The Kardashians, 28-year-old models, and a row over 'vanity surrogacy'.

Everyone thinks Kim Kardashian didn’t want to get fat but actually, she didn’t want to die. 

A hole in her uterus caused by the ripping fingernails of a medical professional was the last straw in a macabre conga-line of fertility issues for the woman who has everything. 

An emergency after the birth of her first child, North, meant: "My doctor had to stick his entire arm in me and detach the placenta with his hand, scraping it away from my uterus with his fingernails," she wrote. After that, everything about her second pregnancy was complicated.

Threatened miscarriage. Endo. Pre-eclampsia. Placenta accreta. Failed surgeries. 

It’s a list that would leave a lot of women – ordinary, feet-of-clay women – thinking that two kids were enough kids. 

But Kim Kardashian is not an ordinary woman, and she wanted more babies. And so, she called someone. And she started researching and, two children later, she’s the self-confessed surrogacy whisperer for Hollywood’s elite. 

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Her sister, Khloé, sought her advice when her obstetrician told her that having a second baby would be complicated and risky for her health, too.

"I'm not gonna get into specifics on camera," Khloé said on an episode of The Kardashians. "But they said it's an 80 per cent chance I'll miscarry... [My doctor] said she would feel terrible putting [an embryo] in without warning me that most likely I wouldn't be able to carry."

And Paris Hilton, who was once Kim’s boss, but now inhabits an entirely different world, called her when she got married, and wanted a baby, but didn’t want to get pregnant or give birth.

“Kim told me about (surrogacy) as well,” Hilton told Glamour magazine. “I’m using the same doctor, Dr Huang, who’s the best, and he has a concierge team that deals with everything.” 

She’s helpful like that, Kim. She’s a get-s**t-done kind of woman, and she has strong opinions on the right way to treat the person who’s going to be implanted with your embryo and carry them to full term. 

You should give them extra money for organic fruit and veggies, so you know what’s going in (sister Kourtney thinks you should get to dictate what kind of TV your carrier watches while she’s pregnant, but Kim thinks that’s woo-woo), she said in the same episode of The Kardashians. Kim knows you need to negotiate out all the details upfront, and that you should be mindful of your gestational carrier's feelings.

"I think the right thing to do is get them to come and see the baby at some point before they leave [the hospital]. You have to make decisions like do you want them to pump and send the milk to you every few days." 

Luckily, what Kim also knows is that in Los Angeles, you don’t have to think of all this stuff yourself, because it's a town full of surrogacy attorneys, and surrogacy concierges. In the "surrogacy capital", it's a multi-million dollar business, and although we may never know how much the Kardashian sisters pay for their babies to bake, with all the discretion and extras required, we do know that a more basic model would set you back around $150,000 US. 

Here in Australia, it’s entirely different. 

Surrogacy as a business model is illegal. People who want or need to use a surrogate are only allowed to compensate for expenses incurred. And, although rules vary from state to state, most places in Australia require proof that a surrogate is needed, not only wanted. 

So Kim and Khloé yes, but Paris, probably not.

Back in LA, there are no such boundaries, unless fertility clinics choose to put them in place. And there are two schools of thought about how appropriate that is. 

On the one hand, reproductive science has made parents out of armies of people who might otherwise never have become parents, never experienced parental love, and never have built families they now couldn’t imagine being without. A selfless act of service, to carry a baby for someone who desperately wants one. The most beautiful gift. 

On the other sits a discomfort with the idea of the rich renting the bodies of the less-rich to do the undoubtedly difficult and often risky business of carrying their children. Avoiding the physical toll of pregnancy for a variety of reasons, and the one that people can't shake a suspicion about is... vanity. 

Vanity surrogacy, or Lifestyle Surrogacy, is a contentious issue to some. 

And it doesn't matter how many times Kim or Khloé talk about why they made the choices they made to build their families, there's a bubbling argument that they – and other celebrities, like Hilton – are normalising surrogacy at scale, and it's not to be celebrated by all. 

For example, Proud Fertility, a surrogacy clinic in Canada, declares its opposition to the process on its "about" page.

"Vanity Surrogacy does away with honour and the sole purpose of being a surrogate. It is when a woman who is medically capable of carrying her own baby refuses to do so for cosmetic reasons such as maintaining their body shape. Vanity Surrogacy can only be described as renting the womb of another woman... It is similar with putting up babies for sale or even breeding animals for the market. A woman who chooses to be a Surrogate Mother should do so from her own willingness to give the gift of family to those who are not able to have it."

While others insist it's not anyone's business why a woman chooses not to carry a child, or why another chooses to carry one for her.

“I don’t have issues with it,” Dr Vicken Sahakian from Pacific Fertility Centre in Los Angeles, told The Guardian. “What’s the end result here? Somebody wants to be a parent. I’m facilitating that."

He says that it's not usually superstars like Kardashian who would use "vanity" surrogacy anyway, but mid-tier actresses and models whose livelihood depends on their bodies, and whose schedules will not allow for breaks to get pregnant and give birth. 

"I understand that it’s controversial, it’s borderline unethical for some people, but put yourself in the shoes of a 26-year-old model who is making her living by modelling swimsuits. Tell me something – is it that unethical, to say let’s not destroy this woman’s career?

“If you’re a 28-year-old model or an actor and you get pregnant, you’re going to lose your job – you will. If you want to use a surrogate, I’ll help you.” 

That's a reality felt by Jamie Chung, an American actress who had twin boys via surrogate in 2021 because she felt she couldn't risk pausing her career. 

"I was terrified of becoming pregnant," she said at the time. "In my industry, it feels like you're easily forgotten if you don't work within the next month of your last job."

For Paris Hilton, her fear wasn't work or money, but birth itself. She has spoken about being assaulted in faux-medical exams as a teenager at boarding school, and said her fear of blood tests and examinations is overwhelming. 

"When I was in The Simple Life," she said. "I had to be in a room when a woman was giving birth and that traumatised me as well. But I want a family so bad, it’s just the physical part of doing it. I’m just so scared… childbirth and death are the two things that scare me more than anything in the world.”

After listening to Kim's advice, Khloé Kardashian did go ahead with surrogacy, and brought her son, Tatum, home in July last year. Just last week, she spoke about how hard it was to go through that process, even with all the concierges in the world.

“A surrogate process – Kim knows – is very hard for me. It’s a mindf**k. It really is the weirdest thing,” she said, on The Kardashians. “People do say it takes a minute to feel connected, but Kim said hers was easy. This is not easy.”

As no choices women make about fertility ever are. However and why ever they make them. 

Image: Getty + Mamamia.