Reviewed by Kallie Yeoman, MS, BSN, RN

It is clear, even from the title—Surrogacy: A Human Rights Violation—how Dr. Renate Klein feels about surrogacy. She has spent many years studying, writing, and educating on women’s health, reproductive technologies, and feminist philosophies, and she cofounded Feminist International Network of Resistance to Reproductive and Genetic Engineering (FINRRAGE). This small but mighty book is densely packed with an examination of surrogacy and her objections to the “dangerous and exploitative nature of the surrogacy process.” She boldly and succinctly exposes the dangers and dilemmas of what she calls the “latest frontier of violence against women.”

While the reader can feel her passion about the subject and cynicism towards exploitation with each turn of the page, there is an abundance of plausible data, resources, and references throughout the book. These references are particularly helpful to those just starting to learn about surrogacy and its effect on the world. The book is outlined into well-organized chapters that paint a clear picture of why the practice of surrogacy should be scrutinized globally.

The book begins by defining surrogacy and the language used within the industry. Readers are quickly introduced to the vivid and blunt language with which Klein writes. She wastes no words as she begins to expose the harms of surrogacy that pro-surrogacy groups and profiteers would like to remain hidden.

Klein then presents the products of surrogacy: the babies. The book includes statements from adoptees to help the reader consider a child’s perspective. After all, children that were the products of surrogacy are starting to speak out. The reader is here confronted with a grotesque account of child abuse—once-celebrated gay fathers used surrogacy as their tool to supply pedophile rings. Such stories scattered through the text make the reader understand the passion with which Klein writes.

For example, she writes that surrogacy “is unashamedly, an adult or parent-centered view, with the basic human rights of newborn babies ignored” (34). Those who wish to be parents ought not “use the pain of their infertility or the inability to have their own child to claim their right to what they believe is their entitlement” (69). She compares surrogacy to prostitution and to eighteenth-century slavery. Much like pornography and prostitution, Klein argues, surrogacy exploits poor women living in less-than-ideal situations.

As the reader continues through chapters four, five, and six, the chapters get longer and the content becomes weightier. Klein marches forward and addresses whether surrogacy is ethical and whether regulation is the answer to the problems it raises. Klein spends a significant amount of time rebuking the work of surrogacy supporter Amrita Pande, who is one of many who believe surrogacy is ethical if we consider it as ‘work.’ Again, Klein uses a distressing story to illustrate her rebuttal: an Indian woman aborts her own baby in order to do surrogacy ‘work.’ It is unimaginable that families facing infertility would desire to exploit poor women in this way, but also not illogical that rich couples do not understand that this is a very real risk.

Klein considers all parts of the world in her book and includes culture differences and current regulations (or lack thereof) around the globe. She pushes the reader to understand the global impact of surrogacy.

During the first decade of the 21st century, the practice of surrogacy in poor countries, especially in India, for rich baby buyers from around the world expanded significantly. What also expanded were critiques of the heartless exploitation of poor and low-class Indian women who were often kept in slave-like conditions in surrogacy houses for the whole duration of their pregnancy (71).

In each chapter of the book, Klein exposes the lack of data and research surrounding surrogacy. There is no research on how offspring of surrogacy feel about their origins. Information about egg donation lacks details about both short-term and long-term risks, so potential egg donors are unable to provide truly informed consent. The practice of in vitro fertilization (IVF) in the USA is largely unregulated, therefore, there are no state or national bodies in place to collects statistics on unfortunate events.

At times one might accuse Dr. Klein of being callous towards those facing infertility. She refers to commissioning parents as “baby buyers” that are “misguided by narcissistic desire.” However, Klein simply seeks to expose the exploitive nature and “inherent danger” of surrogacy, and she uses startling vocabulary in order to do so. She gently reminds the reader that “we should never blame women for decisions they make at particular times in their lives” (17). Like prostitution, “in surrogacy we must not blame the women for being trapped in a dangerous situation. It is the demand for these services that must be scrutinized and exposed” (65).

In her conclusion, Klein expands the discussion and briefly reflects on the potential dangers of DNA editing, gene therapy, and eugenics. Important concepts, no doubt, but perhaps best left to another small but mighty book. Possibly this is a foretaste of future writings from Dr. Klein.

Regardless of your current attitude towards surrogacy, any man or women considering surrogacy should read this book. It is both educational and enlightening. Like Klein, I encourage readers to take an informed stance on the practice of surrogacy. To paraphrase her, it is critical that we not blindly accept information provided by mainstream media, pharmaceutical companies, and those sure to gain monetarily from the practice of surrogacy.

Those who would like to join Renate Klein and the thousands of other who oppose surrogacy can join the Stop Surrogacy Now campaign.

The book successfully exposes the potential harms and ethical dilemmas of surrogacy, which are often not considered by hope-filled, infertile couples and ‘altruistic’ women.