by Mei Fong
Not only did advances in reproductive medicine give affluent Chinese an out from the one-child policy, they also deepened income inequality. Elsewhere it may be a truism that the rich get richer and the poor get children. In China, the rich found it easier to get the whole package: wealth and extra progeny. Increasingly, the well-to-do, or well connected, were willing and able to pay the fines or engineer ingenious ways around the policy, including using fertility treatments both in and out of the country. It’s not that poorer people in China couldn’t have more than one child. But the laws of the one-child policy were structured such that the greatest flexibility was afforded at opposite ends of the income spectrum: the poorest, who live in rural areas where one-child exemptions tended to be more easily obtained, and the richest, for whom such laws increasingly commanded only lip service. China’s middle classes were the ones to whom the rules most applied; China’s poor, the ones who faced the most brutal enforcement.
After the Octomom incident, a user on the Sina microblog service commented, “If you have money, what does the law mean?” Another Sina user commented, “Chinese law is the law of the rich. The rich can have as many babies as they want, because they have the money to pay the penalty.” That message also carried graphic photographs of factory hand Feng Jianmei, she of the forced late-term abortion. Perhaps the most apt representation of where China found itself is, in fact, a dystopian fantasy, Margaret Atwood’s The Handmaid’s Tale. A futuristic story set in a loosely disguised Harvard University, the novel depicts a population rendered infertile by pollution. Women are commodities, and the custom of concubinage has been revived to foster the creation of children.
China is facing a severe pollution problem, which is increasingly being linked to infertility, though scientists have yet to fully understand how. Or, perhaps more to the point, who. In 2013, for example, the government think tank Chinese Academy of Sciences announced the launch of a five-year study of the relationship between air pollution and female infertility. Other scientists, however, argue that the pollution crisis affects men, not women. In 2013, newspapers announced Shanghai was facing a “semen crisis,” with only a third of semen at its main sperm bank meeting World Health Organization standards. Several studies were published linking worsening environmental conditions to the falling quality of Chinese men’s sperm.
It’s not difficult to do the math. With over 60 million females who were never born, killed in infancy, or given away, and another 40 million females experiencing infertility, women who can easily conceive are increasingly scarce commodities in China, just like in Atwood’s book.
We see this not just with surrogates, but with the return of the mistress culture in China. The custom died down with the start of Communist rule but revived with capitalism. The image of officials with mistresses and multiple offspring has become a trope in China, and these women are valued not just for their beauty but for their fecundity, a byproduct of youth. These stories are a refrain in exposés of corrupt officials. Zhong Bifeng, the ex-director of the city construction bureau in Deshan, Hunan Province, was exposed by his mistress. She wrote on Rednet, Hunan’s official bulletin board, that Zhong, desperate for a son, found her through a marriage agency and promised to give her 500,000 RMB, or about $80,000, if she gave him a son. If she had a daughter, she would have an abortion and be given $16,000 as compensation. “When I went to his house to find him on February 2014, I was beaten by his wife,” she wrote. Zhong was expelled from the Communist Party.
Lei Yuanli, vice mayor of Chenzhou City, had relationships with nine lovers and was caught embezzling funds to support them, including establishing a trust fund for an illegitimate son. For embezzling and bribe taking, Lei was sentenced to death, which was later commuted to a twenty-year prison term.
These experiments in reproduction aren’t limited to Chinese shores, nor are they solely China’s concerns. For increasingly, some of these babies are American born.
III
In 2010, Shanghai native Tony Jiang and his wife, quoted as “Jennifer” according to the couple’s request, had a daughter by an American surrogate. Then, twins. All three of their children are US citizens, as the United States is one of the few countries that grant automatic citizenship to children born on its soil. But that’s not why they chose this unusual conception method, said Jiang. For affluent folks like the Jiangs, there are easier ways of getting foreign citizenship. “It would take years,” said Jiang. American-born children can sponsor their foreign-born parents for green cards only when they reach twenty-one. Also, the United States is one of the few countries that require its citizens to pay taxes even when they’re living elsewhere. “A Canadian passport can avoid lots of tax levy. To be honest, a US citizenship to Chinese at this moment is not worth that much money.”
