Neither Sacred nor Unholy, Just Workers: the Cyborg Work of Surrogates

Abstract

This paper analyzes the practice of surrogacy, in which a woman carries someone else’s baby, focusing on the gestational-labor process of these women, called “surrogates”. To present them as hybrid figures, I use Donna Haraway’s concept of cyborg as a heuristic resource. The stigma of the financial compensation for surrogates is analyzed through theoretical contributions about sex work – along with Goffman’s theatrical metaphors – to discuss how the idealized role of who a surrogate should be is linked to the ideal morality of a sacred woman. The gestational labor process is analyzed as a hybrid form of productive and relational work, demonstrating how surrogates negotiate limits between Zelizer’s hostile worlds of market and intimacy. The findings I have presented suggest that surrogates live between two worlds and, in different ways, negotiate their limits, while they live with the idealized role that people expect of them.

Surrogacy; Labor; Gender; Stigma

Resumo

O presente artigo analisa a prática de surrogacy , na qual uma mulher gesta um bebê para terceiros, dando ênfase ao processo laboral-gestacional dessas mulheres, chamadas “ surrogates ”. Objetivando apresentar essas gestantes como figuras bastante híbridas, utilizo o ciborgue de Haraway (2016) como recurso heurístico. O estigma da compensação financeira das surrogates é considerado a partir de contribuições teóricas do trabalho sexual – juntamente com as metáforas da dramaturgia de Goffman (1996) – buscando debater como o perfil idealizado de quem a surrogate deve ser remete à figura da moral ideal da mulher santa. Seu processo de trabalho gestacional é analisado como uma forma híbrida de trabalho produtivo e trabalho relacional, demonstrando como surrogates negociam limites entre os mundos hostis de Zelizer (2011) de mercado e intimidade. Concluo que surrogates vivem entre esses dois mundos e, de diferentes formas, negociam seus limites, ao mesmo tempo que convivem com o perfil idealizado que se espera delas.

Surrogacy; Trabalho; Gênero; Estigma

Introduction

This article analyzes the practice of surrogacy in which a woman – known as a surrogate – carries a baby for someone else, whether for pay or not. If compensated, the financial compensation of the surrogate involves ethical and moral dilemmas, such as the commodification of the female body and the coercion of vulnerable women. To demonstrate that these women are hybrid and quite contradictory figures, I analyze the process of surrogate labor, the stigma of its financial compensation and the idealized role that is expected of them.

I first present the practice of surrogacy and the social debates about it, employing Donna Haraway’s figure of the cyborg as a heuristic resource to situate surrogates in a context of erasure of borders between work and non-work, reproductive and productive, gestation and motherhood, nature and artificiality. I then address the stigma of money in activities that use the female body as a work tool, employing theoretical contributions from the field of sexual work and analyzing the common points that this has with the gestational work performed by surrogates. I also discuss how stigmatization causes these women to try to fit into the ideal profile of an altruistic woman, which involves concepts such as sacrifice, giving, generosity, and honor. This discussion uses Goffman’s (1996) theatrical metaphors to apply to the fronts that these women may use to maintain their role.

Next, I briefly analyze some theoretical categories that try to define what surrogacy is, emphasizing how it is difficult for closed categories to grasp the hybrid character of these women. I analyze the possibility to categorize the gestational activity of the surrogate as a productive activity – with contributions from Lewis (2017 , 2019 ), Russell (1994) and from the Marxist theory of value – considering this a necessary debate, but still not sufficient to encompass the hybridity of this practice. This analysis is complemented by Zelizer’s (2011) concept of relational work, which demonstrates how surrogates move between the hostile worlds of market and intimacy and break with dualist concepts. Finally, I analyze this hybrid model of labor – which I call “cyborg labor”– as a model that, if it does not contemplate the experience lived by all surrogates, is at least able to contemplate a considerable number of lived experiences among the different types of negotiation of limits between market and intimacy.

Surrogacy and the cyborg: between natural body and artificial body

Reproductive difficulties represent a great obstacle to the fulfillment of parenthood for many people. The problems can increasingly be faced with medical advances and assisted reproductive techniques, which assist the human reproduction process – such as in-vitro fertilization¹ – and complementary techniques, such as donation of gametes and surrogacy, which have broadened the range of options for women who are fertile, considering that they have viable eggs, with medical problems that inhibit or make gestation in their own uterus unadvisable, and in cases of a union between people of the same sex and single people ( Graziuso, 2018 ).

Surrogacy can be defined as a practice in which an embryo, fertilized with the genetic material from intended parents² or donors, is implanted in the uterus of a woman (known as “surrogate ” ) who is independent from the parental project, who usually³ has no genetic link with the embryo she will carry. The practice can be classified as altruistic or commercial. In the later case, the surrogate receives financial compensation for the pregnancy.

