Mommies, Daddies, Donors, Surrogates: Answering Tough Questions and Building Strong Families

Mommies, Daddies, Donors, Surrogates: Answering Tough Questions and Building Strong Families

by Diane Ehrensaft

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Ours is an extraordinary time for anyone straight, gay, single, or coupled who's ever wanted a baby of his or her own. Many aspiring parents now depend on some form of assisted reproductive technology (ART) to fulfill their dreams of starting a family. But as Dr. Diane Ehrensaft points out, parents who conceive with the help of a donor or surrogate often struggle with


Ours is an extraordinary time for anyone straight, gay, single, or coupled who's ever wanted a baby of his or her own. Many aspiring parents now depend on some form of assisted reproductive technology (ART) to fulfill their dreams of starting a family. But as Dr. Diane Ehrensaft points out, parents who conceive with the help of a donor or surrogate often struggle with unforeseen questions. How can you help the child understand where he or she fits into the family and into the world? Exactly who is the mommy, and who is the daddy? How will grandparents and other family members react? What will the donor or surrogate have to say about it? In Mommies, Daddies, Donors, Surrogates, Dr. Ehrensaft addresses these topics and guides readers through a host of other concerns that may arise before, during, and after assisted conception. Provocative, compassionate, and immediately practical, Dr. Ehrensaft's far-ranging inquiry raises issues no one affected by ART should ignore.

Editorial Reviews

Publishers Weekly
With the spread of nontraditional families and the rise of infertility, "assisted conception" (donor insemination, egg donation, surrogate mothering or any combination of the above) is a big new fact of life. After two decades of counseling "biosocial" families, Ehrensaft, a clinical and developmental psychologist (Parenting Together; Spoiling Childhood), wrote this honest, down-to-earth manual to help parents work through the problems. Just because people are brave enough to create nontraditional families doesn't mean they've anticipated the difficult questions those arrangements raise. Do shared genes give the biological parent more rights than the "social" parent? Is it wrong to have fantasies about sperm donors? How do you decide how much to involve the "birth other" in the "family matrix"? At what age do you tell your child his or her birth story? What do you tell them? Ehrensaft groups the issues thematically with plenty of firsthand anecdotes. An experienced therapist, she acknowledges up front many things we do that we shouldn't: social moms feeling jealous of surrogates, parents hiding the truth from their children, etc. She understands-and then nudges parents in a better direction. This is a terrifically useful book for nontraditional families and everyone (teachers, ministers, therapists) who works with them. (Aug.) Copyright 2005 Reed Business Information.
Library Journal
This book sparks insightful discussion about the grand new experiment of baby making in the era of rapidly expanding assisted reproductive technology (ART). Ehrensaft, a noted developmental and clinical psychologist, incorporates stories of biological parents, donors, surrogates, and the children they ultimately create and raise. She addresses the psychological struggles and unexpected feelings that may arise, counsels on the sensitive subject of disclosing the truth to children and why it is so important, and examines the larger picture of what "birth-other" families look like to outsiders and why it matters. Including extensive resources, notes, and a bibliography, this is a great resource for anyone involved or affected by ART. Highly recommended for public and academic libraries.-Kari Ramstrom, MLIS, Plymouth, MN Copyright 2005 Reed Business Information.
From the Publisher
"I was blown away by this book. It is the book for anyone who used or is thinking of using any kind of assisted reproduction to help create a family. So many of us are afraid to talk openly about—or just don't know how to talk about—the ways our families were created. This book will help you deal with your own anxieties and confusions and then be able to talk about them in a more comfortable way. Reading it is like talking with a good friend who really understands the big picture, with all its complexities and poignancy. I am overjoyed that a book like this is finally available."—Jane Mattes, CSW, psychotherapist and founder of Single Mothers by Choice

"Dr. Ehrensaft has written an extraordinarily sensitive yet comprehensive book about the issues raised when a surrogate or donor is involved in creating a child. She covers everything from the fears and fantasies of parents-to-be to whether, when, and what to tell children about their origins. This fascinating, thought-provoking book is a 'must' for anyone contemplating taking advantage of these new technologies."—Kim Paleg, PhD, author of The Ten Things Every Parent Needs to Know and "new technology" mother