To them, the main draws offered by America, or more specifically the state of California, were top-flight reproductive services and solid legal protection for parents of children born to surrogates, all of which are unavailable in China.
When they got married, Tony and Jennifer were quintessential yuppies, both with marketing jobs with multinationals that paid well and demanded lots of travel. Both came from small families. Tony, thirty-six, was born slightly before the onset of the one-child policy and has an older sister. Jennifer, from the first one-child generation, has no siblings. Family pressure for the couple to have children early was strong, but in 2008, Jennifer was diagnosed with a smaller-than-normal uterus. It meant she would almost certainly not be able to carry a child to full term.
“I was a little bit disappointed but at that time was not that ready to be a father,” said Jiang. “But my wife was so frustrated. She thinks it’s her problem, she blames everything on herself.”
I met Tony Jiang in Shanghai years after his gynecological odyssey. He was modishly dressed in a snug red sweater, leather pants, and a chunky, expensive-looking watch, the kind that supposedly works equally well when deep-sea diving or Alpine climbing. Not that the busy Jiang has the time or inclination.
Jiang now runs a fertility consultancy business, DiYi Consulting. He is the middleman for a fast-growing market of Chinese clients seeking egg donors, sperm donors, surrogates, and IVF services in America. The genesis of this, of course, was his own experience, which he recounted in a cool analytical fashion, not mincing words.
The Jiangs tried surrogacy repeatedly in China. It cost them two years and close to $30,000. Nothing happened. One surrogate simply vanished, returning home without notice. The other two didn’t get pregnant. Jiang had initially thought, “As long as you pay, you get your babies; it’s easy because basically there is another way to get around it. But in China we tried and realized it is not so simple.”
There are huge differences between Chinese and US IVF services, he said. Chinese fertility clinics are overcrowded, doctor-patient relationships impersonal, and infrastructure rudimentary and not always sterile. (“You have to masturbate in the male toilet,” said Jiang.)
He started exploring overseas options. He considered Ukraine, India, and Bangkok in addition to America. In the United States, a package of IVF, surrogacy, and delivery services would run about $120,000, he calculated, three times what it would cost in India. But American states like California have well-established legal protections for the rights of biological parents. Horror stories abounded of stateless infants born to surrogate mothers in India and Thailand, stranded in legal limbo. Jiang also decided against Ukraine, where “they charge foreigners two or three times more, just like thirty years ago in China.”
So America it was. It was their last chance. “We could not emotionally and financially afford another loss. We would rather try the best place, the most sophisticated solution and process.” Jiang’s parents even quietly suggested that he consider divorce because of his wife’s fertility problems. He didn’t mention the suggestion, he said, but “she could feel it.”
Jiang was referred to three potential surrogates by an American agency. Even though th
e other two surrogates lived in Southern California, nearer to the Santa Monica clinic Jiang had chosen, he selected Amanda Krywokulsky, who lived a short plane flight away in the San Francisco Bay area. She appealed to Jiang because she was white and married to a police officer, all of which suggested stability. “I think it is a felony to impersonate a police officer,” he said, and “culture-wise, I tend to believe in a white family.”
It felt odd to hear Jiang dissect his decisions so openly. An American, I felt, might have made similar decisions but would likely not have openly expressed a preference for a white surrogate. In China, an overwhelming Han ethnic majority has made the population deaf to the nuances of racial political correctness. Lisa Chiya, who runs a Beverly Hills surrogacy agency, said, “Other clientele don’t care so much for demographics, but the Chinese care about education and ethnicity. They ask for college degrees, they want Caucasian or Latina, but they don’t want African American. Always, they say, ‘Anything but an African American surrogate.’”
