There are many misconceptions circulating about women who carry a pregnancy to term and give birth to a child on behalf of others—the so-called “surrogate mothers”—particularly regarding their compensation. In the United States, this work does not allow the women involved to make a living from it alone.
Much like sex work or domestic labor in the not-too-distant past, surrogacy remains largely misunderstood by the general public today. In the research community, however, there now appears to be a consensus on the concept, even though its various realities—starting with compensation—remain largely unexplored.
Furthermore, the most common perception among the general public is that surrogate mothers are most often found in poor countries; however, this phenomenon also exists in the United States. What are the specific circumstances in that country, particularly with regard to the compensation paid to these surrogate mothers?
Of the nearly four million births recorded annually in the United States, just under 2,000 result from surrogacy arrangements carried out under local contracts between “intended parents” and U.S. surrogate mothers. Of these 2,000 surrogacy births, nearly half are for foreign couples. This practice is permitted only in certain states, as it falls under family law, which is governed at the state level; therefore, there are no federal regulations on this matter.
Although surrogacy is still not very widespread, it has existed in the United States ever since biotechnology made it possible—that is, since the 1980s, when the first in vitro fertilizations (IVF) were performed, meaning the fertilization of gametes in a laboratory.
Contemporary surrogacy arrangements are referred to as “gestational”: the gametes used to create an embryo are those of the “intended parent(s)” (or from a donor), never those of the surrogate mother. The surrogate’s role is therefore limited to the pregnancy itself—that is, the process that takes place between the time the embryo is implanted and the birth.
While gestation is generally considered a physiological process, the scientific literature has shown that surrogacy can be viewed as a form of labor, insofar as it involves the deliberate mobilization of human energy to influence nature. This observation dates back to sociological and ethnological research conducted in India in the late 2000s, which shifted the focus beyond ethical and moral debates to a concrete study of the work of these surrogate mothers. This socioeconomic approach to surrogacy has since been the subject of further research, particularly in the United States, which once again demonstrates that gestational work is a supervised and standardized activity.
In fact, in the United States, surrogate mothers are subject to numerous requirements (schedules, prohibited or mandatory physical activities, dietary restrictions, and frequency of contact with the intended parents). Surrogacy is also a form of care work that places a certain mental burden on surrogate mothers. Finally, they must meet a selection process to undertake this role. Among the criteria are: having already had at least one child, a specific body mass index, and, above all, a sufficiently high household income. Women receiving public assistance are excluded from recruitment; according to the agencies that recruit surrogates, this ensures that their motivation is not strictly financial.
Once they are recruited, surrogacy contracts for surrogate mothers generally provide for two options: the pregnancy is carried out either free of charge or in exchange for compensation.
In cases where surrogates do not receive compensation for the pregnancy, they do, however, receive certain financial reimbursements intended to cover pregnancy-related expenses (clothing, travel, lost paid workdays, and the use of personal care services for household and parenting tasks they can no longer perform during pregnancy, etc.).
In the case of so-called commercial surrogacy, these payments are accompanied by a sum that is not earmarked for any specific expense. Can we therefore speak of a profit-making activity in the case of American women? In reality, “intended parents” must pay substantial sums—more than $100,000 (approximately 97,000 euros)—for a pregnancy. But these funds are also, and indeed primarily, used to pay matchmaking agencies, the medical professionals who oversee IVF procedures, and the numerous mandatory insurance policies required throughout the process.
Ultimately, the amount paid to surrogates in commercial surrogacy arrangements in the United States averages $23,000 (approximately 22,000 euros), a figure that can vary depending on the surrogate’s place of residence, prior experience, and occupation.
While this amount is certainly not insignificant, it must nevertheless be viewed in the context of the average salary in the United States, which is estimated at $50,000 per year (approximately 48,400 euros) in 2020. Furthermore, it is impossible for a woman to pursue a long-term career as a surrogate, since surrogacy is limited in duration—if only by age.
Furthermore, these contracts are governed by family law, and as a result, these women do not enjoy any of the social rights associated with employment, nor are they covered by labor law itself. Surrogate mothers therefore do not receive maternity leave during the pregnancy. Finally, payment is most often made in a lump sum at the end of the pregnancy, rather than in monthly installments like a salary.
These formal criteria restrict cash payments to women who must already be wealthy enough not to receive social assistance, and they show us that the U.S. surrogacy market is structured in such a way that middle-class surrogate mothers cannot expect to “make a living” through surrogacy—which the amounts actually received would not allow for in any case.
During his last presidential campaign, the new president said little about surrogacy as such. He mentioned it only last December to announce that IVF would be covered by insurance, although it is unclear whether this also applies to IVF performed as part of a surrogacy arrangement.
While it is certainly cause for celebration for Americans that access to IVF may no longer be solely a matter of social class, we must not be mistaken. This initiative is intended more to encourage a rise in the national birth rate—as many conservative governments do—rather than to recognize reproductive rights. The president, in fact, intends to continue undermining these rights during his second term, starting with the right to and access to abortion and contraception—rights he had already eroded during his first term.
The application of the "Project 2025," developed by the Heritage Foundation and presented as the Trump's unofficial agenda for his second term is likely to lead to a rollback of rights for all workers in the country: privatization of unemployment programs, the elimination of the requirement to pay overtime, across-the-board wage cuts, attacks on union rights… In this context, for pregnant women—whose work is rarely recognized as labor deserving of a wage—the idea of organizing collectively to defend their rights seems like a titanic struggle.