Assisted reproduction techniques trigger social debates associated to new relations among people engaged in the practice of bringing a child into the world. There are no longer only two contributors of the genetic material giving life to an embryo by means of sexual intercourse, but a variety of subjects: intended parents, doctors, gamete donors and surrogates, just to mention the potential human participants. There is also technology that allows the scission – the word outsourcing could be used – of this process. The practice also generates questions about social construction of motherhood and the symbolic role of pregnancy, a reason for which surrogates are often labeled as “biological mothers” ( Luna, 2002 ). However, the term “biological mother” is often criticized by authors such as Teman (2010) , in her study about surrogacy in Israel. The surrogates interviewed did not use the term “mother” but expressions such as “oven” “incubator”, “greenhouse” to define their particular situations:

Shahar, thirty-two, who was already a mother of five when she gave birth to twins for her couple. While narrating her experience, Shahar applied another seemingly dehumanizing metaphor: I am only carrying the babies, I don’t have any part in the issue…I mean, I gave them life, because without me they would not have life. Because the intended mother couldn’t carry them. Only someone with a womb, a good womb, could hold the children for her. So, I am the one…I just held them in my belly, like an incubator. I was the incubator for nine months! And the second that they were born, I finished the job and that was it ( Teman, 2010: 32).

The statement of this surrogate reveals two topics of analysis that are essential to the practice of surrogacy: the complex corporal categorization of nature and artificiality – combined with mechanisms of objectification of their uteruses (analogies to “oven” “incubator” and “greenhouse”) – and the definition of gestation as work. At first glance, a framing of the practice as work can contrast with concepts generally connected to surrogacy, such as “love”, “charity” and “calling”. Surrogates are effectively hybrid and quite contradictory figures. This hybridity can be worked with by means of Haraway’s (2016) concept of cyborg as a heuristic resource. In Haraway’s theory, the cyborg is an “cybernetic organism, a hybrid of machine and organism, a creature of social reality as well as a creature of fiction” (Haraway, 2016:05) that helps us understand a world in which these distinctions make increasingly less sense.

Surrogates are inserted precisely in this context of erasure of borders because they challenge pre-established concepts such as distinctions between work and non-work, reproductive and productive, motherhood and gestation. Among so many contradictions, how is it possible to define who the surrogate is? Is she the biological mother? A provider of gestational services? A charitable woman who helps others who want to be parents? A hybrid figure without precedents? Lewis (2017) was the first author to use the concept of the cyborg to find solutions to the conceptual conflicts of this peculiar gestational labor. In her concept, the surrogate is a cyborg, “one of the monsters that emerge when extant borders, categories, identities, and relations are breached” ( Lewis, 2017: 35).

They are also women who move between the concepts of autonomy and control: their bodies are controlled by doctors, clinics and intended parents, following a rigid medical protocol⁴ , aimed exclusively at successful implantation of the embryo, and which can have collateral effects on the surrogate’s body. However, at the same time that they are controlled, they also seek control, not only of their bodies, but mainly of their emotions: to carry a baby that will not be one’s own involves a psychological preparation that begins before pregnancy, with each surrogate having a particular strategy to create this emotional distance.

Between nature and artificiality, to face the gestational process as artificial is also a strategy to separate pregnancy from motherhood, body from self. Israeli surrogates ( Teman, 2010 ) create true body maps to separate parts of the body that are momentarily disconnected from the self (artificial body) during pregnancy and parts still connected to the self (natural body). Thus, uterus and gestation belong to the artificial body, while self and motherhood⁵ remain intact ( Berend, 2016 ), belonging to the natural body. For Viviani (2020) , this division between natural and artificial is the apotheosis of the control of surrogates, which shows the incredible capacity of these women to control their bodies and emotions.

In this hybrid practice, as much as the break from understanding pregnancy as an affirmation of motherhood is an important consequence, the even more controversial issue is the understanding of the surrogate-cyborg as a worker. The gestational activities of these women are not usually perceived as work, mainly due to recent bans in state regulations that allowed their compensation⁶ . Considering that not all labor activity is paid – but also considering the inevitable relationship between labor and payment – highlights how much the practice of altruistic surrogacy (non-compensated) continues to be faced as an act of generosity and love, which seeks to help people with reproductive difficulties to create their families, while commercial (compensated)⁷ surrogacy carries dilemmas such as exploitation and coercion of vulnerable women and commodification of the female body ( Panitch, 2013 ). There is a constant attempt to place surrogates on one side of the binary “love x money”, as if it were possible to categorize – in such a limited way – a hybrid figure like the surrogate-cyborg, which extrapolates dualist structures. To address this binarism, I will analyze the stigma of financial compensation for activities that use the body as a work tool – with theoretical contributions from the literature about sex work – and how the idealized role of the altruistic woman is defended even by surrogates as a group.

The sacred and the unholy: stigma, representations, and the moral ideal

Studies about sex work provide important lessons that parallel gestational labor. Both the sex work of sex workers as well as the gestational work of surrogates involve the use of the female body as a work tool and generate discussions about the possibility for financial compensation. According to Mac and Smith (2018) , the movement for the rights of sex workers in the United Kingdom has a special connection with the International Wages for Housework Campaign movement, created in Italy in 1972 by a collective of Marxist feminists to reveal the naturalization of domestic labor and its non-paid condition ( Federici, 2012 ). Like sex work, reproductive and gestational work use breasts, uterus and vagina as work tools.

