Surrogacy. The debate on "surrogates" birth in complexity

mere porteuse inde Gestation pour autrui. Le débat sur les « mères porteuses » accouche dans la complexité

Photo Monde2 of 19 June 2009 (S. Bright)

The law on bioethics , ethics vi e which we can understand all the news by reading this, will have to take a position on the issue of surrogacy, debate better known item of surrogacy .

This is a complex issue that lawmakers will have to decide. Today this possibility is banned in France. "The fact to intercede" for use of this practice is liable to one year imprisonment and 15,000 euros fine. This fine is doubled if the act is done for profit reasons. The French ban was passed in 1994 and again in 2004. However there have been cases of surrogacy in France, as authorized by law are not at variance, variance are not because the law did not exist. It was between 1987 and 1991. 70 It is estimated the number of children born to mothers during this period. To my knowledge, there are no epidemiological studies on monitoring these children since what could allow legislators to decide in full knowledge of and avoid the fantasies of both sides. (Shift 24/06/2009: The Express returns in its edition of Thursday, June 25 on this issue via an article taking the journey of three families with the testimonies of children born to carrier mothers).

Many today are the people and organizations to take a stand on this issue.

Among the supporters of a controlled authorization of surrogacy are: the Maia Association , the Committee Clara , Elisabeth Badinter , the Minister for Family, Nadine Morano , Genevieve Delaisi Perceval, a working group of the Senate.

Among the opponents, the fuller ranks, we find the "father" of the first test tube baby French, the doctor René Frydman , the philosopher Sylviane Agacinski, the Housing Minister Christine Boutin, the 'OPECST (Parliamentary office dedicated to ethics which includes several deputies and senators sensitive to these issues and publish reports), the National Consultative Committee on Ethics , Catholic and Protestant churches as well as representatives of Islam and to a lesser extent the c onsistoire of Paris . About the opponents, René Frydman said he was "outraged by the lobbying of certain associations that advocate the legalization of this practice to defend the interests of a few haves". It's bitter, strong, perhaps too much.

Each side has their own influence to advance his ideas. Interviews are given, open blogs, participation in conferences or business conferences, letters and files shipped with parliamentarians, current thinking on ways to advance his ideas, defend his point of view (as the synthesis of the Board State shows) increase its visibility and participate in the construction of the decision on this complex subject.


  1. Accept an act of generosity . "Giving" her body time to pregnancy for a couple to host her own child is a selfless act of high level. This was the main motivation of the French surrogates in the late 80s This act is sometimes offered by relatives of the woman who can not bear his child's mother, sister, friend ... http: // www.
  2. Avoid procreative tourism. Several countries in the world accept surrogacy. These include the United States, Canada, Belgium, Great Britain, the Netherlands, Ukraine, Denmark and Greece, five countries of the European Union. Other countries, such as India, accepts this practice and conduct an industrialization of the process as will be objected by opponents of legalization. Accept surrogacy therefore prevent double standard measures between those who have the financial and cultural means of establishing contacts with foreign countries in this regard, and those who, for various reasons, can not do . The argument is maintaining the principle of equality prevails.
  3. Avoid problems of civil status . As suggested by the Mennesson case , recourse to surrogate mothers abroad is not without its problems upon return to France of biological parents with their child. Who is this child? The child of her mother according to French law? Who is his mother according to the law? The one who gives birth the child. QED. However, the child's interest, here that of having a legal identity, a civil status, without which no act of everyday life can be achieved (a passport, vote, pass a test ...) is essential, in our culture, over all other principles can be put forward.
  4. Do not reject the advances in medical technology. While the donation of gametes, male and female, sperm and ova, is allowed, that embryo donation is accepted, why is it that the loan of his body would it be banned a consenting person? Under q ual ethical principles or moral? Would it not deny the interest of scientific progress in the medical field to reject this progress is reaching?
  5. Help combat the suffering of women who can not have children. Beyond the issue of convenience that could motivate women not to give birth (fear of childbirth, fear of decay of the body thereafter anxiety about suffering ...), there are a number of purely medical reasons that prevent women can bear children. This is the case of women whose uterus has been altered by radiation for example, women with syndrome of Mayer-Rokitansky-Kuster-Hauser . In total, it is estimated, according to the Red Cross, 300 the number of women involved in the Mayer syndrome and postpartum hemorrhage. Or in the society of ours, there is a strong social pressure (not to mention the biological and psychological pressures) that women of childbearing age would. This partly explains fertility levels in our country, and this reinforces the suffering of those who can not afford the social role conferred on them.
  6. A movement is emerging in opinion. Not that the French, according to opinion surveys, have become largely for this evolution, but 1/3 of them are not opposed. Now we know the laws that cause profound changes can not be made without the consent of a significant part of the population. For at least two reasons, first, because it enables supporters of this development to have support and drivers in public opinion, and second, because it suddenly cut the ground from under the feet of opponents, more Supports in opinion, it is less of opponents in the street, on internet forums, in the columns of newspapers. Today, however, the point of view of public opinion, the game is not won for supporters of legalization. They have, however, succeeded in their first bet: to put the issue on the public square. It is no longer taboo. This is a first essential step in the recognition of surrogacy.
  7. This has already been done, it is done. The argument which seeks to demonstrate that these practices are old and still present, despite the ban, are somewhat specious from the point of view of the morality of public debate, but is a fact. In France, as I pointed out in the introduction, this has been an accepted reality for four years. And even today, not that we know how many people are involved, this practice courses. If not in centers in the country at least by citizens traveling abroad.
  8. And the father in all this? It is often considered that the issue of carrier mothers affects mostly women. It is true that there is no carrier-father and for good reason. However, "women can not do on their own children." At one point at least, a little before fertilization, man is needed. By his presence, and his ejaculation or in absentia, having frozen his own sperm or giving his sperm in a CECOS. Or in the case of a couple of potential parents, a man and a woman so in the sense of the law, if we saw the power of desire, desire or need, feminine, father's place, his desire, his desire or need, is neglected. He also has the right to have children, if it exists. And in a free society, it may decide with whom to have them. If this woman he wants for mother of his children can only accommodate the gestation of their child, would it not then undergoes a double sentence. That of seeing his wife suffer and that not being able to be a father.

