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This review is part of the larger book review forum of Sophie Lewis' Full Surrogacy Now.
Sophie Lewis’ work Full Surrogacy Now is an impassioned call for theorizing surrogacy differently. The book examines accounts of actually existing surrogacy practice in media coverage of custodial controversies involving surrogates. These include ethnographic texts focused on commercial surrogacy in India, a sustained critique of a ‘celebrity’ surrogacy doctor making the rounds of Oprahand TED events, media coverage -- from Baby M in the 1980s U.S. to Baby Gammy in 2014 in Thailand -- and media featuring commercial surrogacy in India more generally. The book’s central conceptual aim is to reclaim “surrogacy” as a powerful concept for all gestation, to lay the groundwork for a reproductive communism, to abolish the family form as we know it, and to strive towards a queer polymaternalism.
In important ways, Full Surrogacy Now seeks to defend the perspectives of surrogates against those who would speak for them through the various tropes of victim, rational decision maker or altruistic gift-giver. These tropes have been central to ongoing debates over whether surrogacy is sexual exploitation (Dickenson, 2009), reproductive work (Pande, 2013; Twine, 2011), an embodied fertility service (see Kroløkke and Pant, 2012 on the “repropreneur”), or an act of immeasurable corporeal generosity (Teman, 2010).
These tropes are also at work in the field of organ transplantation, where, to quote Lawrence Cohen, “all considerations outside of dyads like buyer-seller, donor-recipient, or doctor-patients are reduced to secondary processes.” (Cohen, 2003: p. 671) Cohen is an anthropologist but his attention to the geographic specificity of his research in Chennai’s kidney markets highlights how this southern city’s comparatively well-developed medical infrastructure (compared to northern India) made it one of the earliest sites for the development of transplantation technologies. It is also where women’s use of reproductive medicine has more often taken the form of surgical intervention such a tubal ligation compared to women in the north. These observations of geographical variation in the practices surrounding contraception lead Cohen to develop the notion of “prior operability,” as a way to understand those seemingly secondary processes outside individualistic motivations that enable women’s (and men’s) participation in kidney selling. The women in Cohen’s research expressed how they cannot sell a kidney on Chennai’s kidney market unless they can vouch that they have been sterilized and plan for no more children, an observation that links the histories of family planning interventions with the contemporary organ economies that proliferate in Chennai’s slums.
This digression through Cohen’s work is apposite because Lewis’s book considers at length the dyadic positions of the buyers and sellers; the surrogates and the commissioning parents; and the doctor – especially one highly media-savvy doctor with her patronizing references to “her” surrogates. In the text, the geography mapped out of commercial surrogacy focuses largely on two countries: the United States, where contractual surrogacy in its modern form has the longest history, and India, formerly one of the key providers of commercial gestational surrogacy services outside the US – until the state banned foreign access to commercial gestational surrogacy in 2015 and to all commercial gestational surrogacy one year after (Parry and Ghoshal, 2018). What of these secondary, historical and geographical specificities in the surrogacy industry? Does surrogacy in India (or elsewhere) have a similar relationship to the body’s operability, ones willingness to be operated on, albeit in a different context? Cohen (2003: 667) writes that the “‘Operation is not just a procedure with certain risks, benefits and cultural values; it confers the sort of agency I am calling citizenship.”
In Sophie’s work, analysis of surrogacy’s relationship to citizenship – or framed differently, its role in the reproductive biopolitics of the state – makes much less of an appearance than surrogacy’s relationship to capital. State laws and regulations do shape the often difficult-to-track geographies of commercial surrogacy around the globe. In the wake of India’s 2016 surrogacy ban, for example, Indian surrogacy agencies were reported to have flown frozen embryos to surrogates in Cambodia, Thailand and Nepal and to have facilitated travel for Indian women seeking to work as surrogates to countries such as Kenya (The Economist, 2017).
But the aim of Sophie’s book is not so much a thick description of the biopolitics of surrogacy as a revolutionary vision. That vision includes a recognition of the potential for surrogacy to explode normative framings of the natural and the technological. The text gives space to a relentless and unblinking negativity around pregnancy in order to undermine the sentimental versions of maternal-fetal relations that rest on notions such as corporeal generosity and maternal “gifts.” The latter notions suggest that gestation is a largely benign and painless giving of oneself to another. In contesting such one-sided understandings of pregnancy, Sophie gives space to what reads, if I were to be critical, as a kind of inversion of the pro-life rhetoric around abortion as murder. Citing an evolutionary biologist, Sophie dramatizes pregnancy as enabling a kind of fetal agency for biological “manipulation, blackmail and violence” which sits uneasily alongside the more nuanced readings of surrogacy practice (Lewis 2019: 137).