Sex and reproduction are activities that better illustrate the phenomenon called the “ Madonna-whore dichotomy” ( Kahalon et al., 2019 ) – the dichotomy between the figures of the “sacred-woman” and the “unholy-woman” - which consists in seeing the body in only two contexts that cannot mutually exist: as a sexualized body (sexual object) or as a maternal body (sacred). In this understanding, financially compensated surrogates are not workers, but mere victims, practicing a degrading labor activity because of extreme financial need. There is a strong specific stigma of financial compensation, the reason for which non-paid surrogates cannot suffer, because without compensation no sale of the body is involved, only a praiseworthy altruistic activity.

In the same way as sex workers, the stereotyped image of the woman who sells her body as a commodity generates a moral panic⁸ , responded to by prohibitive legislation that seeks to abolish the commodification, but not the work. In the paternalistic fantasy, a woman who uses her body as a work tool must be saved. Lewis (2019) affirms that the financial compensation of the surrogate is the true problem for those who defend criminalization of surrogacy, given that organizations⁹ that fight to end the practice suggest precisely when some surrogates come to be compensated:

Nine times out of ten, you can bet that the reason someone is declaring so vehemently against one specific microbranch of the contemporary economy is because it is a branch of productive labor that involves wombs or orifices, as well as frontal lobes and hands. The fixation on “the inside of a woman’s body” should tip us off ( Lewis, 2019: 53).

For this reason, even women who are compensated for their gestational activities try to fit into the idealized role of an altruist surrogate which involves sacrifice, giving, generosity and honor, characteristics in keeping with the figure of the “sacred-woman”, holy and maternal. For Berend (2016) , the “moral ideal” of surrogates is consistent with Goffman’s (1988) analysis of stigmatized groups: the notable stigma of commercial surrogacy pressures surrogates to present an idealized generosity to fit into the desired role. Using theater and its metaphors of actors, stages, and audiences, Goffman (1996) has addressed how individuals, in their social interactions, strive to present a suitable impression of what is expected in certain situations. Thus, the surrogate must maintain the idealized representation of her role¹⁰ , which means abandoning or hiding everything that is not compatible with it.

In this logic, the representation of the surrogate is a projection of what she wants others to see. To recognize this projection is not to say that the altruism of the woman in realizing her gestational activity is false, only that this altruism is an element that she wants to make visible in her social interactions and can hide other elements that she does not want to include in her representation, such as the stigmatized financial compensation. Goffman (1996) calls “front” a tool that we use to manipulate the idealized impression that we want to give to our spectators. If we want to maintain an idealized impression, our front must be in keeping with our role. I will call surrogates’ front¹¹ the “charity veil”.

The use of the term “veil” refers to an attempt to make invisible certain elements of the gestational activity of surrogates – such as financial compensation and contractual bonuses, for example – reinforcing family and altruistic values, in keeping with the ideal moral of their role. This front can even be used in social interactions among surrogates, in which the idealized role is strongly demanded. In her study of the U.S. forum “SurroMoms Online” , Berend (2016) used Goffman’s theatrical metaphors to explain the search for the moral ideal:

Selflessness and the commitment to “nurturing life” are the ideal traits

of a “great” surrogate. Women compete for the higher moral ground,

not only vis- -vis their couple, but in relation to other surrogates. Even

though the stories are often about IPs [intended parents], the real rivals,

as well as the real audience, are fellow surrogates. The tacit quest is to

be a truly self-sacrificing, giving, and generous woman; other

surrogates are sounding board, supporting cast, and fellow contenders.

These “performances”, to use Goffman’s term, although sometimes

contentious, bolster women’s resolve and help define the ideal morality

of surrogacy. Women discursively perform the selves they are “striving

to live up to” ( Berend, 2016 , n.p).

Sacred and unholy, altruism and money, stigma and veil: among so many contradictions, theoreticians constantly try to frame the practice by proposing categorizations that can respond to the eternal question of who the surrogate really is. Authors such as Federici (2019) categorize the practice as a type of exploitation – considering the surrogate as the biological mother of the baby she carries, who sold her womb and her child¹² – while scholars of bioethics such as Tong (1997) defend a model of surrogacy that is merely altruistic, without payment for the surrogate, because this would be a form of commodification of their bodies. While one category treats these women as victims, the other romanticizes the gestational activity and naturalizes female work as non-paid.

In an effort to untangle these problematic categories, some authors categorize the practice as a form of labor. Lewis (2019) proposes a model of productive labor (clinical and care work) whose main function is to guarantee the rights of these gestating women. In this logic, the clearer the perception of the work, the more evident becomes the discussion of labor rights and conditions of these women, such as the right to fair pay, the right to extra compensation in case of a need for prolonged bedrest, the right to deny medical interventions and negotiate contractual clauses, among others.

Lewis’ analysis of the gestational process of surrogacy differentiates it from the classic gestational process, in which a mother carries her own child. For theoreticians of social reproduction such as Arruzza; Bhattacharya and Fraser (2019), there is no doubt that the classic gestational process (known as reproductive labor¹³ ) would not fit into the category of productive labor: a fundamental condition of productive labor is the production of commodities for sale and the obtention of profit. However, in surrogacy, the surrogate sells her labor power, her capacity to gestate being a process considerably different than reproductive work in its classic concept. At the same time that it considers these differences, a categorization of productive labor alone can still be too closed to contemplate the hybrid figure that is the surrogate. Thus, I will first present an analysis of surrogacy as productive labor, to then present contributions that can contemplate the contradictions of the figure surrogate -cyborg.

