opinion

It Should Be a Woman’s Choice Whether or Not to Use a Surrogate

Women should not need a medical condition for surrogacy to be socially acceptable. If a woman doesn't want to carry her child, she shouldn't have to. Whether for medical reasons, career reasons, or otherwise, all women should have the choice to have children without needing to carry them physically.
September 28, 2021Updated 4 days ago
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It Should Be a Woman’s Choice Whether or Not to Use a Surrogate
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The typical view is that using a surrogate shouldn't be done unless necessary. Most women using surrogates only do so for strictly medical reasons. The overarching social conception of surrogacy is that it should only be done when absolutely necessary, because carrying a child would threaten the life of the mother. But it doesn't need to be a last resort.
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Surrogacy is often seen as a last resort option: something a woman chooses only when all of the other options have been exhausted. Especially for heterosexual couples who do not necessarily physically need to use a surrogate to carry their child, the choice can sometimes be viewed skeptically unless it's required for a mother's health. Experts say there are about 10 common medical conditions that may cause a woman to choose surrogacy. Some of these health-related reasons include infertility, age, a need for certain medications, or pre-existing medical conditions such as a hysterectomy or uterine problems. As such, surrogacy remains a relatively rare occurrence in the United States. Some estimates say that only about 5,000 children per year are born via a surrogate. Finding a surrogate is difficult and challenging for both the surrogate and the expectant mother. Trusting someone to carry a child is a huge leap of faith. Some people often judge women who choose to use a surrogate for reasons other than the medical ones enumerated here. There are stigmas associated with that, such as the idea that women are simply afraid of pain or are vain and don't want to deal with the changes in their bodies. This prevailing view does not need to continue to be the case, however. There are myriad benefits for women who choose to use a surrogate, whether for physical reasons, emotional reasons, or career reasons.
Pregnancy can be excruciatingly hard. From changes in the body and mind to changes in home life, pregnancy can be extremely difficult for many expecting mothers. It is an enormous stress on women that requires them to reorganize their entire lives. That stress can be physical, mental, and emotional: it can even cause women to lose their lives.
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For example, it's exhausting. Pregnancy fatigue presents as extreme physical exhaustion and can affect everything from a woman’s ability to work to her friendships and caregiving responsibilities. Especially when a woman already has other children or major responsibilities outside of the home, the fatigue-inducing hormones caused by pregnancy can pose a major challenge for an expecting mother’s daily functioning.
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Growing a new human can be really tiring. "Pregnancy fatigue" is a real phenomenon where women, especially in the first and third trimesters, describe feeling tired all the time, almost to the point of exhaustion. According to the online source "What to Expect," nearly all women experience pregnancy fatigue while pregnant, especially in the first few months. Pregnancy fatigue can start as early as the first few weeks following conception and implantation. That first phase of fatigue tends to lift by the second trimester. But a second wave of fatigue tends to show up in the third trimester, or around week 28. Many women may again feel a bout of extreme tiredness, forcing them to take frequent naps and lay off their usual activities. Pregnancy fatigue is not simply a mental or emotional problem: it has a scientific basis. Pregnancy hormones cause a variety of changes in the body: from altered sleep patterns to increased levels of estrogen and progesterone that act as a "natural sedative." The fatigue can strongly limit women's ability to work, take care of other children, or just enjoy their normal activities. Constant, debilitating fatigue can cripple women's daily lives.
It's also emotionally challenging. The ups and downs caused by pregnancy hormones can have major negative effects on daily life. Mood swings, even for women without preexisting mental health issues, can be destabilizing. Those effects are even more severe—and sometimes life-threatening—for women with more acute mental health issues. These changes in mood in turn touch every aspect of a woman’s life.
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Many women describe huge mood swings during pregnancy, as well as symptoms such as anxiety and even clinical depression. The range of emotions can be very challenging for pregnant women. The physical fatigue—coupled with the changes in hormones—can cause a woman to go from feelings of elation to weepiness almost instantly. Those feelings in turn can quickly turn to elation. "Pregnancy is a huge transition in a woman's life, and it involves a complex mix of emotions, both good and bad," Dr. Mary Kimmel, medical director of the Perinatal Psychiatry Inpatient Unit, told LiveScience. Anecdotal evidence supports this idea. One author described having a breakdown over a slice of cheese. "As my husband tried to calm me down, I got more hysterical, convinced that my dinner would be ruined and he just didn't understand what I was going through!" she described in an article for Parents magazine. The first trimester is often characterized by tears and forgetfulness—bouts of sobbing, or putting your keys in the fridge. The second trimester tends to be accompanied by extreme happiness and even an increased sex drive. By the third trimester, women can expect "crankiness and power-nesting," according to Parents magazine. That means irritability plus the desire to knit baby clothes and decorate the little one's new room.
Beyond the mental and emotional changes, pregnancy can cause serious medical complications. The medical conditions caused by pregnancy are wide-ranging, both in what aspect of a mother's health they affect and their level of seriousness. From indigestion, heartburn, and bloating all the way up to high blood pressure and gestational diabetes, some of those conditions risk both a mother's and her baby's health.
