Professional Documents
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Medical Anthropology Quarterly 17(1 ):78-98. Copyright © 2003, American Anthropological Association.
78
SURROGATE MOTHERHOOD IN ISRAEL 79
into the maternal role. Echoing the view that women are enslaved to men because
of their "natural" reproductive bodies, Shulamith Firestone (1970) proposed the
"artificial womb" as a possible way to free women from the bonds of their bodies.
A second group of feminist theorists took a different approach, seeing possibilities
for women to exert their agency through the strength and pride exhibited in their
mothering practices (seeChodorow 1978; Dinnerstein 1976; Ruddick 1980). Their
views yet again reflected a belief in the rootedness of the maternal role in nature, as
they grounded their claims in the idea that every woman has a deeply rooted, natu-
ral, biologically determined desire to become a mother. Considering childbirth to
be a "natural" process that creates an immediate, instinctive "maternal bond" be-
tween mother and child, these theorists not only implied that motherhood is the
core of womanhood but also that only women who are mothers can truly exercise
their agency and reach full empowerment (Burner 1993). Romanticizing childbirth
and pregnancy, these theories only strengthen the nature/culture divide in the dis-
cussion of maternal "nature."
A number of female anthropologists have taken a critical look at these theo-
ries and stressed just how rooted in culture motherhood really is. Nancy Scheper-
Hughes's (1992) account of poor women in a Brazilian shantytown, who guard-
edly delay "bonding" with their newborn until the child has proven its will to
survive, and Meira Weiss's (1994) analysis of Israeli parents' astonishingly high
rate of rejection of physically impaired newborns paved the way toward the rupture
of the motherhood myth. Today, prominent anthropologists such as Marylin
Strathern argue that "if nature has not disappeared, its grounding function has"
(1992:195).
Susan Kahn develops this idea, claiming that oppositions between "nature"
and "artifice" are "profoundly destabilized by the advent of the new reproductive
technologies, which have eclipsed "nature" and its ability to serve as a field of
metaphors for culture" (1997:24). Other anthropologists who study reproduction,
such as Sarah Franklin (1995,1998) and Rayna Rapp (1997), continue to challenge
the nature/culture dichotomy in the sphere of the new reproductive technologies
and genetic testing, showing that "nature," now constructed by science, has essen-
tially "become" culture.
genetics and claimed maternity through gestation, parents through surrogacy ne-
gated the importance of gestation in favor of a genetic kinship model.
Ragone* (1998) has also described the act of selectively defining "natural kin-
ship" in the context of surrogate motherhood. She presents cases of women who
begin the process of gestational surrogacy but become traditional surrogates after
IVF treatment fails. This change from gestating a nongenetically related fetus to
providing the female gamete brings about an explicit shift in the way such women
describe their role. As gestational surrogates, they attribute their lack of maternal
feelings for the fetus to the fact that it is not genetically related to them. When this
genetic kinship model no longer serves their purpose, however, they shift to a so-
cial model in which desiring and nurturing a child is more significant than gesta-
tion or genetics.
Whereas in all of these studies, women draw on different kinship models to
make technologically assisted kinship more "natural," the women in my study ne-
gotiate the meanings of nature and artifice in a way that aligns them both with their
own personal systems of meaning and with the reproductive goals of Israeli society
and the nation-state. This study thus presents another perspective on the "ontologi-
cal choreographies" (Cussins 1996) of technologically assisted maternity, because
Israeli surrogates face the challenge of reconciling their actions not only with their
personal ideas regarding maternity but also with their pronatalist national culture.
It is therefore important to outline the connection between maternity, nature, and
nationalism in Israel.
insemination for both married and unmarried Israeli women as well as up to seven
rounds of in vitro fertilization per child for up to two live births. In contrast, one
round of IVF in the United States costs from $5,000 to $20,000 (Kahn 2000). It
comes as no surprise that Israel has more fertility clinics per capita than any other
country in the world and that Israeli women participate in state-sponsored prenatal
genetic screening at exceptionally high rates (Ivry 2001) in an attempt to ensure the
perfect "chosen bodies" of their offspring (Weiss 2002).
The surrogacy law of 1996 brought the "cult of fertility" to a new height, pro-
viding Israeli women with even more options to populate the nation. Through her
contractual relationship with a childless couple, for whom she carries a child to
term in exchange for payment, an Israeli surrogate deviates from the "normal" and
"natural" life course. Because it is opposed to the "naturalness" of motherhood in
the popular Israeli imagination, surrogacy is associated with violations of the natu-
ral order, much like lesbian motherhood in the United States (see Lewin 1995).