Producing babies: surrogacy and the labor process in Marxist theory

The gestational work of surrogates is rarely framed as a form of active production because it is not understood that surrogates produce value. Lewis (2019) cites as an example the fact that when a surrogate suffers a miscarriage, there is a loss of value: the agency will tend to deny a large portion of her compensation. To examine the production of value in the surrogacy process, I will use Marx’s theory of value (2011b). In terms of labor power, Marx said that this is the labor itself: “the purchaser of labor-power consumes it by setting the seller of it to work” (Marx, 2011b:188). Thus, Marx understands labor power as a commodity whose use produces value, as Renault, Duménil and Lowy (2010) teach:

It is necessary to take seriously the fact that Marx sees labor power as a commodity, that is, an object of utility and value. Labor power is shared to be employed; the utility of the labor power for those who acquire it is the labor; its value is the time of labor needed for its “production”, in the very particular sense of the production of the means of subsistence of the worker and his family (…) as occurs with any commodity, labor power has a price, the salary (Renault; Duménil; Lowy, 2010:247).

In surrogacy , the surrogate sells her labor power, her capacity to gestate, which is purchased by the intended parents. The utility of the labor power for those who purchase it is the labor, desired by this couple (or a single person in some cases) who, for some reason, require a woman to carry their child. Meanwhile, the value is the time of labor needed for its production, and the financial compensation of the surrogate is the price of her labor power. In this way, her labor power is not only a useful and desirable commodity, but it also has value.

But surrogacy is definitely not well-paid labor. Data from 2014 indicate that US surrogates receive pay between US$ 20 thousand and US$ 55 thousand while Ukrainian surrogates – a country that also allows the commercial practice – receive between US$ 13 thousand and US$ 37 thousand (Hague Conference On International Law, 2014). The amounts may appear fair to some – and to others high – but not when considering the value of an hour of work. The gestational activity has a workday of 24 hours, seven days a week, for a period of 37 to 42 weeks – considering the range of the term until birth – with the exception of premature births. For example, if a US surrogate would receive financial compensation of US$ 30,000 for a gestation of 40 weeks, she would work 168 hours per week, a total of 6,720 hours for the entire gestation, receiving only US$ 4.46 per hour worked, which is below the minimum wage per hour worked determined by federal law, which is US$ 7.25 (U.S. Department Of Labor, 2019).

In terms of the labor process of the surrogate, this power can be divided into three moments: the labor activity itself, its object of labor and its means of labor (Marx, 2011b). Labor activity is always guided by an end, which in this case is the birth with life of the baby of the intended parents. The object of labor is the embryo implanted in her uterus, and her body can be seen as the means of labor. The production activity is not part of the external world. But is part of the worker’s body. The labor process occurs within her body, with materials metabolized by the organism of the surrogate. The woman’s energy is used to produce modifications within the body, that is, outside the external world. Thus, the tools of labor are not separate from the female body: person and tools are one ( Tabet, 2005 ).

For Tabet (2005) , what is called “reproductive capacity” can be sold, like any form of labor power. A woman who accepts to carry someone else’s child is the owner of her own labor power and thus of her own person. The purchase and sale of her reproductive capacity is agreed to for a fixed time – that is, the length of the pregnancy – which distinguishes a temporary interruption in her capacity (in which the owner of this capacity continues to be the owner) from a complete transfer of this capacity. The temporary character of this interruption and the need for financial compensation are key elements for surrogacy not being a form of appropriation of women, because they maintain the woman as the owner of her own labor power, opting to sell it when and how she wants within the contractual universe.

Upon analysis, the labor process of the surrogate seems to have a certain similarity with a productive labor process. The labor activity of this female worker – with the assistance of her body, her means of labor – operates a transformation in the embryo, her object of labor, according to a purpose conceived since the beginning: the final product, which is the baby. The labor process terminates in the product, but the production process as a whole does not end, because there is still the second part of the production: the process of valorization. It is in this phase that the debates between characterizing surrogacy as productive or reproductive labor arise. Is her labor productive, reproductive or is she a service provider?

Russell (1994) highlights how the visibility of the inclusion of the specific gestational labor of surrogates in the capitalist market generated an equivalence between reproduction and productive labor. Marx (2011b) made a distinction between objects produced directly for use – and which accidentally or occasionally became commodities – and objects produced specifically to become commodities, which have exchange value. Reproduction has always been seen as labor that produces use value, but not exchange value, because the product – the baby – is not destined for sale as a commodity. Thus, a good produced and not offered in the market would not be a commodity, as a good purchased and possessed for private use is also not a commodity (Renault; Duménil; Lowy, 2010).

When goods and services are produced for use, their exchange is not expected, and the activities involved in creating them are not regulated by exchange. The labor involved is only valorized in the act of exchange, which creates a temporary equivalence. For Russell (1994) , when the gestation is integrated to the capitalist market in a visible form – as takes place in surrogacy – it assumes characteristics of the productive process of commodities. Surrogates produce for exchange, because they receive payment, they conduct the productive process and deliver the final product. However, the conclusion is not simple.

