May 7, 2015
US army wives: the most sought-after surrogates in the world
By Sally Howard
The surrogacy business is now booming, and especially in America, where many surrogates are from army families. But it’s a job that has emotional and physical repercussions
In January Devon Cravener, 37, gave birth for the sixth time. She didn’t cuddle Brielle, a healthy 7lb 4oz baby girl born by elective caesarean. Instead, she took a brief look at the shock-headed newborn and watched as she was handed over to a tearful fortysomething couple from New York. Cravener saved her hugs for later, after her husband, Kristopher, a 6ft 3in bear of an ex-military man, had driven her home to their clapboard house in Reading, Pennsylvania, a city regularly cited as one of the country’s most impoverished.
“My daughter knows the drill after my deliveries,” she says. “I shower her with love. I always get that loving feeling after a delivery. I feel physically lighter, but lighter in my heart, too.”
Devon Cravener is one of America’s many thousands of wombs for hire, and business is booming. Since her “surro career” began in 2007, Cravener has carried babies for four couples from nearby New York State, the latest for a couple who had spent several years pursuing IVF. “[The mother] was paranoid I might take the baby and run,” she says. “It took her months to calm down.”
In New York State paid surrogacy arrangements are illegal. But neighbouring Pennsylvania is one of a handful of American states – including California, Ohio and Illinois – that adopt a liberal stance, legally recognising the “commissioning” couple or individual as the child’s parents or parent from birth. These legal and geographical incentives have led to an increasingly visible trade in surrogacy in Cravener’s recession-hit community: her obstetrician was treating five surrogates at the time of her last pregnancy.
Cravener fits the profile of the typical American surrogate. She undertook her first surrogacy aged 32; the average age is 29. Like many, she is educated to high-school level and married with her own biological child. (Agencies typically require that surrogates have their own children already, to prove they can carry a foetus to term, and prefer them to have completed their own families.)
But Cravener is also typical in being married to a military man: 20 per cent of the surrogate babies born in America each year are carried by military wives, a cohort that represents less than one per cent of the female population of childbearing age. Melissa Brisman, a fertility lawyer and the CEO of the American surrogacy agency Reproductive Possibilities, explains their appeal. “We like army wives because they have a good support system and husbands who are open to the idea of surrogacy.”
For the wives, the principal attraction is economic. Military life – typically moving posts every three to four years – can be inimical to a spouse’s career development, and while salaries for corporal-rank soldiers have been frozen at $24,000 since 2009, Cravener has received between $30,000 and $50,000 for each of her surrogacies. The cost to the commissioning parents ranges from $60,000 to $150,000 including agency and medical fees.
No wonder, then, that the global commercial-surrogacy industry is now estimated to be worth $2 billion. In Britain surrogates cannot be paid except for “reasonable expenses”, and contracts drawn up between parties cannot be legally enforced. The pool of “altruistic” surrogates cannot meet rising demand. In March a report by the Australia-based non-profit organisation Families Through Surrogacy found that UK citizens are the most likely in Europe to turn to foreign surrogacy; 271 British babies were recorded as being born via a foreign surrogate in 2014.
In America surrogacy has become mainstream, with several celebrities speaking openly about it, including Sarah Jessica Parker and Nicole Kidman. And as the practice has spread, a subculture of online and offline support networks has bloomed, with its own jargon. “Commissioning parents” and “intended parents” are used interchangeably, while surrogates identify as “carriers”, “tummy mummies” and “surro sisters”; critics of the practice refer to them as “breeders”. When the eggs come from the intended mother or a donor, the surrogate is technically a “gestational carrier”, but “surrogate” is still commonly used.
America’s first formal commercial-surrogacy contract was written in 1982. To begin with, these early surrogates were both gestational and biological surrogates, meaning that their own eggs were fertilised using the commissioning fathers’ sperm. In the 1990s advances in IVF opened up the possibility of purely gestational surrogacy, in which the surrogate carries a foetus she is not genetically related to, created from an egg and sperm from the intended parents or donors.
Many US states outlawed paid surrogacy in the wake of the 1988 case of Baby M, in which a surrogate refused to cede custody of a child she had been contracted to carry. Today some states are making moves to liberalise surrogacy laws, while others are seeking to impose stricter limitations. Since the collapse of Surrogenesis, an agency whose owner was convicted of fraud in 2013 and ordered to repay $1.7 million to her victims, there have been calls for tighter regulation. But despite this, and the emergence of a community of first-generation surrogate children critical of the “commodified” nature of their conception and birth, the American surrogacy market is growing by an estimated 25 per cent per year. America is now the world’s leading destination for commercial surrogacy, with thousands of babies delivered to surrogates for domestic and overseas parents each year.