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Being pregnant can cause a huge range of medical issues, from the annoying to the life-threatening. Still others threaten the health or even life of the baby. Many of the most common medical issues aren't serious but certainly aren't pleasant, including cramps, indigestion, heartburn, varicose veins, and a blocked nose. It can also cause more worrisome problems: being pregnant increases the risks of developing serious complications from influenza, for instance. More serious complications include anemia, high blood pressure, and certain kinds of placenta issues that may lead to bedrest or even premature delivery of the baby. Rare conditions in pregnant women, such as hyperemesis gravidarum, cause such intense vomiting that it can lead to women being hospitalized for dehydration. Both Kate Middleton and the comedian Amy Schumer were afflicted with hyperemesis. “It’s very miserable,” Dr. Amos Grunebaum, director of obstetrics at New York Presbyterian/Weill Cornell Medical Center, told TODAY. “You feel like you can’t do your daily activities, and you really want to eat and you can’t, and hopefully you get treatment really quickly.” Other conditions can cause a risk not just to the mother's health but to the baby's as well. Gestational diabetes, where a mother's blood sugar levels are too high, can cause preeclampsia, early delivery, the need for a Cesearean birth, or a baby born with low blood sugar, breathing problems, and jaundice, according to the U.S. Office on Women's Health.
Clothing changes can be costly and annoying. Maternity wear is a billion-dollar industry. Some upscale maternity clothes are priced as high as $200–300 per garment. For many women, both the cost and the time required to invest in maternity wear is a major hassle. Not to mention the environmental costs associated with so much textile waste.
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For many women, shopping can be fun activity to pass the time. But buying a whole new wardrobe for just a few months can be both a financial burden and a nuisance. Maternity wear—even if it just seems like a few new pairs of jeans and some stretchy tops—can actually be hugely time-consuming. Maternity clothes are a $2 billion industry, according to some estimates. Fortune Magazine reported that the average woman spends $50-60 per month every month during their pregnancy—resulting in $500 overall. Other options are far more expensive. In recent years, a market for high-end maternity clothes—especially those that can be extended and worn after pregnancy—has reached an increasing audience. Take Hatch for instance, a maternity clothing line designed to be worn before, during and after pregnancy, as their website reads. “The idea that you only have five months to invest in a piece of clothing that you’re buying, it doesn’t allow you to have an emotional affair with that garment,” Hatch’s founder Ariane Goldman told Racked. Each item is meant to function "during a time where it’s really needed, but stays in your closet, and it lasts because it’s wanted.” Each Hatch piece reflects that longevity: they're priced at $200–$300 per garment. It's also wasteful: especially for women who only want to have one kid, or who don't have other women friends getting pregnant, those clothes may be destined for the landfill. Especially for working women who need to look professional, the costs add up when you can't just wear an oversized tee shirt to the office. And few workplaces defray the cost.
Food planning for pregnancy can be another logistical nightmare: requiring time and money. From pre-conception to post-natal, sometimes changes to a woman's diet are necessary and require time, money and planning. Whatever a mother eats, her growing fetus consumes, and many women therefore devote a lot of energy to ensuring that all of their meals are nutritious and well-balanced. This is often a huge undertaking.
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A proper diet during pregnancy is "critical to your baby’s growth and development," according to the American Pregnancy Association. Pregnant women need to make sure they're eating at least an additional 300 calories per day, including a balance of vegetables, grains, and proteins. That means thoughtfully planning and preparing meals, including shopping, chopping, and cooking. There are a huge amount of restrictions what women can eat when they're pregnant, such as raw fish, high-mercury fish, raw meat, shell fish, caffeine, soft cheeses, deli meat, among many other things. Especially for women on bedrest, or perhaps because of all of the restrictions on what pregnant women can eat, women may find themselves increasingly eating at home during pregnancy. And that means a skyrocketing grocery bill is just par for the course. Meal planning can be complicated, too. Trying to make sure to get a proper, balanced diet, all while avoiding certain foods, means more time spent planning, cooking, and cleaning. It can be so complicated that there are dozens of articles on the Internet devoted to pregnancy meal-planning. There are even those who encourage women to follow a strict diet while they're trying to conceive. That may mean several additional months of expensive, intricate meal planning. Prenatal vitamins can supplement this balanced eating, but some of the top-shelf ones are costly. One month of prenatal vitamins can cost as much as $60-$90.
Childbirth is long, painful and dangerous. It is one of the most challenging experiences women go through, and especially for women with preexisting medical conditions—it can cost them their life. Even in developed nations such as the United States, the maternal mortality rate remains exceptionally high. And many more women who don't die often have to deal with long-term health consequences.
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The process itself is long, uncomfortable, and frightening. It can last as long as several days. For some women who don't encounter serious complications, the pain and suffering of childbirth can be traumatic, lasting over the course of several days. Even in the case of deliveries deemed normal, women may require stitches, months of recovery, and even reconstructive surgery.
