Adoption and Surrogate Pregnancy Global Issues

by Faith Merino

Author Faith Merino Isbn 9780816080878 File size 3MB Year 2010 Pages 339 Language English File format PDF Category Family and Friendship Adoption and surrogate pregnancy are the two most realistic options currently available for millions of couples unable to carry a pregnancy to term In the past decade international adoption has become increasingly popular for those who wish to avoid the wait of adopting domestically Yet because of unique political economic and cultural circumstances with

Publisher :

Author : Faith Merino

ISBN : 9780816080878

Year : 2010

Language: English

File Size : 3MB

Category : Family and Friendship







Faith Merino
Foreword by Pamela Anne Quiroz
Professor of Policy Studies and Sociology, University of Illinois

GLOBAL ISSUES: Adoption and Surrogate Pregnancy
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Library of Congress Cataloging-in-Publication Data
Merino, Faith.
â•… Adoption and surrogate pregnancy / Faith Merino ; foreword by Pamela Anne
â•…â•… p. cm. — (Global issues)
â•… Includes bibliographical references and index.
â•… e-ISBN: 978-1-4381-3059-0
â•… ISBN-10: 0-8160-8087-9
â•… ISBN-13: 978-0-8160-8087-8
â•… 1. Adoption—Case studies. 2. Surrogate motherhood—Case studies. I. Title.
â•… HV875.M44 2010
â•… 362.734—dc22
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List of Tables and Graphs╇╇ vii
Foreword by Pamela Anne Quiroz╇╇ viii

PART I: At Issue
Chapter 1:

Introduction╇╇ 3
Adoption╇╇ 6
Surrogate Pregnancy╇╇ 16
Ethical Concerns╇╇ 21
Conclusion╇╇ 23

Chapter 2:

Focus on the United States╇╇ 28
History and Law╇╇ 28
Characteristics of Participants╇╇ 39
Conclusion╇╇ 42

Chapter 3:

Global Perspectives╇╇ 48
Introduction╇╇ 48
China╇╇ 53
India╇╇ 61
Great Britain╇╇ 68
Guatemala╇╇ 75
Conclusion╇╇ 81

PART II: Primary Sources
Chapter 4:

United States Documents╇╇ 93

Chapter 5:

International Documents╇╇ 117
China╇╇ 138
India╇╇ 152
Great Britain╇╇ 162
Guatemala╇╇ 171

Part III: Research Tools
Chapter 6:

How to Research Adoption and Surrogacy╇╇ 185
Becoming Familiar with the Topic╇╇ 185
Perspectives and Angles╇╇ 190
Sources╇╇ 193

Chapter 7:

Facts and Figures╇╇ 199

Chapter 8:

Key Players A to Z╇╇ 216

Chapter 9:

Organizations and Agencies╇╇ 229

Chapter 10:

Annotated Bibliography╇╇ 250
Adoption and the Issues╇╇ 250
Surrogate Pregnancy and the Issues╇╇ 255
Adoption and Surrogate Pregnancy
╅╅ Worldwide╇╇ 261
Adoption and Surrogate Pregnancy in the
╅╅ United States╇╇ 269
Adoption and Surrogate Pregnancy in
╅╅ China╇╇ 275
Adoption and Surrogate Pregnancy in
╅╅ India╇╇ 278
Adoption and Surrogate Pregnancy in
╅╅ Great Britain╇╇ 281
Adoption and Surrogate Pregnancy in
╅╅ Guatemala╇╇ 284

Chronology╇╇ 287
Glossary╇╇ 312
Index╇╇ 323


List of Tables and Graphs
╇ 1. International Adoptions to the United States, 1998–2009


╇ 2. International Adoptions to the United States by
Sending Country, 2004–2009


╇ 3. International Adoptions to the United States and Europe,


╇ 4. International Adoptions to the United States
by Sex and Age, 2002


╇ 5.

U.S. Adoptions in 1992 and 2001

╇ 6.