Rather than figuring the fetus as violent and the gestating woman as her unfortunate and undeserving victim, perhaps pregnancy could instead be generatively interpreted through the notion of destructive plasticity that philosopher Catherine Malabou explores at the end of a life – that is, the brain’s capacity to self-destruct. For Malabou, the brain’s (and by extension the body’s) capacity to destroy the subject at any moment, without warning, is the radically de-essentializing tendency of biology. Malabou (2012) writes that “the history of being itself consists perhaps of nothing but a series of accidents which, in every era and without hope of return, dangerously disfigure the meaning of essence.” (p. 91) In other words, construction and destruction are “laws of life”—inescapable vulnerabilities that accompany the living. We are all vulnerable, yet we are not equally so. Sophie’s book picks up the question of what to do with that understanding, and why it matters.
Surrogacy, the book argues, should be fully recognized as a form of work. This is not an apology for the commercialization of surrogacy, for where surrogacy is commercialized, Sophie is clear about its exploitative class and racial dynamics. This is an important point since any defense of surrogates as workers and surrogacy as a form of work leaves one open to the charge from some feminists of justifying the basest forms of bodily exploitation and commodification. The argument that surrogacy is a form of work is most clearly articulated in the text when read alongside the historical excavation of other forms of reproductive labor in which the “product” generates value.
Other scholars identify surrogacy – as the book does – as a form of what Melinda Cooper and Catherine Waldby (2014) call “clinical labor,” a value-generating activity that is embodied, and involves the assumption of a whole host of risks but also the compliance with medical regimes. Clinical labor is the name for making one’s bodily biology accessible to another. For Cooper and Waldby, it is the work of surrogates, egg donors, and clinical trial participants, amongst others. In being conceptualized as labor, these practices enable analytical insights into the material processes of value-creation of the biocapitalist-reproductive-pharmaceutical economy. However, the objective of Full Surrogacy Now seems somewhat different from Cooper and Waldby’s efforts to “rematerialize” the bioeconomy. Cooper and Waldby suggest that clinical labor is a class-in-formation whose antecedents are both the embodied work of care and the appropriation of slaves’ reproductive capacities. But where Cooper and Waldby stop there, with a critique of the dematerialization of value-generation in the bioeconomy and the development of a concept that can make visible and central the embodied contribution of anonymized, often invisible workers, Lewis articulates the aim of Full Surrogacy Now otherwise, asking early on:
“What if we reimagined pregnancy, and not just its prescribed aftermath, as work under capitalism – that is, as something to be struggled in and against toward a utopian horizon free of work and free of value?” (Lewis 2019: 9).
What would an anti-work perspective on gestation as surrogacy as work look like? The making available of one’s bodily biology to do work for another could be one (admittedly partial, for Lewis has many more creative expressions) description of surrogacy. Surrogacy could also describe the very act of pregnancy itself, Lewis argues, if pregnancy was not so wrapped up in the romance of the family and the presumed “naturalness” of the maternal-fetal relation. Pregnancy can be and has been imagined and lived as an encounter with (an)other. However, imagining the exchange of bodily vitality between pregnant person and fetus in the same terms as exchanges between strangers can provoke a kind of incredulity. In a recent collaborative effort to articulate the conceptual tools needed for research on tissue donation (see Kent et al.,2019), my co-authors and I argued that breastfeeding could be usefully conceived as donation. Yet this assertion was met by considerable perplexity on the part of reviewers, unable to conceive of how could breastfeeding a child one has birthed be conceptualized as donation in any way. Donation, it seems, is presumed to only meaningfully take place between strangers. This perplexity and its underlying assumptions are instructive: the site of the family and the corporeal labor of ‘reproduction’ is again here excluded from the realm of economic (market/gift)analysis. If breastfeeding is donation (or work?) and pregnancy is work (or donation?), what follows?
