With its torrents of blood, animal howling, vagina hilarity and creepy relish in terms such as “cord prolapse”, “ovarian torsion”, “placental abruption”, the television adaptation of Adam Kay’s This Is Going to Hurt has not pleased everyone.
Yet if some of us were unlikely to enjoy pleasantries such as Kay’s “same shit, different vagina”, with others finding its scenes of chaotic maternity staff and mashed innards actively disturbing, you could also see this ugliness as a potentially helpful corrective to enduring, often officially encouraged myths about the desirability of all-natural deliveries. This tendency probably contributed to tragedies like those at first hushed up at the Shrewsbury and Telford NHS trust. Only the intervention of bereaved mothers, as the BBC’s Panorama has reported, brought the hospital’s avoidable fatalities to light. The senior midwife, Donna Ockenden, who will soon publish her final report on the scandal, has previously told Panorama about the maternity unit’s pride in its low-intervention births. “Low caesarean section rates were a prize.”
Added to this, and to the many personal accounts that followed the NHS’s recent recognition – after it coerced countless women into compliance with its caesarian-avoidance targets – that “normal” childbirth can be deeply unsafe, unpredictable and terrifying, Kay’s misogynistic capers may even be well timed to educate another body of influential officials. The Law Commission would still prefer, judging by its proposals for facilitating surrogacy in the UK, to see childbirth as a routine if occasionally risky procedure after which, to the convenience of all involved, compliant female participants can be expected to emerge intact. You could easily take these lawyers for loyal students of the late childbirth guru, Sheila Kitzinger, with her mantra that pregnancy is not an illness, were it not that her related precepts on euphoric delivery might conflict with their own project for more numerous and efficient baby handovers.
To this end, the Law Commission has proposed, in defiance of a UN rapporteur’s 2018 warnings about baby-trafficking, that surrogacy clients should become the baby’s official parents prior to birth. Two weeks, they estimate, would be enough, afterwards, to allow the birth mother to change her mind. Such mind-changing in surrogacy is far from rare, to go by figures reported by Ukraine’s Ministry of Justice, but, as with so much about surrogacy, there is no reliable data. The Law Commission’s confidence in British arrangements appears largely based on one small study of local altruistic surrogacy likely to be unrepresentative of any new, paying version.
Later this year, the commission will publish recommendations informed by wider consultation, though affirmation might be a better word, given this body’s apparent fondness for contributions from parties with a known emotional or professional investment in the industry. In contrast, the lawyers awarded eight pages out of more than 450 to ethical objections to, for instance, the instrumentalising of female bodies and the coercion of poor women. An almost Europe-wide ban on the practice was likewise disregarded. Instead, entitling their consultation paper Building Families Through Surrogacy, the lawyers begin: “As society changes, surrogacy is becoming more common.” So, you might argue, is online fraud.
Even given the tendentious claim that “surrogacy is an accepted form of building a family”, the commission had to acknowledge that it has been imperfectly applied to the point that exploitation of women in Thailand, Nepal and India led to its prohibition. And although they wrote before Covid and, now, the Russian war on Ukraine exposed more extreme risks of cross-border surrogacy, the commissioners, visiting Ukraine, were witness to dehumanising practices the industry doesn’t bother to conceal. Prospective parents will receive, for instance, this account of Ukraine’s breeding attractions from a thriving outfit called Growing Families: “Surrogate mothers tend to come from lower social classes, yet live in clean and modern homes and be [sic] employed.”
As Russia invades, there are estimated to be hundreds of Ukrainian surrogate mothers carrying foreigners’ babies. In one of many news reports dwelling on the feelings of intending parents, the director of Growing Families has shared his concern for clients “desperate to get their embryos out of Ukraine”.
But what might appear compelling reasons to reconsider surrogacy will only strike its advocates – or UK law commissioners – as another reason to enhance the domestic offer. In the UK, it is argued, the business of female incubation can be better regulated. Age-wise, for instance, the commissioners suggest that 18 is quite old enough for a woman to market her womb to more affluent consumers – or to have this done for her by a better-paid professional. There is no proposed need for an existing child, no maximum number of pregnancies. “We are concerned,” they explain, “not to discourage people.”
What if a surrogate (the commissioners dislike adding the word mother) is left not just permanently changed, but physically or mentally impaired by childbirth? Infertile? Dead? In a section on compensation whose very blandness is more offensive than any contribution from Adam Kay, the commissioners accept that the sort of hazards depicted in This Is Going to Hurt could damage, even kill, its UK surrogacy recruits. Like surrogacy’s paying clients, they clearly considered that women’s injuries and the occasional hysterectomy or death could be a price worth paying for this inessential service. As the UN’s rapporteur said, warning about the sale of babies, “there is no right to have a child under international law”.
It’s a few months until the law commissioners are due to publish recommendations. Even if they remain determined to trivialise ethical concerns reflected in the almost Europe-wide prohibition of surrogacy, to disregard heartbreaking case histories and classify other “feminist” objections as therefore marginal, they still have time to watch Ben Whishaw shout, over another malfunctioning female body: “I can’t do this, this woman’s going to die and it’s all my fault.” It could, so to speak, be them.
• Catherine Bennett is an Observer columnist