I was familiar with this bias, which stems in part from a cultural preference for fair skin. For the Chinese, prettier means paler. For a people striving to get out of the fields into cubicles, paler skins also symbolize success. An African American friend once indignantly stormed out of a Beijing spa because they tried to push skin-whitening treatments on her. The proprietor simply couldn’t understand why anyone would be offended. To her, everyone wants to be bai, fu, mei: “white, lucky, beautiful.”
The Jiangs were lucky not to encounter a similar racial bias in their search for a surrogate mother. Three couples had also been referred to Krywokulsky for her consideration, and the Jiangs were the only Chinese couple. She was most drawn to them, she said. “I think it was just the way they talked about wanting their own child, and the failed attempts. This was a last-ditch attempt. It touched my heart.”
She was trying surrogacy at the suggestion of a friend, who’d done it twice before. Krywokulsky had had an easy pregnancy with her son, at that time a toddler, and had enjoyed being pregnant.
“I think one of the biggest questions people ask is, ‘How do you dis-attach?’ I tell them you have to keep in mind, the baby’s not genetically yours. It’s not going to come out looking like you. For me, the big thing was helping people.”
Around Christmas 2009, the Jiangs flew out to visit Krywokulsky in her home in a suburb some two hours from San Francisco. Krywokulsky showed them around and introduced them openly as the couple for whom she would be a surrogate. “She was so nice,” said Jiang.
He was reassured by the family’s solid middle-class credentials. “She lives in a nice house, so I don’t think she would purely do this for money,” he said, “but nobody is really pregnant for fun, you know.”
For her services, Krywokulsky would be paid $30,000, a standard rate on the market. Given the effort and time spent, it isn’t a huge sum, and many surrogates I spoke to say financial incentives are only a part of their motivation. Sometimes, even this financial incentive can be reduced. Krywokulsky and her husband had expected her medical bills during pregnancy to be covered under her husband’s work-provided plan. But the insurance company later billed Krywokulsky for half the costs of her checkups—to the tune of some $15,000—stating they would not fully cover pregnancy for compensation. A friend of Krywokulsky’s received a similar insurance bill. Some fertility consultants now advise surrogate mothers to get insurance under the Affordable Care Act, which does not explicitly preclude coverage for surrogate pregnancies, though this may change.
After the visit, the Jiangs began fertility treatments. In April 2010, they were in Santa Monica for the retrieval and implantation process. By mid-April, Krywokulsky was pregnant. Two weeks later, they were told it was a single pregnancy, which was a slight disappointment—“I was hoping for twins because I didn’t want to do it again,” Jiang said. Two more weeks later, another slight disappointment: scans showed a female fetus. Jiang’s father had hoped for a boy to carry on the family name. “I told myself I would have to do it again,” he said.
The relationships among three busy individuals across several continents deepened as the pregnancy progressed. An Icelandic volcano exploded in the spring, stranding Jennifer for weeks in Switzerland, where she had been working. Isolated and depressed, she waited to hear if Krywokulsky was pregnant. Early in the pregnancy, Krywokulsky had a fender-bender. Jiang said, “When I read those e-mails I had a lot of sweat on my hands. I thought about making an irrational call to the agency requesting Amanda stay away from cars, but I realized it was stupid. Nobody’s on public transportation. She was a housewife, how could I forbid her from driving?” He learned to trust Krywokulsky.
In the fall, a kink in their plans. The state of California initiated drastic budget cuts, and Krywokulsky’s husband was laid off. Jiang, in France on a two-month work stint, offered to fly to San Francisco to comfort Krywokulsky. She had lost her insurance, so Jiang paid for coverage under COBRA, the pricey program that allows the recently unemployed to continue receiving health coverage. It cost over $600 monthly. At this point, Krywokulsky was five months pregnant.
