology, Human Reproduction, 24, 11: 2683-
      2687.




2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263
                                        2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263




 Zsuzsa BEREND received her PhD from Columbia University in 1994 and has been
 teaching sociology at University of California Los Angeles since 1996. Her recent
 ethnographic research project investigated the interconnections between the
 economic and emotional realms in US surrogacy, and the ways in which
 surrogates’ discussions and debate on a large and influential online support forum
 shape meanings, understandings, and practices. She published, among others, in
 Medical Anthropology Quarterly, Sociological Forum, and American Anthropologist,
 and her book, The Online World of Surrogacy was published by Berghahn Books in
 2016.
 berend@soc.ucla.edu

 Corinna Sabrina GUERZONI is an Adjunct Professor in Anthropology at Istituto Euro-
 peo di Design (IED) in Milan, Italy, and a Postdoctoral Researcher at Western
 Fertility Institute (California). In 2013 her MA thesis on Italian lesbian
 motherhood won the “Mara Baiocchi” Prize as the best Italian MA in Gender and
 LGBT Studies. In 2017, she obtained her PhD in Cultural and Social Anthropology
 at Milano-Bicocca University (Italy). Among her latest publications: “Reshaping
 Relatedness? The case of US Surrogacy”, Antropologia, 2019 (with Zsuzsa Berend);
 “‘Loro lo fanno, io lo cucino. Gravidanza, maternità e filiazione nel contesto della
 surrogacy gestazionale statunitense”, Etnografia e ricerca qualitativa, 2018.
 corinna.guerzoni@gmail.com




This work is licensed under the Creative Commons © Zsuzsa Berend, Corinna Sabrina Guerzoni
US surrogacy: An interview with Zsuzsa Berend
2019 | ANUAC. VOL. 8, N° 2, DICEMBRE 2019: 255-263.
ISSN: 2239-625X - DOI: 10.7340/anuac2239-625X-3836