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For every story of easy child labor, there are ten horror stories to counteract it. Some women are in labor for multiple days before they give birth, only sleeping for a few minutes between contractions and chewing ice chips to stay hydrated. Even a natural birth without complications can involve excruciating pain and last for hours. For first-time mothers especially, the process tends to be extremely long and can involve intense pain even with medication. The first stage of labor, or early labor, involves contractions coming every 5–30 minutes. Many women describe the contractions feeling like intense menstrual cramps that can last up to 60 seconds. Some women say even the early contractions are far more painful than cramps, however. “I was told it would feel like very bad menstrual cramps, but that's not what it felt like to me. It was much more intense and it was almost all in my lower back. Every time a contraction would come, my lower back would slowly begin to seize up. It was kind of like the muscles inside were slowly twisting harder and harder until it became almost unbearable, and then it would slowly subside," one woman told Parents magazine. The second stage is active labor, where contractions come every 2–5 minutes and can be more intense and lasting longer. This phase can last upwards of eight hours. The average first-time mother spends upwards of six hours in active labor, according to a recent federal study. From there is delivery, when the cervix is dilated 10 centimeters. This is when a woman starts to actively push to deliver the child. It can last as short as a few minutes or take several hours of excruciating pain. “Pushing was the worst. I could feel every stretch, pull, and tear. The burning was like no other. I remember feeling there was no way I could push the baby out, it won't fit,” one woman told Parents magazine.
When complications do occur during childbirth, they can be life-threatening or debilitating Occurrences of serious complications during childbirth are rising in the U.S. and can threaten the lives of both mother and child. Emergency hysterectomies alone have risen by over 50 percent. What's more, the public perception of serious complications is that they are rare, meaning that women and doctors alike might not take symptoms seriously until it is too late.
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Bacteria that are typically active in the vagina before pregnancy can cause an infection in open wounds after a mother delivers her baby. This bacteria can affect the uterus and areas around the uterus. There is typically a low chance of developing these infections unless the woman is young and there is an unscheduled cesarean, or a long delivery with excessive bleeding. About one in three women deliver their babies via C-section. Of those women, as many as 18% will go on to develop chronic pain from the scar tissue resulting from that surgery. One young mother lost nearly half her body's blood during her c-section. After a week in the hospital, she thought the worst was over, but she went on to develop chronic pain around the scar tissue where the incision was made. Common complications during childbirth include perineal tears (when the area between the vagina and the anus tears or is surgically cut), excessive bleeding, perinatal asphyxia (when the child does not get enough oxygen), and abnormal heart rate of the baby. Many of these conditions also go unmonitored after childbirth because women are so focused on their child's health that they neglect their own. One study found that as many as 40% of women don't go to their own doctor's appointment check-up after giving birth. Kristen Terlizzi, who cofounded the National Accreta Foundation, had her uterus, appendix, and part of her bladder removed in 2014 because of a life-threatening placenta condition. “There’s this misconception that these complications are rare,” she told ProPublica. “And we [women] get brushed off — ‘The risk is not a big deal.’ But it is.” A 2017 investigation from ProPublica found that serious complications during childbirth in the U.S. were "skyrocketing." More than 50,000 women suffer severe complications each year—a number that has doubled since the 1990s. Women who survive severe complications often deal with long-term consequences such as severe pain, the inability to give birth again, and intense trauma. Emergency hysterectomies, for instance, have risen 60%. Not only is a hysterectomy an invasive surgery with a potentially long recovery time, but it renders women unable to get pregnant again. In 2014 alone, doctors in the U.S. had to carry out 4,000 emergency hysterectomies.
Pregnancy and childbirth can cause lingering health issues. From postpartum depression to increased risk of heart attack and stroke, complications can be severe and long-term. The health issues from having a child can linger for years after the child is born, and some are so severe that they can prevent women from being able to care for their children in the way they would like to.
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Those complications can be mental and emotional. Pregnancy and childbirth can have extraordinary mental and emotional effects on the mother, many of which go undiagnosed. From the "baby blues" all the way up to post-partum depression, the mental effects of childbirth can be severe. And they are very common: hundreds of thousands of women are estimated to suffer annually from post-partum depression.
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Having a baby can be one of the most exciting and fulfilling new challenges. Alongside the late-night feedings and diaper changes, however, many women have to deal with mental health problems that their husbands do not. The "baby blues," where women experience bouts of crying and sadness in the week following childbirth, affects at least half of all mothers. The Cleveland Clinic estimates that 50–75% of women experience these symptoms. Up to 15% of those women will develop full-blown postpartum depression, with symptoms such as frequent crying, anxiety, irritability, and fatigue. Those symptoms can last from a few weeks up to a full year. Part of what can be challenging about treating PPD is that it presents differently in different women. For some new mothers, it’s an intense anxiety about failing their new child, while for others it has more of the hallmarks of traditional, clinical depression (such as a lack of interest in usual activities and feelings of sadness). About 400,000 to 800,000 mothers in the U.S. suffer annually from PPD, though that number may be an underestimation. One study found that up to 50% of cases of PPD will go undiagnosed. Undiagnosed PPD affects women of color disproportionately. Only a single drug has been developed and approved to treat PPD in the U.S. Women are often treated with anti-depressants or talk therapy. Left untreated, PPD can greatly reduce a woman’s quality of life—and sometimes even end in suicide. And a new study found that women who experienced postpartum depression for several months were at a heightened risk of developing long-term, clinical depression that lingered for years. The researchers also found that a mother's depression could have negative effects on her kids: the children of women who suffered from this kind of prolonged depression were twice as likely to have behavioral problems as the children of women who did not.
They can also be physical and even life-threatening. This can temporarily affect a mother’s lifestyle or responsibilities or permanently impact her physical health and well-being. Some of these complications can even result in the death of the mother. Bed rest, infected wounds, and lingering issues with major organs are all potential post-partum consequences.
