In the wake of publicity created by the Baby M Case {1} it seems unlikely that any in the United Stated can have remained unfamiliar with surrogate motherhood or can have failed to form an opinion. The Baby M Case raised, and ultimately left unanswered, many questions about what constitutes motherhood, fatherhood, family, reproduction, and kinship. When I began my field research in 1987, surrogate mother programs and directors had already become the subject of considerable media attention, a great deal of it sensationalized and negative in character. Much of what has been written about surrogate motherhood, has, however, been largely speculative or polemical in nature. Opinions have ranged from the view that surrogate motherhood is symptomatic of the dissolution of the American family {2} and the sanctity of motherhood, to charges that it reduces or assigns women to a breeder class structurally akin to prostitution (Dworkin 1978) or that it constitutes a form of commercial baby selling (Annas 1988; Neuhaus 1988).

Data for this chapter is the result of nine years of ongoing ethnographic research. Twenty-eight formal interviews with traditional surrogates and 26 with gestational surrogates were conducted, as well as 26 interviews with individual members of couples (i.e., individuals who had enlisted the services of traditional, as well as, gestational surrogates) in addition to five ovum donors.

Aside from these formal interviews I also engaged in countless conversations with surrogates, observing them as they interacted with their families, testified before legislative committees, worked in surrogate programs, and socialized at program gatherings with directors and others. The opportunity to observe the daily workings of the surrogate mother programs provided me with invaluable data on the day-to-day operations of such programs. I attended the staff meetings of one such program on a regular basis and observed the consultations in which prospective couples and surrogates were interviewed singly by such members of the staff as the director, a psychologist, a medical coordinator, or the administrative coordinator. In addition to these formal interviews I was able to observe numerous consultations between program staff, intending couples and prospective surrogate mothers, as well as, conducting thousands of hours of participant observation. I have attempted, whenever possible, to select individuals from the various phases of the traditional and gestational surrogacy process, e.g., individuals who have not yet been matched, who are newly matched and but are attempting "to get pregnant," who have confirmed pregnancies, who have recently given birth, as well as individuals for whom several years have elapsed since the birth of their child. My decision to interview individuals in all stages of the process has been, motivated by my wish to assess what, if any, shifts individuals might experience as they go through the process.

Historically there have been three profound shifts in the Western conceptualization of the categories of conception, reproduction, and parenthood. The first occurred in response to the separation of intercourse from reproduction through birth control methods (Snowden et al. 1983), a precedent that may have paved the way for surrogate motherhood in the 1980's (Andrews 1984:xiii). A second shift occurred in response to the emergence of assisted reproductive technologies (ART's) and to the subsequent fragmentation of the unity of reproduction, when it became possible for pregnancy to occur without necessarily having been "preceded by sexual intercourse" (Snowden et al. 1983:5). The third shift occurred in response to further advances in reproductive medicine that called into question the "organic unity of fetus and mother" (Martin 1987:20). It was not, however, until the emergence of reproductive medicine that the fragmentation of motherhood became a reality; with that historical change, what was once the "single figure of the mother is dispersed among several potential figures, as the functions of maternal procreation-aspects of her physical parenthood-become dispersed" (Strathern 1991:32).

Traditional Surrogacy

There are two types of surrogate mother programs: those which I call "open" programs, in which surrogate and couple select one another and interact throughout the insemination and the pregancy, and "closed" programs, in which couples select their surrogates from information- biographical and medical information and a photograph of the surrogate- provided to them by programs. After the child is born in a "closed" program, the couple and surrogate meet only to finalize the step-parent adoption. Due to advances in reproductive medicine and to consumer demand there are now also two types of surrogacy, traditional surrogacy in which the surrogate contributes an ovum to the creation of the child and gestational or IVF surrogacy where the surrogate gestates the couples' embryos. Studies of the surrogate population tend to focus, at times exclusively, on surrogates' stated motivations for becoming surrogate mothers (Parker 1983). Their stated reasons include the desire to help an infertile couple start a family, financial remuneration, and a love of pregnancy (Parker 1983:140). As I began my own research I soon observed a remarkable degree of consistency or uniformity in surrogates' responses to questions about their initial motivations for becoming surrogates; it was as if they had all been given a script in which they espoused many of the motivations earlier catalogued by Parker: motivations that also, as I will show, reflect culturally accepted ideas about reproduction, motherhood, and family.