Surrogacy is transgressive because it places women in unique relationships
with "nature." Commissioning mothers see themselves as having failed to heed
their "natural" and national calling, whereas surrogates risk doing something
"against their maternal nature," that is, relinquishing the children they bear to the
custody of others. In gestational surrogacy, where the embryo is formed from the
commissioning couple's genetic substance, surrogacy is seen as a medium for the
commissioning mother to achieve her natural, national duty and to realize her
womanhood. At the same time, it places the surrogate in the problematic position
of violating her "natural" procreative urges and denying her maternal instincts, her
gendered national duty, and her cultural role. Surrogacy is thus a practice that si-
multaneously reifies and subverts the national and natural orders.
Given the mandate of motherhood in Israel, how do women retain their cul-
tural role and their national and personal identities when they take part in a pro-
creative process that does not result in their own motherhood? I argue that the
medical arena emerges as a site through which Israeli surrogates negotiate this
careful paradox. Medicalized reproduction becomes a field of potent metaphors
that surrogate mothers draw on in their efforts to align "nature," "maternity," and
national reproductive goals with their role as surrogates. In this light, it is impor-
tant that we consider how "nature" and "culture" are understood in the context of
medicalized childbirth in Israel.
seen as empowering women to control their own processes of pregnancy and birth
(Turkel 1995).
The effects of medicalization on women's lives have been explored in various
contexts, from hospital rituals to medical rhetoric. Anthropologist Robbie Davis-
Floyd (1992) claims that obstetric rituals surrounding childbirth in U.S. hospitals
communicate culturally specific messages about the necessity of culturally con-
trolling natural processes and about the untrustworthiness of nature. She suggests
that these rituals also communicate the weakness and inferiority of the female body
and the validity of patriarchy. Likewise, Emily Martin (1992) has shown that de-
scriptions of human reproduction in medical textbooks reflect similar themes, at-
tributing negative, feminine characteristics to the "fragile" human egg and posi-
tive, masculine characteristics to the "macho" sperm under the guise of "natural
facts."
Whereas Davis-Floyd's and Martin's research reflects postindustrial, capital-
istic forces in the United States, the medicalization of childbirth in Israel mediates
interactions between pregnant Israeli women and the state. Israeli reproductive
legislation entitles Israeli women to miss 40 hours of work without a salary cut for
medical appointments during pregnancy. The state not only funds a woman's
medical care during pregnancy and her hospital expenses but it also rewards her
with a special monetary grant for giving birth in a hospital rather than at home
(Ivry 2001; Morgenstern-Leissner 2002).
In surrogate pregnancies, the state's implicit desire to gain control reaches an
apex. Whereas all of the benefits mentioned above are extended to both the surro-
gate and the commissioning mother, the surrogacy law of 1996 directs that surro-
gacy births be carried out exclusively in Israeli hospitals and only in those units ap-
proved within the context of the law. The "Law of Agreements for the Carrying of
Fetuses," as it is called, made Israel the only country in the world besides the
United Kingdom to allow state-controlled surrogacy (Benshushan and Schenker
1997) and the only country where all surrogacy contracts are legislated by a gov-
ernment-appointed committee (Kahn 2000). The members of the committee, who
are chosen by the national Health Minister, must approve every surrogacy contract
carried out under the law.'
Although the law is a fascinating patriarchal artifact eagerly calling for an in-
depth anthropological analysis, here I will focus on its effect on the medicalization
of Israeli women's bodies. In order to qualify for surrogacy, medical and genetic
histories of the surrogate and both members of the commissioning couple must be
supplied to the committee. In addition, they must provide proof from the rabbinate
of their Judaism and a statement from the police pertaining to any criminal records.
Furthermore, all three are examined for disease and mental deviance through a se-
ries of blood tests, psychological examinations, and social aptitude tests.
The law limits surrogacy to couples in which the woman is unable to become
pregnant or to carry a pregnancy to term. Often such women are forced to prove
their barrenness to the committee.2 "Traditional" surrogacy, in which the surrogate
herself provides the female gamete, entails simple artificial insemination. The Is-
raeli surrogacy law, however, limits the surrogacy option to the gestational variant
only, which is necessarily dependent on IVF technology. The female gamete can
be supplied either by the commissioning mother or by an anonymous donor, but
the law specifies that the commissioning father must provide the sperm.