"This is a great resource. It offers concrete examples and suggestions for dealing with many issues that are likely to come up as I raise my kids. There is so much to learn from the stories Dr. Ehrensaft shares of others who have walked this path before me."—Anne-Marie, "new technology" mother of two

"This is the first book to map the emotional terrain of parenthood that is aided by a 'birth other,' the author's inventive term for a donor or surrogate. Dr. Ehrensaft sensitively explores the hopes and dreams, concerns and fears of parents and prospective parents, and offers the best available knowledge for facing the tough questions. Wise, highly readable, and insightful, this is an essential guide."—Anne C. Bernstein, PhD, author of Yours, Mine, and Ours and Flight of the Stork: How Children Think (and When) about Sex and Family Building

"This groundbreaking book demystifies technology and focuses our attention where it should be—on the gift of life, and the human beings involved in creating a family. Dr. Ehrensaft tackles your medical questions, your psychological questions, and your parenting questions, all in one readable, authoritative volume."—Susan H. McDaniel, PhD, Department of Family Medicine, University of Rochester School of Medicine and Dentistry

"Few issues are more stressful than navigating the emotional minefield of assisted reproduction. Diane Ehrensaft serves as a sensitive, knowledgeable, and inclusive guide through the minefield. Her understanding of the assisted reproduction process and the often difficult and thorny issues it raises for couples and individuals is brilliant. Dr. Ehrensaft's refreshing openness and deft touch make this an invaluable resource."—Kate Kendell, Executive Director, National Center for Lesbian Rights

The Family Journal
"The highlight of the text is the variety of experiences covered....This book helps to increase our understanding and awareness of families impacted by assisted reproduction in all its many forms."
Parents' Press
"Above all, Ehrensaft's book is a reassuring one....Ehrensaft uses her experience as a therapist to break down the potential parent's insecurity, gently encouraging her to face her fears, the better to overcome essential addition to the literature—and an unusually well-written one."
Today's Parent
"A must-read for anyone thinking of having a child with the help of a 'birth other' in Ehrensaft's coinage, this book can help all of us understand these new families. We are luck Ehrensaft has given us this intensely knowledgeable and humane book."
Donor Conception Network
"Diane Ehrensaft brings the insight of a clinical and developmental psychologist to all the big questions that arise both before family creation with donor conception and afterwards....A pleasure to read and accessible to all who enjoy getting information from books....She addresses not only the obvious feelings and practicalities faced by would-be parents, but also some of the more difficult emotions and fantasies that are often around but rarely spoken about. All this is undertaken with great empathy for the would-be parent(s)."

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Guilford Publications, Inc.
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Read an Excerpt

Mommies, Daddies, Donors, Surrogates

Answering Tough Questions and Building Strong Families

By Diane Ehrensaft

The Guilford Press

Copyright © 2005 The Guilford Press
All rights reserved.
ISBN: 978-1-60918-939-6


Beware Gifts Bearing Children

Mommy, Mommy, when I grow up, I want to be a mommy just like you. I want to go to the sperm bank just like you and get some sperm and have a baby just like me.

— Six-year-old Emily, dreaming of motherhood

You go to the sperm bank and become a mommy. No storks showing up at the doorstep with a bundle. No birds-and-bees sex scenes. Emily knows a new story—the story about parents who very much want a child and have found a new way to have one with the help of assisted reproductive technology. To Emily, it is such a good story that someday she wants to be one of those mothers, just like her mommy. I want to continue Emily's story and invite all of you to come with me as I tell what I have learned about women and men who have become parents with the help of sperm donors, egg donors, or surrogates and all I have learned about the children as well. I might be telling your own story, or maybe your story-to-be.

For everyone, parenthood today is an extremely stressful endeavor. As I open this story, you may already be imagining how much more stressful it can become if you're a parent or a child in a donor or surrogate family. And not just stressful, but complicated. These "new-fangled" methods of making babies are here to stay, and each week we read about a revolutionary new way to get a baby using reproductive science. Doctors can now mix an infertile mother's egg with someone else's egg to create a viable egg and then a fetus genetically related to both women. With future scientific advances, an adult skin cell may be able to be substituted for a sperm or an egg, meaning two women could create a baby genetically related to both of them, and so could two men. What next?

