Emily Galpern delivered these remarks on surrogacy at the Black Women for Wellness 2019 annual conference in Los Angeles, California. The theme of the conference was "400 Years: Reflections on Lessons Learned & Imagining Our Futures."

Good afternoon. I’m honored to be here with all of you.

I’m going to talk about compensated surrogacy and implications for reproductive justice.

As we look at reproductive oppression, another piece of the picture is the new global landscape created by the development and marketing of assisted reproductive technologies.

Surrogacy is an arrangement where a woman agrees to carry-and-birth a child for another person or couple, with the help of assisted reproductive technologies. In compensated surrogacy, she’s paid for this. Many surrogacy arrangements also involve a sperm or egg donor.

Who seeks to have children through surrogacy? Mostly it’s people with medical infertility, women for whom pregnancy would be unsafe, single men, and gay male couples.

And in all these cases, people who can afford it.

Surrogacy in the US can cost anywhere from $60,000 to $150,00. The surrogate receives about a third of that; the rest goes to a fertility agency, clinic, lawyer; and to an egg donor if there is one.

Some people hire surrogates and egg donors in other countries to lower the costs. Other folks cross borders because they face discriminatory policies in accessing surrogacy in their country. Many come to the US, to states that are considered “surrogacy friendly.” California is one of the most surrogacy friendly places in the world.

Laws vary: some states and countries have none. Some explicitly allow surrogacy. Some countries only allow it if there’s no compensation to the surrogate. Other countries ban it altogether. More US states are trying to pass laws to regulate surrogacy.

Surrogates and egg providers are in positions of unequal power in their relationships with agencies and intended parents, and not usually given enough information about the health risks or their rights.

We know that women, especially women of color, have faced reproductive oppression in many forms. Today’s speakers have talked about the multiple ways that Black women have been forced to reproduce; prevented from reproducing; punished for reproducing; and denied access to reproductive health services. Women all over the world do not have complete control over our bodies and our reproduction.

In this context and with this history, how do we view surrogacy? Using a reproductive justice lens, we are faced with significant questions:

Is paid surrogacy inherently exploitative of surrogates and egg donors? When US intended parents go to other countries to hire surrogates and egg donors there for a lower price, does that heighten exploitation? Should surrogacy be legally prohibited? Or permitted and regulated? Could good regulation sufficiently safeguard the rights and health of surrogates and egg providers?

If we think surrogacy should not be permitted, what are ways we can stand in support of family formation for all those who otherwise might not be able to have genetically related children, including gay couples?

If we think surrogacy should be permitted, what can we do to safeguard everyone involved: the health and rights of surrogates and egg providers; the health, rights and best interests of the children born; the rights of intended parents to be legally recognized as parents?

Black Women for Wellness, and the Surrogacy360 project I work with, and a number of reproductive justice organizations are grappling with these challenging questions and working to find a way forward that is aligned with reproductive justice principles.

In this environment of new forms of reproduction, we are aiming to transform a world full of oppression to one where all women’s lives are valued, where women can work without exploitation and have real options for financial sustainability, and where women have the power and resources to determine their futures.