SURROGATE MOTHERHOOD IN ISRAEL 83
The medicalization of the surrogate's body is written into the surrogacy con-
tract itself in the form of her agreement to refrain from the use of alcohol, ciga-
rettes, and all drugs during the pregnancy.3 Her body is harnessed by her signed
agreement to refrain from sexual contact and to stop her regular work during part
or all of the pregnancy; to receive daily injections, undergo periodic blood tests,
and ingest all medicines and vitamins vital for fetal growth. She must also agree to
any prenatal screening or diagnostic procedures, such as amniocentesis, and to
abort the fetus or undergo selective reduction, cesarean section, or intrauterine fetal
surgery, according to doctors' recommendations. The surrogacy law thus emerges
as an extreme example of medical, legal, and state intervention in Israeli women's
bodies and lives. •
As a result of these strictures, surrogacy in Israel is shaped into a locus where
"culture" controls procreation with the help of powerful state institutions. It is
within this web of power controlled by legislation, state representatives, and doc-
tors that Israeli surrogates maneuver. Despite the encompassing reach of this
power nexus, however, surrogacy is also a locus where women creatively exercise
personal agency.
home birth. Fox and Worts (1999) similarly found that some of the women they in-
terviewed perceived medicalized birth as more empowering than nonmedicalized
birth. Whereas many women welcomed medical intervention because it promised
to leave them in better shape to assume their maternal responsibilities, other
women complained of a lack of control because of the hospital staffs failure to inter-
vene quickly enough in response to their requests for pain relief.
Methods
It is not mine. It is all artificial The hormones do it all instead of me. My brain
doesn't even know that I am pregnant. My brain is suppressed with the shots that
they give me. It turns my brain back to zero. Then all that is needed is given
through pills. Through hormones . . . the brain is the injections. Instead of the
brain ordering one, two, three, the hormones need to go up, need to go down, and
then the injections do everything.
86 MEDICAL ANTHROPOLOGY QUARTERLY
In her narrative, Orna clearly outlines the relations among her mind, body,
and personal self. So firmly set on consciously disembodying the pregnancy, Orna
claims that her "brain doesn't even know" that she is pregnant. Like Sima, she pro-
jects conscious determination on the hormones that enter her system, replace any
traces of "nature" in her body, and "do it all instead" of her. The injections become
her brain, with her body an artificial entity that is "other" to her and over which she
has resigned all control. In this way, Orna established how all personal aspects of
her being are clearly divided from the mind and body that she has partitioned off
for involvement in the surrogacy process. This rhetorically enabled division sub-
sequently allows her to "medically prove" that this pregnancy is not her own.
Like Orna, Rinat also embraces the medical manipulation of her body to es-
tablish that the surrogate pregnancy is outside of "nature." She too claims that the
hormones regulate the surrogate body:
It isn't regular. You have to take their hormones, because the hormones aren't
yours. And you start to get bloated.... In the beginning I got a bit round... and I
am usually very small in my pregnancies! See, now [pointing to her stomach, cur-
rently pregnant with her own child], from the beginning of this pregnancy, mine,
till now, I've gained one kilo or so. With them [pointing to her two youngest chil-
dren playing on the floor], I lost weight during the pregnancy.... But here [point-
ing to a photo of herself pregnant, with her arm around the commissioning
mother] I weighed seventy something kilo from the injections and the hormones
that they gave m e . . . suddenly I got a bottom, I got a tummy, I got thighs... from
the hormones. The hormones change your body. And my hair fell out. I would go
like this [scrunches her hair] and it fell... because of the hormones. They aren't
yours. The hormones that enter your body are strangers. They give them to you in
injections. It is hormones for the baby to develop well.
Rinat compares her "natural" body during her own pregnancy with the "artifi-
cial" body that the hormones created during surrogacy. She details how signs of
her own body's naturalness fell away during surrogacy and how her body changed
shape as "proof of its "otherness": her hair fell out in bunches, her stomach and
bottom grew round. Like Sima and Orna, Rinat has not only willingly relinquished
control of her body to medical management, but she also seems to encourage the
hormones to enter her body and relieve her of responsibility for this pregnancy.5 It
is she, however, who remains ultimately in control. She welcomes these "strang-
ers" into her system in order to use them as conceptual pawns to help her disem-
body and depersonalize the pregnancy.
