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Birthing a Mother: The Surrogate Body and the Pregnant Self. Elly Teman. University of California

Press: Berkeley. 2010. xiii+361pp.

Reviewed by: Sarah S. Willen, Assistant Professor, Department of Anthropology, Southern Methodist

University.

In this superb ethnography, Elly Teman draws upon nearly a decade of fieldwork in Israel –where reproduction and motherhood are fetishized as women’s “national mission” (Berkovitch 1997; Ivry

2009) – to explore a controversial new form of reproductive innovation: gestational surrogacy. This

uncommon mode of human procreation involves the implantation of embryos created from the gametes of

the “intended parents” in the uterus of a woman who agrees to serve as “gestational surrogate.” Teman

began her research in 1998, when surrogacy in Israel was still “in its ‘diaper’ stage” (p. 19), and

eventually interacted with approximately two-thirds of all parties to the estimated 350 births that took

place via gestational surrogacy in Israel between 1998 and 2005. As the first full-length ethnography of

this particular form of surrogacy, Birthing a Mother  offers a vivid, thoughtful, and phenomenologically

sensitive window onto a rare and extraordinary “joint body project” (p. 178).

The Hebrew word for surrogacy derives from the word “inn” (pundak), hence a surrogate

( pundeka’it ) is linguistically marked as a fetus’ temporary “innkeeper.” This impersonal way of markingsurrogacy, which eschews any sense of maternal connection, is affirmed by Teman’s research subjects,

who describe their role as that of “oven” (p. 31),“incubator” (p. 32), “hothouse” (p. 33) or “guesthouse”

(p. 58). As one woman put it, “It is not my egg, and I have no connection to this child” (p. 58). Yet this

refusal of maternal connection involves strategy, not malice; it is a powerful tool through which

surrogates both protect themselves and help intended mothers bond with the fetuses they have created but

cannot carry. This is the linchpin of Teman’s argument; Israeli surrogates, unlike surrogates elsewhere,

birth not only babies but also new mothers. Specifically, surrogates pursue a deliberate and iterative

process of “shifting” the developing pregnancy rhetorically, symbolically, and metaphorically from their

own bodies onto intended mothers’ eager, detail-hungry “pregnant selves.” Gestation of both fetus and

mother thus involves liminal, emotionally intense, and socioculturally unscripted processes of

psychological transformation.

Three contextual considerations are marked as salient early in the text. First, the religio-cultural

mandate to “be fruitful and multiply” (p. 52) in this “Land of Imperative Motherhood” (Remennick 2000:

821) helps explain Israeli intended mothers’ desperation – and their perseverance. Second, the state’s tight

control over many aspects of gestational surrogacy facilitates the temporary colonization or occupation of

surrogates’ bodies in the service of national priorities including pronatalism and (although this point

unfortunately is made only in passing) the preservation of biopolitical boundaries [“Jew versus Arab,

ethnic divisions, and the gender divide” (p. 73)]. Third, the country’s small size facilitates much more

regular social contact between intended parents and surrogates than elsewhere, and an extremely high

degree of emotional intimacy between surrogates and intended mothers is the frequent result.

The narrative is elegantly arranged in four parts. Part I “Dividing” shows surrogates “upturning

any connotations that the [structurally more advantaged] couple is more powerful” by reading intendedparents’ “hunger” for biological children as a “classic signifier of powerlessness” that can be resolved

(only) through their fecundity, their “power to feed” (p. 37). Part I also outlines the “full repertoire of

painstaking skills” (p. 87) that help surrogates draw and patrol the sharp boundary between “me” (e.g.,

brain, heart, “normal” pregnancy symptoms, the ability to breastfeed postpartum) and “not-me” (e.g.,

emotional and physiological reactions to hormone injections, the intended parents’ embryos/fetus, their

entire midriff but especially their growing belly, “abnormal” pregnancy symptoms, a postpartum lack of

milk production). This boundary results from deliberate strategies, practices, and “somatic modes of

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attention” (Csordas 1993) that demand a considerable amount of cognitive and emotional work. As one

surrogate put it, “You have to really classify your emotions … classify, sift apart” (p. 75).

Part II “Connecting” reveals a complex triangle of connection (between surrogate and intended

mother) and disconnection (between fetus and surrogate). Surrogates and intended mothers become so

deeply involved in one another’s lives that intended mothers’ “prosthetic consciousness” of the growing

fetus becomes “integrated seamlessly into the surrogate’s body map, in which the belly was marked as adistanced space” (p. 141). Both groups of women experience a kind of “medical merging” (p. 121):

pregnancy test results are reported to intended mothers rather than pregnant surrogates; surrogates insist

that the intended mother’s name be indicated on sonogram printouts; intended mothers experience

couvade-like symptoms; and intended mothers are hospitalized, complete with gowns and identifying

bracelets, during labor and delivery.

Part III “Separating” traces the “extreme alteration in roles” (p. 193) that takes place postpartum.

This shift results not only from the newborn’s journey from the surrogate’s body into the intended

mother’s arms, but also from the complex reorganization of relationships as the intended mother desires

to claim sole motherhood, the surrogate fears losing an important new friend, and the state insists on

serving as buffer between the two. Part III also explores gestational surrogacy as a form of gift exchange

whose outcome hinges on the intended parents’ response. Whereas the “momentous acknowledgment” ofsome new parents “results in a positive experience for all concerned” (p. 225), others’ outright denial

leaves surrogates feeling “used, discarded” (p. 227), and betrayed. The longer-term consequences of these

fragile social bonds form the focus of Part IV, “Redefining.”

Like any excellent book, Teman’s inevitably leaves some questions unanswered. The

perspectives of men, including both intended fathers and surrogates’ partners, rarely appear. Although her

ethnographic evidence is largely persuasive, one wonders on occasion whether Teman’s parsimonious

model of liminality and transformation might be a bit too neat, or whether the intense intimacy of the

early surrogacy dyads she studied remains the norm now that such arrangements are slightly more

common. These questions of generalizability seem especially relevant from the perspective of

psychological anthropology. Surrogates work extremely hard both to create protective body maps and, at

the same time, to channel “pregnant embodiment” (p. 142). Intended mothers work equally hard toembody pregnant selfhood through cognitive means like empathy and identification and even, in some

instances, by wearing pregnancy costumes or taking hormones to induce lactation. What do these

herculean cognitive labors tell us about the power – and the limits – of social, cultural, political, and

psychological influences over the human reproductive process?

Not only does Birthing a Mother  shed illuminating light on the complex conditions and

constraints that shape contemporary experiences of gestational surrogacy, but it also provides an

evocative, experience-near, and highly teachable window onto the dizzying swirl of debate about the role

of technology in (re)shaping human notions of kinship, identity, morality, and limit. The book’s lucid and

accessible writing, powerful narrative arc, and elegant interweaving of evidence and analytic insight will

make this an indispensable resource for specialist scholars, undergraduate and graduate students, and

general readers curious about the brave new world of gestational surrogacy.

REFERENCES CITED

Berkovitch, Nitza

1997 Motherhood as National Mission: The Construction of Womanhood in the Legal Discourse in

Israel. Women's Studies International Forum 20(5-6):605-19.

Csordas, Thomas J.

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1993 Somatic Modes of Attention. Cultural Anthropology 8(2):135-156.

Ivry, Tsipy

2009 Embodying Culture: Pregnancy in Japan and Israel. New Brunswick, NJ: Rutgers University

Press.

Remennick, Larissa2000 Childless in the Land of Imperative Motherhood: Stigma and Coping among Infertile Israeli

Women. Sex Roles 43(11-12):821-841.