I also began to uncover several areas of conflict between professed motivations and actual experiences, discovering, for example, that although surrogates claim to experience "easy pregnancies" and "problem-free labor," it was not unusual for surrogates to have experienced miscarriages, ectopic pregnancies, and related difficulties, as the following examples reveal. Jeannie, age 36, divorced with one child, described the ectopic pregnancy she experienced while she was a traditional surrogate in this manner: "I almost bled to death: I literally almost died for my couple." Nevertheless, she was again inseminated a second time for the same couple. As this, and other examples demonstrate, even when their experiences are at odds with their stated motivations, surrogates tend not to acknowledge inconsistencies between their initially stated motivations and their subsequent experiences. This reformulation of motivations can be seen in the following instance. Fran, age 27, divorced with one child, described the difficulty of her delivery in this way: "I had a rough delivery, a C-section, and my lung collapsed because I had the flu but it was worth every minute of it. If I were to die from childbirth, that's the best way to die. You died for a cause, a good one." As both these examples illustrate, some surrogates readily embrace the idea of meaningful suffering, heroism, or sacrifice, and although their stated motivations are of some interest they do not adequately account for the range of shifting motivations uncovered in my research.

One of the motivations most frequently assumed to be primary by the casual observer is remuneration and I took considerable pains in trying to evaluate the influence of monetary rewards on surrogates. In all programs, surrogate receive between $10,000 and $15,000 (for three to four months of insemination and nine months of pregnancy, on average), a fee that has changed only nominally since the early 1980's. As one program psychologist explained, the amount paid to surrogates is intentionally held at an artifically low rate so as to screen out women who might be motivated by monetary gain alone. One of the questions I sought to explore was whether surrogates were denying the significance of remuneration in order to cast their actions in a more culturally acceptable light as acts of pure altruism, or whether they were motivated at least in part by remuneration and in part by other factors with the importance of remuneration decreasing as the pregnancy progresses, the version of events put forth by both program staff and surrogates.

The opinion popular among both scholars and the general population, that surrogates are motivated primarily by financial gain, has tended to result in the oversimplified analyses of surrogate motivations. The following, however, are typical of surrogate explanations for the connection between the initial decision to become a surrogate and the remuneration they receive. Dismissals of the idea that remuneration serves as a primary source of motivation for surrogates of the kind expressed by Fran were frequent "It [surrogacy] sounded so interesting and fun. The money wasn't enough to be pregnant for nine months."

Andrea, aged 29, was married with three children, she expressed the idea that remuneration motivates most surrogates. As she said here, "I'm not doing it for the money. Take the money: that wouldn't stop me. It wouldn't stop the majority."

Sarah, age 27, who attended two years of college, and married with two children, explains her feelings about remuneration:
What's $10,000 bucks? You can't even buy a car. If it was
just for the money you will want the baby. Money wasn't
important. I possibly would have done it for expenses,
especially for the people I did it for. My father would have
given me the money not to do it.

The issue of remuneration proved to be of particular interest in that, although surrogates do accept monetary compensation for their reproductive work, its role is a multifaceted one. The surrogate pregnancy, unlike a traditional pregnancy, is viewed by the surrogate and her family as work; as such, it is informed by the belief that work is something that occurs only within the context of a paid occupation (Ferree 1984:72). It is interesting to note that surrogates rarely spend the money they earn on themselves. Not one of the surrogates I interviewed spent the money she earned on herself alone; the majority spend it on home improvement, gifts for their husbands, a family vacation, or simply to pay off "family debts."

One of the primary reasons that most surrogates do not spend the money they earn on themselves alone appears to stem from the fact that the money serves as a buffer against and/or reward to their own families - particularly to their husbands, who must make a number of compromises as a result of the surrogate arrangement. One of these compromises is obligatory abstention from sexual intercourse with their wives from the time insemination takes place until a pregnancy has been confirmed (a period of time that lasts on average from three to four months in length, but that may be extended for as long as one year).

The devaluation of the amount of the surrogate payment by the surrogates themselves as insufficient to compensate for "nine months of pregnancy" serves several important purposes. First, this view is representative of the cultural belief that children are "priceless" (Zelizer 1985); in this sense surrogates are merely reiterating a widely held cultural belief when they devalue the amount of remuneration they receive. When, for example, the largest and one of the most well-established surrogate mother programs changed the wording of their advertising copy from "Help an Infertile Couple" to "Give the Gift of Life," the vastly increased volume of response revealed that the program had discovered a successful formula with which to reach the surrogate population. With surrogacy, the gift is conceptualized as a child, a formulation that is widely used in Euro-American culture-for example, in blood donation (Titmuss 1971) and organ donation (Fox and Swazey 1992).