As active participants in the medical manipulation of their bodies (Teman
2001), these women partake in a Goffman-like exercise in intentional submission,
subordinating their will to the structural power of the medical practitioner to
achieve their own purpose (Cussins 1996). Their compliance thus overturns any ar-
guments that have been made in the past regarding the control of women's bodies
by medical technology (see Corea 1985). What could be seen simply as a classic
example of women willingly accepting the medicalization of their bodies thus be-
comes a lesson in the clever strategies that they use to subvert external control of
their bodies from within the system. If medical technology is an implicit part of
gestational surrogacy, then these surrogates make sure that they are the ones to
shape its course. As a result, they view themselves as powerful agents who allocate
SURROGATE MOTHERHOOD IN ISRAEL 87
control over their bodies to the artificial substance that best suits their own concep-
tual boundaries of body, self, and nature.
The excerpts above add another layer to the interconnected map that joins na-
ture, medical technology, and maternity for these surrogates. Whereas hormones
created artificial, impersonal relationships, here we see that kinship and nature are
rooted in the genes. Whereas Ragone' (1998) and Cussins (1998b) both found that
U.S. gestational surrogates drew on genetic models of kinship instrumentally—
discarding them in favor of social kinship models when they no longer served the
surrogate's purpose—Israeli surrogates used this model of genes, maternity, and
nature consistently as their central explanatory model.7
Drawing from media accounts of Israeli surrogates, Kahn (2000) suggests
that these particular beliefs about the biogenetic origins of motherhood are essen-
tial to Israeli women's willingness to become surrogates. Her argument suggests
that without the medical knowledge that they have no genetic connection to the
child, these women might not have chosen to become surrogates at all—a hypothe-
sis that is impossible to test in the Israeli case because traditional surrogacy is pro-
hibited by law.8
Kahn also points out (2000:152) that the biogenetic understanding of related-
ness professed by Israeli surrogates directly contrasts with the Halakhic under-
standings of relatedness that are at the core of the surrogacy law. In other words, al-
though Jewish law determines kinship through gestation rather than genetics,
surrogates dismiss the importance of gestation in favor of a genetic kinship model.9
88 MEDICAL ANTHROPOLOGY QUARTERLY
Rinat links nature with maternity in a way that allows her to refute the taunts
of her neighbors, who see her actions as transgressive. Whereas her own children
are "naturally" her responsibility because they share a common biogenetic sub-
stance with her, Rinat has no maternal connection to the surrogate fetus because
she shares "nothing" (repeated six times) with him. Rinat's preteen daughter has
adopted her mother's interpretation and uses it to explain her mother's actions to
her friends: "He is not related to us. His blood isn't our blood. Nothing is ours. It is
the blood of the commissioning mother, of the parents. I would like to have him as
a brother, but he isn't ours."
Rinat's daughter adds the element of blood to the conceptual model of nature
and motherhood. Nature not only exists in the genes and selectively in the womb,
but it also resides in the blood of genetically related kin. Parents and children share
the same blood, according to this model, whereas those who are not genetically re-
lated, even if they are gestated in the same womb, share "nothing." As reflected in
Rinat's daughter's words, surrogates use the nature/maternity model to explain to
their children where their familial blood boundary ends and the commissioning
couple's blood and genes begin. Another surrogate takes the idea of blood/nature
even further, using it to explain how her own natural biological system has re-
mained untouched by the biogenetic substance of the commissioning couple, even
as they coexisted in her body. She embraces scientific discourse to explain her
"biological" distance from the fetus in an assured, didactic manner:
The egg and the sperm aren't mine, right? There are cells, I just develop those
cells. I mean, the cells divide with his genes. For instance: when you get a blood
transfusion, you don't change all of your blood.... The blood that they give you,
it helps you make more of your own blood. It has to be the same type of blood, be-
cause you can't mix two different types of blood, but it just helps your own body
SURROGATE MOTHERHOOD IN ISRAEL 89
recover by itself. It is the same thing here. You have a cell, an embryo, and it just
needs a little help from outside in order to develop into a fetus. The genes of the
child aren't mine . . . I feed him, develop his genes. But not mine. My genes are
something else. His looks, his personality, he takes nothing from me. It is all there
in four little cells, eight cells, thefirstcells, everything is already there. Even the
shape of his nose is in those two cells.... I have nothing to do with this embryo. I
have no genetic connection to him I have no connection to him.
