(UPDATED) Human Rights and the Business of Reproduction: Surrogacy Replacing International Adoption from Guatemala

This is the first in a three-part series of articles on the global surrogacy trade.

UPDATE: Subsequent to the publication of this article, MLJ , a firm cited below, changed their website to delete any reference to Mark Reder’s expertise in “surrogacy arrangements,” text originally cited in this piece.   This change occurred roughly 72 hours after publication.

Since the turn of the Millennium, approximately 200,000 children have been adopted from abroad by U.S. families. Success stories include positive outcomes for children who make significant developmental gains as compared to children left behind in institutions in their home countries. However, one down-side has been what some call a “baby trade” in which some adopting families have paid at least $25,000 and upwards to $50,000 to be matched with very young and healthy children.

The most alarming and systematic problems in recent times were in Guatemala. While there were legitimate adoptions, especially of older children, it is believed that payments to birth mothers for their infants became routine. It was estimated that at the peak of this practice, Guatemala sent 17 children a day to other countries as inter-country adoptees. Under these conditions, the demand for infants became such that Claudia Rivera, a child rights advocate, asserts that “children were manufactured” in the nation to supply the system. Another Guatemalan women’s health advocate, speaking on the grounds of anonymity about her assistance to sex workers, underscored the contribution of inter-country adoption pressures to the grave situation of human trafficking in the nation.

The indigenous population represents approximately 50 percent of Guatemala’s population. Because of systemic discrimination, the majority of indigenous women have had little or no education, are unable to read and have few economic options beyond selling goods in markets. Marketers may earn as little as a dollar-a-day and experience some of the greatest gender-based oppression in the Americas. Photo by Karen Smith Rotabi.

She recounted the experience of a 17-year old girl who was sold by her parents into prostitution; when she later became pregnant, her infant was sold into inter-country adoption. That particular child most likely lives in the United States today as an adoptee.

Coercive child relinquishments are also a problem in an environment of extreme poverty where there is no attempt to provide the birth mother with counseling to insure informed consent and to protect her basic rights. In Guatemala there have been allegations of child theft to supply the adoption industry and today several kidnapping cases remain unresolved. During a recent US speaker’s tour on violence against women, Guatemalan human rights defender Norma Cruz recently reminded audiences that this form of child kidnapping is the cruelest kind of violence against a mother, describing the experience as an “eternal suffering.”

Cruz’s advocacy efforts include legal actions on behalf of women who have experienced this pain and she has been seeking international legal resolution without satisfaction. Cruz further underscored that these alleged kidnapping crimes took place in an environment already characterized by the highest rate of violence against women in the Western Hemisphere and, as such, seeking legal advocacy to exercise rights is a dangerous act in and of itself.

In response to concerns for child sales and theft, a new era of reform has been underway in both Guatemala and the United States, in accordance with the Hague Convention on Intercountry Adoption. Both nations, along with over 70 other countries, have ratified the international agreement which was developed to prevent child sales and theft and ultimately promote the best interests of the child. Practically speaking, the Convention has cooled the international adoption industry with regulations that set forth standards for agencies to act with financial transparency and improved child placement practices, and with obligations to prevent child sales and theft. This is a tall order in sending nations where bribery, corruption, and human trafficking are known problems. Still, for those concerned about adoption practices and ethics, this has been an important step forward in curbing abuses and raising standards of care.

With this new system, combined with problems like the recent adoption scandals in Russia and other nations, inter-country adoption has undergone radical decline and it is no longer the opportunity it once was for building families.  In the US, the practice peaked in 2004 with 22,990 children sent to the nation as adoptees as compared to only 12,753 in 2009.

As adoption has become more difficult, the global surrogacy industry has begun to surge to meet the fertility demands of individuals and couples seeking to secure healthy infants.

A handful of adoption agencies and service providers with prior significant interests in Guatemala have been shifting to meet this need. For example, attorney Mark Reder of MLJ Adoptions based in Indianapolis boasts international surrogacy as a practice area of expertise, calling the activity “surrogacy arrangements.” Because Guatemala is recognized by the UN to have the greatest gender inequality in the Western hemisphere and the nation has no regulatory laws on surrogacy, “expertise” on such matters is more about the how to, where to, and with which vulnerable woman to contract the service. In the current environment, the information and service that will be offered will undoubtedly be tailored to meet the needs of those who have the privilege to pay for surrogacy.  One has to wonder how information will be imparted to Guatemalan women who may well be illiterate and lack the legal savvy to truly understand the contracts they will be required to sign.