The gift formuation holds particular appeal for surrogates because it reinforces the idea that having a child for someone is an act for which one cannot be compensated. As I have already mentioned, the gift of life narrative is further enhanced by some surrogates to include the near-sacrifice of their own lives in child birth (Ragoné 1996;1999).

Fran, whose dismissal of the importance of payment I have already quoted, also offered another, even more revealing account of her decision to become a surrogate mother: "I wanted to do the ultimate thing for somebody, to give them the ultimate gift. Nobody can beat that, nobody can do anything nicer for them." Stella, age 38, married with two children, noted that the commissioning couples "consider it [the baby] a gift and I consider it a gift." Carolyn, age 33, married with two children, discussed her feelings about remuneration and having a surrogate child in these terms: "It's a gift of love. I have always been a really giving person, and it's the utlimate way to give. I've always had babies so easily. It's the ultimate gift of love."

For Euroamericans it is "gift realtions" rather than economic exchanges that characterize the family (Carrier 1990:2). Thus, when surrogates minimize or dismiss the importance of money, they are on the one hand reiterating cultural beliefs about the pricelessness of children, and they are on the other hand suggesting that the exchange of a child for money is not a relationship of reciprocity but of kinship.

Once a surrogate enters a program, she also begins to recognize just how important having a child is to the commissioning couple. She sees with renewed clarity that no matter how much material success the couple has, their lives are emotionally impoverished because of their inability to have a child. In this way the surrogate's fertility serves as a leveling device for perceived, if unacknowledged, economic differences-and many surrogates begin to see themselves as altruistic or heroic figures who can rectify the imbalance in a couple's life. Her sense of place and her social network are greatly enlarged as she receives telephone calls from the program, rushes to keep doctor's appointments, meets with prospective couples, (she may even be flown to other cities to meet couples), and later on attends, (in the open programs,) surrogate support-group meetings, monthly or semi-monthly. She may attend (in some programs) individual therapy sessions, she is often taken out socially by her couple, may receive gifts from her couple for herself and her children, be telephoned regularly by her couple, receives cards and letters from them, and attends holiday parties and other social events hosted by the program. Her sense of importance is also enhanced when she tells others about her new and unusual work. Once a surrogate meets, selects, and is selected by her couple and begins insemination, (another rite of passage that confers additional status upon her), the couple becomes central to her life, adding an important steady source of social interaction and stimulation.

The entire surrogate experience serves to alter the balance of power in the surrogate's personal life, giving her entrée to a more public role and creating new and exciting demands upon her time. From the moment she places a telephone call to a surrogate mother program to the moment she delivers a child, the balance of power in a surrogate's personal life is altered radically. Her time can no longer be devoted exclusively to the care and nurture of her own family because she has entered into a legal and social contract to perform an important and economically rewarded task: helping an infertile couple to begin a family of their own. Unlike other types of employment, this activity cannot be regarded as unfeminine, selfish, or nonnurturant.

In this sense, we can see how surrogacy assists surrogates in their efforts to transcend the limitations of their domestic roles by highlighting "their differences from men … [b]y accepting and elaborating upon the symbols and expectations associated with their cultural definition" (Rosaldo 1974:37), for example, motherhood. The gravity of the task provides the surrogate with an opportunity to do more than care for her family alone, and surrogates often report feeling that they are undertaking a task laden with importance, a project that fills them with a sense of pride and self-worth. Sally, aged thirty-three, married with two children, is a full-time homemaker. In the following passage, she discussed how surrogacy provided her with a feeling of unique accomplishment:

Not everyone can do it. It's like the steelworkers
who walk on beams ten floors up; not everyone can
do it, not everyone can be a surrogate.

Gestational Surrogates
From 1987 to 1993 over 95 % of all surrogacy arrangements were traditional. As of 1994 a profound shift occurred with 50% of all surrogacy arrangements gestational and as of 1999 that percentage continues to increase at the largest surrogate mother program (which is also the largest ovum donation program). With the advent of gestational surrogacy, however, reproduction is not only separated from sexual intercourse and motherhood but from pregnancy as well. In addition, gestational surrogacy creates three discernible categories of motherhood where there was previously only one: (1) the biological mother, the woman who contributes the ovum (traditionally assumed to be the "real mother"); (2) the gestational mother, the woman who gestates the embryos but who bears no genetic relationship to the child; and (3) the social mother, the woman who raises or nurtures the child.