By imagining the child as a whole unit simply transferred into her body for
the length of the pregnancy, this surrogate concretizes the separation between the
fetal body and her own. She repeatedly refers to the hormones as "injections that
neutralized my natural cycle" and to the*medicines that stopped her "natural" ovu-
lation cycle "so that the doctor could control my body." She imagines an "other"
residing in her body without becoming part of it. The fetus exists in a separate
blood/kinship system that does not disrupt or mix with her own "blood," even
while developing within her.
From the conceptual constellation that has been mapped out so far, it appears
that surrogates view their own and the commissioning mother's biological systems
as naturally imbued with genetic substance, blood, and bodily reflexes that give
rise to traditional maternal feelings. These natural properties, however, can be
stripped away temporarily or suppressed by the introduction of an "artificial" sub-
stance into the body. Whereas informants never mention the hormones the com-
missioning mother receives to increase her egg supply, they describe those injected
into the surrogate as having the potential of erasing any "natural," maternal feel-
ings that may reside in the surrogate's unmedicated body. Calling on different defi-
nitions of what is natural and maternal and what is not, these women engage in se-
rial moves of embodiment and disembodiment, personalization and
depersonalization, through which they ultimately create a personalized logic of
maternity: of what constitutes it and to whom it belongs (Cussins 1996).
The constructed nature of this model comes to light when compared with the
narratives of IVF patients, who receive similar hormone treatments but view them
as bringing "nature" back to the body (Cussins 1996; Franklin 1998; Sandelowski
1993) rather than replacing it with artifice. Why are Israeli surrogates so deter-
mined to prove that "nature" has no part in the surrogate pregnancy? And to what
lengths do they go to prove this point?
Fooling Nature
At the height of their navigation of the nature/culture paradox, Israeli surro-
gate mothers see themselves as "conquering" or "fooling" nature. This notion can
best be summed up in the words of a surrogate named Sarah, who whispered to me:
You know what I said to Danit? [her commissioning mother]. I said, "It is kind of
like we are fooling G-d!" I mean, I believe in G-d and I know that it is a horrible
thing to say... I hope that I don't get punished for saying it, but it is kind of true. I
mean, maybe we're not fooling G-d, but we're definitely fooling nature. Yes, I
guess that G-d is the one who helped us find one another and the doctor, of course—
so G-d is helping us fool nature.
90 MEDICAL ANTHROPOLOGY QUARTERLY
using medical metaphors to control the location of "nature" and maternity during
surrogate pregnancy. Carefully mapping "nature" and maternity onto the appropri-
ate body, they engineer medical intervention in their bodies to "conquer," "fool,"
and force "nature" into complying with their reproductive quest Their clever ma-
nipulation of language reunites motherhood and nature through the subversive re-
versal of the very discourse that separates reproduction and motherhood (Martin
1992). Consequently, instead of emerging as passive victims of the medicalization
of their bodies, Israeli surrogates use scientific language to exercise personal
agency (Teman 2001).
The question, however, remains: What ends does this agency serve? Why
do Israeli surrogates need a conceptual model that locates genes, blood, and nature
so explicitly? And why do they go to such lengths to prove where they "end"
and the surrogate pregnancy begins? These strategies appear extreme in com-
parison with those employed by U.S. surrogates (see Cussins 1998a, 1998b;
Goslinga-Roy 2000; Ragon^ 1994, 1998, 2000; Roberts 1998). Accordingly,
the Jewish-Israeli experience of surrogacy may be read as a product of the Israeli
cultural context.
The strategic negotiation of nature and artifice thus may be a method of sur-
vival in a complex cultural terrain wherein these women are forced to "work the
system" (Greil 2002) on a larger scale to get ahead. As single mothers in a family-
oriented society, women who become surrogates are already in a socially marginal
position and have limited access to financial resources (Kahn 2000). In fact, it is
precisely their status as unmarried women with children that places them in the
stringently defined group permitted to be surrogates under Israeli law. Although all
of the surrogates I interviewed assured me that "there are other ways to make
money," surrogacy appealed to them because it promised a financial jump that
would be impossible for them through traditional avenues. They saw it as an op-
portunity to acquire a significant monetary gain, US$20,000-30,000, in a relatively
short time.
The great cultural significance given to motherhood in the Israeli context,
however, makes surrogacy explosive terrain to navigate, especially because it is
carried out directly under the eyes of the state. As a result, surrogates not only jug-
gle the meanings of nature and maternity but also the meanings of gender role ful-
fillment and national belonging.