Armed with information from his agency’s previous adoption work in the nation, Reder has the knowledge and networks to be well-positioned in this emerging market. North American and European families are now looking to him and other entrepreneurs to supply healthy infants but at the societal level, there is no real discourse about the inherent ethical dilemmas and human rights concerns involved.

Desperately poor, Guatemalan women will inevitably find themselves being offered an opportunity to earn a wage to birth a baby in this dollar-a-day nation—not unlike previous underground adoption activities. The financial payment for surrogacy in Guatemala is unclear, but inter-country adoption experts estimate that some women earned approximately $1,500 for child-relinquishment signatures in the old adoption system, which amounts to just over $5 a day for a normal 280 day gestational period. For a woman of privilege in the United States looking for fertility alternatives, this is a bargain-basement price, but extreme poverty is the only reason why any Guatemalan woman would agree to such an arrangement. It is a reminder to all of us that poverty is coercive and the fertility choices that are made, on both sides of the global surrogacy arrangement equation, will be determined by both economic opportunity and oppression. 

Those developing surrogacy services in this desperately poor nation should take caution as they pioneer in this area of global fertility practice. As a business model, they are stepping into a grey area of human rights which will challenge us all to consider what is right and wrong and how far to take the privilege of purchasing power. Developing an expanded or more precise definition of human trafficking and a new area of regulatory control will become important considerations in this next wave of the global baby business.

It should be noted that very little is currently known about the exact nature of Guatemalan surrogacy services and the mechanics of such arrangements–how women get impregnated, by whose sperm and with whose eggs and so on. However, in a follow-up report by Dr. Nicole Bromfield, the case of surrogacy in India will be investigated, shedding light on these practices elsewhere.

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  • cmarie

    excellent article. You mention payments to mothers though.   I understand that prior to Guatemala becoming Hague complient (as far as adoption was concerned), payments may have been  provided to people bringing babies to orphanages or lawyers for adoption.  But, doubtless in the vast majority of cases, the people receiving money were not the childrens’ mothers.  They may have been other powerful family members or even neighbors with no right to be near the baby at all.  People seem to assume that if money changed hands it went to the mother and certainly there is no reason to believe that.  Likewise, I’m sure many of the women working as surrogates will be doing it against their will and never see the money they earn.  Imagine a young widow with children, dependent on her in laws for support.  How does she say no to this?  Just like in India, the human rights violations are heartbreaking.

  • amyc

    While I am all for surrogacy programs, I do believe in their being highly regulated. It would be too easy for women to slip through the cracks of the system if it is not regulated properly. One question I ask when I hear somebody talk about adopting a child from another country: Do you know how many children right here in America need a home? I always advocate adopting a child from your own country first. How are we to help other countries’ children if our own children are orphaned/homeless/starving? Believe me, it happens more often in the USA than people want to imagine.