For Cravener, the money – usually paid in instalments throughout the pregnancy – is “nice”, but her decision to be a surrogate was as emotional as it was material. In 2007 her four-year-old biological son, Gabriel, died of the rare childhood cancer neuroblastoma. “No child could ever replace our lost son, so my husband and I decided that we’d never have another biological child. I’d carried my two babies with zero complications, so I thought, ‘Why not give this gift to other parents?’?”
She answered an ad placed by Reproductive Possibilities in her local newspaper, and three weeks later an agent contacted her to initiate a psychological screening. Once cleared she began a procedure now familiar to her: a match was made, followed by a Skype call then a face-to-face meeting with the intended parents. Contracts were drawn up, and the biological protocols began: she used birth control to prevent her conceiving her own child, then the embryo transfer was made, followed by self-administered hormone injections that cause the body to act as if it has conceived naturally.
“It’s no walk in the park,” she says. “You have to be emotionally strong. You’ve got to take your shots, deal with mood swings and work out what you’re going to do if you need bed-rest when your own kids need you. Most of all, you’ve got to take on board that the baby you’re carrying is not your baby. You have to hand the baby over. If that freaks you out, you’re not going to make it as a surrogate.”
Kristine Young, 23, is a first-time surrogate based near Carlsbad, the city that has become the epicentre of the Californian surrogacy business: it is 16 miles from the West Coast headquarters of the Marine Corps. She has been contracted to carry a baby for a couple from China and miscarried in March. She admits that it has been “an emotional rollercoaster”, but is not worried for herself. “Everyone asks, ‘How will it feel to give up a baby?’” she says. “But how could it feel like your child when you don’t feed it, don’t bond with it?”
A single mother (she separated from her two-year-old son’s father, a marine, last year), she will undergo a second transfer next month. “I’m rooting for it to happen, for my intended parents’ sake.” She hopes to use her fee for a deposit on a house with a garden for her son to play in. “If something went wrong and I could never have another child of my own, it would be rough. But I’m young and in good health, so you take a leap of faith.”
Melissa Rineer, 33, the wife of a marine and a mother of two, recently, as she puts it, “retired my body” following two surrogacies for foreign parents. She undertook her first surrogacy in 2012, when she and her husband were living at the Marine Corps base near Carlsbad.
Rineer became a surrogate after a chance meeting with a social worker who worked for a local surrogacy agency. “It felt like fate,” she says. The money would enable the couple to pay off debts and start a college fund for their children. Her husband, John, “was along for the ride. He said, ‘Your body’s your body.’”
Rineer contacted Extraordinary Conceptions, which is typical of California agencies in that 70 per cent of its clients are from overseas. To Rineer, this was a bonus: she had heard that domestic parents could be more pushy, demanding regular updates and bump pictures. “I liked the idea of getting on with my own life while I was taking care of their baby.” In both cases she delivered by elective caesarean, with the intended parents spending two to three weeks in California either side of the handover. Rineer was open about her surrogacy with casual enquirers. “During my last surrogacy a woman in the grocery store asked my son if he was having a brother or sister,” she says. “She opened her eyes real wide when he said, ‘No, my mum is carrying a baby for someone in China.’”
The heightened frequency of caesareans in surrogate births is one of the factors that led the former nurse Jennifer Lahl to set up the Center for Bioethics and Culture Network, a California-based lobbying group. She points to a recent study conducted in a California university hospital that found higher rates of infant mortality in surrogate deliveries, and higher medical costs. “There’s a higher risk of pre-eclampsia and maternal hypertension associated with gestating with donor eggs,” Lahl says. “And a much higher chance of multiple births due to a more-the-merrier approach to transferring fertilised embryos.” The American Society for Reproductive Medicine’s guidelines, which include a limit of five deliveries per surrogate, “are rarely enforced”, she says. “It’s like the Wild West out there.”
Meanwhile, calls for the legalisation of paid surrogacy in Britain are becoming more high profile. In April Nick Clegg suggested that the UK should investigate the Californian model of legislated commercial surrogacy. But in the meantime the British fertility lawyer Natalie Gamble advises intended parents to be clear-eyed about the legal implications of commissioning an overseas surrogate.
“Under UK law the woman who gave birth to the child is [automatically] its legal mother,” she says. “Her partner, male or female, is its legal second parent.” Although in practice British children born to overseas surrogates are granted UK citizenship, the process can take months; one of Gamble’s clients was stuck in India waiting for a British passport for her child for more than six months. Happily, the fate of “stateless” surrogate children isn’t a risk in America, where surrogate-born babies are entitled to a US passport, enabling them to travel to the UK.
But as far as Lahl is concerned, the idea that this is a rights issue for parents is a red herring. “What about the rights of women to their own bodies? You can dress it up however you want, what we’re talking about is buying babies.”
Devon Cravener, for her part, dismisses the critics and is weighing up whether to be a surrogate for a fifth time. “It is my body, and as long as my immediate family supports me I don’t care what those critics’ opinion is,” she says. “They haven’t seen the joy in my intended parents’ faces.”