Hektoen International

A Journal of Medical Humanities

“Sara, Bill, Kristine, … you’re pregnant!” Gestational surrogacy, biomedicalized bodies and reconceptualizations of motherhood

Eva-Sabine Zehelein
Frankfurt, Germany

The day we left the hospital, a therapist from the perinatal loss department presented us with two death certificates and asked us if we wanted the bodies for a burial. . . . We were being taken out the back like the trash, sparing those families who came to the hospital and left with a baby, arms full of balloons and flowers and plush toys, the unsightly image of two devastated parents with shell-shocked eyes and dangling arms empty, like wraiths. (Connell 2013, 2)

In Vitro Fertilization (IVF)
Wikimedia Commons

In Bringing in Finn, Sara Connell describes a long and excruciatingly painful journey to parenthood. This dramatic opening vignette portrays a moment after the stillbirth of twins, and pulls the reader into the story of Sara’s six-year-long attempt to have a child. She exposes the self-altering and potentially self-destructive traumatic experiences she and her partner endured over long years of hope, fertility treatment, and destitution: hormone shots for follicle stimulation, “medically scheduled sex,” egg retrieval, in vitro fertilization (IVF) and embryo transfer, pregnancy, stillbirth of twins via C-section, posttraumatic stress disorder, and five more IVF cycles resulting in one miscarriage. Sara travels her own road of healing from self-hatred and hurt to self-discovery and restoration. Her own biological mother becomes the gestational host for Sara’s and Bill’s child so that Sara can become the mother of Finn.

Memoirs by women who have received a child by gestational surrogacy1 in the context of which they are the “intended parent” (IP) are a rather recent phenomenon. These “IP memoirs”2 present a double-bind, broadening the definition of “mother” and the practice of mothering but also reaffirming core tenets of patriarchal motherhood through romanticized notions of motherhood and mothering and depictions of “new momism” (O’Reilly 2010). IP memoirs are situated at the intersections of personal trauma narrative, autopathography, matriography, scriptotherapy, and biography. The authors work through their intimate trauma of not being able to conceive or bear children. By detailing the medical aspects of infertility treatment and pregnancy loss necessitated by the “dysfunctional” body, IP memoirists engage in normative discourses about health and disease. Couser has suggested the term “autopathography” for narratives about illness or disability that challenge socio-cultural perception of conditions as not-normal, deviant, or pathological. The biological becomes biographical when not only the medical aspects of assisted reproductive technologies are detailed, but also non-pregnancies, miscarriages, still-births, and times of high hopes and utter despair. The IP memoir is thus also a story about the sick body, the emotional hardships of becoming an IP, and finally being a mother to a child to which one has not given birth. Since Sara cannot fulfill all the parameters of “being a proper mother,” she accentuates the genetic-as-natural bond between child and herself, the intended mother. Being passive during both pregnancy and birth, she creates the narrative of herself as mother. Emphasizing the bond between mother, daughter, and child as a holy triad of interconnectedness, she may convince some readers that this form of surrogacy is actually the most natural. Moments when Sara feels “like a whole and complete mother-to-be” alternate with times when she thinks “that I didn’t deserve this gift—that if I couldn’t have a baby on my own, the ‘normal’ way, I didn’t deserve to have one at all” (Connell 2013, 252-253). Writing this book is for Sara a “writing out and writing through traumatic experience in the mode of therapeutic re-enactment” (Henke 1998, xii). She reaches motherhood and enters mothering after arduous times, justifying the individual decisions to eventually find closure. That her mother at age sixty carries her child to term is presented as a “gift . . . of life” (Connell 2013, 179).

