Many couples who struggle with infertility say they would go to the ends of the earth to have a child. Some use surrogate mothers in the United States, but the high cost and legal complications keep that option out of reach for many families. So some Americans are going global --to countries like India– to make it happen.
In her new book The Baby Chase: How Surrogacy is Transforming the American Family, Leslie Morgan Steiner chronicles the journey of Rhonda Wile, an Arizona nurse who became a mother through international surrogacy. Her three children were born to surrogate mothers in India. Wile and Steiner sat down with Tell Me More host Michel Martin.
Convincing grossed out husband
Wile: My husband was very much against it in the beginning. He really knew less than I did and thought it was, in simple terms, he thought it was gross....As we talked, you could see it in him, he got more and more excited, he got more understanding. I said to him "this is our dream, we want to have a family, and everything we've come into we've hit a roadblock. So let's just be open minded." And that's all that I wanted.
Criticism that surrogacy exploits women
Steiner: Surrogacy is a shocking idea for almost everyone the first time they think of it. Several states and many countries have banned it...but I didn't come across any exploitation of women. I think hypothetically it is possible. But clinics and clients screen very carefully for surrogates who are mentally healthy, physically healthy, have already had children and completely understand the complexity of what they're getting in for. So I think there are a lot of checks and balances in the process.
Going to India with an open mind
Wile: Being that India is a third-world country, it's certainly not what we're accustomed to here in the Western society. But for me, going with an open mind and looking at the whole situation, we had decided we would look at it first and see. ... The more we got involved — when we actually got to meet our surrogate, hold her, and meet her family, and [see] the smile on her face, meet the doctors — the idea of exploitation just totally went out the window for us.
MICHEL MARTIN, HOST:
I'm Michel Martin and this is TELL ME MORE from NPR News. They say it takes a village to raise a child, but maybe you just need a few moms in your corner. Every week, we check in with a diverse group of parents for their common sense and savvy advice. Today, though, we are talking about how far some people are willing to go just to become a parent. Now you've probably heard of celebrities like Sarah Jessica Parker or Elton John who've hired surrogates to carry their babies. Sometimes they've also used donor eggs to make a pregnancy happen.
But the expense and legal complications put surrogacy out of reach in the U.S. for many couples. So more Americans are going global to make this happen, to places as far as way as India. That journey is detailed in a new book. It's called "The Baby Chase: How Surrogacy Is Transforming the American Family." It's by Leslie Morgan Steiner, one of our regular parenting contributors. She's also a mom of three, and she's back with us. Leslie, thanks so much for joining us.
LESLIE MORGAN STEINER: A pleasure to be here.
MARTIN: Also with us is Rhonda Wile. She's a mom who's profiled in the book. She's a nurse from Arizona and her three children - with her husband - were born via a surrogate in India - two surrogates, in fact. Am I right about that?
RHONDA WILE: That's correct.
MARTIN: And she's with us here also. Thank you so much for joining us.
WILE: Thanks for having me.
MARTIN: "The Baby Chase" is out today. So, Leslie, you were saying that surrogacy is transforming the American family. How so?
STEINER: Well, you know, for centuries, infertility meant you couldn't have your own biological children. But today, because of advances in surrogacy and IVF, anyone can have a baby. So two openly gay men who want to raise their own biological children together or a woman who had cancer in her 20s and had her uterus removed or a 50-year-old law firm partner who was decided after menopause that she wants to have her own child - because of surrogacy, all of those people can have their own babies today.
MARTIN: Well, you actually make the point in the book that actually surrogacy has always existed, we just haven't called it that. You know, when celebrities have, like, sham marriages, for example, or when people had mistresses. And so other cultures...
STEINER: Or in the Bible, surrogacy is mentioned over 20 times. So surrogacy is ancient, but what is different now is that advances in IVF and acceptance of surrogacy mean that there's a new kind of surrogacy called gestational surrogacy where the sperm, the egg and the uterus are all supplied by three different people. So the surrogate doesn't have any biological or genetic connection to the baby. And this makes it easier for her psychologically, and also it's more clear, legally, that it's never her child.
MARTIN: How did you get interested in this?