Arguments against.

  1. There is no GPA free trade. It's a punchline. In very many cases, surrogacy is manipulated to become a business. In India, women confined in a nursing home, are recruited to become mothers carriers on behalf of foreign or domestic super-rich who "buy" this possibility for just under 10,000 euros. In Ukraine, it takes 15,000 euros. In North America, about 40,000 euros. Depending on the nature of contracts, legal responsibilities, insurance, the price varies. The earth is flat, wrote the American journalist Thomas Friedman. Nothing is more true regarding surrogacy. It is possible to choose its production area and the guarantees that come with it. The argument is without question but it remains theoretical. No one can say exactly that in France it would go the same way as the practice is prohibited. Everything leads us to believe that this is a considerable barrier to acceptance by the public: a child can not have a price, even if we do not speak here of child buy but loan or lease bellies then the tenant eviction.
  2. This is not "a public health priority." In an interview on this issue given the weekly L'Express, the gynecologist René Frydman, says already assisted reproductive demands, which he supported, Fertilization in vitro insemination ... are difficult to meet. For reasons of ways in rare medical centers offering these services or because of a strong lack of gamete donors. Thus, the Biomedicine Agency indicates in its annual report that 400 couples per year are awaiting egg donation but only 220 women volunteers each year to the medical treatment inherent in the gift and ultimately to several their eggs.
  3. The medical profession does not accept this technique. The vast majority of doctors are reluctant to accept changes in the legislation on surrogacy. Jean-François Mattei, MD, former health minister, author of a remarkable book on bioethics, asserts against for reasons explained here. However, even if at the time of the debate the authorization of the Voluntary Interruption of Pregnancy in France in the early 70's, there were more than 10,000 against the anti-abortion sign a call, it is difficult to change laws Bioethics without their consultation or their consent. The pressure group that is, even if its forehead is not always united, is a strong power of influence even more than many parliamentarians are from their ranks and thus sensitive at least atavism their arguments .
  4. The surrogate mother's status is unclear from a legal point of view. Who is the woman who gives birth to a child who is not biologically his? Who is this child for this woman in labor? It does not measure well the psychological effects for the woman who gives birth to let his child to his biological mother. The senate of the working group that studied the issue suggests that the surrogate mother can change your mind within three days after delivery. That is to say, it may decide to keep the child who is not quite, far from it, his own. Usually, in the classical case, during the three days following the birth of a child, the family, aunts, uncles, brothers, sisters, fathers, mothers, friends came to motherhood or hospital, or the kitchen, or in the pool, to see the child, praise the mother, the father of the child, discuss its resemblance to so and so, give gifts, take it in her arms. At birth the child already has nine months. Is given, it was given a name, an identity. He was welcomed into his family with open arms. It is the future. There is hope. How then accept that for three days, three long days, a couple or in the feverish expectation of a change of mind of the woman in labor? What anguish! What suffering of waiting! Finally, what about the right enforceable visit might ask the surrogate mother? She still carried the child, fed, spoken, whispered maybe even words of love. And if this is not the case, as studies have shown the importance of the peace of the mother during the pregnancy and the presence of the father, why is it that child would deprive from the Initially, beyond the vicissitude of couple lives of these attentions.
  5. This implies a contract that does not qualify. Use a surrogate suppose a contract between the two parties, the carrier and the recipients, with commitments from both sides, rights, duties. From a philosophical point of view, this assujétion, the alienation of man by man is not admissible. This is already happening in the contracts, but not with these implications, this constancy during the time of pregnancy. This contract also entails legal responsibilities. What will happen if the surrogate mother prefers the fair at rest, alcohol Strawberry rolled cigarette the Russian cigarette? Selection of surrogate mothers should be able to guarantee upstream part of the seriousness of the candidates but can not ensure full loyalty of the surrogate mother vis-à-vis its commitments.
  6. And if the biological parents refuse the child? This question is rarely asked. It can be assumed that a couple who engages in this process knows why he is undertaking, weathered its reflection, tried everything outside of this process. But what if during the time of pregnancy parents separate? Does the common law on parental authority applies? How to decide?