Forget about what's next; even with what's right now you may be faced with many complex questions: Do these techniques pose any risks? How do I (or will I) feel about the child who was made by me and someone else? How do I (or will I) feel about the child who was made by my partner and someone else? How will my child feel about me? Will it affect how I feel about my partner (if I have one)? How do I feel about the someone else (the donor or surrogate)? Where does that person fit into my family? How will I talk to my child about his or her beginnings? Will I tell other people? If I do, what will I tell them? Is my child okay? For any parent, these are daunting questions, and up until now you may have been left to sort them out on your own. I'd like to offer what help I can.

And not just to parents—donors and surrogates need help; friends, family, colleagues, and lovers need help; professionals need help; policymakers need help; the communities and the society in which your children grow need help as well. So I am enlisting all of us to come together as a village to ensure the health and well-being of the children and the parents who are members of the new swell of "alternative to the stork" families.

In both the wisdom and innocence of their youth, Emily and the children around her have already begun to tell the story that I want to tell, maybe even better than I can. Seven-year-old Andy has two mothers. He is out on the playground. Two boys stop him. They taunt him: "Andy, you can't have two mommies. You have to have a mommy and a daddy." Andy, glaring at them, hurls his retort: "Stupid, haven't you ever heard of donor insemination?" Jade, the six-year-old daughter of a single mother, ran up against a similar taunt. She offered a simple response: "Well, a man helped us." Her friend quickly rallied to her defense reminding Jade's taunters of yet another classmate. "And Lilly, she was made from a dish."

Sylvie is eight years old and in love with life, with its theme of different strokes for different folks. She tells me what she's figured out—none of her friends live with their father; she's the only one who does. She goes into her litany: Jennifer has two moms, Mandy's parents are divorced and her father lives far away, and her friend Katy, "Well, she has a mom—and ... and ... [with an arching wave of her arm] and a father somewhere else." In fact, Katy has no father. Her mom has always been a single mother. Katy was conceived with the sperm from an anonymous donor, something Katy has known since she was a tiny child.

The children tell us their stories—of mommies going to the sperm bank, babies made in a dish, boys with two mommies, fictive fathers who float somewhere in the universe. Now it is time for us to tell a story—to our children and to ourselves. It is time for a story that will make sense of the new advances in reproductive technology and the families that are born of them.

Emily, Andy, Jade, and their classmates are universes away from the playground prose of my childhood, "Johnny and Susie sitting in a tree, k-i-s-s-i-n-g," where standard fare was fantasies of heterosexual couples kissing, marrying, and making babies. Sylvie negotiates the new vagaries of reproductive technology by making up a father for Katy because nothing else made sense to her. Every day on the playground, in living rooms, in bedrooms, and in doctors' offices, all of us, not just Emily, Sylvie, Andy, and Jade, are trying to make sense of these radical new situations where children are conceived with the help of donated sperm, eggs, or wombs. We make up stories, we get our facts mixed up, but most of all we experience waves of worry and angst that often render us helpless or incapacitated in our thinking about the topic or in our actions, both at home and out in the world.


If we think about it, it is as though we are just emerging from the Dark Ages into a Renaissance as we rub our eyes and try to comprehend the profound changes in biological, psychological, family, and social life that have been ushered in by the new reproductive technologies. We have hardly begun to digest the new possibilities:

Donor insemination—the oldest form of assisted reproductive technology—a process whereby sperm is introduced into the female reproductive tract through the use of an artificial device.

Egg (ovum) donation—the process by which ova are extracted from one woman and joined with sperm through in vitro fertilization to be carried by another woman who will gestate the child.

Surrogacy—the process by which a woman carries a child conceived (through donor insemination or in vitro fertilization) with her egg or an egg donor's egg and a man's sperm, to be raised by that man alone or by that man and his male or female partner.

Gestational care—the process by which a woman gestates a baby for another individual or couple by means of an embryo transfer conceived by that couple or from another woman's egg and donated sperm.

Embryo adoption—the process whereby an embryo, created through in vitro fertilization from the egg of a woman and the sperm of a man, is gestated in the womb of another woman to be raised by her alone or by her and her partner, individual(s) who have not provided the gametes (eggs or sperm) and have no genetic ties to the child.