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Mothers can be placed on bed rest This reduces a woman's ability to work, care for other children, or even complete basic tasks. While some people might imagine bed rest to be a casual diagnosis, wherein a woman is simply "taking it easy" for a while, that is often not the case. Some women put on bed rest are so debilitated that they can barely get up from bed to get a drink of water.
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Being placed on bed rest is a relatively common occurrence during pregnancy and can result from a variety of conditions. High blood pressure, cervical changes, vaginal bleeding, premature labor, poor fetal development, gestational diabetes, and placenta complications are just a few of the conditions that may lead to a woman being placed on bed rest for as long as several months. Bed rest is prescribed to thousands of women each year. Its severity can range from simply taking it easy to literally limiting women to their beds for months on end. This is done in the goal of reducing the risk of a premature birth or a miscarriage. It is often prescribed to women with hypertension or who have a history of preeclampsia. The consequences on women and their families can be severe, however. One woman, for instance, was put on bed rest for several months when she already had a 3-year-old daughter. Her husband was forced to quit his full-time job in order to take care of them both, drastically reducing their income just as they needed it more than ever. Confined to the couch or the bed, the woman told NPR: "I wouldn't even get my own glasses of water. So I like to say that 'I was on bed rest, and he was on house arrest,' because he really couldn't leave either." The effectiveness of bed rest continues to be debated, all while the practice itself carries its own risks. Some recent studies have claimed to find that bed rest can be riskier for some women than simply continuing on with normal activities. Doctors claim it can even be fatal in certain cases. "One of the most dangerous things that can happen when a woman is on bed rest is having a blood clot," said Anne Drapkin Lyerly, an OB-GYN and professor of bioethics at the University of North Carolina at Chapel Hill. "You can have blood clots in your legs or in your pelvis. And if those clots travel to your lungs, it's life threatening."
Wounds can become infected, and other complications can be severe. Occurrences of serious complications during childbirth are rising in the U.S. and can threaten the lives of both mother and child. Emergency hysterectomies alone have risen by over 50 percent. What's more, the public perception of serious complications is that they are rare, meaning that women and doctors alike might not take symptoms seriously until it is too late.
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Bacteria that are typically active in the vagina before pregnancy can cause an infection in open wounds after a mother delivers her baby. This bacteria can affect the uterus and areas around the uterus. There is typically a low chance of developing these infections unless the woman is young and there is an unscheduled cesarean, or a long delivery with excessive bleeding. About one in three women deliver their babies via C-section. Of those women, as many as 18% will go on to develop chronic pain from the scar tissue resulting from that surgery. One young mother lost nearly half her body's blood during her c-section. After a week in the hospital, she thought the worst was over, but she went on to develop chronic pain around the scar tissue where the incision was made. Common complications during childbirth include perineal tears (when the area between the vagina and the anus tears or is surgically cut), excessive bleeding, perinatal asphyxia (when the child does not get enough oxygen), and abnormal heart rate of the baby. Many of these conditions also go unmonitored after childbirth because women are so focused on their child's health that they neglect their own. One study found that as many as 40% of women don't go to their own doctor's appointment check-up after giving birth. Kristen Terlizzi, who cofounded the National Accreta Foundation, had her uterus, appendix, and part of her bladder removed in 2014 because of a life-threatening placenta condition. “There’s this misconception that these complications are rare,” she told ProPublica. “And we [women] get brushed off — ‘The risk is not a big deal.’ But it is.” A 2017 investigation from ProPublica found that serious complications during childbirth in the U.S. were "skyrocketing." More than 50,000 women suffer severe complications each year—a number that has doubled since the 1990s. Women who survive severe complications often deal with long-term consequences such as severe pain, the inability to give birth again, and intense trauma. Emergency hysterectomies, for instance, have risen 60%. Not only is a hysterectomy an invasive surgery with a potentially long recovery time, but it renders women unable to get pregnant again. In 2014 alone, doctors in the U.S. had to carry out 4,000 emergency hysterectomies.
In the worst case scenarios, they can die. The U.S. has the highest maternal mortality rate of any industrialized country. In the modern era, many Americans forget just how common it is for women to die in childbirth. Blood clots and infections can advance quickly. And Black women and women of color are vastly more likely to die in childbirth than their white counterparts in the U.S.
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In the United States, approximately 700 women die each year as a result of complications from child birth. The maternal mortality rate in this country has been increasing since 2000, despite the fact that most of these deaths are preventable. The rate of maternal mortality in the U.S. is higher than that of any other industrialized country by some measures. Especially when compared to other developed nations, the U.S. has a staggering number of maternal deaths. In 2018, for instance 17 women died for every 100,000 live births—more than double the rate for countries with similar healthcare and economic systems. The differences in maternal mortality are stark when it comes to race and ethnicity as well. The maternal mortality rate for 100,000 live births more than doubles when the mother is Black (coming in at a rate of 37.1 deaths per 100,000 live births). Women are advised to monitor themselves post-childbirth for warning signs of blood clots, infections, and hemorrhage, which can be potentially life-threatening. Severe complications—such as kidney, heart, or liver failure; bleeding in the brain or long-term comas—can also be fatal for mothers. Some of the complications during pregnancy and childbirth—such as pre-eclampsia and gestational diabetes—put women at higher risk of heart disease, diabetes, and stroke throughout the rest of their lives. Even if they don't die in childbirth, therefore, they might die from complications that arose during childbirth. "Both of these conditions are associated with basically a doubling in their lifelong risk for cardiovascular disease," Dr. Lisa Hollier, president of the American College of Obstetricians and Gynecologists, told NPR.