The issue of the opening of surrogacy for gay couples is not an issue here. Because it is assumed that it is the biological child, from the gametes of a couple, so differentiated between men and women, to be carried by the surrogate mother.

We see from reading these arguments gathered that this issue is complex by its possible consequences. It also confronts us with our a priori. As Sylviane Agacinski said, "In this area, France is not late, she is ahead." Everyone will make his opinion , Sylviane Agacinski is clearly against, but in any case, our country is undoubtedly ahead of the issue of public debate around this theme.

Mikaël Cabon

"Should we legalize surrogacy?" - Kewego
Sylviane Agacinski and François Olivennes discuss this thorny issue.

The woman is on the photo illustration of the home page of this article is not a surrogate. This photo is taken from the database of the US Department of Agriculture.
  • gmail Gestation pour autrui. Le débat sur les « mères porteuses » accouche dans la complexité


  1. [...] To surrogate mothers in France, I have just published an article on the issues on the blog Lobbycratie. . A major issue for our society like that of research on stem cells, [...]

  2. Eric75 said:

    Surrogacy (where the woman carrying the child has no genetic connection with the increased embryo) often amalgamated with traditional surrogacy (where the woman has a child of her own genes) began in 1984 California. Following fears of conflict over custody and parentage of children born by this action, but also to respond to the risk of commodification of the female body, commissions have studied laws to regulate the practices which premiered was passed in 1985 in England.
    Followed Australia, Israel, New Zealand and the US states (mostly by case law). Following the implementation of these legal provisions, conflicts over phenomena that could be called "moral panic" disappeared. And from the practice of surrogacy is growing continuously in terms that are no longer disputed, no authority is also income legalization.
    It is unfortunate that the effectiveness of these legal provisions has not been evaluated by the French institutions which are expressed on the GPA or fluttering like against-examples or "less-called ethics" of the few countries such as Belgium and India, where there is no legal framework.

    The interest of the child and the notion of kinship:
    The interest of a child who is not yet born is a very abstract concept that refers to the same perception of kinship, and in the end is used as a "right" of the child not to be born, so passive eugenics to couples who can not bear children. The very history of humanity should prevent us to limit the relationship to one of the biological, gestation, at the expense of transmitting a genetic and especially the social fact: mother or father is the one who behaves as such under the definition given society.
    This is not to deny the importance of trade in utero between the pregnant woman and the fetus, but considering the huge variety of experiences of pregnancy and absence of uterine determinism. The claim that the GPA would be synonymous with abandonment falls into this simplistic approach of kinship. If we followed this definition of abandonment, it would return to France in the legalization of embryo donation to be consistent. But this is not because a child is desired and expected continuously by a couple can not be considered abandoned. The attachment is not a biological function but a psychological construction.
    Claim gestational biological primacy is often an expression of defiance, a refusal of the intrusion of thought medicine as a form of mechanized reproduction. Unlike the stereotypical view of a delivery under the sole protection of Mother Nature, we must remember that half a century, advances in reproductive medicine, whose performances are fantasized specimen and incubator, has to end in our rich countries to the scourge of child mortality and the dead women in childbirth.
    Infertile couples never claim of "right to a child" but the "right of children", including the right not to be deprived of the history of his birth, when everyone agrees, starting with the adoptive parents need to delete the secrets related to the birth.