  • karen-smith-rotabi

    Since writing this blog, a number of people have reached out and congratulated me on exploring global surrogacy. Some of those individuals are old friends who shared concerns about Guatemala’s previous intercountry adoption system and it was good to hear from them. Some are noted Guatemalan human rights defenders and it is always an honor to help with the cause of social justice for they take risk everyday in speaking out against abuses. Others have been involved in criticism of India’s booming surrogacy system and they wanted to know more about the emergent system in Guatemala and how it may fit with their ongoing advocacy efforts. And, very specifically, the director of MLJ Adoptions requested a retraction of the story because she feels that the agency was misrepresented in the blog. While Reder’s bio on the adoption agency website did have the mention of Reder’s surrogacy expertise at the time of writing the blog, she takes exception to any suggestion of unethical behavior and stands behind his practice as an ethical attorney. Further, she states that the agency is not involved in surrogacy arrangements in Guatemala and is not using their networks in the nation to carry out such activities. I am pleased to hear this and I am more than happy to communicate that she underscored her personal as well as agency commitment to ethics. As such, she has requested a retraction and as a professional social worker, I can understand her concerns. So, the facts at hand are that Reder does work for the agency and, until recently his biography on the agency website stated that he had expertise in surrogacy “arrangements.” That fact and description have now been removed from Reder’s biography—it seems that this removal happened as a result of my original blog.  This is an interesting predicament because Reder does call himself an adoption attorney as well as boasting involvement in surrogacy arrangements. However, to respond to the MLJ Adoptions and their concerns, I would like to take this opportunity to state that I have absolutely no personal knowledge of any specific unethical practices by MLJ Adoptions or Mr. Reder in the area of adoptions or surrogacy. Further, I have no reason to believe that the agency has done anything specifically that falls within an unethical range of practice and international surrogacy has most definitely not been determined to be unethical by any state licensing authorities or other professional organizations. The point of the story was to indicate a shift from intercountry adoption to surrogacy given the dramatic decline in intercountry adoption as an option for family building. I did not mean the story to be an attack on a particular agency and it was intended to bring discourse about a new and emerging human rights concern in Guatemala. I have long been committed to speaking out against human rights violations in the nation as it is notorious for some of the gravest abuses in the Western hemisphere. And, as I said previously, engaging in surrogacy services in the nation is complicated because guaranteeing women’s rights is difficult in an environment of impunity. For readers who are unaware of the concept of impunity or the grave circumstances of women in the nation, I suggest that they learn more about violence against women at the Guatemala Human Rights Commission’s website (www.ghrc-usa.org) where they describe the For a Woman’s Right to Live campaign. There, readers can learn about the fact that only 2-3% of murders of women are even prosecuted in the nation and more about this dynamic can be found on http://www.StopFemicide.com where I am a contributor. I have a commitment to this campaign to end violence against women and the current environment for women, a lack of law enforcement and justice, in Guatemala is critically important when considering the rights of women and global surrogacy services. As I said in the original blog, little is known about surrogacy in Guatemala because it is happening very quietly. I would like to hear more from those involved in developing international surrogacy generally and Mark Reder himself specifically could shed some light so that  we call can learn more about the emerging surrogacy practices, especially the international market. I welcome inclusion of such discourse in this series on global surrogacy, especially given the stated commitment to ethics that MLJ Adoptions has clearly stated in their correspondence to me related to my original blog. Since the agency director and attorney Michelle Jackson* has a background and expertise in surrogacy herself, as indicated by the following online article (http://www.jhdj-law.com/index.php/news/article/attorney-michele-jackson-quoted-in-indiana-lawyer-surrogacy-article/), I would also welcome her comment on surrogacy in the international arena, especially since she also has an interest in human rights. Clearly her knowledge of the issues related to surrogacy and human rights would help us all understand the changing nature of the practice in the USA and abroad.


    What I do know is that in general women are fearful for their very lives in Guatemala and it is difficult, if not impossible, to guarantee fair treatment for women in workplaces and across society in general. I don’t expect surrogacy to be any different—thus I suggested caution for anyone starting such an activity in the nation.  Finally, to be explicit, I would like to restate that I “retract” any suggestion of any specific act of impropriety or unethical behavior (in the past or future) on the part of MLJ Adoptions or Mr. Reder for that was not the point nor was it my intention. Focusing on that detracts from the real problem—a lack of regulatory control over global surrogacy in Guatemala, the USA, and other nations. At the end of the day, I don’t expect individuals involved in earning their living from surrogacy to regulate this, but rather I am a firm believer in the development of proactive and appropriate regulation. A number of US states regulate the practice and some even prohibit the practice. This leaves me to ask why shouldn’t the women of Guatemala have the same benefit of oversight? And, I am saddened that the women of Guatemala seem to be the target of out-sourcing of such activities because it is just easier and less expensive in the developing nation where oversight of the activity is lacking. This trend towards using women’s wombs for surrogacy in developing nations does not come without consequence to all involved.


    *Note: Ms. Jackson apparently does not practice her surrogacy work through MLJ Adoptions as she has made it very clear that the agency is not involved in such arrangements.


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