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 womens 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
(pundekait) is linguistically marked as a fetus temporary innkeeper. This impersonal way of marking
surrogacy, which eschews any sense of maternal connection, is affirmed by Temans 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 Temans 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 states 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 countrys 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 intended
parents 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

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 anothers lives that intended mothers prosthetic consciousness of the growing
fetus becomes integrated seamlessly into the surrogates body map, in which the belly was marked as a
distanced 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 mothers 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 newborns journey from the surrogates body into the intended
mothers 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 of
some 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, Temans 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 Temans 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 to
embody 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 books 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.

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, Larissa
2000 Childless in the Land of Imperative Motherhood: Stigma and Coping among Infertile Israeli
Women. Sex Roles 43(11-12):821-841.