The growing prevalence of gestational surrogacy is, in part, guided by recent legal precedents in which a surrogate who does not contribute an ovum toward the creation of a child has a significantly reduced possibility of being awarded custody in the event that she reneges on her contract and attempts to retain custody of the child. However, while legal factors have certainly contributed to the meteoric rise in the rates of gestational surrogacy, it should be remembered that for couples the ability to create a child genetically related to both parents is the primary reason that gestational surrogacy continues to grow in popularity.

But not all gestational surrogate arrangements involve the couple's embryos; numerous cases involve the combination of donor ova and the intending father's semen. Why then do couples pursue gestational surrogacy when traditional surrogacy provides them with the same degree of biogenetic linkage to the child, has a higher likelihood of being successful, and costs less? Typically, several reasons are cited (by the staff of the largest surrogate mother program); the primary reason is that many more woman are willing to donate ova than are willing to serve as surrogate mothers. This surrogate program is now also the largest ovum donation program in the U.S. with over 300 screened donors on file.

The second reason, as previously mentioned, is that the U.S. courts would, in theory, be less likely to award custody to a gestational surrogate than to a traditional surrogate who contributed her own ovum to the creation of the child. {4}

But perhaps most importantly, when commissioning couples choose donor ova/gestational surrogacy, they sever the surrogate's genetic link to and/or claim to the child, whereas with traditional surrogacy the adoptive mother must emphasize the importance of nurturance and social parenthood, while the surrogate mother deemphasizes her biogenetic tie to the child. (Put in here something on Euroamerican kinship and privileging the blood…)

An additional reason, and one of critical importance, is that couples from certain racial, ethnic and religious groups (e.g., Japanese, Taiwanese, and Jewish) were rarely able to locate women who were willing to serve in the capacity of surrogate but who could find women who were, willing to donate their ova. Thus, couples from particular ethnic/racial/religious groups who are seeking donors from those groups often pursue ovum donation/gestational surrogacy as a result.{4}

The gestational surrogate's articulated ideas about relatedness (or more accurately, the presumed lack thereof) also produces a shift in emphasis away from potentially problematic aspects of gestational surrogacy, such as race and ethnicity. Unlike traditional surrogate arrangements in which the majority of couples and surrogates are EuroAmerican, it is not unsual for gestational surrogates and commissioning couples to come from diverse racial, ethnic, religious and cultural backgrounds. In fact, approximately 30% of all gestational surrogate arrangements at the largest program now involve surrogates and couples matched from different racial, ethnic, and cultural backgrounds. I have, over the last four years, interviewed a Mexican-American gestational surrogate who was carrying a child for a Japanese couple; an African-American gestational surrogate who had attempted several embryo transfers unsuccessfully for both a Japanese couple and a EuroAmerican couple; A EuroAmerican gestational surrogate who had delivered twins for a Japanese couple; and a Taiwanese couple looking for an Asian American ovum donor and gestational surrogate.

When I questioned Carole, an African-American gestational surrogate (who at twenty-nine was single, with one child, and had yet to sustain a gestational pregnancy) about the issue of racial difference (between herself and her couple), she stated:
I had friends who had a problem because [they thought]
I should help blacks. And I told them, "Don't look
at the color issue. If a white person offerred to help you,
you wouldn't turn them down."

However, the following statement by Carole reveals that the issue of racial difference is further nuanced as a positive factor, one that actually facilitates the surrogate/child separation process:
My mom is happy the couple is not black
because she was worried I would want to
keep it [the baby]. The first couple I was
going to go with was black. I don't want to
raise another kid.

When I questioned Linda who is a thirty-year old Mexican-American woman pregnant with a child for a couple from Japan) about this issue, her reasoning illustrated how beliefs concerning racial difference can be used by surrogates (and couples) to resolve any conflicting feelings about the child being related to a surrogate by virtue of having been carried in her body:
No, I haven't [thought of the child as mine],
because she's not mine, she never has been.
For one thing, she is totally Japanese, It's a
little hard for me. In a way she will always be
my Japanese girl; but she is theirs.