Both pregnancy and maternity leave can greatly interfere with work. They are time-consuming and challenging—and may result in permanent consequences for a woman's career. The time spent at doctors appointments, on bed rest during pregnancy, and during maternity leave can all add up. And they may mean long-term effects on promotions, reputation, and client retention.
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Doctor's appointments during pregnancy can be frequent and time-consuming. With upwards of a dozen appointments over the course of nine months (If not more, depending on a woman's health), the time lost can have long-term effects on a woman's goals, whether they be personal or professional. Frequent visits near the end of a pregnancy can mean women might have to miss important meetings or other engagements.
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In order to ensure proper prenatal development, doctors urge expecting mothers to come in for frequent visits, especially during the second and third trimesters. Toward the end of the pregnancy, the frequency of visits increases to once every two weeks and then once every week in the final months. Women with high risk pregnancies—such as geriatric pregnancies or pre-existing conditions—may have to attend even more frequent doctors appointments. Women can expect to see their doctor more than a dozen times during their pregnancy. For working women, this schedule can be extremely disruptive. Factoring in travel from work to the doctor's office and back, plus wait times, and the actual appointment itself, women are forced to lose 2-3 hours of their work day for a doctor's appointment. This problem is magnified for women who live in rural areas or working-class women—two groups who have less choice over where and when their doctors appointments are. That can also mean longer transportation times which in turn means more life disruptions. This loss of time, especially at high-pressure jobs, can be hard to catch up on. It may allow other colleagues to advance or to take on additional clients.
Even a short maternity leave can have negative work consequences. The law doesn't always protect pregnant women from losing their jobs. Many employers will find loopholes or excuses to dismiss pregnant women or new mothers from jobs, even if they are long-term employees. Meanwhile, the women who do return to their jobs waiting for them may have difficulties catching back up on work they missed during maternity leave.
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While an employer is not allowed to legally fire someone simply for taking maternity leave, many employers seem to find loopholes to do just that. Women are then put in the impossible position of losing their jobs just as they might need the income more than ever: while starting a new family. Just this summer a former SoulCycle employee sued the company, claiming she was fired for taking maternity leave. Jordan Kafenbaum, the former senior director of instructor programming and talent management of SoulCycle, says she was fired just 32 days after giving birth. In her lawsuit she described her termination as “blatant pregnancy discrimination and retaliation.” Her case is just one of many similar ones that happen all the time, at companies both big and small. Another case that took place in recent years occurred where a woman claims she was fired from her job at Ramsey Solutions in Tennessee simply for getting pregnant out of wedlock. Even for those women who are not outright fired, many return to an office where colleagues have taken over some of their responsibilities or clients. Research found that some women who take maternity leave may even find it harder to advance or get promoted after they return. Especially in high-powered jobs where the pace of work moves quickly, even a short few weeks out of the office can put women too far behind their male counterparts. This kind of lost income when it comes to being passed over for promotions can be both hard to measure and difficult to prove in a court of law, meaning that women have little recourse to protect themselves from it. Researchers writing for the Harvard Business Review found that both men and women held negative preconceptions when they saw that a woman had taken a long maternity leave. These slight perceptions can have major consequences: resulting in a woman not getting a job or not being promoted at a new job. As the researchers concluded: "Evidence from a variety of countries reveals that the longer new mothers are away from paid work, the less likely they are to be promoted, move into management, or receive a pay raise once their leave is over. They are also at greater risk of being fired or demoted."
With surrogacy, the impact on work becomes similar to what a man might undergo. Women don't experience changes to their bodies as a result of the pregnancy and can continue working in the same capacity. While there will certainly still be some changes in lifestyle, when pregnancy is taken off the table, the process no longer becomes the life-altering thing it is when a woman is forced to become pregnant in order to have a child.
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Surrogacy allows women to experience pregnancy in much the same way a male partner might. Because the women who use a surrogate have no impact on their own bodies (or less impact, depending on if they harvest their own eggs), they can continue doing the exact same activities without much interruption. They can continue working or enjoying their usual activities without the fatigue, physical changes, and hormonal mood swings that occur. Without the physical toll of pregnancy, the disruptions are minimized. Whether that be for career freedom or to spend more time taking care of existing children, this is important.t Especially for women in high-powered jobs, using a surrogate can help level the playing field between men and women. "There’s an advantage to being pregnant, the bonding, I understand that, and from experience I can say that most women love to be pregnant. But a lot of women don’t want to be pregnant and lose a year of their careers,” fertility specialist Dr Vicken Sahakian told the Guardian. While both partners might attend some of the more crucial doctors appointments, they don't need to be present for every single one. That fact alone frees up hours of time over the course of nine months (or more, if you include postnatal visits). Both this physical freedom and freedom of time can begin to level the playing field between men and women at work. This is all the more important given the usual timing of pregnancies—when women are in their late 20s and early 30s—at a crucial point in building their future careers. When women are taken out of their careers for a year or more at this crucial time, it can be difficult to recover. With surrogacy, at least some of the discrimination that women endure can be reduced. “I am very proactive when it comes to women and I believe there is a double standard,” fertility specialist Sahakian said. “Every day I see how prejudiced this society is, how male chauvinistic it is, how women are judged.”