“There is a thin line between paternalism and exploitation when considering the surrogate’s needs. Similarly, there is a thin line for the intended parents between reproductive autonomy and accountability” (Braverman, Casey and Jadva 2012, 304). The reader of IP memoirs might look for advice and support, but may also be highly critical of surrogacy arrangements. IP memoirists thus represent themselves as quasi-confessional, with intimate health and medical details engaging with, contesting, yet also reinscribing the cultural norm of patriarchal motherhood and pro-natalism. To justify why they desire a child3 they may revert to notions of the sick body deserving treatment, confronting their own incapability through a quest taking them from hope to ordeal to ultimate happiness—a child. Sara’s story is one of suffering, a trauma narrative and autopathography, but also one of resistance, resilience, reconciliation, and healing (Harris 2003, 1). By writing how she ended her self-hatred and rebuilt connections with her parents, especially with her mother, and how she witnessed and co-experienced her mother’s pregnancy, Sara performs her idiosyncratic scriptotherapy. As Henke has observed: “It is through the very process of rehearsing and re-enacting a drama of mental survival that the trauma narrative effects psychological catharsis” (Henke 1998, xix).

Finally, IP memoirs are also creation stories, the first chapter of children’s biographies. To publicly disclose intimate details about themselves, their families, and the conception and genesis of their infant(s) potentially deprives the latter of their autonomy to construct their own identities in narrative. Maybe these children deserve stories that are enfolded by the warmth of a little romance after all.


  1. Here, the surrogate is not genetically related to the child/children she carries. IPs use their own oocyte(s) and sperm or sperm and/or oocyte(s) from a donor. Through IVF/ICSI, one oocyte is fertilized with one sperm ex utero and one to three blastocysts are transferred to the uterus of the gestational carrier. Thus, a second woman can, although she does not share in the pregnancy and birth process, claim the infant as “hers” since she is genetically related. To separate gestation and genetics allows for a revolutionary act in human history: the severance of the symbolic umbilical cord—the argument that to nurture an embryo in utero establishes automatic and exclusive motherhood status and a unique natural bond between pregnant woman and embryo; nurture not necessarily nature.
  2. This is part of a research project supported by the WSRC (Brandeis University) and the Fritz Thyssen Stiftung.
  3. This yearning for a child is partly socially produced (Marsh and Ronner 1996, 252-253) and infertility, a medical condition, is also culturally framed and deeply embedded in discourses about true motherhood and pro-natalist worldviews.


  1. Braverman, Andrea, Polly Casey, and Vasanti Jadva. 2012.  “Reproduction through surrogacy in the UK and the USA.” In Reproductive Donation. Practice, Policy and Bioethics, edited by Martin Richards, Guido Pennings, and John B. Appleby, 289-307. Cambridge: Cambridge University Press.
  2. Connell, Sara. 2013. Bringing in Finn. An extraordinary surrogacy story. Berkeley: Seal Press. Kindle.
  3. Couser, G. Thomas. 1997. Recovering Bodies: Illness, Disability, and Life Writing. Madison: University of Wisconsin Press.
  4. Harris, Judith. 2003. Signifying pain: constructing and healing the self through writing. Albany: State University of New York Press.
  5. Henke, Suzette A. 1998. Shattered Subjects: Trauma and Testimony in Women’s Life-Writing. London: Macmillan Press.
  6. Marsh, Margaret, Wanda Ronner. 1996. The Empty Cradle. Infertility in America from Colonial Times to the Present. Baltimore: The Johns Hopkins University Press.
  7. O’Reilly, Andrea. 2010. “The Motherhood Memoir and the ‘New Momism’: Biting the Hand That Feeds You.” In Textual Mothers/Maternal Texts: Motherhood in Contemporary Women’s Literatures, edited by Elizabeth Podnieks and Andrea O’Reilly, 203-213. Waterloo: Wilfrid Laurier University Press.

EVA-SABINE ZEHELEIN, PhD., is an adjunct professor of American Studies at Goethe University Frankfurt and a Visiting Scholar at the WSRC at Brandeis. She has published broadly, and her monograph Science: Dramatic: Science Plays in America and Great Britain was published in 2009 (Winter Press). She has been a visiting researcher at Emory (2015), the University of Calgary (2013) and visiting professor at the University of Alberta (2013). Currently, her research focuses on the representations of Assisted Reproductive Technologies in cultural narratives.

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