In this quote, we can see how Linda recapitulates one of the initial motivations cited by gestational surrogates, the desire to bear a child for an infertile couple while highlighting the lack of physical and racial resemblance, or biogenetic tie.
If I was to have a child, it would only be
from my husband and me. With AI [traditional
surrogacy], the baby would be a part of me.
I don't know if I could let a part of me ….
AI was never for me; I never considered it.
Carole and Linda are aware, of course, as are other gestational surrogates, that they do not share a genetic tie with the children they produce as gestational surrogates. But concerns such as Carole's about raising an African-American couple's child reveal how racial resemblance raises certain questions about relatedness even when there is no genetic tie.{5} Although she knows that the child is not genetically hers, certain boundaries become blurred for her when an African-American couple is involved whereas with a EuroAmerican couple the distinction between genetic/nongenetic or self/other is clear. Cultural conceptions such as this about the connection between race and genetics deserve further exploration.

Not surprisingly, the shift from traditional to gestational surrogacy has attracted a different population of women. Overall, women who elect to become gestational surrogates tend to articulate the belief that traditional surrogacy, even though less medically complicated{6} is not an acceptable option for them because they are uncomfortable with the prospect of contributing their own ovum to the creation of a child. They also cannot readily accept the idea that a child who is genetically related to them would be raised by someone else. In other words, they explicitly articulate the opinion in traditional surrogate (where the surrogate contributes an ovum) the surrogate is the mother of the child, whereas in gestational surrogacy (where she does not contribute an ovum) she is not. They are nonetheless interested in participating in gestational surrogacy because it provides them with access to the world of surrogacy{7}. This often includes, interestingly enough, women who have been voluntarily sterilized (tubal ligations).

For example, Barbara, age 30, married with three children, a Mormon and a two-time gestational surrogate (now planning a third pregnancy) stated,
The baby is never mine. I am providing a needed
environment for it to be born and go back to mom
and dad. It's the easy kind of babysitting.

Oddly enough, IVF surrogates' beliefs (as well as commissioning couples) run contrary to current legal opinion as expressed in the findings of both Britain's Warnock Report and the Australian Waller Commission's report that "when a child is born to a woman following the donation of another's egg the women giving birth should, for all purposes, be regarded in law as the mother of that child" (Shalev 1989:117). It should be noted that the opinion expressed by both the Warnock Report and the Waller Commission not only contradicts the views expressed by IVF surrogates as well as commissioning couples who choose gestational surrogacy precisely because it eliminates the issue of genetic relatedness for them, it also contradicts EuroAmerican kinship ideology, specifically the continued emphasis on the importance of biogenetic relatedness.{8} However, this effort to expand our definition of biological relatedness, which has until recently depended on a genetic component, runs contrary to the EuroAmerican emphasis on biogenetic relateness, in which genetic parents are legally and socially considered the "real" parents. This fragmenetation or dispersal of parenthood, a byproduct of reproductive technologies, has resulted in what Marilyn Strathern has describes as the "claims of one kind of biological mother against other kinds of biological and nonbiological mothers" (1992:32) and fathers.

How then to account for the gestational surrogate's motivations? Should a gestational surrogate's maternal rights be "modeled on the law of paternity, where proof of genetic parentage establishes … parentage, or … on the nine month experience of pregnancy as establishing the prepondernat interest of … parentage" (Hull 1990:152). It is of fundamental importance to gestational surrogates to circumvent the biogenetic tie to the child, and they do so in spite of the greatly increased degree of physical discomfort and medical risk they face in IVF procedures (as compared to risks associated with traditional surrogacy, which are the same as those faced in traditional pregancy) {8}. Any effort, legal or ethical, to argue that pregnancy is a determining factor in parenthood not only fails to consider EuroAmerican kinship ideology but perhaps most importantly neglects to consider the position of the gestational surrogate and commissioning couple.

The medical procedures commonly encountered by gestational surrogates [the self-administraton of hormonal medications] can cause considerable discomfort. In the following example, Barbara discussed her experience:
After a while you dread having to do it; I had lumps from
all those injections. Two times a day and twice a week, three
injections a day. If you don't do it, the pregnancy would be
lost … You are just [as] concerned with the pregnancy as if
it's your own, sometimes more.