Preferences for Adopted Children in the United States, 2002

╇ 7.

Adoption Demand in the United States, 2002

╇ 8. Children Born to Single Mothers Relinquished for Adoption
in the United States, 1973–2002




╇ 9. Perceptions of Adoptive Parents in the United States, 2002


10. Racial Differences in Views of Birth Parents in the
United States, 1997


11. Total World Fertility Rates, 1998


12. Percentage of Women in Developing Countries
Who Have No Say in Their Own Health Care Needs


13. Millennium Development Goals on Maternal and
Child Health, 2005


14. U.S. State Laws on Surrogacy, 2005
15.╇ International Laws on Surrogacy, 2004




Despite undergoing many changes in the past several decades, the family
remains an important institution of social organization. The family is the
first opportunity children have to realize their role as part of a larger group
(e.g., neighborhoods, racial groups, nation-states). Therefore, it is important
to understand how the creation of families intersects with social, economic,
and ethical issues, and what types of changes must occur for families and
societies to thrive.
While the motivations for pursuing adoption and surrogate pregnancy
vary, those who seek adoption and surrogate pregnancy undeniably represent
cultures of privilege; they can afford to use other people’s children or other
women’s bodies as a means to their ends. The practices surrounding adoption account for millions of dollars in local and global economies, which is
often exchanged between countries with asymmetric economic and power
relations. Independent adoption lawyers, for-profit adoption agencies, and a
variety of businesses profit from the commercialization of adoption by selling
dolls, clothes, books, and other cultural artifacts. Some agencies specialize in
organizing roots trips or culture camps for adoptive families.
In the process, adoption has stimulated the growth of illegal activities and
abuses of human rights. The practices of private adoption (i.e., adoptions
handled by a privately funded and licensed agency that places infants or
young children) prompted UNICEF to assess it as a high risk activity and one
that required an international framework to reduce the abuses of children.
The result was the 1993 Hague Convention on Intercountry Adoption. The
goals of the Hague Convention were to serve as an international governing
structure for adoptions, encourage domestic adoption of children as a priority over intercountry adoption, create neutral authorities to regulate and provide information on transnational adoption, and prevent the abduction, sale,
or trafficking of children. In short, its purpose was to promote civil society,
global equity, and respect for human rights.


C hFaoprteewr oTr idt l e
The debate continues as to whether transnational adoption represents a
global humanitarian effort or a neocolonial project that allows countries with
more economic resources to exploit, either directly or indirectly, those with
few resources. In my own work on adoption I have argued that institutional
and interpersonal relations are now often viewed and conducted from the
position of extreme individualism, and adoption and surrogate pregnancy are
no exceptions. Parent selection among sending countries involves individual
preferences, historical and current relations with a particular country, views
of children from sending countries, and the marketing of programs by private
adoption agencies. Does the “rescue” of some children occur at the expense
of others? How does rescue work? Do policies that support adoption and surrogacy impede policies that would have a broader impact on a larger number
of children? How does surrogate pregnancy operate and what is the impact
on women of color and women from poor countries? In short, are adoption
and surrogate pregnancy simply neocolonialism at its worst, purchasing, absorbing, and transforming the bodies of the less fortunate? Or does the fact
that financial incentives for participating women are comparatively greater
than what many women could hope to gain through alternative labor support
a humanitarian view?
In the past 15 years, researchers and activists have addressed the issues
of adoption and reproduction by refocusing our attention beyond questions
involving the integration of individuals, identity development, or even the
morality of fertility treatment and surrogate pregnancy, to ask other questions, such as, how do children and women come to occupy particular social
spaces in the first place (i.e., adoptive status or surrogate)? How do we create
just policies and link these policies to systemic changes so that women and
children can occupy other spaces? Regardless of good intentions or factors
beyond participants’ control, it is still the case that these activities are situated within unequal contexts, and participants have varying degrees of control. Therefore, any resolution to these issues needs to include the voices of
all participants.
Adoption and surrogate pregnancy have become part of the conversation
on social responsibility, global human rights, and justice, and Faith Merino’s
book assists us in understanding these issues. Merino provides the history of
adoption and surrogate pregnancy and situates these activities in rich case
studies that encourage us to delve deeper into the social, ethical, and moral
implications of building families. More important, she allows us to draw our
own conclusions on these important matters.
Adoption and Surrogate Pregnancy provides an excellent starting point
for examining the history, the alternative ways in which family-building