STEINER: Oh, my goodness, because it's such a fascinating subject. And my first two books, "Crazy Love" and "Mommy Wars," deal with issues that are paramount to women today - you know, marriage, motherhood, work. And to me, the idea of not being able to have a child when you've wanted your whole life to have a baby is fascinating. And it's a really important part of womanhood. And this subject is so complex morally, medically, financially, and there's so many wonderful, personal stories behind infertility and surrogacy. So it appealed to me as a writer.
MARTIN: So, Rhonda, how about - does that describe you? You had always wanted to be a mother. It was just what you envisioned for your life.
WILE: Yes, absolutely. Since I was a little girl, I always dreamed of becoming a mother. I never imagined not having children.
MARTIN: And that became more difficult than you had envisioned that it would ever be, for all kinds of reasons, including kind of some unique, you know, medical issues that you had that made it difficult for you to carry a baby to term. So how did you start considering surrogacy? Do you remember how the idea presented itself to you?
WILE: Yeah. Once we - for us - it came down to cost for us. We decided adoption was not an option for us at the time, and we ended up - once I found out that I had the didelphys uterus, which is ultimately two uteruses, we went to a multitude of different doctors. And each of the doctors - of the average of the doctors - basically said we recommend surrogacy. So at that point...
MARTIN: Did you even know what that was at that point?
WILE: I knew about surrogacy, but I didn't know all the details and complexities of it and the cost and all that was involved. I was a little crushed at first because what woman doesn't want to carry their own child and feel them move inside of them and those amazing feelings? So it took us a while to get to that point, and I actually have a friend that I worked with at the time who was a surrogate in the United States.
MARTIN: She was a surrogate.
WILE: Correct. So I asked if she wouldn't mind sitting and talking to my husband and I because my husband was very much against it in the beginning. He really knew less than I did, in fact, and thought it was, you know...
MARTIN: What? He thought it was what?
WILE: In simple terms, he thought it was gross. Those were his words, in simple terms. And he didn't quite understand the whole situation. So we sat down and we talked with her for about an hour, and as we talked, you could just see it in him. He got more and more excited. He got more understanding. And the fact that he actually sat - I said to him, you know, this is our dream. We want to have a family, and everything that we've come into we've hit a roadblock. So let's just be open-minded and talk to her, and that's all that I wanted. And that's what we did. And...
MARTIN: Why India?
WILE: Well, when we finished the conversation with her, she basically told us the cost, and at that point we felt deflated again. Another roadblock, in a sense, is how we felt.
MARTIN: What is the cost in the United States?
WILE: It can range anywhere from $80,000 to upwards to $120,000 - $150,000. And that doesn't necessarily include all of the IVF procedures, the surrogate - hiring of the surrogate, the surrogacy pregnancy. There's so many details involved in it. And then, depending on who you have, you usually go through an agency, and then that increases the cost as well. At that point, our first question to her was, well, are you still willing to do it? And she said, no, I'm retired. But in the event, we started looking back and I said this has to be - this has to be our way of having a family. This has to be the answer. It seemed so possible, so let's look into it further. And...
MARTIN: And all roads eventually led to India
MARTIN: Because - it was still not free. Let's just be clear about that.
MARTIN: Your out-of-pocket costs were what? About $50,000?
WILE: About that with our first son, yeah. And that was only because it took a couple of attempts for us to get pregnant. But the whole process can start anywhere from about $26,000 to $32,000, from everything. From - the only thing that's not included in that would be your travel costs and your food and your accommodations. So you're talking from A to B, starting out and bringing your baby home.
MARTIN: If you're just joining us, we're talking about the new book "The Baby Chase: How Surrogacy Is Transforming the American Family." My guests are author Leslie Morgan Steiner. That's certainly a name that you know. She's one of our regular contributors to our parenting roundtable. Also with us is Rhonda Wile. That's who was speaking just now. She's a mom of three. And she has her children, her three children, through surrogacy in India.
You heard - Leslie, back to you. You heard Rhonda say that her husband thought it was gross. And, I mean, that can be a catchall for a lot of feelings and opinions. And one of the feelings and opinions that some people have is this is really exploitation. This is exploitation, you know, of the strong - of the most vulnerable by the most privileged.