The baby was born in December 2010, on the first day of sunshine after a week of rain. Jennifer held Krywokulsky’s hand during the vaginal birth, which went easily and quickly. “I think I pushed three times,” said Krywokulsky.
Everybody cried: the Jiangs, Krywokulsky, her mother, “even the nurse was tearing up,” said Krywokulsky.
One year later, the Jiangs began to think about trying for another baby. “You look at the one-baby family in China. A lot of kids don’t know how to share, they get extremely bored and indulged by grandparents,” said Jiang. They still had several frozen embryos in storage. They approached Krywokulsky again, and she agreed.
This time, things were different. Krywokulsky’s son was now old enough to ask questions. “I told him, ‘Mommy’s having a baby for someone else,’” said Krywokulsky. As it turned out, she was having two. The twins were born prematurely, one month ahead of schedule. Jiang’s insurance coverage didn’t kick in so early. Uninsured, he was billed about $10,000 for every day the twins spent in intensive care. In the end, the hospital bill came to a stunning $280,000, though Jiang was able to negotiate it down to $220,000 for an immediate cash settlement. Now Jiang advises his clients who are expecting twins to purchase coverage for premature births. The premium is pricey—$50,000—but worth it, he said.
These are high sums indeed, but fertility consultants in America tell me that’s fairly common with their Chinese clientele. “I’ve never gone back and forth in negotiations with them, which is not typical of US and other countries,” said Wendie Wilson-Miller, coauthor of The Insider’s Guide to Egg Donation, who also runs an egg donor agency.
The two families regularly communicate by Skype or e-mail once a week. “I play a pretty big part in their family, like a sister who lives farther away,” said Krywokulsky.
In late 2012, Jiang quit his job to set up DiYi. “In my previous job, out of fifty-two weeks I’d spend thirty-two traveling. With three kids, I needed a better work balance.” He puts his clientele into four categories: people suffering from infertility; single men or women who need third-party help to have children; gay people (“It’s not that rare; I believe in this country there are 50 to 60 million highly discriminated against gay people”); and, until recently, people trying to evade the one-child policy.
The last category included people whose jobs were at risk if they have more than one child, such as government officials or executives at state-owned companies. “People who fall into this category are rare, less than 10 percent. Most people I see are infertile; that’s about 75 percent of the business.”
Recently, Jiang consulted with some clients and learned the intended father was a high-ranking government official who was very afraid of exposure, he said. They ultimately backed out. “Basically people are coming to me for family building. They’re eager for the child, that’s the ultimate essence. They are
so eager for a child.”
IV
Jiang’s clients are part of a bigger group who come to America to have babies. It’s a surprising reversal of the tide that began with Americans going to China for babies a decade ago. While there are no reliable figures on how big this phenomenon is, there is ample evidence that the numbers have risen sharply in recent years. The Washington, DC–based Center for Immigration Studies estimates that there are forty thousand so-called birth tourists annually but does not break down the figure by nationality. Several news reports say at least ten thousand Chinese “anchor babies” were born in America in 2012, citing an estimate by the Maternal Management Organization, a little-known online platform dedicated to monitoring and rating confinement centers for Chinese women giving birth in the States.
Confinement centers are establishments that cater to the Chinese tradition of a one-month postnatal “confinement period,” called zuoyuezi “sitting the month,” which some consider essential to the future health and well-being of child and mother. These kinds of places have mushroomed in Southern California in recent years, to cater to Chinese nationals giving birth in America. They typically charge $30,000 and upward for an all-inclusive six-week stay. They have also made an easy, centralized target for the anti-immigration movement, amid growing calls from extremists for a repeal of the Fourteenth Amendment, which grants citizenship to all persons born or naturalized in the United States. Since 2010 the number of raids on confinement centers has increased, and a major 2013 operation involving federal agents is “likely to culminate in the biggest federal criminal case ever against the booming ‘anchor baby’ industry,” said the Wall Street Journal.