We may readily accept the story of Zeus birthing Athena from his head, yet that doesn't protect us from getting overwhelmed by the real reproductive technologies that allow people to have babies in ways only dreamed about in ancient myths. And before we have a chance to get our heads around the possibilities of borrowed eggs, sperm, and wombs, sensational media headlines both intrigue and trouble us with announcements of even newer miracles that already render these routes to parenthood obsolete or mundane. Soon we may be able to clone ourselves.

Baby boomers are believed to be the driving force behind this mad rush into the future. Baby boomers—a large, affluent generation born in the aftermath of World War II with the belief that the world was their oyster, a generation that typically postponed parenthood, a generation growing up in an ecologically polluted environment suspected to be interfering with fertility—were not going to be stopped short when they encountered problems with having babies. They would reach for whatever means possible. Not God, but technology is on their side. Yet whether we are baby boomers, the parents before them, or the next generation, we are all stumped. If we cannot even get into focus the reality of a child with up to five parents (sperm donor, egg donor, gestational carrier, legal parents), how are we to fathom a child who has three genetic parents or only one genetic parent or might be his own grandpa?

The story I would like to tell is a "strange bedfellows" story. More than a century ago, when the first reported donor insemination baby was recorded, Western medicine broke ground for infertile heterosexual couples to have a baby of their own. To this day, assisted reproductive technology is a boon to those couples or individuals unable to conceive a baby because of problems with their reproductive system or because of illness or disease that would contraindicate either carrying or conceiving a child. But now all of these men and women are joined by a whole other group of people wanting a child and celebrating that they can have one—people who have nothing wrong with their reproductive systems but are gay, lesbian, or single and, therefore, need some outside help to have a genetically related baby of their own.

The strange bedfellows don't always share the same emotional experiences. Those turning to assisted reproductive technology after confronting infertility often find themselves working through a sequence of desire, frustration, disappointment, and mourning. Single people and gay and lesbian families who discover in donorship or surrogacy a revolutionary new opportunity to become parents more likely find themselves traversing from desire to excitement to appreciative anticipation. So our story must weave together the experience of those who thought they never could but now discover they can have a child of their own and the experience of those who once thought they could and now discover that they cannot. Such an intricately woven story must inevitably be one of both sadness and celebration. It must be a story with many beginnings and many endings, but a single story nonetheless: the story of parents who raise a child who was brought to them not by the stork but with the help of another person—an egg donor, a sperm donor, or a surrogate.

This is not a brave new world, but a fertile new world. Right up to the present we seem to exclusively link assisted reproductive technology with infertility. We have books like Beyond Infertility: The New Paths to Parenthood 2 that itemize all of the assisted reproductive techniques to help a couple get a child of their own once they have confronted their inability to conceive. No mention is made of gay, lesbian, or single people who have no problems with their fertility. Yet increasing numbers of prospective single, gay, or lesbian mothers and fathers are availing themselves of these new paths to parenthood. For individuals in same-sex couples and for single people, the problem is not that their bodies do not work, but that they do not have another's body to work with. So in our new fertile world of reproductive technology, we might want to take the emphasis off the problem of infertility and put it on the solution—a solution that embraces not just problems with an individual's reproductive system but also the choice to have a child without the traditional male-female coupling. I suggest we just start thinking of this whole new world of possibilities as "assisted conception." This replacement is a twofer. "Assisted conception" removes the stigma and negative connotations historically associated with the word "infertility" while simultaneously including fertile gay, lesbian, and single people who avail themselves of these new options for parenting.

Entrance into the twenty-first century has brought with it a sea change not just in baby making but also more broadly in the definition of family. Over the past few decades we have watched increasing divorce rates result in new families with a mix of biological and nonbiological ties. We have also witnessed the increased acceptance of adoption, the trend for many to become parents first and choose partners later, and the technological advances that create myriad new combinations of biological and nonbiological parenthood. These transformations shake up our belief that blood is thicker than water and replace it with the sensibility that family ties are built more on love than on blood. Those of you who are using sperm donors, egg donors, or surrogates to build your families are our trailblazers. You are also part of the new generation of parents that increasingly accepts that "somebody else's child" can also be your child. Just as people no longer raise an eyebrow when a man pushes a baby stroller, your experience in your own families forecasts a time when no one will think twice about "yours and somebody else's" as they peek into the stroller.