STEINER: Right, and, you know, surrogacy is a shocking idea for almost everybody the first time they consider it because it shakes our centuries-old definition of pregnancy and parenthood. And as a result, most religions oppose surrogacy, several states and many countries have banned it. And even though doctors consider infertility a disease, most health insurance doesn't cover surrogacy as a treatment. We are really in the infancy of gestational surrogacy - commercial surrogacy - being accepted in this country and around the world. But I tell you, the thing it doesn't - I didn't come across any exploitation of women.
I think that hypothetically it is possible, but clinics and clients screen very carefully for surrogates who are mentally healthy, physically healthy and have already had children and completely understand the complexity of what they are getting in for. So I think there are a lot of checks and balances in the process because obviously you're not going to hire somebody to carry a baby for you if she is vulnerable to exploitation. You want somebody who's grounded and stable. So I think - I understand exploitation is the first thing that people are worried about, but in writing this book, and I researched it around the world for three years, I didn't come across that as a realistic concern.
MARTIN: Rhonda, can I ask you, did you think of that? Was that one of your concerns or your husband's concerns that, you know - I'm sure you don't see yourself as very privileged. I mean, your husband's a firefighter, does some very dangerous work. You're a nurse. You do very demanding and important work. You both do very important and demanding work. You don't see yourself as privileged, but in contrast to the women who are carrying your children, you are. Did that occur to you?
WILE: I think initially it did. Being that India is a Third World country, it's certainly not what we're accustomed to here in the Western society. But for me, going with an open mind and looking at the whole situation, we had decided that we would look at it first and see. Each step progressed more. And the more we got involved and the more - when we actually got to meet our surrogate and hold her and meet her family and the smile on her face, meet the doctors, everybody that was involved in it, the idea of exploitation just totally went out the window for us.
MARTIN: What was the biggest surprise for you when you went to India and you eventually pursued this process? What was the biggest surprise? What was the biggest thing that struck you that was not what you had expected?
WILE: I think Mumbai in itself is like a whole new world. For me, I'd never been outside the United States, essentially. And going to a Third World country, the noise, the dirt, the poverty - just those types of things that I wasn't - was very much in your face - that I wasn't used to.
MARTIN: Did you have a concern then about the health of your potential surrogates? That being in conditions that were not the ones you were used to, that they would have the proper nutrition, the proper healthcare, the proper circumstances to deliver a healthy child.
WILE: I think, initially, when we went into the process, those were some of the questions we had for the doctors. They quickly eased our minds. And when we were actually there, we got to do a lot of things, and we researched ourselves. Being that we were the first couple - international couple - for the doctors, there were a lot of questions we had. We didn't have anybody else to refer to. So we got to go. We asked to go see where the surrogates stay. We got to go to our surrogates' home. And they told us what the criteria were for them - that they have to be such - a certain distance from the clinic so that in case they do need care, they're there. They - the doctors themselves go in and look at the houses to make sure that they are getting the proper nutrition they provide for them.
MARTIN: And you ended the process being very happy, you know, about it. Your kids are beautiful by the way. I've seen pictures of them.
WILE: Thank you.
MARTIN: They are beautiful. You wound up also using a donor...
MARTIN: ...From India - an egg donor from India. And you are a huge fan, and you feel really strongly. And you also feel that the money that you paid the surrogates helped them improve their own lives.
MARTIN: Have you heard anything that has changed your - or given you any pause about this? Because since the book has come out, and since there have been some more reporting on this, there are a lot of people who have deep ambivalence about it, and they say that they find it - more information doesn't make them more amenable to this. They feel that it is exploitative.
WILE: Correct. And we knew going into this from day one that it would be a very controversial topic. When we went to India initially, we literally fell in love with the country. We consider it our second home now. And so, we know that it's controversial and, honestly, to be quite open about it, we have not received any negative feedback to us, personally. When we're out on the streets, if we bring up the topic, meeting people face-to-face. Behind the scenes, on media and responses to articles that we've done in the past has been somewhat nasty.
MARTIN: I'm curious how you're going to explain the - explain your children's birth story to them. Have you thought about that?
WILE: We've already started the process. We knew from day one when we started our blog, and then when we originally met with Leslie and knew that it would be published in a book, we couldn't very well keep it from them. But we never had those intentions in the beginning.