It’s not fair that women should carry pregnancies when men are simply free of it. It can create a burden that results in more gender disparity. And we are already live in a society in which gender discrimination plays out in nearly ever career field. Women are faced with challenges in the workplace and in their personal lives that men simply never have to experience. But that inequality can be mitigated.
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Gender may be a social construct, but biological sex is not a choice. The X and Y chromosomes determine biological sex. Biological sex is like a genetic roll of dice, something that neither women nor men have any control over. It can, however—despite its randomness—have a huge effect on people’s lives.
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All mammals have their biological sex determined by chromosomes, which are made up of DNA. "DNA contains the specific instructions that make each type of living creature unique," explains the National Human Genome Research Institute. Humans in particular have 46 paired chromosomes, each of which determine different biological traits. Our chromosomes determine everything from Down syndrome to biological sex. (Gender identity and sexual orientation are of course not the same thing as biological sex). The 23rd pair of chromosomes in humans are the sexual biology chromosomes. When an egg is first fertilized, a chromosome from the sperm cell joins a chromosome from the egg cell, determining the fetus's biological sex. While there are some exceptions, including intersex people who are not fully biologically male or fully biologically female, the vast majority of women have two X chromosomes, and most men have an X and a Y chromosome. The Y chromosome induces the male phenotype (the observable trait of male biological sex) long before birth. This process is random. In 1959, scientists discovered that this process takes place in mammals on a part of the Y chromosome called the SRY. As biologists explained: "In human embryos, the SRY gene encodes a unique transcription factor that activates a testis-forming pathway at about week seven of development. Before this time, the embryonic gonad is 'indifferent,' meaning that it is capable of developing into either a testis or an ovary." There are many old wives' tales, about everything from sexual positions to changes in diet, that claim to change the biological sex of a fetus, but doctors have dispelled all of these. The only way to be certain of a fetus's biological sex is through in vitro fertilization, and even then it's not a guarantee. “Even with genetic testing, the sex cannot be 100% guaranteed,” one doctor explained for the Cleveland Clinic.
In other cases of inequality, trying to level the playing field is accepted as reasonable. Improving the lives of those who have been marginalized, whatever the cause, is important for all of society. Not only does it help those marginalized people, but increasing equality is important for the U.S. at large—creating a more free, equal, and prosperous nation.
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Physical, genetic, and accidental circumstances help create inequalities. Whether through birth, accident, or inheritance, circumstances outside of an individual's control can affect him for life. For those involved, these incidents make work, relationships, and everyday life more challenging. They can even reduce basic, daily functioning.
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Genetic diseases can reduce quality of life and work ability. That can affect someone's mental and physical capacities. It can also put strain on their mental health. The practical and emotional toll of these disabilities should not be underestimated—and they are far more common than one might expect.
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Genetic disorders, for instance, can both reduce a person's quality of life and result in limited work opportunities. While some babies can be at a higher risk for genetic disorders based on a mother's age and lifestyle, many of these genetic issues are simply heritable traits that parents can do nothing to prevent their child from getting. Most of what DNA does is instruct cells to make proteins. When a genetic mutation occurs, however, it affects this process. Some causes of genetic mutations and potential genetic diseases include chemical exposure, radiation exposure, smoking, and UV exposure from the sun. Disorders with a genetic component such as autism or ADHD can make it more difficult for employees to work with colleagues or focus on a task. They can also affect a person's social life and romantic life, as they are disorders that can result in substantial problems in interpersonal relationships. Physical genetic disorders, such as muscular dystrophy, may result in reduced mobility which can affect both manual labor jobs and office jobs (someone with MD, for instance, might not be able to access a building that doesn't meet ADA standards). They can also be costly, requiring long-term medical care and living situations that are adapted to a person's physical disabilities. According to results from the Human Genome project—which sequenced the DNA of thousands of people—there are over 6,000 genetic diseases. Of those, 10 are the most common. Those include cystic fibrosis, Down syndrome, fragile x syndrome, hemophilia, Huntington’s disease, Duchenne’s muscular dystrophy, sickle cell anemia, thalassemia, tay-sachs, and Angelman syndrome. Many of these disorders lead to physical and/or mental challenges. Those can in turn affect both someone’s ability to work and their quality of life. Whether it's relatively small things such as a slowness to read facial cues (as is the case with autism), or physical disabilities that make it impossible to hold down a job, these genetic disorders can affect every aspect of someone's daily functioning.
Even ordinary accidents can have long-term effects on individual agency. Millions of daily injuries can determine people's future. Even mundane accidents can exert a lifetime of consequences. Even tripping or a minor injury can end up affecting someone's mobility—and in turn their career and quality of life—for years to come.
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Ordinary accidents—from falls to car accidents—can reduce a person's capabilities. These injuries happen every year to millions of Americans, affecting not only their lives and well-being but that of their families as well. Reduced mobility can cause enormous ripple effects in a person's life. Car accidents alone, for instance, are a significant factor. Each year in the U.S., there are about 6 million car accidents. Of those, 2 million drivers will experience permanent injuries as a result. Whether because of lost limb or chronic pain (especially back injuries), mobility can be greatly reduced following a severe car crash. Some people might need even to go on disability benefits, a choice determined by the Social Security Administration (SSA). Other types of injuries such as tripping, spraining an ankle, or being injured by a falling object are in fact very common. As many as 8 million emergency room visits annually are owing to falls. The likelihood of falling—and of serious injury—increase greatly with age. One in three adults above age 65 will have a slip and fall accident, according to statistics from a law firm. There are a slew of workplace injuries, too, from violence between employees to strained muscles that can reduce mobility over time. Depending on the circumstances from the injury, an employee may or may not be eligible for workers' compensation. The benefits from that can be piecemeal and may take months to put in place. Victims of accidents may see reduced mobility and a need for extra help for things they once did on their own. Especially for people who are isolated (such as elderly people), these effects can be even more dramatic. That can mean lost income or even reduced access to life-saving healthcare services.