We can understand that the product of the gestational labor of the surrogate has exchange value precisely because its use value is alienated: she will not keep the product of her labor for herself, with the intended parents the true consumers of the use value. However, in the process of capitalist production, labor power is purchased at a price proportional to its value, but it is capable of creating more value (known as surplus value). Surplus value is the source of all the other incomes, except for wages (the price of labor power). In the gestational activity, it is difficult to identify this surplus value, because the financial compensation appears to be integrally the price of the labor power of the surrogate.

However, it is possible to see the surplus value in processes of surrogacy intermediated by agencies. The intermediating agencies are responsible for the match between the surrogate and the intended parents. This intermediation is not always legally required (there are independent surrogates), but it is quite common, because it is understood that surrogates are placed under rigorous selection criteria by agencies. There are no official data about the values charged by agencies for the intermediation, but it is estimated that it is about US$ 25 – US$ 30 thousand in the United States ( Alvarez; Fernandez, 2019 ). Thus, the agency stipulates a value for the production process of the baby at the same time that it stipulates the value of the labor of the surrogate. The difference between these two values is the surplus value. The profit of the agency is directly related to the gestational activity of the surrogate.

Under this logic, agencies exploit surplus value, because they know that the process of producing a baby has a value greater than that paid to the surrogate for her labor power. This difference in value is the surplus value and the profit, which the agencies reinvest in themselves, constituting constant capital and expanding even more the activity and availability of the product – babies – to intentional parents, who are consumers of use value. The agencies come to control the variable capital needed (the amount invested in the labor) to produce the good. Therefore, the adjustment of the price of gestational labor provided by the surrogates in this case is not considered by the surrogates.

The particularity of the production process is more evident when the labor is compared with classic reproductive work. Despite the need to consider the state interest in the production of people and consequently of labor power, there is not precisely a purchaser of the labor power of this reproductive worker in the classic sense, and she is not financially compensated for her activity. As much as her activity should be recognized as labor, it is undeniable that the labor process is different than the labor process of the surrogate. Her reproductive labor produces use value, but not exchange value.

Russell (1994) , who analyzed surrogacy as a productive process more than twenty years ago, believed that the gestational labor of surrogates had not completely become a productive process, because the process of valorization is incomplete. There are impasses, such as the difficulty to measure the exchange value of gestational products, by specifying the total time of labor for production – considering that the time of gestation is variable – and to compare this process with other labor processes that take place in a capitalist economy.

However, the main problem of treating the gestational activity as a productive process is still moral. We spend a lot of time refuting arguments that surrogacy involves the sale of babies to then come to treat the process of valorization of the baby as the final product – and consequently, as a commodity. However, it appears evident that the payment is related to the sale of the surrogate’s labor power. The intended parents are purchasers of her capacity to carry a child, paying for the time needed for production, not for the final product.

The same analogy can be applied to doctors specialized in assisted reproduction: their financial compensation is linked to their work of in-vitro fertilization, not for the baby itself. However, while surrogates are called baby sellers, doctors are glorified as heroes who assist intended parents to establish families. In addition to a moral issue, the polemical financial compensation of surrogates is also a gender issue. Lewis (2019) emphasizes that it can be a better strategy to agree with the arguments that the baby is a commodity. It is seen as the “property” of the intended parents; it is the product of a gestational process and is often objectified by surrogates as a strategy of emotional distancing. Thus, to understand that there is a degree of objectification can be useful to the debates about the moral conflicts of surrogacy.

The difference should be considered between the valorization process found in gestation under surrogacy from that of a mother who sells her own child. In classic reproductive labor, the product resulting from the labor process has use value. Without moralizing the decision of a mother to sell her child, this is a product produced for use that accidentally became a good. It was not produced specifically to become a commodity. The labor power of this mother, her gestational capacity, was not sold to a specific purchaser as took place in surrogacy, and the payment thus refers exclusively to the baby, not to the gestational labor. In surrogacy, as analyzed, surrogates produce specifically for exchange. This is not accidental, but planned, a productive activity with a specific purpose.

We can also discuss if the labor activity of the surrogates is similar to that of a service provider, considering the simple provision of gestational services. When money is exchanged directly for labor, “the labor is purchased as service, which by all purposes can be seen as an expression to the special use value that labor provides like any other commodity” (Marx, 2011a:398). However, it should be considered that the gestational activity is not an end in and of itself, because the goal is the production of a final product (the baby). This activity can be compared with other subjects engaged in the practice of bringing a child into the world, like doctors – specialists in assisted reproduction, obstetricians, etc. – and attorneys responsible for the legal process. Their activities are an end in themselves, for this reason they are service providers. If a surrogate suffers a miscarriage, there is no loss of value to these service providers. The doctor, for example, will receive the same financial compensation for an in-vitro fertilization, even if it does not result in a fetus; or if there is a fetus but it is not born alive. On the other hand, the surrogate will have a significant reduction in her pay if the fetus is not born alive.

The analysis of surrogacy as productive labor is of extreme importance, because we must discuss how these women are alienated from the product of their labor, how they should be paid for their long period of work, and mainly how morality and stigma affect only their gestational work, not the work of doctors, clinics, agencies and lawyers involved in the practice. However, to think of the work of the surrogate only as a form of productive labor does not contemplate all its hybridity and runs the risk of categorizing it, in a closed manner, in one of the sides of the binary “love x money”. Moreover, this model alone does not consider the existence of an idealized role of sacrifice, giving, generosity and honor into which many surrogates try to fit. I will present some possible combinations of this model with Zelizer’s model of relational work (2011), highlighting that this is only one possible hybrid categorization among others that can exist to define the practice of surrogacy.