Adoption and Surrogate Pregnancy
is framed, and the current debates surrounding adoption and surrogate
pregnancy. As Merino illustrates, the implications of adoption and surrogate pregnancy speak to issues of immigration, citizenship and nationality,
culture, race, gender, and social class. Adoption and Surrogate Pregnancy
is fundamentally about providing information necessary to reframe issues
of family-building in the 21st century and thus encourages us to address
important social and ethical issues. Merino also subtly reminds us that our
solutions to these complex issues will affirm our commitment to families,
society, and our conception of global justice.
—Pamela Anne Quiroz
Professor, Policy Studies and Sociology
University of Illinois, Chicago


Part I


At Issue


Few elements of human life are so protected and difficult to govern politically
as the family unit. This is due, in part, to the prevailing belief that human
life is bifurcated into two separate domains: public life (work) and private
life (family). Historically, the two have been maintained as distinct areas of
human existence that do not (or should not) overlap. But with increasingly
rapid developments in reproductive technology, the family unit is being
thrust into the public eye as politicians, the legal system, the media, and
scientific and religious communities are asked to determine what constitutes
a family. In the practice of surrogate pregnancy, as many as five people can
lay claim to a child: the contracting parents, the surrogate mother, and the
egg and sperm donors (if used). How are courts to define and decide kinship
bonds? Is kinship defined through biological relatedness or intent to love? Is
it both, and if so, what takes precedence?
The goal of this book is to address family formation through adoption
and surrogate pregnancy and its global effects. For most people choosing to
have children, the question of when to start a family is difficult to answer, as
career, financial stability, and the support of family and friends must be taken
into account. But for those suffering from infertility, the question of how is
even more difficult to answer. According to the Centers for Disease Control
and Prevention (CDC), in 2002 11.8 percent of U.S. women (both married
and unmarried) were unable to get pregnant or carry a baby to term.1 The
wealth of media attention devoted to issues of infertility and childlessness
over the last four decades has led many to wonder about a possible infertility epidemic. Though infertility rates have remained stable since the 1950s,2
and even dropped among married couples between 1965 and 1982 from 11.2
percent to 8.5 percent, many social factors have contributed to the perception of a higher infertility rate, particularly the number of women who delay
childbearing in favor of career development.3 In 1950, approximately one in
three women in the United States participated in the workforce. By 1998,