Military injuries can put people at a disadvantage. Mental trauma and physical injuries are common, to the point where some have described them as an "epidemic." Women in particular are subject to sexual trauma as well. The scars from these wounds can last long after someone is eventually discharged from the armed forces.
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Military injuries—including psychological trauma—are extremely prevalent among members of the armed forces, regardless of which branch of the military Americans might serve in. These injuries can include those sustained in training or while deployed, and they might be physical and/or emotional. The Army, for instance, describes the problem of military injuries as an "epidemic." According to a recent report, the rate of injury is 2,500 per every 1,000 soldiers. This means that the average American serving in the Army will endure at least two musculoskeletal injuries. This figure includes injuries sustained both on missions and from Army garrisons. According to Brown University's Watson Institute for International and Public Affairs, the most common injuries include: "second and third degree burns, broken bones, shrapnel wounds, brain injuries, spinal cord injuries, nerve damage, paralysis, loss of sight and hearing, post-traumatic stress disorder (PTSD), and limb loss." Other injuries include "toxic exposure from dust and burn pits and resulting respiratory, cardiac, and neurological disease." As the Watson Institute points out, many of these conditions go undiagnosed meaning that the official Department of Defense figures are likely far lower than the actual numbers. One of the most common injuries suffered by combat veterans is post-traumatic stress disorder. As many as 20% of all veterans suffer from post-traumatic stress disorder (PTSD). Persistent flashbacks, moodiness, or anxiety caused by PTSD can prevent veterans from functioning or working normally. Many who suffer from this condition might go untreated, as stigma surrounding mental illness persists in many communities. Specifically for women, military sexual trauma and other issues can cause permanent damage. Some 23% of female veterans report being sexually assaulted, and 55% report being sexually harassed, according to the Department of Veteran Affairs. The actual figures are likely even higher, given the number of women who are afraid to report sexual assault for fear of career repercussions. All of these different injuries can disadvantage people who suffer from them, whether physically or psychologically. These obstacles might mean consequences both for a military career and for any civilian career that might follow. In addition, they can challenge people in their family lives, interpersonal relationships, and day-to-day functioning.
But there are ways of mitigating inequality. Laws and policies can help marginalized people rise up, especially those that target specific types of injustice, such as discrimination on the base of gender, race, or sexual orientation. This legislation can slowly help level the playing field. At the same time, corporations can enact their own internal guidelines to create more diversity in the private sector.
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Affirmative action procedures are in place. Both in the private and public sector, these policies look to level disadvantages and negate some existing institutional prejudice, whether against women, people of color, or disabled people. Data has shown the effectiveness of these programs.
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The United States has an affirmative action policy that must be upheld by all contractors and sub-contractors working on behalf of the federal government. There are multiple state and federal laws that guarantee these policies for women, people of color, people with disabilities, and other marginalized groups that might face an additional set of obstacles in the workplace. According to the U.S. Department of Labor: "affirmative action must be taken by covered employers to recruit and advance qualified minorities, women, persons with disabilities, and covered veterans. Affirmative actions include training programs, outreach efforts, and other positive steps." Furthermore, there are several offices of the federal government dedicated to ensuring compliance with these guidelines. Other types of affirmative action—both at schools and in private workplaces—work to mitigate the marginalization of people of color, disabled people, and LGBTQ+ people. Rather than a federal obligation, some of these policies are put in place by private institutions seeking to create a diverse environment for the better of the whole community. Affirmative action began under President John F. Kennedy in the 1960s. The idea was that fighting against discrimination was not enough; the government had to actively do something to create a more equal world. Since Kennedy's time, the term has evolved and changed significantly. In the beginning, the task force created by Kennedy was simply charged with the motto: “Don’t just stand there. Do something," according to an article in the New Yorker. In the intervening decades, affirmative action policies have often become more concrete. In 1978, the Supreme Court ruled that quotas for marginalized groups in schools or workplaces were unconstitutional. Rather, today, many companies instead have proactive policies intended to hire staff who are both diverse and qualified. Affirmative action laws tend to follow from the executive branch of government, with Democratic presidents tending to expand affirmative action policies and Republicans generally restricting them. Under President Barack Obama, for instance, the federal government put regulations in place that rewarded schools that worked to serve minority populations in the form of federal money. President Donald Trump reversed many of Obama's policies in that respect.
U.S. labor laws have been in place for 100 years. This legislation has helped reduce inequality and protect the working population, both from potentially unsafe work environments as well as negligent bosses. Labor policies specific to women and protecting their rights in the workplace have existed for nearly as long.