From an anti-work perspective, Sophie is hopeful, I think, that what could follow is a disaggregation and disentanglement of bodies from identities, and a multiplying of possible exchanges and flows. Sophie’s book gives her readers tools to rethink surrogacy within feminism, and to rethink the family through surrogacy. Wresting pregnancy and birth from the naturalized space of the family has been made technically possible. Surrogacy, like other reproductive technologies, further unravels the ties that bind pregnancy and birth to the heteronormative family. Downing the tools of reproductive labor, the resistant tactics of the birth strike, with its revolutionary origins in enslaved women’s efforts to refuse to reproduce, are newly visible in the politics and theories of recent responses to climate change (Elks, 2019) and austerity (Brown, 2019). The work of imagining new future births, families, gestations, and labors proliferates (Benjamin, 2019; Haraway, 2016). To cite Kathi Weeks’ writings on the potential of anti-work movements (2011), what could follow is the possibility of more “time for pleasure, politics, and the creation of new ways of living and new modes of subjectivity.” (p. 170)
‘As demand for surrogacy soars, more countries are trying to ban it’ 2017, The Economist, 31 May, viewed 14 June 2019, <economist.com/international/2017/05/13/as-demand-for-surrogacy-soars-more-countries-are-trying-to-ban-it>.
Benjamin R (2018) Black AfterLives Matter: Cultivating Kinfulness as Reproductive Justice. In: Clarke A and Haraway D (eds) Making Kin not Population: Reconceiving Generations. Chicago: Prickly Paradigm Press, pp. 41-66.
Brown J (2019) Birth Strike: The Hidden Fight overWomen’s Work. Oakland: PM Press.
Clarke A and Haraway D (eds) Making Kin notPopulation: Reconceiving Generations. Chicago: Prickly Paradigm Press.
Cohen L (2003) Where It Hurts: Indian Material for an Ethics of Organ Transplantation. Zygon 38 (3): 663-688.
Cooper M and Waldby C (2014) Clinical Labor: Tissue Donors and Research Subjects in the Global Bioeconomy. Durham: Duke University Press.
Dickenson D (2009) Body Shopping: The Economy Fuelled by Flesh and Blood. Oxford: Oneworld Publications.
Elks S (2019) A New ‘Climate Strike’: Opting for No Children as Climate Fears Grow. Thomson Reuters Foundation, 10 May, viewed 14 June 2019, < reuters.com/article/us-global-women-climatechange/a-new-climate-strike-opting-for-no-children-as-climate-fears-grow-idUSKCN1SJ02Z>
Haraway DJ (2016) Staying with the trouble: Making kinin the Chthulucene. Durham: Duke University Press.
Kent J, Fannin M and Dowling S (2019) Gender Dynamics in the Donation Field: Human Tissue Donation for Research, Therapy and Feeding. Sociology of Health & Illness 41(3): 567-584.
Kroløkke CH and Pant S (2012) “I Only Need HerUterus”: Neo-liberal Discourses on Transnational Surrogacy. NORA - NordicJournal of Feminist and Gender Research 20(4): 233-248.
Lewis S (2019) Full Surrogacy Now: Feminism Against Family. New York: Verso Books.
Malabou C (2012) The Ontology of the Accident: An Essay on Destructive Plasticity. Cambridge: Polity Press.
Pande A (2010) Commercial Surrogacy in India: Manufacturing a Perfect Mother‐Worker. Signs: Journal of Women in Culture and Society 35 (4): 969-992.
Parry B and Ghoshal R (2018) Regulation of Surrogacy in India: whenceforth now? BMJ GlobalHealth 3(5), e000986.
Teman E (2010) Birthing a Mother: The Surrogate Body and the Pregnant Self. Berkeley: University of California Press.
Twine FW (2011) Outsourcing the Womb: Race, Class and Gestational Surrogacy in a Global Market. London: Routledge.
Weeks K (2011) The Problem with Work: Feminism,Marxism, Antiwork Politics, and Postwork Imaginaries. Durham: Duke University Press.
Other essays from this forum include:
Introducing Full Surrogacy Now, Kai Bosworth and Elizabeth Johnson
Not Just Babies and Biology, Paul Jackson
Wages Against Gestation Work!, William McKeithen
Will Families be Different in the Future?, Reecia Orzeck
Love, Care, and Comradeship, Alex Loftus
Response, Sophie Lewis