Adoption and surrogate pregnancy
three in five women were participating in the workforce. Among women
between the ages of 34 to 45, labor force participation doubled from 34 percent in 1950 to 76.3 percent in 1998.4 Coinciding with this increase was a
rise in the number of women who chose to delay childbearing. Between 1969
and 1994, the median age at first birth rose from 21.3 years to 24.4 years, and
the proportion of first births for women in their 30s rose from 4.1 percent
in 1969 to 21.2 percent in 1994. This percentage spike is even higher for college-educated women: 45.5 percent of first births were to female graduates in
their 30s in 1994, compared with 10.2 percent in 1969.5 By 2002, the average
age of U.S. mothers at first birth was 25.1 years, an all-time national high.6
Among European women, the average age at first birth rose from 27.1 years
in 1980 to 28.6 years in 1993. In Italy and the Netherlands, the median age at
first birth has remained stable, at 29 years, since 1960.7
Worldwide alarm over infertility was catalyzed in 1973, when a French
sperm bank found that a patient’s chances of achieving a successful pregnancy
after artificial insemination directly corresponded with her age. While women
under the age of 31 had a 74 percent chance of becoming pregnant following
artificial insemination, that number dropped to 61 percent for women between
the ages of 31 and 35, and to 54 percent for those over the age of 35.8 Thus,
because a woman’s fertility decreases with age, more women today are faced
with the possibility of suffering from infertility than they were 50 years ago.
Though one-third of all cases of infertility among couples are male-related, age
does not affect male fertility as dramatically as it does female fertility.9 Furthermore, a rise in voluntary childlessness may contribute to an overall worldwide
perception of failing reproductive health among women. Women in developed
nations are having fewer children, with an average of 1.5 births for western
European women and two births for North American women. Discussions
of an infertility epidemic rarely mention developing nations, however, where
birth rates have remained consistently high. In sub-Saharan Africa, the average
woman gives birth to six children, while in the Middle East and North Africa
the average birthrate is four per woman.10
New developments in reproductive technology, including the advent of
birth control and legalized abortion in the 1960s and 1970s, have given women
and men more control over career and family planning. Nevertheless, judging
from the media attention the topic has received, the accompanying redefinition of the family has also caused collective anxiety over the future of the traditional family unit. In the decade between 1968 and 1978, a total of 18 articles
on infertility were published; since 1978, however, an average of 13 articles on
infertility have been published every year. In 1978 alone, the year that Louise
Brown became the first baby to be born through the use of in vitro fertilization (IVF), a total of 16 articles were published.11 The private family unit has

become a highly politicized and publicly debated facet of human existence.
In the mid-1980s, the U.S. war on drugs and increasing public and political
concern over prenatal drug exposure led to discussions of fetal rights and fetal
abuse. Throughout the 1980s and 1990s, several U.S. bills were introduced that
would have defined the use of drugs during pregnancy as child neglect, and
one bill would have mandated forcible sterilization for women convicted of
fetal abuse.12 Many pro-choice activists have argued against such legislation,
as indeed the concept of fetal abuse does not legally coincide with women’s
reproductive rights. While to date no fetal abuse laws have been passed in the
United States the introduction of such legislation was an explicit manifestation
of public fear for its future citizens.
The family, while seemingly objective and self-defined, cannot be
separated from issues of gender, race, class, and commerce, and it is for this
reason that adoption and surrogate pregnancy remain hotly contested topics. As alternative means of creating families, both adoption and surrogate
pregnancy are rife with debates over their potential for exploitation, as well as
their capacity to magnify existing social injustices. Many argue, for example,
that while international adoption has flourished within the last decade as
more adoptive parents look overseas for healthy infants, hundreds of thousands of children await placement in the United States. These children tend
to be harder to place due to age, minority status, and possible health problems. Thus, international adoption, while altruistic in appearance, is considered by some a social injustice. Similarly, when individuals turn to surrogate
pregnancy as a means of becoming parents, the question of why they choose
not to adopt inevitably arises. One director of a surrogacy center addressed
the issue with biting clarity: “It is not, nor should it be the sole responsibility
of the infertile to remedy this particular societal problem. Every one of you
in the audience should ask yourself why you haven’t adopted one of these
children. You don’t have to be infertile to adopt.”13
What role does fertility play in addressing social injustice, and do infertile couples have an obligation to be color-blind and politically correct when
creating their families? How imperative is the biological drive to reproduce
and have a genetic child of one’s own?
There is a plethora of angles from which to view adoption and surrogate
pregnancy, as well as a wealth of ideological rhetoric when arguing for or
against reproductive alternatives. To successfully research this topic, one
must be able to identify the rhetorical frames that are so often used when
debating such a controversial issue.
As technology continues to develop and global regulations become more
standardized, both adoption and surrogate pregnancy will become increasingly accessible and more provocative as topics of discourse. At present, both

Adoption and surrogate pregnancy
reproductive alternatives challenge basic, deeply held beliefs regarding kinship bonds and family relationships, and as these reproductive alternatives
continue to evolve, so too will the face of the family unit.