Vicky, age thirty-three, EuroAmerican, married with three children, who had given birth three weeks earlier, explained how she was able to sustain her motivation and commitment throughout the difficult medical procedures:

It was hard, but it needed to be done for the baby's sake.
All the shots [were] on a daily basis. I didn't mind it at all,
but it had to be at a certain time. It was like a curfew. Sure
it was painful, but it does go away.

The sentiments expressed by Barbara and Vicky are similar to those expressed by traditional surrogates who have experienced difficult, sometimes life-threatening pregnancies and deliveries. Both cast these experiences in terms of meaningful or heroic suffering (Ragoné 1996). The vastly increased physical discomfort and scheduling difficulties are, however, a price that gestational surrogates are willing to endure in order to circumvent what they regard as the problematic biogenetic tie. Barbara expressed a belief shared by many gestational surrogates about their pregnancies when she stated:
I separate AI [artificial insemination] and IVF completely,
almost to the point I don't agree with AI. I feel like that
person is entering into an agreement to produce a child
to give to someone else. I feel it is her baby she is giving
away. [emphasis mine]
In a similar fashion, Lee, age thirty-one, married with two children, EuroAmerican, who was waiting for an embryo transfer, discussed the differences between traditional (AI) and gestational surrogacy
Yes, it's [the fetus] inside my body, but as far as I am
concerned, I don't have any biological tie. The other
way [AI], I would feel that there is some part of me
out there.

This view of surrogacy differs in several important ways from the one expressed by traditional surrogates, who advance the idea that the term "parent" should be applied only to individuals who actually choose to become engaged in the process of raising a child, regardless of the degree of relatedness. They achieve this perspective in part by separating motherhood into two components: biological motherhood and social motherhood. Only social motherhood is viewed by traditional surrogates as "real" motherhood; in other words, nurturance is held to be of greater importance than biological relatedness. In this respect, it is the gestational surrogate, not the traditional surrogate who tends to subscribe to a decidedly more traditional rendering of relatedness.

It was perhaps impossible to predict with any degree of certainty that advances in reproductive medicine coupled with an increase in consumer demand would produce such a profound shift in the rates of traditional (AI) and gestational surrogacy. Assistive reproductive technologies, e.g., surrogate motherhood, ovum donation, and sperm donation have called into question what was once understood to be the "natural" basis of parenthood. As we have seen, traditional surrogates underplay their own biological contribution in order to bring to the fore the importance of the social, nurturant role played by the adoptive mother. In this way motherhood is reinterpreted as primarily an important social role in order to sidestep problematic aspects of the surrogate's biogenetic relationship to the child and the adoptive mother's lack of a biogenetic link. For traditional surrogates nurture takes precedence and ascendancy over nature; motherhood is understood as a social construct rather than a biological phenomenon. Gestational surrogates however, interestingly remain committed to the genetic model of parenthood{10}, reasoning that "real" parenthood is in fact genetic.

Many of the early theories about the future of surrogacy focused, at times exclusively, upon its potential for exploitation but they failed to take into consideration the fact that both fertility and infertility must be contextualized: both are embedded in a series of personal, social, historical, and cultural processes and practices. Within surrogates' statements, assessments, and questions is testimony to the plasticity and resilience of family, which in spite of these seemingly odd changes, persists.

Acknowledgements

I owe a very special thank you to Dr. Sydel Silverman of Wenner Gren: The
Foundation for Anthropological Research for her support. An additional thank you is also owed to the University of Massachusetts-Boston for ongoing support in the form of Faculty Development Grants. I am especially indebted to the women and men who have shared their experiences with me over the last ten years; their belief in and commitment to this research has made it an engaging and rewarding experience. I would also like to extend very special and heartfelt thanks to the directors, psychologists, and surrogate program staff who have over the years generously given of their time and their expertise.