Culture affects family and family alters culture in round-robin ways. We used to have the biological versus the social family (adoptive families, for example). Now we have the new hybrid—the biosocial family. With the advances of reproductive technology, we have three kinds of parents: genetic, social, and gestational. So a child conceived with a sperm donor can have a genetic mommy and a nongenetic daddy, known as a social father. A mommy using an egg donor and her husband's sperm can have a little girl who is biologically but not genetically linked to her mommy (a gestational mother) and genetically linked to her daddy. Any of these mothers and fathers can qualify as the legal parent of the child.

In our culture, blood is still thicker than water. But what about when blood and water commingle? In families using donated gametes or borrowed wombs, we have both blood and water. Max is Julie's biological son. Jordan is his daddy and Julie's husband, but not Max's biological father. Sperm donor #143 from the local sperm bank holds that position. Will Max be as strongly attached to Jordan as he would be to a biological dad? Will Julie think Max is more her child than Jordan's? Will Jordan feel he has a thinner relationship with Max because Jordan is "water" rather than "blood"?

And what about when two different forms of "blood" commingle? Marilyn and Phyllis have been a couple for ten years. They both have a strong urge to have a child. They know how hard it is to adopt as a lesbian couple. They also would like to have a child with biological ties to both of them. They are in their thirties, and both women are healthy and fertile. They decide to turn to assisted reproductive technology but are worried about an inequality in their maternal relationships with their child-to-be if only one of them has a biological tie to the baby. So they decide to extract eggs from Marilyn, fertilize them in vitro with an anonymous sperm donor, and implant the embryos in Phyllis's womb. This way each will have a biological link to their child: one as genetic mother, one as gestational mother. But how will Phyllis feel about a child who will never have any physical resemblance to her? And how will Marilyn feel about never having carried or birthed her child, never knowing the child from the inside out? And how will their child perceive each of them? Will one or the other of her mothers, the mother who carried her or the mother who conceived her, feel more like her "real" mom?

When we introduce a sperm donor, egg donor, or surrogate into family building, we have difficulty shaking the anxiety stirred up by all these questions. How can a sperm donor not be a daddy if a child is produced with his sperm? How can the surrogate not be a mommy if she grew the child in her womb? The challenge to our traditional beliefs about the saliency of blood relations and the relationship between blood and bonding gets to the core of the issue of assisted reproductive technology that we will be exploring in the pages of this book: Who is the mommy? Who is the daddy? How will the children see it? How will the parents feel it? What do the donors and surrogates have to say about it?


I have invited us to come together as a village to support the families in this fertile new world. It is not only the health of individual families, but also the larger social and psychological ramifications of the new advances in reproductive technology that should be of concern to all of us as a society. Important issues get raised: What is a family? Who holds the parental rights? Are there social or moral limits to the advances in reproductive technology (as in the present controversy about human cloning)? And so forth. But it is you parents who are on the front lines, carrying the banner for all of us, struggling in your daily lives to find answers to the bigger questions that affect us all. It doesn't matter if you are a heterosexual couple, a lesbian couple, a gay couple, or a single lesbian, gay, or heterosexual person. The story I am about to tell, a tale of anxiety trumping clear thinking and the journey toward clarity and calm, is a story for all of you. Each of you will have your own individual and idiosyncratic experiences, but all of you share the thrills and challenges of creating a baby with a "someone else" who is not your lover or spouse. You all have experienced a deep desire to have a child or you live with a person who has, and all of you have turned to assisted reproductive technology to help you. And for all of you, within yourselves, between the two of you when there are two, and between you and the culture surrounding you, the risk that anxiety will cloud clear thinking seems to come with the territory.

Let us zoom in on the culture for a moment. People often malign parents who use donors or surrogates. Headlines about exorbitantly priced searches for the perfect egg donor with a high IQ, beauty, and physical prowess don't just inform, they also reinforce—even stimulate—our discomfort and judgment about affluent people in market pursuit of designer children. But such parents are rare exceptions. Most parents using assisted reproductive technology do so because they strongly desire to have and to love a child and find this the best or only way to have one.


Excerpted from Mommies, Daddies, Donors, Surrogates by Diane Ehrensaft. Copyright © 2005 The Guilford Press. Excerpted by permission of The Guilford Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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