Bill Handel arranges surrogate births for infertile couples. And he gets paid for his work. Anything wrong with that? By Jack O'Sullivan
Bill Handel is everything the British love to hate about Americans. Loud, brash, the fat boy who thinks he knows everything, he sounds like the 19th-century carpetbagger in search of political fortune or the Sergeant Bilko tourist decked out in Bermuda shorts and Hawaiian shirt, with wife in improbable hat visiting the Tower of London and wondering if he can buy one of the Crown Jewels. But he probably best belongs in a Western, dressed in a frock coat and top hat hawking snake oil and other remedies on a dusty street outside the saloon. A salesman to his very core, Handel recalls that hapless huckster, dressed in a white suit, whom Clint Eastwood repeatedly humiliates in The Outlaw Josey Wales.

He has certainly been dodging the bullets this week. For Bill Handel deals not in cure-all potions but in new-born babies, in arranging surrogate births for infertile couples.

Tomorrow, in London, he will meet 10 British childless couples. Each has already approached his Centre for Surrogate Parenting and Egg Donation in Los Angeles. The press has rounded on a man who dared to circumvent a typically British legal fudge, which does not prohibit surrogacy but bans both the advertising of surrogacy and its arrangement on commercial terms by a third party. "Womb pimp" screamed one critic.

Handel takes all this on the chin. He has, after all, made his millions as a radio talk show host ("They pay me ridiculous sums of money for calling people morons every morning from five till nine"). And he appreciates that the worst outcome of his week in Britain would be obscurity. ("I know that even if you write a really horrible article about me at least people will get to hear about our centre.")

His visit, for all the vitriol it has generated, has also highlighted the hypocritical and dangerously amateurish British approach to surrogacy. Because commerce is banished from British practice and the NHS steers clear of it, surrogacy here is shadowy, haphazard and agreed upon on a private, ad hoc basis. The system is rife with potential for fraud, broken agreements, the involvement of inappropriate people and consequent damage to children. The British charity Childlessness Overcome Through Surrogacy offers voluntary guidance and screening, but it is poorly financed to do the job properly. Against what is happening here, Bill Handel's approach looks open, professional and caring.

"We turn down 19 out of 20 women who want to be surrogates," says Handel. "All our surrogates are over 21 and financially stable. We don't accept them if they are on the dole. They must already have children and preferably they are married. We pick women who have a history of easy, uncomplicated pregnancies and take pride in their children." So why, I asked, would they give up a child?

"They all know infertile couples and want to help them," he says. "These women are generally bright, but they may not have made much impact on society. They are not career women or brain surgeons, they haven't invented anything. Their satisfaction lies in being pioneers, creating families for couples, doing something major, which they might not otherwise do while living a quiet, middle-class life.

"There is a four-month screening process, in which we do a lot of psychological tests, expensive medical tests, checks on criminal records, education, their credit rating. We even check their driving records. The proof of the pudding is that in almost 500 births in over a decade, only one surrogate mother has attempted to keep the baby." For all her hard work, a surrogate mother can expect to be paid up to about pounds 10,000, the same cut the centre takes to fund its 12 staff; legal and medical expenses add pounds 15,000, which makes the total cost to the would-be parents pounds 35,000. Handel does not make big money out of the centre.

Couples are also checked. "They meet psychologists. We need to know if they're crazy." Several meetings with the would-be surrogate take place before the baby is conceived. The surrogate mother may carry a baby who is biologically her own (fertilised by the would-be father's sperm) or an embryo for which the egg is donated by the childless woman or a third party. In all, five adults can be involved in making one baby.

And after that? Typically, says Handel, the baby is taken by the new parents soon after birth. Under Californian law, if they are its biological parents, their names (and not the birth mother's) go on the birth certificate, avoiding the need for adoption procedures. Already, says Handel, 20 British couples have acquired babies and returned. None has had legal difficulties here. Many families stay in touch with the surrogates, encouraging children to know and meet their birth mothers.

All this seems fine, I say, a sound dose of American professionalism improving on British amateurism. But the big question remains: does surrogacy damage the psychological health of women and children? After all, the history of adoption is of women left riven with guilt in later years and children bereft at abandonment by birth parents. Why should those involved in surrogacy feel any different?

To this neither Handel (nor the British legislators who allow non-commercial surrogacy) can give a conclusive answer. It is too soon to be sure about the birth mothers (the oldest surrogate child is 17), although they all are very positive about the experience, he says. "We know," he admits, "that some women who, as teenagers, give up their babies for adoption can in their thirties, 20 years later, have a huge epiphany when everything comes down on them like a ton of bricks."

And the children? "My guess is that these kids are so busy doing their soccer practice and going to school that they don't have time to think about these things. The kids we have looked at seem very comfortable with what has happened. But the bottom line is that it's too soon. We still don't know. But what if, when they are 20 or 30, they do turn out to be screwed up? I say to you: so what? The alternative is that these kids never existed. Would you prefer that they never existed?"n