Million-Dollar Baby: How Much Would You Pay for a Baby If You Couldn't Have One?

How much would you pay for a baby, if you couldn't have one?

Given that 1 in 12 U.S. women of childbearing age are infertile and it's a practice that's growing in acceptance, legality and practice, surrogacy's price tag is clearly pregnant with possibilities.

Sarah Jessica Parker and Matthew Broderick's recent surrogate twin birth pulled the issue into the debate ring with forceps. And whether or not you agree that surrogacy is a form of prostitution or baby selling, a way for the rich and famous to avoid disrupting their career plans or figures for progeny, or a form of exploitation, it's indisputable that surrogacy is often about a wealthier couple hiring a poorer woman to breed for them, and not paying that woman very much.

So consider this. Even though gestational surrogacy (when a woman carries a child not made of her genetic material, versus traditional surrogacy, when the woman who carries the child is also its genetic mother, impregnated with donor sperm) is illegal in several states, in the rest of the states it's a growing market.

Right now, unlike many medical procedures, the cost is subject to the free market. Couples pay the surrogate, the agency (when they use one), the IVF clinic and the legal fees at market value. Even though many argue that "most surrogates do it for altruistic reasons," as the practice develops, and a supply-and-demand issue inevitably emerges, the question is, should the cost be regulated to ensure that both rich and poor infertile couples can afford to have babies made of their own genetic material?

It's a feminist conundrum. On the one hand, why shouldn't surrogates be able to charge as much as they want for something they provide with their bodies? No one suggests that we limit the amount men can charge for lifting heavy planks of wood on a construction site, to name a ridiculous example. And I see almost nothing written about how men should sell their sperm for bargain-basement dollars to ensure even poor women can buy a vial.

But right now, even if a surrogate makes $25,000 (plus medical expenses) for her 10-month job, that's far less than minimum wage, and I think we can all agree that making the next generation is at least as important as making burgers. So why shouldn't surrogates be paid more?

On the other hand, we know what happens when there is any kind of desperation. Women who have struggled with infertility for years, in a culture that still defines motherhood as a key part of female identity, will arguably pay whatever they can afford.

They would pay hundreds of thousands of dollars, I'd wager, if that's what it cost, and they had that cash. I know an infertile couple, an artist and a musician. Should we tell them that they will simply never have a baby made of their genetic material, where an investment banker can? Should the rich and famous be the only ones who can afford it?

It's already not affordable for most, despite some claims that lots of non-celebrity, not "especially wealthy," Americans are doing it. I mean, how average can you be if you can afford the procedure?

To start with, you typically need to do at least one round of in vitro fertilization to retrieve eggs from the donor mother, fertilize them with the donor father's sperm and transfer them to the surrogate, which is about $8,000, plus about $4,000 in medication. You need to pay the surrogate, often $12,000-$30,000 for a single child (more for twins), and pay for medical fees. There are sometimes agency fees, travel fees (if you live in a state where surrogacy is illegal and you work with a surrogate in another state), extra legal fees (like to get the biological parents' names on the birth certificate in states where that's not automatic, and to create a contract with the surrogate if the arrangement is not done through an agency), and maternity clothing fees and other expenses. The total cost for a single birth is often $40,000-$70,000. And that's with the surrogate often earning far less than minimum wage.

Even if surrogates' motives are mostly altruistic, if demand increases, more surrogates will inevitably wonder if fairer compensation for their significant effort and valuable service might is in order. While it would be fairer to them, it would make the practice unaffordable for all but the elite: a situation that bears some resemblance to Margaret Atwood's dystopic novel The Handmaid's Tale.

So it seems there are three options. The first is to follow Canada's lead. In Canada, it's illegal to pay surrogates. You can pay for expenses related to the cost of pregnancy -- food, transportation to medical appointments, vitamins and so on (with receipts required for everything). It proves the altruism case, and can lead to some very meaningful experiences for both surrogate and parents. But it also means that though in theory most Canadian couples can access the service, in practice, there are almost no willing surrogates.

One Canadian woman I know, who found a volunteer surrogate on Craigslist, was afterward besieged by dozens of calls and e-mails from other women begging for her help. Very few women will volunteer to carry a baby for a relative or friend, let alone a stranger.

Alternatively, we could continue to let the free market determine the rate. Which, in my opinion, will (and should) climb, to fairly remunerate the surrogates.

Or, for the sake of debate, we could treat it more like the college-education funding model. Here's how it could work: All couples apply through an agency and are psychologically evaluated, as they are now. Then after being either accepted or declined based on that psychological assessment, they're given a means test.

Investment bankers pay more than teachers, but each pay, let's say, 10 percent of their net worth -- the former might pay $200,000, the latter, $10,000. And surrogates receive a standard amount that fairly remunerates them for their time and effort -- maybe even one that increases with each healthy birth?

Yes, educating people about adoption is a great idea. So is working to make motherhood into more of a choice and less of a necessity for female identity. But if we want surrogacy to be an option for more than the rich and famous in the future, we might have to carry a new model to term.