Verso, 2019. 224 pages.
In the first segment of the 1963 Oscar-winning anthology film Ieri, Oggi e Domani, Sophia Loren plays the role of Adelina, a Neapolitan woman who sells black market cigarettes to support her family. When she receives a fine that she cannot pay, she risks jail time. However, as Italian law states that a woman cannot be imprisoned while pregnant, she manages a series of pregnancies over the span of several years in order to avoid prison. The episode, written by playwright Eduardo De Filippo, is based on the true story of a Neapolitan woman. These kinds of things, of course, can only happen in fiction, or backward and amoral places, like Southern Italy. It could be strange to imagine a middle-class woman in the North of the world using her pregnancy for her personal advantage. Pregnancy and maternity are presented as the quintessence of femininity, and women are expected to find a deep fulfilment in the simple fact of giving life to their baby; no ulterior motive can taint this experience. This is perhaps why – amongst other techniques for assisted procreation – surrogacy has been the most debated and controversial. It exceeds the cultural boundaries in which pregnancy and motherhood are constructed, and introduces the suspicion that women might use pregnancies for other reasons.
Surrogacy is currently banned in several countries, and, in many cases, these bans are praised by several feminist groups that consider the practice degrading for women, arguing that surrogate women are used as human incubators, and that, when a payment for the service is included, surrogacy can corrupt the experience of birth, turning it into an economic transaction. Other voices in the crowded debate have expressed a more favourable opinion, provided that the practice is strictly regulated. Full Surrogacy Now, by Sophie Lewis, provides an innovative theoretical analysis that breaks free from these positions and asks not for regulated surrogacy, but, on the contrary, for an extended and hybridised surrogacy that goes beyond the current legal constrictions. Lewis explores how an expansion of surrogacy could contribute to shattering the rigid idea of motherhood and the context in which it is mostly experienced: the family. As the introduction reads, ‘[t]he aim is to use bourgeois reproduction today (stratified, commodified, cis-normative, neo-colonial) to squint toward a horizon of gestational communism’ (p. 21). The traits of surrogacy that some feminists consider most worrisome, such as the duplication of maternal figures and the alteration of the biological and legal axiom of the certainty of the mother (Mater certa est), are positively redefined in Lewis’s theoretical formulation, as such traits offer the opportunity to dismantle the hetero-patriarchal paradigm of maternity. ‘Where pregnancy is concerned, let every pregnancy be for everyone’ (p. 26), says Lewis.
The book, divided into seven chapters, begins by exploring the anti-surrogacy positions in the feminist movement through the discussion of international collective FINRRAGE and the campaign Stop Surrogacy Now, and then focuses on the analysis of the gestational labour, made evident by commercial surrogacy. In the central chapters, Lewis explores the experience of surrogates in India – particularly the figure of Dr Nayna Patel, a prominent Indian physician at the head of a fertility empire – through a variety of sources (documentaries, articles, scholarly books). In the final chapters, the author explores surrogacy’s potential in revisiting the dominant model of family.
While we are waiting for the (gestational) communism
In the book, Lewis especially focuses on India, which is one of the few countries that allows commercial surrogacy. As mentioned, surrogacy is entirely banned in other countries. In some cases, such as Canada, the United Kingdom, and some U.S. states, the law allows only the ‘altruistic’ variation of surrogacy, that is, one in which every form of payment for the surrogate is explicitly excluded. The debate in some countries that ban surrogacy entirely, such as France and Italy, also converges on presenting a non-commercial, altruistic version of the practice as the only potentially acceptable option (see Roman 2012 for the French and Guerzoni and Motterle 2018 for the Italian context).