Motherhood is not only socially venerated and of national significance in Israel,
but it is also a significant determinant of inclusion in the Jewish-Israeli collective.
Susan Kahn (2000) has shown how unmarried women in Israel use motherhood as
a channel of status enhancement, because the stigma against single women in Israel
is far greater than that against single mothers. Nevertheless, just as becoming a
mother moves a single woman from marginal status to a more "natural" or normative
status (Kahn 2000), denial of motherhood can also make a Jewish-Israeli woman
"other."
It is this reverse path that Amir and Benjamin (1997) illustrate in their discus-
sion of women who decide to terminate their pregnancies because of personal con-
cerns. They argue that Israeli abortion committees ritually and symbolically dis-
tance such women from the collective because they have Dejected their expected
"natural'Vnational role. Amir and Benjamin conclude that the normative Israeli fe-
male subject is a mother who wants and is instinctively attached to her children,
SURROGATE MOTHERHOOD IN ISRAEL 93
whereas women who give up their children or refuse to reproduce are labeled
deviant. Under these circumstances, agreeing to give birth to a child and then relin-
quish custody in exchange for money is a major social risk.
Paradoxically, Israeli surrogates find themselves participating in a reproduc-
tive act wherein they are simultaneously creating and denying motherhood. In this
light, the surrogates' careful management of the meanings of maternity and nature
can be seen as strategies for aligning their actions with cultural and national under-
standings of maternity, shaping surrogacy into a status-enhancing experience per-
sonally and dismissing the threat of their further marginalization. By designating
the surrogate pregnancy "artificial" and distinct from the "natural" mothering
of their own children, they avoid the stigma attached to denying their "maternal
natures."
Moreover, by emphasizing how unnatural surrogate pregnancy is for them
and how natural it is for the commissioning mother, they are able to align their ac-
tions with the reproductive goals of the state. Surrogates establish themselves as
conformist Israeli women who have heeded their "natural" and national reproduc-
tive calling in the past and are now continuing their missions as good national sub-
jects by helping childless women achieve their own "natural'Vnational goal. To this
effect, they are not denying but facilitating motherhood and thus are not acting
against society's interests but, rather, are fulfilling them. The surrogates' concep-
tual logic even protects the state's interests because they so vehemently protect
maternity's rootedness in nature—an ideological tenet that is in conformity with
the patriarchal interests of the state.
Within this context, Israeli surrogates' firm attempt to control meanings asso-
ciated with the surrogate pregnancy raises further questions: Do they go to such
lengths to subvert medical control of the pregnancy only to make their actions
compatible with the pronatalist, patriarchal ideology of the Israeli nation-state?
Could they be partaking in this extreme form of medicalized self-abnegation all in
the service of ensuring national belonging?
Moreover, does their crusade act to strengthen traditional gender categories
that associate women with nature and motherhood? As single women rendering
themselves "artificial" to produce "natural" families for married, heterosexual cou-
ples, are they reaffirming a patriarchal view of the family that only serves to further
marginalize single women (Kahn 2000)?
The answers, as Greil (2002) suggests, lie in the middle ground between ac-
quiescence and resistance. Indeed, the actions of Israeli surrogates have not altered
any of the cultural definitions attached to gender roles that would signal a change
in the power structure (Lcwin 1995). In fact, their need to comply with national,
social, and cultural dictates of Israeli society is part of what motivates them to exer-
cise agency in the first place. However, surrogates emerge as "problem solvers op-
erating creatively within a system that they do not control" (Greil 2002:103),
working the system to make it fulfill their needs. Ultimately, they work within
"culture" to shape "nature" to facilitate personal, national, and cultural aims all
at once.
94 MEDICAL ANTHROPOLOGY QUARTERLY
NOTES
Acknowledgments. An earlier version of this article was chosen as the winning essay
of The Council on Anthropology of Reproduction's Second Annual Graduate Student Paper
Prize. I thank Gail Landsman and the members of the CAR prize committee for this honor.
I would like to extend my thanks to my dissertation advisors and mentors Meira Weiss,
Eyal Ben-Ari, and Don Seeman for their helpful comments on earlier drafts of this article
and for their support at all stages of this research. I would also like to thank Susan Kahn and
Aviva Dautch for their insightful comments on later drafts of this article and for taking the
time to discuss it with me at length. I am also indebted to Shulamit Reinharz for her helpful
suggestions, Rhisa Teman and Avi Solomon for their editing help, and the anonymous MAQ
reviewers for their suggestions. Finally, a heartfelt thanks to the women who shared their
surrogacy stories with me.