We have pictures of both of our surrogates up on the wall, holding the kids with their family. When we went back to have our twins, my oldest son, Blaze, was with us and we actually were able to go back and she was able to meet him. He played with her sons and we went to her house, which she said was very important for her because she said if it wasn't for Gerry and I, she wouldn't have the house she has right now.
MARTIN: So for you, it's all good. But Leslie, I have to ask you about this because the criticism of your book - which, as I said, is just out - is that people who reviewed it say its entirety too cheerleader-y about this issue which is - remains fraught. In fact, one of the points that it makes is that one of the first known surrogates in the United States, Elizabeth Kane - I don't know if that's her real name, but is known as Elizabeth Kane - turned against the whole process and later became an advocate against the whole process. What do you have to say about that?
STEINER: Well, it's also true of Mary Beth Whitehead, one of the most famous traditional surrogates from New Jersey, but those women were - they were working as traditional surrogates. It was their egg. It really was very much them giving up their own baby for money. And it was - they had no support at the time. Surrogacy is very different now because of the psychological separation - because it really isn't your baby. It's your body, but it's the intended parents' baby from the very beginning. So I...
MARTIN: Did you start the process as pro-surrogacy as you seem to have ended up in the book?
STEINER: No, no. Not - I didn't. I didn't. And I...
MARTIN: So what was the determining factor that made you feel like this is all good?
STEINER: Because I really - as a mother myself, and as somebody who's never suffered from infertility, I really believe that everybody who wants a baby should have a baby. I think that it's the most beautiful thing, wanting a child. And I think everybody should be able to have a baby. And...
MARTIN: But what about those who say that that's not true? That that's hokum or that that's socialized into women. That's not a biological imperative, it's - that is socialized into you.
STEINER: That's fine for them to think that, but they - I have talked to so many people desperate for babies, and I - there's no arguing with that. You know, the people who are desperate for babies, they - they understand that this is a deep and passionate human right. And I think that, you know, this is a very new idea. It gives a lot of people the creeps. It's hard for them to get their heads around it. But surrogacy - having a baby via surrogate when the woman who is the surrogate is doing it voluntarily, she is well compensated, she's taken care of - I think that it can be like adoption. That it's - it can be awkward, and there's a lot of gravitas involved that you can't disrespect, but it ultimately is a very beautiful thing.
MARTIN: Do you see that, in the future, you think that surrogacy will be viewed in the same way as adoption?
MARTIN: Because there are a lot of people who feel that - I mean, there are some people who feel that adoption is not quite right, but there are other people who feel that adoption should always be your first - just on a moral and ethical level - should be the first choice and should be - that society should steer in that direction as a matter of policy because there are many children who are not well cared for.
STEINER: Well, I think one of the first things you learn as a parent is that you really shouldn't be judging other people. Their desire for children, their lack of desire for children, or the way they raise their families. And I think it's the same thing about conception. And some people want a biological connection to their babies. That's natural, too. And, you know, I just - I think that parenthood is - the reason I'm a cheerleader for surrogacy is because infertility is a cruel and crippling illness that strikes at random. And it's very common, 10 to 12 percent of the population has it. And I think that we need a lot of solutions to infertility - adoption, surrogacy, IVF treatments. And I just - I was really won over by Rhonda and Gerry. I think that they are wonderful people who should have had 10 children, and getting to know them...
MARTIN: Rhonda's like, whoa, hold on here.
STEINER: And seeing what they went through, I couldn't help but have sympathy for it and become an advocate for this.
MARTIN: Well, all right. Well, we'll see. Clearly, there are other points of view here, and I'm sure we'll be hearing from of those points of view.
STEINER: As we should.
MARTIN: As we should. Rhonda - that's Leslie Morgan Steiner. She's one of our regular parenting contributors, a mom of three. Her latest book is "The Baby Chase: How Surrogacy is Transforming the American Family." It's out today. Also with us, Rhonda Wile. She's a nurse and mom of three who is profiled in the new book. And they were both kind enough to join us in our Washington, D.C. studios. Thank you both so much for joining us.
WILE: Thank you.
STEINER: Thank you so much, Michel.
MARTIN: And that's our program for today. I'm Michel Martin and you've been listening to TELL ME MORE from NPR News. Let's talk more tomorrow. Transcript provided by NPR, Copyright NPR.