An Idaho woman who was serving as a gestational surrogate for a couple from Spain died from complications from her pregnancy on October 8. Brooke Brown, 34, had served as a surrogate three times before, but this time, according to The Gift of Surrogacy’s Facebook page, she died from an amniotic fluid embolism just days before she was going to deliver twins via cesarean. The children did not survive either.

Jennifer Lahl, president of Center for Bioethics and Culture, first broke the story of Brown’s death. She told me that there are two red flags in this case: the way the mainstream media won’t report or investigate this incident and the fact that few sources have mentioned the death of the twins. Since both the surrogate and the babies she was carrying died, in what was apparently a commercial surrogacy, the media and the appropriate government agencies ought to have begun some investigation.

The surrogacy industry downplays the extent of the the physical, emotional and psychological problems with surrogacy, as well as the extent of abuse, negligence and death. Just in the two days since Brown’s story come out, Lahl told me, she has been contacted by three former surrogates who all experienced medical complications during their surrogacy and were treated “more like a breeder” than a patient. Lahl, who has talked with many surrogates over the last few years about the abuses they have had to endure, points out that most surrogates are not told of the added risks when carrying embryos made from donor eggs. Many of the surrogates she has talked to were never told of the risks involved in carrying multiples, risks such as pre-eclampsia, maternal hypertension and gestational diabetes.

Gestational Surrogacy

Gestational surrogacy is when a woman carries a child for someone else, including single parents. The child is usually genetically related to one or both of the commissioning couple and almost never related to the surrogate. Typically the commissioning couple cannot have their own children, although there are a growing number of cases of “social surrogacy” in which a woman hires a surrogate out of convenience or for cosmetic reasons, and increasing numbers of homosexual couples are using to technology. Gestational surrogacy can come in either “altruistic” or “commercial” forms, although this line is often blurred. The cost to those receiving the child range from $85,000 to $125,000, according to Mirah Ribin, author of The Stork Market: America’s Multi-Billion Dollar Unregulated Adoption Industry.

Almost all international surrogacy arrangements are commercial, meaning that the mother is compensated for medical expenses and the agency arranging the surrogacy is paid a fee. While some countries have very strict policies on commercial surrogacy or ban the practice, the United States has few laws on surrogacy and what laws it does have vary from state to state. Some states permit altruistic surrogacy but ban commercial surrogacy. Idaho has no laws on surrogacy.

According to one surrogacy agency, Creative Family Connections, gestational surrogacy is legal in Idaho, but it is one of the “yellow light states,” where “there are potential legal hurdles; or results may be inconsistent.” Idaho grants post-birth parentage orders to whomever the intended parents are regardless of whether they are a single parent, married, unmarried, heterosexual, homosexual, genetically related or not. This makes Idaho, and other states with equally lax laws, an attractive market for people from other countries, like Spain, where surrogacy is illegal.

Advocates of surrogacy believe it is an altruistic practice that provides a child for a couple that could not have biological children in another way. In Brooke Brown’s case, many of the people who knew her have commented on how kind she was. Unlike the dire conditions in countries, such as India, women in the U.S. can choose to become a surrogate and often do because they want to help others. The agency that promoted a GoFundMe page to raise money for Brooke’s family considers this a “worse-case scenario” and encourages people to pray for her family.

Critics say that surrogacy commodifies women by turning their bodies into “commercial products.” Last summer Switzerland outlawed surrogacy because it degrades women and it amounts to buying and selling children which violates international laws on trafficking and slavery. Reports on international surrogacy cases reveal how it exploits the poor, which has led to recent efforts by India’s government to ban commercial international surrogacy. Additionally, the lax laws in the U.S. and other countries where surrogacy is legal have left many children in legal limbo with no nationality and no protections if they are abandoned.

“American women are being paid to put themselves at significant physical risk every day in this country to produce babies for others,” said Lahl in a press release. “These mostly low income women are injected with powerful hormones and other drugs to maximize chances of pregnancy, virtually without government oversight. Women didn’t get this far to be treated like breeding animals.”

“I never thought I’d see the day when women were being openly marketed for their uteri,” she added. “Members of Congress profess to care about women’s needs. Well, let’s see if they mean it.”

Heather Zieger has a background in chemistry and bioethics and works as a freelance science writer in Dallas.