    Exploitation or empowerment of women?
    The woman carrying the child of another would be used as a machine, "devoid of humanity"? Note that the use of degrading and reductive vocabulary such as "wombs for rent" almost exclusively by those who claim to respect the dignity of women. This willingness to caricature denies the autonomy of women and denigrates the same principle of the gift.
    The dignity of the woman she would be better met if we understood that in surrogacy, it seeks to act as fair and rational as possible, respecting others? The fundamental challenge for society - but for women - is to ensure that they are properly informed of the proposed approach, and that their expectations are not at odds with those of the intended parents. To get to this logic of exchange and mutual respect, we must admit that for some women, pregnancy is a fulfilling life period.

    Infertile couples want a real debate takes place on the issue of altruistic legislative framework that puts an end to the ban on surrogacy in France. Our country can no longer hide behind moralizing caricatures while the GPA already exists on the national clandestinely ground, with all the risks that implies lack of supervision.

    We can not go to France to do as if nothing had changed since the debates before 1994, as if we still had no recoil as if the good practices do not exist. France, the country of human rights, can no more continue to deny the existence and rights of children born by surrogacy abroad.

  3. Claire said:

    It's great fun to read this article in the light of the proposal of gestation legalization bill for others filed on 27 January 2010 by 70 senators. We realize that almost all of the arguments against surrogacy are false.

    Thus, as is this bill, we can do the GPA without commerce, without contractual regime, giving a clear status to the surrogate mother, establishing a lineage that protects the child of an (unlikely) withdrawal of the parents ...

    This leaves only the argument that the medical profession would not accept this technique. What is wrong! Just read the survey "results questionnaire Medically Assisted Procreation (GEFF, BLEFCO and CNGOF the SFG and FNCGM, 2 October 2008" to know the reality.

    This speaks for itself.

  4. Lahoyashra said:

    There is little, on a forum, I read these words:

    "Personally, I am against the GPA.
    Wanting to have a child at all costs (at any price ... to trade child design yuck) while so many children are suffering and waiting to be adopted. I dare not approach the psyche that the child can develop to have been designed like that and trauma to the surrogate mother. It's really a mindset rich and selfish. Somali women are trying to save the children from starvation, then the belly location ... Would rather welcome these children and make them momentarily adopt history to save them. It is in this sense that I have written that the GPA is a selfish rich stuff. »

    And presto, 4 lines received idea on the GPA but also on adoption.

    Otherwise, I am annoyed by the fact that we mix two different words to me: "Surrogate Mother" and "surrogate".
    In most documents, the use of "surrogate" mask the profound differences that there are between surrogacy (the woman who carries the child also provides the ovum) and Surrogacy said GPA (wife carrying the child has no genetic link to the child). Indeed, recent studies have reported many molecular exchange between mother and child. These exchanges are regulated by mitochondrial DNA says. Unlike nuclear DNA, which is transmitted by a combination of the nuclear DNA of the parents, mitochondrial DNA is transmitted only by women. Thus, in case of surrogacy, the woman who carries the child transmits its genetic heritage to the child, and intrauterine exchanges are governed by its own mitochondrial DNA. The contribution of the infertile woman is in this case as in purely social adoption. But, in case of surrogacy, the woman who carries the child does not transmit genetic heritage to the child, and intrauterine exchanges are governed by the mitochondrial DNA of the infertile woman who provided her own eggs . Thus, the contribution of the infertile woman is present in this case not only in terms of physical examination with the child, but even participates uterine life through its mitochondrial DNA. To simplify, there are two women involved in pregnancy.

    These biological clarification seem very important. With this light, I think it's best:
    - Maintain the prohibition of surrogacy because of the resemblance and development of links between the woman and her unborn child.
    - To legalize surrogacy which allows to have a biological continuity between the child and the infertile couple, even during pregnancy. And which also minimizes the risk of suffering of women in recovering the child to his parents because the child does not look like him.