Surrogate Motherhood Warning : Many Fear Future Identity Problems for Babies

Marilyn Johnson taped the thump, thump, thump of the heart that beat within her womb. Then she and her husband sent the cassette off to Canada, where two people eagerly awaited the first sounds of their child-to-be. Throughout the nine months that the surrogate mother carried her “gift to life,” a present that came with a $10,000 price tag paid by the infertile Canadian couple, a loving friendship grew stronger by the week.

Today the surrogate child that was named after Johnson is 2 years old. But for Johnson, the phone calls, photographs and cassette tapes never stopped. In fact, Johnson, 32, is trying to become a surrogate a second time--for the same couple.

Johnson is but one example of a new twist to surrogate motherhood: Many surrogates and infertile couples are forming relationships that last beyond the pregnancy and birth. In fact, some sisters and best friends have offered their wombs to infertile loved ones.

‘Here’s Your Baby’

In early November, Sherry King placed a newborn, still connected to her by the umbilical cord, into her sister’s arms. “Here’s your baby,” King told Carole and Ernie Jalbert of Danvers, Mass. Recently, the legal adoption went through, and now King, the little girl’s biological mother, is her aunt.

In a small but growing number of cases, the children have some recognition that they were “given to mommy” by Aunt Sue or Best Friend Marie.

While these children would never have been if not for the unique relationship created by surrogate motherhood, a whole host of questions emerges from lawyers, sociologists and psychologists who fear that the child will ultimately suffer identity problems.

Who, after all, is the real mother? And if the biological mother (whose egg was fertilized with the sperm of the husband of an infertile woman) is around for years to come, what effects might this have on the child?

The most important question, which can’t be answered for years to come, is: How are these children going to respond to the news that “auntie” or “mommy’s best friend” is their biological mother?

Bond Terminated

Traditionally (that is, since the term surrogate mother was coined in the early 1980s), the bond between the newborn and the surrogate mother was terminated once the child was born and the baby could be legally turned over to the biological father and his wife.

“I really don’t think our friendship will end,” Johnson said, however, of the relationship between her family and the Canadian family. “The baby knows that my children, 5 and 13 years old, are her brother and sister. She calls me ‘older Marilyn.’ She will grow up always knowing. Her parents talk openly around her. I really do not see her as my child.”

According to mental health professionals interested in these issues, the adults involved in such open arrangements suffer. Generally, surrogates give up the rights to the baby and move through a grieving period, much the same way couples mourn a dead child. But if the surrogate remains in the picture, she is constantly reminded of having given up the child, and the other couple is constantly reminded by her presence of its fertility problem.

“It is difficult for everyone involved,” said Dr. Philip Parker, assistant clinical professor of psychiatry at Wayne State University in Michigan. “Most families don’t want contact with the surrogate after the child is born. The biologic mother thinks, ‘Not only have I lost a child, but good friends, too.’ ”

Last week, those involved in and studying the surrogate phenomenon gathered at Wayne State for a conference--”Making Babies: Can We Do It Better?” The discussions centered on some of the issues raised by these new family roles and the legal, social and medical rights of the child, the surrogate and the biological father. Surrogates spoke openly about how they felt after delivering and relinquishing the rights to a child carried for nine months. They discussed such concerns as: Should the new parents tell the child--and when? What right does a surrogate have toward the child? Can she change her mind? What legal recourse does the adopting family have in such a traumatic event? What about informed consent? Should all parties involved be counseled? How much money should the surrogate request?

The last question is at the crux of every legal, moral and ethical issue involved in surrogate parenting. Baby selling is illegal; is surrogate mothering just a clever way to sell babies? (Women receive anywhere from $10,000 to $20,000 for carrying a baby to term for another couple.)

The legal system turns to the closest thing it knows to curb such transactions: adoption laws. In most states, it is against the law to consent to the adoption of a child until after it’s born, according to Doris Jonas Freed, a lawyer for the New York chapter of the American Bar Assn.

In addition, it is illegal to pay money for a child. But there are no laws regarding surrogate motherhood. Thus, most of these arrangements are made and handled in a sub rosa manner.

So far, while many legislative bills have been introduced to protect the rights of the baby born to a surrogate, none has become law. Only one state, Michigan, has passed a law making it a violation of the adoption laws to pay money in connection with a surrogate-born child adoption. But now, a new kink enters the surrogate controversy: A new generation of surrogate mothers--family and friends of infertile couples--is delivering gratis.

‘A Whole New Entity’

“With no money changing hands, we are looking at a whole new entity,” said Alex Moschella of Rollins & Moschella, the Boston law firm that handled the adoption of Carole and Ernie Jalbert’s daughter, Kristen Jennifer. In this case, one of a handful of no-fee cases, Moschella ensured that the adoption went through the normal legal channels. In Massachusetts, when unrelated people seek to adopt a child, a state agency investigation is mandatory. But these people are blood relatives. “We are trying to treat this as a step-parent adoption,” the lawyer said in an interview before the adoption was finalized. “Ernie is the biological father, and his wife, Carole, merely wants to adopt Kristen.”

According to researchers, money is not the only thing enticing women into becoming surrogates. Parker followed 30 surrogates and found that there were a number of reasons people chose to have babies for other women. While more than 90% of the 30 surrogates he followed required a fee, that was never the whole story. Many wanted the experience of pregnancy. One-third of the women had a prior voluntary loss (through abortion or adoption) and decided to overcome the loss by becoming a surrogate.

LeRoy Walters, director of the Center for Bioethics at the Kennedy Institute of Ethics at Georgetown University, believes that carrying a child for a friend or family member may ensure a healthy life style on the part of the surrogate. “A woman will be more careful not to smoke or drink during pregnancy because she will be seeing the child in the future,” he theorized. “If this is a non-commercial transaction, in many respects it is similar to giving up a kidney to a relative.”

As long as those parties involved discuss the potential pitfalls, the “what ifs”--what if a surrogate does not give up the child after birth or a child is born with a defect, for example--Walters said he doesn’t think there are really any ethical dilemmas.