It Matters How We Talk About Surrogacy

In recent years, the conversation around surrogacy has grown, especially as celebrities have continued to open up about their own experiences with it. Despite more cultural understanding and acceptance of the many ways to expand one's family and welcome a baby, there are still many stigmas surrounding surrogacy — even the common language used to describe it, advocates say.

When someone welcomes a baby with a gestational carrier (the medical term for a surrogate), you've likely heard that they "used a surrogate" or welcomed their little one "via surrogacy." However, fertility and surrogacy specialists tell Scary Mommy why some feel these terms belittle and demean both intended parents and surrogates alike.

Surrogacy 101

First, a quick refresher on the surrogacy process, in which a person chooses to carry a baby for someone else. Dr. Brian Levine, founder and CEO of surrogacy matching platform Nodal, explains that this form of third-party reproduction typically includes a legal agreement in which parental rights are assigned to the intended parent(s) after the gestational carrier gives birth.

There are two types of surrogacy: traditional (in which a carrier provides their egg and has a genetic connection to the child) and gestational, in which someone carries a baby created from the intended parent(s)’ sperm and egg or a donor embryo. Due to the tricky legal and emotional ramifications, traditional surrogacy is rarely practiced in the U.S., and most surrogacies you’ll hear about are gestational, which means there’s no biological relationship between the carrier and the baby.

The process can be time-consuming, explains Ashley Greene, program coordinator at Nodal. “Several steps must be completed, including matching with intended parents, screenings, medical workup, psychological evaluation, legal clearance, and embryo transfer.”

It can also carry with it a hefty emotional weight, adds Dr. Beth Rackow, a fertility expert at Columbia University Fertility Center. “For many individuals, surrogacy is not a choice but a necessity due to medical issues, reproductive issues, or life circumstances. Some situations could include anything from medical conditions (such as cancer) in which pregnancy is not safe or possible, to a disorder of the uterus (fibroids, scar tissue in the uterine cavity, etc.) to a history of a hysterectomy to a same-sex/queer couple who want to have a family. Although there are individuals who choose surrogacy for other reasons, many of us had no other way to have a child. No matter the reason, pursuing surrogacy is an intensely personal decision.”

Stigma and Misunderstandings

There are a lot of cultural and societal misunderstandings surrounding the process, Brianna Buck, Nodal’s head of community, told Scary Mommy. Some people think it’s often done by someone you know or as a favor; others tend to be “unaware of the medical and legal safeguards put in place to protect both surrogates and intended parents.”

Greene, a mom of three and surrogate herself, also dislikes questions about how she is willing to “give up” the baby. “This common stigma implies, first of all, that it is my baby to give up and, second, that this pregnancy (and bond with the baby) is like the pregnancies I’ve had with my own children,” she explains. “This stigma is so impactful to the intended parents especially. They give up so much control as it is and already worry so much about whether or not they will bond with the baby. That’s without mentioning the awful — and very inaccurate — thought in their head that a surrogate might keep the baby.”

“Another stigma is that surrogacy is ‘baby selling,’” she adds. “For obvious reasons, this impacts both the surrogates and intended parents immensely. First and foremost, it’s illegal. Second, you are taking this beautiful thing and turning it into a commodity — acting like babies are stocks to be brokered is terrible.”

Language Matters

As with all things related to parenthood, representation and language matters, even though no two journeys or experiences are the same. “I cringe when I hear ‘using’ a surrogate,” says Greene. “It makes me feel so icky inside. Surrogates should never be ‘used’ but looked at like partners and collaborators in the process.”

A carrier “is an equally powerful part of the surrogacy team,” adds Buck. “‘Using’ someone’s body will always have a negative connotation and inaccurately represents the position of the surrogate in the team. Saying ‘via surrogacy’ removes the humanity of the surrogate by focusing on the process rather than the people involved.”

“When describing a surrogacy team, I always use ‘working with’ a surrogate,” she says. “This emphasizes the collaborative nature in which surrogates and intended parents work together throughout the journey.”

Carly Vollero, Nodal’s general counsel, explains that word choice “is vital when explaining to my daughter the role surrogacy played in bringing her into this world. Throughout the process, I wanted our surrogate to feel honored and definitely never referred to as ‘used.’ It remains essential to me that my daughter continues to learn about the person who allowed us to parent her in the first place. We will forever deeply value her and the gift she gave us.”

Ashley Ostoff, a gestational carrier who works with The Biggest Ask, doesn’t particularly mind these terms, but says, “I do think it is really important that surrogates be recognized for what they have done for a family. They are a person, as well as a surrogate.”

On that front, Greene says she “despises” terms like “surrogate mom” or “surrogate mother.” Buck added, “The surrogate is not a parent to that child, and in gestational surrogacy — the most common type of surrogacy — the surrogate is not genetically related to that child. The only ‘mother’ of the child is the intended mother. This goes back to the stigma of the surrogate ‘giving away her child.’”

Dr. Briana Rudick, a fertility expert at Columbia University Fertility Center, adds, “surrogate means ‘replacement’ or ‘substitute.’ I can imagine that this could make both parties wary. For the intended parent, that a ‘replacement’ is even needed, and for the gestational carrier, that they’re just standing in as a ‘substitute’ when it really means more.”

The Bottom Line

Ultimately, all parties want to feel their roles in the process are acknowledged and respected. “Appreciating each individual’s contribution to the surrogacy process — and selective use of the titles ‘mother,’ ‘father,’ and ‘parent’ — helps to define relationships,” says Rackow. “We need to be more open about all the different ways that individuals become parents, and recognize all the helpers — including surrogates — who are critical for some of us.”