Surrogate mother is a woman who agrees to bare a child in her womb, in exchange for a fee or agreed upon contract for a couple who are childless due to infertility. Often, the surrogate mother is the biological mother of the child, conceiving it by means of artificial insemination with sperm from the husband. The other kind of surrogate motherhood is what we called in vitro fertilization wherein using the wife’s egg and the husband’s sperm, and the resulting embryo is implanted in the surrogate mother’s uterus. Thus, the surrogate mother is not genetically related to the child.

For over one hundred years artificial insemination was used as a way of managing male infertility that kept the family intact and allowed children to be born to a married couple. Artificial insemination was generally kept secret. Couples did not tell friends, family, or the children themselves that donor sperm was used, thus maintaining the fiction of biological paternity.

Though stories of surrogate motherhood, often with familial surrogates, date back two thousand years, in 1976 the lawyer Noel Keane arranged the first formal agreement between a couple and a surrogate mother in the United States. The marketing of “surrogacy” developed as a solution to female infertility. Brokers entered the scene, hiring women to become pregnant via artificial insemination with the sperm of the husband of the infertile woman. In 1986 surrogacy came to national attention with the case of “Baby M.” In this case, the woman hired as a surrogate, Mary Beth Whitehead, later refused to relinquish the child. After a protracted court battle, in which Whitehead’s parental rights were stripped and then replaced, the hiring couple won custody of the baby, but Whitehead remained the legal mother with visitation rights.

The Center for Surrogate Parenting (CSP) estimates a cost of $56,525 for traditional surrogacy, in which artificial insemination is used, and a cost of $69,325 if another woman’s egg is used. Approximately $15,000 of these fees are paid to the surrogate herself for the time and sacrifice of the pregnancy. When surrogacy agreements first surfaced in the mid-1970s, there was no payment for surrogate motherhood, and it tended to involve middle-class and blue-collar couples, with friends and sisters helping each other. Once payment became the norm, the demographic changed: “the majority of the couples remain largely upper-middle-class people, whereas the majority of the surrogates are working class women”

That surrogacy has become a business has not meant that contracting couples do not value the surrogate or that the surrogate does not care about the child or the couple. Very careful screening—approximately 95 percent of potential surrogates are rejected—ensures that situations similar to that of Mary Beth Whitehead do not happen. Surrogates are chosen for their commitment. In the only ethnographic study of surrogacy, Helena Ragoné found that couples adopted one of two strategies in dealing with their surrogate. “Egalitarians” wanted to maintain a relationship with the surrogate mother and did not see her as a means to an end. Since in all of Ragoné’s cases the children were still quite young, it is difficult to know how this would play out. “Pragmatists” simply dropped the relationship with the surrogate, taking the child as theirs, and considering the payment sufficient acknowledgment of the role of the surrogate.