It seems that the only way in which surrogacy might be introduced in some Western contexts would be by emphasizing its altruistic nature and underlining the fact that the bond between the birth mother and the child will be preserved. The safeguard of such a bond seems to resonate with the multiplications of motherly figures mentioned by Lewis. However, it is also evident that the surrogacy becomes more acceptable when it is regulated in such a way that makes it more similar to a traditional pregnancy. The possibility of a payment is presented as problematic, as if money could invalidate the voluntary nature of surrogacy. But, as the bioethicist Chiara Lalli points out: ‘it is bizarre that, in order to be a voluntary act, surrogacy must be an unpaid act: of what other activity would we say so?’ The other activity that has been performed voluntarily and without payment is the (prevalently female) reproductive and care work. Lewis affirms that ‘all that really separates [pregnancy and surrogacy] is the possibility of a wage’ (p. 44). Some participants in the ethical debate seem convinced that, in order to make surrogacy acceptable, the wage distinction should be erased. Is this because a remunerated surrogacy could lead to the question as to why regular pregnancies are unpaid?
Birth rates, particularly in Western countries, are thought to significantly impact the present and future national population. However, reproduction is presented as a private and female affair: what is measured is the number of children that women have, and a decrease in birth rates raises questions as to why women do not want to have children. Raising children is also still predominantly a female issue: services for childcare are, directly or indirectly, presented as policies for women. However, women’s involvement in reproduction is never explicitly acknowledged as work, let alone remunerated through a wage. What might happen if, using surrogacy as a picklock, we decided to open the Pandora’s box of reproductive labour? Lewis’s analysis goes in that direction, as she defines, and rightly so, pregnancy as ‘the world’s (other) oldest profession’. Throughout the text, the expression ‘gestational labour’ is used in order to make explicit how gestation and reproductive activities are, indeed, work. Moreover, Lewis refers to the Wages for Housework movement in positing the possibility of having waged gestational work. To this regard, however, she writes:
“Wages for all gestation-work” is not a petition and it does not describe an exciting destination. (Who’d get that excited about wages anyway?) It describes a process of assault on wage society. It’s a noir joke, a provocation, an insurgent orientation intended to expose the ludicrousness of treating work as the basis for receiving greater or smaller amounts of the means of survival. (pp. 76-77)
The ambiguity of the word ‘provocation’ is perhaps problematic, as it is not clear whether considering wages as a provocation excludes the possibility of obtaining, in the meanwhile, a remuneration for the labour performed. I agree with Lewis in that we should not get too excited about a wage, but we should also not ignore that, in the era of gig economy and unpaid internships, asking for a wage for jobs that until recently were normally paid is also treated as a provocation. The amount of work activities recognized as such and decently compensated is decreasing, whereas the number of different forms of unpaid labour that people have to perform just to stay alive are increasing. The increasing popularity of online fundraising platforms such as GoFundMe, through which people affected by life-threatening diseases market themselves in order to raise funds to access potentially life-saving treatments, is a sombre example (cf Snyder et al. 2016).
In this context, I think it is absolutely possible to read the provocation suggested by Lewis as not dissociated from the possibility of claiming an actual wage for reproductive and gestational labour. In order to illustrate the potential inherent in the gestational work performed by surrogate women, Lewis offers us a story of a surrogate in India that is partly real and partly fiction, and shows how she is able to organise other surrogates in a strike action. As every pregnancy is work, what would happen if groups of pregnant people, not only surrogates, could organise and unionise? In this regard, we can slightly modify a French slogan and say: On veut des thunes en attendant le communisme gestationnel.
‘Against family’ but of what kind?
As the subtitle of the book,
“Feminism Against Family” suggests, extending the cultural and legal boundaries of surrogacy is seen as an opportunity to destabilise the paradigm of the traditional family. But, although omnipresent, family is an elusive word. In Full Surrogacy Now, we do not find an explicit description or definition of the term, but, between the lines, one can imagine a prevalently – but not uniquely – heterosexual, middle-class, white family, composed by two parents, characterised by a gendered division of the roles, and financially able to ‘reject and outsource the work of private mothering to a not insignificant extent’ (p. 77). This is, in brief, a family model hegemonic in Northwestern Europe and North America. As Lewis discusses, interstitial, progressive alternatives to this model are, and have been, put into practice and ‘inventive kinning has taken place in every corner of the planet’ (p. 148). Many of us raised at the periphery of this traditional model have direct experiences with multiple parental figures, and of deep bonds outside the narrow limits of the mononuclear family. From this perspective, it becomes evident that what characterises the hetero-patriarchal model of the family is not so much its spread, but the pervasiveness of its symbolic power, and its social and legal legitimacy.