Market and intimacy: moving between hostile worlds

Among dualist conceptions, surrogacy involves market relations (surrogates discuss contractual clauses, negotiate extra pay, receive payments) but also relations of intimacy (they create bonds of affection with the intended parents, to different degrees). Surrogates make an effort to mark the borders between these two types of relations, which are also two moral definitions of surrogacy that compete with each other ( Berend, 2016 ). These negotiations between moral fields are better understood by means of Zelizer’s concept of “relational work” (2011), which establishes good combinations between economic and affective transactions.

There is a considerable effort to negotiate meanings and limits in relations that involve intimacy and financial transactions. The hybrid association between market and intimacy – which Zelizer calls “hostile worlds” – is connected not only to the stigma of financial compensation, but to the fear that these hostile worlds should not mix ( Majumdar, 2018 ). For this reason, the use of the already mentioned “charity veil” as a front is understandable. The veil becomes a tool that marks the borders between the two worlds, like a true mantle that hides the market relations in the idealized representation of the surrogates.

Some surrogates look for a balance between the two worlds, highlighting the strong connection created with the intended parents, while they simultaneously define their gestational activities as labor and negotiate contract clauses. Others seek a more rational relationship, limiting the degree of intimacy with intended parents. Finally, there are surrogates who focus more on the emotional relationship constructed with the intended parents and hide the contractual relations, establishing a profile that is more compatible with the ideal morality that is expected from a surrogate.

The relational work of surrogates involves a balance between altruism and self-protection, between giving and receiving. However, in the idealized representation of her role, there is a tenuous line between altruism and exploitation. Berend (2016) presents negative accounts from surrogates who needed bedrest during the pregnancy, requiring assistance for domestic activities and caring for their children, extra costs not included in their contracts. The prolonged bedrest led one surrogate to lose her job, without having a contractual clause that would compensate her for this. Using the metaphor of the veil, it becomes especially concerning when the surrogate fails to completely see one of the hostile worlds: without contractual protection, the altruism can easily become exploitation.

The borders between these two worlds are particularly difficult to manage in paid care work ( Zelizer, 2011 ), a category into which surrogacy can fit. Care can be defined as labor that encompasses a group of material activities and relations that consists in offering a concrete response to the needs of others ( Kergoat, 2016 ). Gender is a factor in care, whether it is outsourced or in the family realm, with women being the main people responsible for this type of activity. In a capitalist society in which the value of labor is demonstrated monetarily, labor considered to be female is rarely treated as active production, with the labor of care seen as a form of relief of human suffering, whether this suffering is of an ill elderly person or of a couple with reproductive difficulties.

Lewis (2017) frames the practice of surrogacy as a form of productive care precisely to challenge this category, in which women are the main workers and their activities are constantly defined as “calling” and “assistance”, which justifies their precarious wage. However, the understanding of productive care work does not contemplate all the peculiarities of the practice without help from Zelizer’s (2011) concept of relational work. She conducts a reading of the insertion of money in daily life under a relational perspective that focuses mainly on the social interactions and economic exchanges in which it is necessary to attribute monetary equivalence, in cases that are morally difficult to define as exchange value – as in those that involve a baby.

The “tension between economic aspects and those that are supposedly inalienable and unnegotiable of life and of human relations” (Freire, 2014:266) collide with the codes of morality and substantiate the reasons that surrogacy is so disturbing: there is an erasure of the borders between the hostile worlds of the market and intimacy, because the surrogate conducts the gestational activity (considered sacred) in exchange for financial compensation (considered unholy), and the product of this process is a baby. It is not by chance that many surrogates seek the ideal morality – focusing on the emotional bond that they create with the intended parents – while they hide the market relations of the practice using the charity veil. However, as examined, use of the veil can become dangerous when surrogates don’t recognize one of the hostile worlds and remain contractually unprotected, giving space to exploitation by agencies and intended parents, and subject to risky complications to themselves and their families, such as the loss of employment due to prolonged non-renumerated bedrest.

It is for this reason that the concept of labor must be present, beginning from a construction of productive labor, which is too limited, to reach a construction of relational productive labor – a cyborg labor – which challenges a view of the dualist world between economics and intimate relations. Even this quite hybrid construction is not able to contemplate the experiences of all the surrogates but considers the constant negotiation of limits and border markings made between the hostile worlds.

Some surrogates negotiate their limits more than others, living between the two worlds, but presenting a slight preference for one: there may be a compensated surrogate whose main motivation is to create ties with the intended parents; while another may have a more financial motivation, creating ties with the intended parents, although imposing limits on this relationship. Others accept the erasure of borders between the two worlds, comfortably living both the market relations as well as the relations of intimacy during their work period. Neither position is morally superior to the other, and all can be contemplated in a cyborg labor model (productive and relational).