The earliest known example of a written adoption law can be traced back to
the Babylonian Code of Hammurabi around 1780 b.c.e., in which child welfare and parent-child bonding are viewed as legitimate concerns.14 In many
other ancient societies, such as Greece and Rome, adoption was less a matter
of placing orphaned children with families than it was about establishing an
heir. In ancient Athens, for example, the need to have an heir meant that
adult men often adopted other adult men rather than children.15
Adoption refers to the matching of a parentless child with a family that
wants him or her. In most cases, this serves a humanitarian purpose, but
historically it has also been true that some children have been adopted for
purposes of labor and exploitation. Today, in most developed countries,
adoption is perceived as a matter of love and child well-being.
Adoption can be a complicated process, and it is important for both
adoptive and birth parents to understand the different types of adoption from
which to choose, as well as the language of adoption. Various terms exist
to designate sensitively the different individuals involved in the adoption
process. Because of the delicate and highly emotional nature of adoption,
language must be employed carefully and respectfully. The following list of
terms relates to the participants in the adoption process.
•â•‡ Adoption triad: Refers to the relationship of the birth parents, adoptive
parents, and adoptee.
•â•‡ Birth/biological parent: The individual who is terminating his or her
parental rights; formerly referred to as the real/natural parent.
•â•‡ Adoptive parent: The individual who is awarded parental rights. At a
certain point in the process, the parties involved are encouraged to refer
to the adoptive parent simply as the parent.
•â•‡ Waiting child: A child in foster care who has been legally released for
adoption; formerly referred to as an available or adoptable child.
•â•‡ Special needs child: A child who is difficult to place. This term does not
refer exclusively to children with disabilities, but rather includes older
children, children of mixed race, children who are part of a sibling group
that should not be separated, children with developmental delays, and
African-American boys over the age of eight.

•â•‡ Child with special needs: Refers exclusively to a child with physical disabilities or developmental delays; formerly referred to as handicapped
or feebleminded.
•â•‡Transracial adoption: An adoption in which the adoptive parents and
the adoptee are of different ethnic backgrounds; formerly referred to as
cross-racial or mixed-race.
•â•‡ Intercountry/international adoption: Refers to the adoption of a child
from another country; formerly referred to as a foreign adoption.
Language is a subtle but useful framing device for emotionally charged
topics like adoption, in which certain terms may be used to connote positive
or negative meanings. The terms above are considered positive adoption
language and developed out of a movement to create adoption-friendly language. Positive adoption language emerged in 1972 in an effort to afford birth
parents and adoptive parents the “maximum respect, dignity, responsibility,
and objectivity” possible in the decision-making process.16 Some individuals
and organizations, however, object to the use of positive adoption language.
The First Mothers Action Group asserts that such language has been developed to prioritize adoptive parents at the expense of birth parents. In her
rebuttal to an article on positive adoption language, Diane Turski of the First
Mothers Action Group argued that the term birth parent is dehumanizing
and equates the role of the birth parent to that of an incubator or breeder.17
For purposes of clarity, this book uses the terms birth parent and adoptive
parent to distinguish between the two parties.

Types of Adoption
Adoption is not a uniform process. Every situation is unique, and various
types of adoption exist to meet the needs of all individuals. They include the

Open Adoption
In an open adoption, the birth parents maintain a relationship with the child
and continue to play a role in his or her life. In some cases, other relatives
may also visit the child, including grandparents and siblings. Open adoption became popular in the United States in the 1970s and continues to gain
momentum as a viable alternative to what many feel is a process that has
been unnecessarily shadowed in secrecy and shame. Proponents of open
adoption believe it to be emotionally healthier than closed adoption. Birth
parents are allowed to know their child’s future and find closure in knowing that they did not abandon their child, but rather devised an alternative