In Lewis’s analysis, two elements emerge as central in the different forms of non-normative and ‘inventive kinning,’ and can play an essential role in redefining what is called family. The first is the redefinition of the maternal role, which is directly linked to the subversive and revolutionary potential of motherhood. The second is the importance of reconsidering the idea of children as a personal property of the adults – what Lewis defines as ‘the child’s nonfungibility’ (p. 83). In relation to this, Full Surrogacy Now has similarities with previous feminist reflections according to which a profound redefinition of the family has to include a redefinition of childhood and of the idea that it is necessary to put children under the legal control of the adults (see Delphy, 1991). Lewis’s analysis of non-normative kinship focuses primarily on communities and does not suggest that it is only up to women to put into practice forms of revolutionary mothering. However, mother is a word so dangerously associated with woman that we should ask whether every redefinition of motherhood, even the most revolutionary one, does not risk linking women to maternal ideology once again.
The horizon of gestational communism should liberate the maternal role from the alienation and the oppression that have characterised it, and these new relations should include the ambivalence associated with care roles. Full Surrogacy Now does not, indeed, eschew discussing abortion and death. However, what it is not mentioned is the genuine lack of interest that some women have in the maternal role that is imposed upon us, and the possibility to simply opt out of every form of gestational work is not explored. If we want to discuss how we can change kinship and social relations, we should not follow the old habit of the feminist movement of ignoring women without children. We should start to acknowledge how women that are childfree by choice, or childless by circumstance, are eroding the power of the traditional family, redefining the meaning of motherhood, and helping to seize the unexplored potential of unmotherhood (Malinowitz, 2002). In her recent book, Sheila Heti discussed how Jewish women are expected to counterbalance the losses of the Holocaust, and offered an alternative course of action: ‘[I]n protest, we will make no more people […] in retaliation for the crimes that were committed against us. We will make no more aggressors, and no more victims, and in this way, do a good thing with our wombs’ (2019, p. 162).
If we want to envisage new, liberating futures and redefine gestational work, we should not underestimate the creative and subversive power of doing nothing.
 “Che per essere un atto volontario la gpa debba essere gratuita è bizzarro: di quale altra attività lo diremmo?” (Lalli 2015)
 The original, which does not include ‘gestationnel’, translates to ‘we want some dough while we wait for communism’.
Delphy, Christine (1991) Libération des femmes ou droits corporatistes des mères ? Nouvelles Questions Féministes, 16/18: 93-118.
Guerzoni, Corinna S. and Tatiana Motterle (2018) Sul corpo delle surrogate. Analisi del discorso pubblico italiano sulla gestazione per altri. gender/sexuality/italy,5
Heti, Sheila (2019) Motherhood. London: Vintage.
Lalli, Chiara (2015), Nessuno scelga al posto delle donne sulla maternità surrogata, Internazionale (https://www.internazionale.it/opinione/chiara-lalli/2015/11/10/maternita-surrogata-donne)
Malinowitz, Harriet (2002) Unmotherhood. JAC, 22(1): 11-36.
Roman, Diane (2012) La gestation pour autrui, un débat féministe ? Travail, genre et sociétés, 28: 191-197.
Snyder, Jeremy, Annalise Mathers and Valorie A. Crooks (2016) Fund my treatment!: A call for ethics-focused social science research into the use of crowdfunding for medical care. Social Science & Medicine, 169: 27-30.
Greco is a Wellcome Trust Fellow
at the Centre for the History of Science, Technology and Medicine at the
University of Manchester. She specializes in the study of cancer and has
further research interests in medical innovation, inequalities in access to
healthcare, and gender and health. She has obtained a PhD in Health and Social
Sciences from the EHESS and between 2016 and 2018 she has been a Newton
International Fellow of the British Academy. She is the recipient of the 2016
Barbara Rosenblum Dissertation Scholarship for the Study of Women and Cancer (firstname.lastname@example.org).