Surrogates are cyborgs who live between two hostile worlds while they try to negotiate limits and demark border between them. The experience of each surrogate is unique, and they also coexist with the idealized role of who a surrogate should be (the profile that encompasses sacrifice, giving, generosity, and honor), this is reinforced by society, by the agencies and even by the surrogates themselves as a group. They are expected to have a calling for the activity, a love for what they do, but a sufficient distancing to not become attached to the baby. Alienated from the product of their labor, they support all the risks of the labor activity that is poorly valued, working 24 hours per day, 7 days a week, until the gestational process is completed. Even so – differently than what many feminists who want to abolish the practice preach – they do not want to be saved and rescued by paternalistic legislation.

Cyborg-surrogates teach us that their gestational activities are difficult to define and frame, which makes them even more interesting. In a world in which borders make even less sense, these workers appear not to be concerned with the controversy in which they are inserted. Questioned by conservatives and feminists, these women do not want to be victims or villains for either group. They are workers who move between categories of reproduction and production, nature and artificiality, market, and intimacy. They are considered sacred by some, unholy by others. As Haraway (2016) teaches, between humans and machines, reality and fiction, the cyborg is about the power of survival – it takes a route to escape the labyrinth of dualisms – grasping its tools to mark the world, the same world that labels them as different.

Conclusion

The cyborg-surrogate is a worker who erases borders without choosing a side between the dualisms of the body and machine, nature and artificiality, labor and non-labor. Exercising an activity that is often linked to concepts such as “love”, “calling” and “charity”, are women who have their bodies controlled by doctors, clinics, and intended parents, while they simultaneously demand control over their bodies and emotions, separating artificial bodies from natural bodies. Constantly framed on one side of the binary “love x money” surrogates are defined either as victims – who practice a degrading activity because of financial desperation – or as saints, if they are not compensated for their gestational activities.

There is a strong stigma over their financial compensation, a debate about which the literature of sex work offers many lessons, including the dichotomy of the figures of “sacred-women” and “unholy-women”. However, the dichotomy winds up generating abolitionist positions – both concerning sex work and surrogacy – ignoring the necessary discussions about labor rights for these professionals, increasingly marginalizing their work while continuing to compensate the other agents involved in the practice, punishing only the working women.

The stigma also causes the compensated women to try to fit into the idealized role of the altruistic surrogate that contemplates the concepts of sacrifice, giving, generosity, and honor. An idealized morality is sought mainly by surrogates as a group, who constantly try to maintain this representation of their role. To do so, they use a front – which I call the “charity veil” – that tries to make invisible certain elements of the gestational activity while reinforcing elements in keeping with an ideal morality.

The analysis of the gestational process of surrogates as productive labor helps to distinguish the practice from classic reproductive labor by women who gestate their own children. This differentiation demonstrates how surrogates sell their labor power, undergo a long work period – in which they bear all the risks – and in the end, are alienated from the product of her labor. Their gestational activity effectively has elements of productive labor, considering that they are not mere service providers, because the gestational activity is not an end in itself, but has the objective to produce a final product, which is the baby.

However, the model of productive labor alone does not account for the hybrid nature of the surrogate because it does not recognize the existence of an idealized profile that many surrogates try to fit into. A hybrid categorization is possible using the concept of relational labor, in which meanings and limits are negotiated in relations that involve intimacy and financial transactions. In this context, the use of the “charity veil” as a front makes even more sense, because there is a desire to hide the market relations and highlight the relations of intimacy in the idealized representation of the surrogates. The hybrid model of productive relational labor is known as cyborg labor, which is presented as a model that contemplates a variety of different experiences of surrogates, that is, different degrees of negotiation of limits between two hostile worlds. Whether applied to surrogates who highlight relations of intimacy, market relations or those that accept the erasure of the borders between the two worlds, this model does not consider any morally superior positioning. As such complex figures, surrogates are neither victims or villains, neither sacred nor unholy, only workers.