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For over the past century, the U.S. has had a labor department, meant to guide policies and legislation for workers. Labor activists in the first decades of the 20th century fought for such rights as sick pay, vacation days, and benefits for injured workers. By the 1930s, the secretary of labor would establish the five-day work week, paving the way for other progressive reforms. The United States Department of Labor has had a Women's Bureau for 100 years. The first law was passed 100 years ago and gave the bureau the right to "formulate standards and policies which shall promote the welfare of wage-earning women, improve their working conditions, increase their efficiency, and advance their opportunities for profitable employment.” During and after the Great Depression, labor protections were hugely expanded, establishing unemployment benefits, social security, and a federal minimum wage. The New Deal was designed primarily by a woman, Secretary of Labor Frances Perkins. The protections established throughout the 20th century were designed to reduce inequalities and to protect workers—of all identities—from being exploited.
In turn, these changes can improve the livelihoods of those affected greatly. Both in the short- and long-term, these efforts show major pay-offs, in terms of increased access to opportunities and in turn increased earning. And those positive effects trickle down through future generations, creating a ripple effet of wealth.
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Better access to education and jobs are the key to higher income and a better quality of life. Increased earnings can enrich future generations. Many disadvantaged people are simply looking for a foot in the door: a way to showcase the skills they've long had and simply have not had the opportunity to utilise. And that kind of wealth-building can in turn help their descendants, slowly starting to level the playing field over time.
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The more chances someone has at something, the higher probability they have to learn from mistakes and ultimately become successful at it. Therefore, giving people more opportunities to be hired for a job gives them more chances to eventually succeed. Once they're hired, they can do a good job, work their way up, and continue to earn a great wage. That in turn can create generational wealth, setting up their children and grandchildren to earn more than they did. Affirmative action and labor laws allow people to get a foot in the door to these better opportunities. One study found that U.S. university students admitted based on affirmative action went on to earn a higher salaries thanks to that policy. A similar trend can be seen among people with disabilities. While people who are differently abled remain among the highest groups of the unemployed, studies have measured the positive effects of the passage of the Americans with Disability Act (ADA). While the economic benefits of the ADA require further research, one study found that since 1990 when the ADA was first passed, income poverty among people with disabilities has declined.
More wealth leads to better health and access to healthcare. Earning money is not just about earning money for its sake: Socioeconomic status and well-being are interwoven. Without financial stability, total health is not possible. Vice-versa is true as well: the better health someone is in the better they may be able to perform in a job, all while teaching their children better health habits so they too might have the tools to succeed.
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Having the time to focus on eating right, reducing stress, and getting exercise gives people an overall better quality of life. Studies have found that a higher income correlates to better overall well-being. Or, as the American Psychological Association puts it: "wealth secures health." That's because having a low income correlates with a lower ability to buy nutritional food, or to have the time or money to exercise. It's also psychological: struggling to make ends meet every month puts a mental strain on people that actually damages their physical health. A whole host of factors can affect someone's socioeconomic class and their resulting health, from their gender and sexual orientation, to their ethnicity. "We've often chosen to focus on either ethnicity or class rather than on the interaction between the two," said Hector F. Myers, PhD, a professor of psychology at the University of California at Los Angeles. "We've become a lot more sophisticated in our thinking recently."
Having children can be a key life goal for many people. A life without a family of their own can feel incomplete. Raising children is a top priority for millions of people who want to go through this life-altering experience. Having children can also bring joy and fulfillment that other goals, such as career ones, cannot accomplish.
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They can bring immense happiness. They can bring immense happiness. Especially under the right conditions, children improve not only overall happiness but also fulfillment. Those right conditions often include physical and mental well-being, financial stability, a long-term career, and support from the government if necessary. The U.S. can look to several other countries for examples of how this can work.
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Recent studies have shown that people with children report being happier overall than those without children. However, parents in some countries are happier than others. The key is the social policies put in place by each country. If the policies help parents manage the responsibility of childcare with the ability to earn an income, then parents will be happier. American parents tend to be less happy than their English or Australian counterparts, one study found. In countries such as Norway for instance, parents reported higher happiness than non-parents—perhaps because of a strong social safety net that eases the burden of child-rearing. Children can be challenging and time-consuming, but most parents out there say they are worth the sacrifice. Seeing a child grow and engage with the world can bring back a parent's sense of childlike wonder, allowing them to view the world with new eyes.
Parents grow emotionally, too, from raising children. Parents not only teach their children how to become emotionally stable adults; many parents grow emotionally from raising children. Whether it’s becoming more patient and kind, or experiencing the world. With a new-found sense of wonder, the challenges of parenting can turn into rewarding opportunities for growth and appreciation.
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There are many new experiences people encounter after having children. And some people will develop new skills and insights as a result that can be applied to other aspects of their lives. For example, being a parent can teach people to have more patience with others, to communicate more simply, and to value present moments over focusing on the past or the future. Other parents report being more forgiving and being able to discern the petty from the truly important. Having children forces people to prioritize—managing their time differently than ever before and only making time for the most important things. Others say they feel more grateful and thankful for the small pleasures in daily life. Some say they even feel more grateful for their own parents after having children of their own. "Becoming a mother has been one of the biggest blessings in my life," wrote one mother. "Being a mother is by far the most challenging but most rewarding job I’ve ever had."
CLOSURE
The stigma surrounding using a surrogate should be questioned: pregnancy, childbirth and maternity-leave are a huge physical and emotional burden. With surrogacy, more women can experience the joys of having children without the significant professional, physical, and mental challenges that go along with pregnancy and childbirth.
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