Surrogate Mothering, 1991 Style

August 11, 1991

For some people, the decision of a Midwestern woman to bear the children of her daughter and son-in-law, given their start in a laboratory dish, presents little ethical difficulty. Arlette Schweitzer, 42, learned seven years ago that her daughter, Christa Uchytil, could never bear children. She told doctors she would do anything, including donate her own uterus, to her daughter. Then she found she could, in effect, do just that. No money changed hands and, since Christa's egg was fertilized by her husband's sperm, no messy clouds were left about who the "real" parents would be.

For others, the picture is far less clear. Few scientific discoveries have shaken traditional views of parenting harder than the "assisted fertility procedures" introduced with the 1978 birth of Louise Brown, the first "test tube baby." "Surrogate parenting," which produced New Jersey's notorious "Baby M" case, has been one of the most troubling.

An industry now serves desperate couples unable to have children unaided -- 200 sperm banks and 200 infertility clinics in the United States alone, according to the Birmingham, Ala.-based, American Fertility Society. More than 10,000 babies have been born through these facilities. Insurers have begun coverage for some of the expensive procedures -- up to $10,000 per pregnancy -- and nine states mandate coverage of clinic users.

The sticky issues revealed in the "Baby M" case have perplexed the courts. Legal controversies entangle every phase of technology-assisted reproduction: custody fights over frozen embryos, fights over a surrogate's desire to keep a baby and a father's court-ordered adoption of children conceived with a donor's sperm. Twelve states restrict commercial surrogacy. Four outlaw it altogether, as do six European countries. hTC Congress, upset over reports some fertility clinics misrepresent success rates, has considered regulating them.

The bottom line has to be the best interest of children, however produced. What's best for the Schweitzer-Uchytil twins is likely to be done with minimum discomfort all around. But where divorce, discord between surrogates and would-be parents or, sadly, birth defects arise, painful adjustments must be made by courts. Baby-selling, barred in New Jersey by its Supreme Court's ruling on "Baby M," cannot be allowed anywhere. Nor should authorities permit extravagant clinical claims to victimize the hopeless.

Surrogacy is likely to continue, even if restricted to cases in which the birth mothers have no genetic links to implanted fetuses. Legislative guidelines to limit the pain which accompanies breakdowns in relations between parties to such agreements are far better than court slugging matches. Best wishes to the Schweitzers and Uchytils, but the rest of us still have important issues to resolve.

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