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• 1
  This is a fertilization technique that takes place outside the body, in which the egg and sperm are previously removed from their donors and joined in an artificial culture in a special flask ( Frazão, 2000: 3).
• 2
  The people who want to raise this baby are known as the intended parents. It is common to hear the term “genetic parents” although the intended parents are not always the genetic parents, if a donation of gametes is involved. Thus, I use the generic term “intended parents” (which encompasses “intended mother” and “intended father”).
• 3
  There are two types of surrogacy : traditional and gestational. The traditional takes place when the surrogate uses her own eggs for fertilization, that is, she will have a genetic link with the embryo. The gestational occurs when the surrogate receives an embryo already fertilized with gametes of other people, with no genetic tie to her, effectively acting only for the purpose of gestation. Due to possible psychological implications if a surrogate has a genetic tie with the embryo she carries, the practice is no longer common, with most fertilization clinics opting to only work with gestational surrogacy ( Trimmings; Beaumont, 2013 ). For this study, the term surrogacy will be used as a synonym for gestational surrogacy.
• 4
  The medical protocol generally begins five weeks before the embryo transfer and can last up to 16 weeks afterwards. Among the medications that must be used are doxycycline (an antibiotic used at the beginning of the process to treat possible light pelvic infections); Lupron (a hormone that prevents the surrogate from ovulating, giving the doctor control of her cycle); estrogen (a hormone used to thicken the uterine wall and later help in the embryo implantation); progesterone (a hormone that continues the preparation of the uterus for the embryo after the use of estrogen); aspirin (to increase the chances of implantation); tetracycline (an antibiotic used after transferring the embryo to avoid rejection); Medrol (a steroid that suppresses the immune system and increases the chances of a successful implantation) and pre-natal vitamins. The protocol encompasses oral and injectable medications and suppositories. Source: Surrogate.com [ https://surrogate.com/surrogates/pregnancy-and-health/list-of-medications-involved-in-surrogacy/ - accessed: 25 Oct. 2020].
• 5
  Parenthood in surrogacy will not be debated in this article, because the topic is usually more related to discussions about intended parents. However, it is important to make some distinctions. Israeli surrogates demonstrate a quite naturalist approach to motherhood, generally emphasizing the nature of the embryo and its genetic link with the intended mother. In the Israeli model of surrogacy, the religious question is extremely important: both intended parents and surrogate must be Israeli and Jewish. Thus, it is also an ethnic question involving strengthening of national identity, added to the importance of the figure of the “Jewish mother” in the culture of the country ( Graziuso, 2018 ). On the other hand, US surrogates see the intention (Strathern, 2014), not the genetics, as the basis for parenthood of intended parents. Therefore, it can be seen that in general, surrogates link their own maternal experience to their natural bodies. This approach does not appear to me to be a denial of the idea of motherhood as socially constructed, but as a mere strategy for protection of the self, an emotional barrier to help disconnect from the fetus and affirm that they are not the mothers of the babies they are carrying.
• 6
  Currently, the commercial practice is permitted in Russia, Ukraine (only for heterosexual couples), Colombia, Georgia and in some US states. In recent years, some countries banned the practice, such as Thailand, India, and Mexico ( Graziuso, 2018 ).
• 7
  It is important to emphasize that I do not consider altruistic and commercial surrogacy as opposites, thus defining that compensated surrogates do not also have altruistic motivations. However, this is the nomenclature officially used to differentiate practices in which surrogates are financially compensated from those in which they are not, the reason for which it is used in this study.
• 8
  A moral panic occurs when a condition, episode, person or group of people arise and become defined as a threat to social values and interests ( Cohen, 2002 ), as is the case of surrogacy. The consolidation in New York in the 1990s of the argument that surrogacy is “baby selling” – and which gave origin to a law prohibiting the practice in 1992 – had a strong relation to a moral panic generated by dissemination of fake news with the support of the local press, particularly an editorial in The New York Times in 1988 with the headline “It’s Baby Selling, and it’s Wrong” (The New York Times, 1988). Fake news was used to create riot, reinforcing a report constantly repeated at the time, although never proved, that New York had become “the surrogacy Capital of the country” and estimated that “40% of all the sales contracts in the country are signed in New York”. The source of this data was never informed ( Graziuso, 2018 ).
• 9
  Stop Surrogacy Now is the best-known abolitionist organization, which frames the practice of commercial surrogacy as exploitation of poor women and the sale of babies. Source: Stop Surrogacy Now [ https://www.stopsurrogacynow.com/ - accessed: 27 Nov. 2019].
• 10
  It is necessary to remove the weight from Goffman’s theatrical metaphor, often seen excessively literally and not metaphorically, as if surrogates play a false role. To say that there is an idealized role does not mean that it is false, to the contrary: “when we say pejoratively that a person is making a real theatrical act, we may be insinuating that she put a bigger effort than usual to present something that is not, in any way, an act. We may need some terminological help to take away the burden that “theatrical act” carries” (Goffman, 2012:168).
• 11
  By presenting the concept of “front”, Goffman (1996) uses the example of doctors who hide their mistakes – to create an ideal front of infallibility – and owners of commercial establishments that, in times of rationing, hide their sacrifices to maintain a front of normality and thus not loose clients. In this way, in addition to hiding contractual relations, surrogates can use a front to hide feelings that they judge to be incompatible with their idealized role: they can feel anger at the intended parents at some moment, regret, attachment and missing of the baby after birth, etc.
• 12
  In an interview with the newspaper El Pais in Setember 2019, when questioned about surrogacy, Silvia Federici responded: “It is an abomination. Not only a uterus is sold, a baby is also sold. You cannot sell another person. The surrogate produces a person only to sell it without taking responsibility for it. In the United States, there is an unregulated underground market of families who have subrogated babies who are born with malformations, the product is not perfect, or is not the desired sex, and they circulate on the Internet” ( Moraleda, 2019 ). Federici presents alarming information about the practice, but does not cite sources that prove their truth. In her new book “Beyond the Periphery of the Skin” , Federici defines the surrogate as a biological mother and presents new affirmations without providing sources, like declaring that “there is evidence that some surrogate children are channeled to the organs market” ( Federici, 2019 ).
• 13
  Federici (2012) emphasizes that, at first, “reproductive work” was the term used for all kinds of domestic labor, exercised within the family nucleus. However, in this article, I will use the term “reproductive work” only for the gestational activity of a woman who carries her own child, differentiating this activity from gestational work of surrogates.

Publication Dates

• Publication in this collection
  06 June 2022
• Date of issue
  2022

History

• Received
  05 May 2020
• Accepted
  17 May 2021