Notes

1. A couple, Elizabeth and William Stern, contracted with a surrogate, Mary Beth Whitehead, to bear a child for them because Elizabeth Stern suffered from multiple sclerosis, a condition that can be exacerbated by pregnancy. Once the child is born, however, Whitehead refused to relinquish the child to the Sterns, and in 1987, William Stern, the biological father, filed suit against Whitehead in an effort to enforce the terms of the surrogate contract. The decision of the lower court to award custody to the biological father and to permit his wife to adopt the child was overturned by the New Jersey Supreme Court, which then awarded custody to William Stern, prohibiting Elizabeth Stern from adopting the child while granting visitation rights to Mary Beth Whitehead. These decisions mirrored public opinion about surrogacy (Hull 1990: 154).
2.See Rapp (1978: 279) and Gordon (1988:3) for a historical analysis of the idea of the demise of the American family.
3. In June 1993, the California Supreme Court upheld the decisions of both the lower court and the court of appeals with respect to gestational surrogacy contracts. In Anna Johnson v Mark and Crispina Calvert, Case #SO 23721, a case involving an African American gestational surrogate, a Flipina American mother and a EuroAmerican father, the gestational surrogate and commissioning couple both filed custody suits. Under California law, both of the women could, however, claim maternal rights: Johnson, by virtue of being the woman who gave birth to the child; and Calvert, who donated ovum, because she is the child's genetic mother. In rendering their decision, however, the court circumvented the issue of relatedness, instead emphasized the "intent" of the parties as the ultimate and decisive factor in any determination of parenthood. The court concluded that if the genetic and birth mother are not one and the same person then "she who intended to procreate the child-that is, she who intended to bring about the birth of a child that she intended to raise on her own-is the natural mother under California law."
4. Why women from certain cultural groups are willing to donate ova but not serve as surrogates is a subject of considerable interest. Since gestational surrogates reason that they, (unlike traditional surrogates and ovum donors,) do not part with any genetic material, they are thus able to deny that the child(ren) they produce are related to them. Given the parameters of EuroAmerican kinship ideology, additional research will be required to ascertain why ovum donors do not perceive their donation of genetic material as unproblematic.
5. During the course of the interview, I specifically asked her what her feelings and ideas were about having a child for a couple from another racial background. (I also asked this question of all the surrogates who were matched with couples from different racial backgrounds).
6. Gestational surrogates often complain about the discomfort they experience due to having to self-inject two or three times per day for as long as three to four months of the pregnancy. They report that progesterone is especially painful, since it is oil-based and has a tendency to pool and lump under the skin. Even though the largest of the surrogate programs claims to inform gestational surrogates about the need to self-administer shots, several gestational surrogates reported that they had not anticipated either the frequency or the discomfort of the injections.
7. I have discussed elsewhere in great detail the system of rewards that makes surrogate motherhood attractive to this group of women (Ragoné 1994; 1996, 1999).
8. While there are in fact observable differences in family patterns within the U.S. most notably among poor and working poor AfricanAmerican communities whose alternative models of mothering/parenting may stem from "West African cultural values" as well as 'functional adaptations to race and gender oppression' (Collins 1991: 119; Stack 1974), we should not, be tempted to lose sight of the fact that such perceived differences in family patterns do not necessarily weaken EuroAmerican kinship ideology. It continues to privilege the biogenetic model of family.
9. Aside from studies of the increased rates of multiple births there are few longitudinal studies on the effects of infertility treatments. Research does, however, suggest that infertility patients have an increased risk of ovarian cancer (Jensen, Riis, et al. 1981). The question remains, although an infertile women knowingly accepts the risks associated with infertility treatments, do surrogacy and ovum donation programs provide their populations with adequate information about the possibility of long-term risk?
10. Once a gestational surrogate has begun to develop a relationship with her couple and has experienced several unsuccessful embryo transfers, she may begin to reformulate or revise her initial beliefs concerning relatedness and family. An unsuccessful gestational surrogate may, for example, opt to become what is referred to in surrogate-mother programs as a "cross-over," someone who chose initially to participate in gestational surrogacy but then decided to become a traditional surrogate.

Biographical Statement

Heléna Ragoné is the author of numerous publications: Surrogate Motherhood: Conception in the Heart (1994), her first book, was the first ethnographic study of surrogate motherhood. In it, she documents the experiences of the women who choose to become surrogate mothers as well as those of two previously inaccessible populations: commissioning couples and surrogate mother program staff. She has since co-edited three collections, Situated Lives: Gender and Culture in Everyday Life, Reproducing Reproduction: Kinship, Power, and Technological Innovation and Ideologies and Technologies of Motherhood: Race, Class, Sexuality and Nationalism. She is currently completing Distant Kin: Gestational Surrogacy and Gamete Donation, an ethnography that will explore the meteoric rise in the rates of gestational surrogacy and ovum donation in the United Sates. She is also completing Riding Danger: Women in Horse Culture, an ethnography that highlights how and why women negotiate the risk of death and serious physical injury in the highly gendered sport of horses and riding.
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