How the Story of a Surrogate, Expectant Parents, and a Baby Reveals the Pitfalls of Repro Tech

How the Story of a Surrogate, Expectant Parents, and a Baby Reveals the Pitfalls of Repro Tech March 6, 2013

Fundamentally, it is simply a sad story, one that took place just a few miles from where I live, in the hospital where I gave birth to two of my own babies.

As CNN reports, Connecticut resident Crystal Kelley agreed to carry a baby for a couple who had three children and wanted a fourth. The couple’s three children had been conceived via IVF and there were pregnancy complications. The mother was unable to carry another child herself, but the couple had two embryos left in storage that they wanted to use with a surrogate.

Kelley is a single mother of two children for whom surrogacy fees would make a big difference in her ability to care for her family. So contracts were signed, the two embryos were transferred into Kelley’s uterus, and she became pregnant with one baby. Everyone was thrilled. And then things got complicated.

With the parents standing behind her, the ultrasound technician at the hospital put the wand on Kelley’s stomach. The test confirmed her worst fears: It showed the baby did have a cleft lip and palate, a cyst in the brain, and a complex heart abnormality.

The doctors explained the baby would need several heart surgeries after she was born. She would likely survive the pregnancy, but had only about a 25% chance of having a “normal life,” Kelley remembers the doctors saying.

In a letter to Kelley’s midwife, Dr. Elisa Gianferrari, a maternal fetal medicine specialist at Hartford Hospital, and Leslie Ciarleglio, a genetic counselor, described what happened next.

“Given the ultrasound findings, (the parents) feel that the interventions required to manage (the baby’s medical problems) are overwhelming for an infant, and that it is a more humane option to consider pregnancy termination,” they wrote.

Kelley disagreed.

“Ms. Kelley feels that all efforts should be made to ‘give the baby a chance’ and seems adamantly opposed to termination,” they wrote.

The letter describes how the parents tried to convince Kelley to change her mind. Their three children were born prematurely, and two of them had to spend months in the hospital and still had medical problems. They wanted something better for this child.

“The (parents) feel strongly that they pursued surrogacy in order to minimize the risk of pain and suffering for their baby,” Gianferrari and Ciarleglio wrote. They “explained their feelings in detail to Ms. Kelley in hopes of coming to an agreement.”

The two sides were at a standoff. The doctor and the genetic counselor offered an amniocentesis in the hope that by analyzing the baby’s genes, they could learn more about her condition. Kelley was amenable, they noted, but the parents “feel that the information gained from this testing would not influence their decision to consider pregnancy termination.”

The atmosphere in the room became very tense, Kelley remembers. The parents were brought into the geneticist’s office to give everyone some privacy.

After a while, Kelley was reunited with the parents.

“They were both visibly upset. The mother was crying,” she remembers. “They said they didn’t want to bring a baby into the world only for that child to suffer. … They said I should try to be God-like and have mercy on the child and let her go.”

“I told them that they had chosen me to carry and protect this child, and that was exactly what I was going to do,” Kelley said. “I told them it wasn’t their decision to play God.”

Then she walked out of the room.

“I couldn’t look at them anymore,” she said.

The couple went on to offer Kelley $10,000 to terminate the pregnancy. Both the parents and Kelley retained lawyers. Kelley ultimately moved to Michigan, which does not recognize surrogacy contracts and would therefore view Kelley as the baby’s legal mother. Kelley found a family who had other children with special needs who was willing to adopt the baby. On June 25, 2012, Kelley gave birth to a baby girl. The baby has significant health issues, including a heart defect, a cleft palate and lip, and heterotaxy, a condition in which her internal organs are not in the proper places. In the months since her birth, she has had multiple surgeries and faces many more treatments. Her adoptive mother says, “Ultimately, we hold onto a faith that in providing [her] with love, opportunity, encouragement, she will be the one to show us what is possible for her life and what she is capable of achieving.”

As I said, a sad story. And an important one. Stories, I believe, are the most important foundation of conversations around the possibilities, limits, and pitfalls of today’s reproductive and genetic technologies. I also believe it is important to receive such stories as the complex, nuanced things that they are, rather than transforming them into morality tales that become a tool for arguing what is right and wrong, who was saintly and who was selfish. So rather than coming to clear conclusions about this story and who was most at fault, I will simply outline the many pitfalls of reproductive technology that this story highlights and a few opinions along the way:

First, this story shows that money is a significant motivator, if not the only one, for surrogates who offer their wombs to prospective parents. As the reporter tells it, Kelley sought a surrogacy arrangement primarily because of financial need, not altruism. While I’ve read many surrogacy stories in which a desire to help is a primary motivator, with the large sums of money involved, surrogacy is clearly a business arrangement in many (most?) cases.

Second, it highlights the unique relationship that a woman and a growing fetus haveI believe that the fact that we are conceived and borne in intimate relationship with another human being is a sign of God’s primary creative motivation, to be in loving relationship with God’s creatures, who must be in loving relationship with others if we are to thrive. For this reason, I am more leery of surrogacy than of almost any other reproductive technology, because it disturbs this primary relationship in and through which we are created. This is also why I am even more leery of the prospect of artificial wombs, which at least one evangelical bioethicist has called a “morally acceptable” option for giving frozen embryos a chance at life. To disturb the primary, fundamental relationship in which all of us are initially made and nurtured is to transform a child from a creature formed in relationship to a product manufactured in isolation.

Third, this story reveals the common temptation to use technology to overcome all human limitations, to solve every perceived problem, whether that limitation is wanting another child when one’s body is unable to carry one (“solved” with the use of IVF and surrogacy), or being faced with the daunting prospect of raising a sick child (“solved” through pregnancy termination). I do not believe that the prospective parents in this case were evil. I believe they truly saw what they desired—a healthy fourth child—as a good thing for their family and their child. The point at which I would press them to question their motivations and decisions most deeply wouldn’t necessarily be in the desire to terminate (though that is indeed a fraught decision requiring deep discernment), but rather the desire to have another child in the first place, rather than accepting in gratitude the family they had, as well as the inability of their bodies to create another life. (One facet of this story that goes unexamined in the news coverage is whether the couple was motivated at all to pursue a fourth child in part because they did not want to leave those two embryos behind in a freezer—a motivation that raises even more questions about how reproductive medicine is performed and its many ethical and emotional pitfalls.)

Fourth, both parties in this story invoked a merciful God in their favored decision. To the parents, sparing a child great suffering seemed like the merciful thing to do. For Kelley, God’s mercy was evident in giving the child a chance to live. I am sympathetic to both views. I do, however, believe that the impulse to accept, welcome, and care for those who suffer more closely mirrors how Christ operated in the world than the impulse to “spare” those who suffer from life itself.

Finally, this story ends in hope, in a new story still to be lived and told by the adoptive parents and their child in whom they “see a little girl who’s defied the odds, who constantly surprises her doctors with what she’s able to do —make eye contact, giggle at her siblings, grab toys, eye strangers warily,” and who has “an infectious smile.”

If ever there was a story that sharply outlines the many, complex, difficult, emotional, ethical conversations that we need to have around the promises and pitfalls of reproductive technology, this is it.

What do you see in this story?



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