This research was funded by grants from the Hebrew University Social Sciences De-
partment, the Minerva Center for Human Rights, the Lafer Center for Gender Studies, the
Shaine Center for Social Research, and the Israeli Society of Academic Women.
Correspondence may be addressed to the author at the Department of Sociology and
Anthropology, Hebrew University, Mt. Scopus, Jerusalem, 91905, Israel; e-mail: mslula®
mscc.huji.ac.il.
1. The committee comprises seven members: two gynecologists, an internal specialist,
a clinical psychologist, a social worker, a lawyer, and a religious representative (Ben-
shushan and Schenker 1997). Surrogacy arrangements carried out within Israel without the
committee's approval are illegal, and participation in them is a punishable crime.
2. Most of the women seeking a surrogate either have no womb or have attempted IVF
up to 23 times at the expense of the state. The committee informed one participant in this
study that she must undergo IVF an eleventh time to prove her inability to bear a child. Fol-
lowing her subsequent pregnancy and miscarriage, her surrogacy petition was approved.
3. The surrogate must seek a doctor's and the commissioning couple's approval before
taking even such common drugs as aspirin.
4. Although medical metaphors appeared in the narratives of all eight of the surro-
gates' discussed here, I draw heavily from the richly layered, yet representative narratives of
Rinat and Orna.
5. It is important to point out that, like Rinat, all of the surrogates interviewed strongly dif-
ferentiated between the surrogate pregnancy and pregnancies with their "own" children. Just as
they stressed the "artificial" nature of the surrogate pregnancy, they also stressed how immediate
and "natural" their maternal feelings were during their own pregnancies (see Teman 2001 for ex-
amples of this). As Ragone* (1994) has described in the case of U.S. surrogates, they prided them-
selves on being "good mothers" and evenframedthe payment receivedfromsurrogacy as an act
of maternal love aimed at providing a better future for their children.
6. Although the secretary of the surrogacy committee estimated that roughly half of all
surrogacy agreements in Israel involved the use of eggs from anonymous donors, none of
the women I interviewed admitted that the eggs were not the commissioning mothers'. Be-
cause frozen embryos were often used, the surrogate may not have been aware that the com-
missioning mother had not provided the female gamete. Conversely, this information
simply may not have fit into their conceptual scheme and, therefore, was disregarded.
7. Ragone* (1998) shows that women who begin as gestational surrogates but become
traditional surrogates later in the process are forced to discard the claim that the child is not
theirs because it is not genetically related to them and to adopt a different interpretation. This
is because in traditional surrogacy the woman is genetically linked to the child. Traditional
surrogates, then, replace the genetic kinship model with a kinship model based on intention,
in which they claim that the child was "conceived in the heart" of the commissioning
mother, making her the "real" mother of the child. In the Israeli case, the genes are always
the deciding factor in the surrogate's ideas about maternity.
SURROGATE MOTHERHOOD IN ISRAEL 95
8. Traditional surrogacy, whereby the surrogate provides the female gamete, is not al-
lowed in Israel, whereas it is permitted in the United States. Thus Israeli surrogates do not
face the possibility of being the gamete provider themselves, and they can thus consistently
maintain the genetic model.
9. The surrogacy law requires that the surrogate and commissioning mother be of the
same religion. This is to ensure that the child will be considered Halakhically Jewish. Jew-
ishness is determined matrilineally. Therefore, a child is considered to be Jewish if it is ges-
tated in a Jewish woman's womb. Gestation can thus pass on Jewishness, but genetic
material cannot: If an embryo formed from non-Jewish genetic material is gestated in a
"Jewish womb," the child is considered Halakhically Jewish. If a Jewish couple's genetic
material is gestated in a "non-Jewish womb," however, the child is not considered Halakhi-
cally Jewish (Kahn 2000).
10. It will be interesting to see how this maternal logic is negotiated in other reproduc-
tive spheres, such as egg donation and local and international adoption.
11. See Teman (in press) for a discussion of the ways that the commissioning mother's
maternal "nature" develops during the pregnancy and how she comes to intuitively "know"
and sympathetically embody the pregnancy.
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