Adoption and surrogate pregnancy
plan for his or her care. Adoptive parents are said to find security in receiving official permission from the birth parents to adopt their child and have
greater access to information regarding their new child’s genetic health history. The adopted child has a complete and accurate history to refer to and
may develop a better comprehension of the circumstances that led to his or
her adoption, rather than suffer from a feeling of abandonment. Open adoption may also help facilitate easier identity formation for the child as he or
she matures. The overall experience of open adoption as described by many
participants is that of knowledge, communication, and security.
Open adoption can also have disadvantages. The various parties involved
may not agree on the appropriate amount of contact between the birth
parents and a child, leading to disappointment for some and frustration for
others. In some situations, the birth parents and adoptive families may find
themselves in unstable or unhealthy relationships, which can disrupt both
families’ lives and cause possible confusion for the adopted child. And while
some claim that open adoption aids in a child’s identity formation, it may also
contribute to confusion and uncertainty in this regard.
The United Kingdom became one of the first countries to make a
national move toward open adoption by unsealing birth records in 1975,
thereby granting adoptees the right to access identifying information. While
no mandate regarding relationships between birth and adoptive parents
exists, the nation has formally prohibited social workers and adoption agencies from making any promises of anonymity to birth mothers.

Closed Adoption
When birth parents and adoptive parents choose closed adoption, they
agree to anonymity and the severance of all communication. No identifying
information is shared between the parties and no contact is made prior to or
after the adoption. The process of a closed adoption was originally developed
to protect birth mothers from the stigma of being unmarried and pregnant,
as well as adoptive parents from the stigma of being infertile. Proponents of
closed adoption emphasize the importance of privacy (not secrecy), which
they believe to be beneficial to the birth parents, the adoptive parents, and
the adopted child. Many assert that closed adoption allows adoptive parents
to establish their family without the possibly intimidating influence of the
birth parents, while allowing the birth parents to heal from a difficult and
perhaps traumatic situation. Furthermore, the child may benefit by being
able to assimilate into the family with greater ease.
Some of the possible disadvantages associated with closed adoption
include, for birth parents, a lack of information about their child, which may
intensify feelings of grief and guilt. As the very nature of closed adoption was

designed to allow the birth parents to continue their lives “as if nothing happened,” this may lead to an unhealthy state of denial in which the biological
parents do not cope with their decision to relinquish their parental rights,
but rather deny that the child was ever born. For adoptive parents, the lack
of information in a closed adoption may allow them to imagine their child as
a parentless orphan with no history or background. As with the birth parents,
this may lead to a state of denial in which the adoptive parents deny that the
child has any identity beyond the insulated family unit.
In many countries, closed adoption has been the norm for thousands
of years. In ancient India, kinship and intimacy within the family unit was
considered so important that an adopted son who openly declared his status
as an adoptee could be punished by having his tongue cut out. To announce
one’s status as an adoptee was to shame the family by announcing its deviation from normative familial structures.

Semi-Open Adoption
Generally speaking, open adoption is the norm in most industrialized nations
today, but many consider the entire adoption process to be on a spectrum
between open and closed. Kathleen Silber, associate and clinical director of
the Independent Adoption Center (which arranges only open adoptions),
avers that in the future the very term closed adoption will be rendered obsolete as today virtually all adoptions involve some level of openness.18
For families who desire some degree of physical and emotional distance,
semi-open adoption is a viable alternative to fully open adoption. In a semiopen adoption, birth parents and adoptive parents may meet, but do not
exchange identifying information, and while the two families may maintain
contact throughout the years as the child grows, all contact is facilitated and
monitored by a mediating party, such as a lawyer or adoption agency. The
families may exchange cards and letters, but all items are screened to censor
identifying information. Both families have the option of discontinuing contact at any time, at which point the third party mediator will keep all letters
and cards on file to be claimed when desired.

Semi-Closed Adoption
Semi-closed adoption exists for families who do not want any future contact,
but nevertheless desire some information about one another. Birth parents
are allowed to choose from previously screened and approved couples to
decide who will raise their child but may not contact the prospective couples.
This type of adoption may be beneficial to birth parents who desire confidentiality and anonymity but do not want to feel as though they are abandoning
their child. By choosing semi-closed adoption, they may feel empowered by

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