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Abstract

In this article, I discuss methodological and ethical dilemmas when recruiting participants with the help of medical and institutional gatekeepers during my ethnographic fieldwork on commercial surrogacy in St Petersburg, Russia. Based on four case studies, I argue for the use of situational ethics. Solid up-front ethics that are approved by institutional advisory boards are important to ensure that the researcher has done their best to identify potential ethical issues prior to data collection and offer deontological safeguards. However, as empirical researchers, we are familiar with the unanticipated that is bound to happen once we commence data collection. In such cases, when the proposed and approved ethical conduct is no longer suited and researchers must make new ethical choices, situational ethics that take the immediate context into consideration are crucial. I further argue that situational ethics must not only be an extension of procedural ethics when the latter are no longer suited but an alternative to procedural ethics in order to make the research empowering, reciprocal and transformative of existing disadvantaging power relations. With this article, I contribute to the growing literature that argues in favour of situational ethics.

Keywords

Feminist ethnography gatekeeper recruitment Russia situational ethics surrogacy surrogate mother

Introduction

In this article, I discuss methodological and ethical dilemmas that I encountered when recruiting participants with the help of medical and institutional gatekeepers during my ethnographic fieldwork on commercial surrogacy in St Petersburg, Russia. In this article, I make a case for the need for situational ethics that consider the particular research context when evaluating the situation ethically, rather than acting according to pre-established guidelines. I base my argument on four case studies.

Gatekeepers are individuals who ‘[stand] between the data collector and a potential respondent. Gatekeepers, by virtue of their personal or work relationship to a respondent, are able to control who has access, and when, to the respondent’ (Keesling, 2008: 299). Participant recruitment via gatekeepers is common in ethnographic research in clinical contexts (Inhorn, 2004; Mattingly, 2005). Often depending on the goodwill of the gatekeepers, participant recruitment via gatekeepers demands deft negotiation skills as well as the researcher’s awareness of power dynamics to guarantee each participant’s fully informed and voluntary given consent. Furthermore, in long-term studies such as ethnographic research, it is crucial for ethically sound research to practice negotiating access to a research field. Taking a participant’s consent should not be seen as a unique, one-time act and from then on unlimited valid circumstance, but as an ongoing process that requires re-negotiations over the time of research (Miller and Bell, 2002: 53). As researchers who recruit participants via gatekeepers, we need to repeatedly assess who does and who should have authority to grant or restrict the researcher’s access to potential participants (Inhorn, 2004) and when authority becomes illegitimate or even abusive.

Research into surrogacy arrangements is one example of research that requires negotiations with gatekeepers for access. Surrogacy arrangements harbour multiple asymmetrical power relationships between the diverse involved actors: the surrogacy workers,¹ their client parents, medical staff and agency staff. As ethnographers, we spend extended time ‘in the field’ and establish our own relationships within these existing relationships. Enmeshed in asymmetrical power relations, it is crucial to make ethical choices that guarantee all participants’ well-being. For researchers who are inspired by a feminist standpoint epistemology to be transparent about research steps, empower research participants and challenge existing power relationships (Brooks and Hesse-Biber, 2007: 4), additional challenges arise when we try to abide by these choices within asymmetrical power relations.

The literature shows a growing critique of standard ethics (Goodwin et al., 2003; Guillemin and Gillam, 2004; McAreavey and Das, 2013; Schrag, 2011; Williams, 2005 Munteanu et al., 2015) as well as a growing acceptance of situational ethics in ethnographic research (Flyvbjerg, 2001; Goodwin et al., 2003; Munteanu et al., 2015). This article argues for situational ethics.

What kinds of ethics do we follow?

Most universities, funding bodies and research host organisations require empirical researchers to seek ethical approval before commencing their research to assure prevention of harm. However, many problems or potential conflicts are difficult to define in advance as they can develop spontaneously, unexpectedly or in situations where the ethnographer has little control (Goodwin et al., 2003: 567). The definition of ethical issues and of adequate conduct can also be at the discretion of the reviewer (Carnevale et al., 2008: 26) and varies across cultures or national institutions (Williams, 2005). In preparing my ethical approval application, I mainly referred to the British Sociological Association Statement of Ethical Practice (2002) and the Code of Ethics of the American Anthropological Association (AAA; 2009). In St Petersburg, however, none of the medical sites that I recruited for my ethnographic fieldwork required me to seek ethical approval. Neither did senior doctors or medical gatekeepers want to know that I had ethical approval from my home institution.

As Goodwin et al. (2003) have noted, ‘there seems to be an acknowledgement amongst ethnographers that [unforeseen, spontaneous] dilemmas […] are an accepted, almost obligatory feature of fieldwork’ (p. 567). While it is mandatory that researchers do their utmost to identify potential ethical issues prior to data collection and develop strategies to put in action to overcome these issues, this acknowledgement actually needs to be given room already in the application for ethical approval (McAreavey and Das, 2013).

Researchers need to be aware of the necessity and reality of situational ethics during research in addition to the procedural ethics of the a priori formal ethical review (Guillemin and Gillam, 2004; Munteanu et al., 2015). Situational ethics were pioneered by Fletcher (1966: 26) and take the particular context of the research site and situation into account when evaluating the situation ethically rather than acting according to pre-established guidelines. Likewise, members of the ethical review committee need to allow for situational ethics that are deliberated within the process of research and make room for the latter in the ethical review process to forestall researchers resorting to telling committees only what fits within standardised procedures, or in other words, what they want to hear (Tolich and Fitzgerald, 2006: 73). Allowing room for the unexpected is an opportunity for empirical researchers to better prepare for the unexpected. They need to acknowledge their limits in preparing for the unpredictability of empirical research and therefore prepare to be flexible, spontaneous, context-aware and situational rather withhold [such scenarios] from the research proposal and encounter them unprepared.

In the following, I first introduce my research methodology of conducting feminist research, my research field and the original plan of participant recruitment via gatekeepers. Next, I present my four case studies of recruiting research participants via gatekeepers. For each case, I present the ethical dilemma, my evaluation of the situation and consequent actions. Finally, I conclude by arguing for the need of situational ethics.

Feminist ethnography on commercial surrogacy: the research methodology, the research field and ‘plan A’ for participant recruitment via gatekeepers

This article emerges from my doctoral research, for which I conducted a feminist ethnography on the social organisation and cultural framing of surrogacy in St Petersburg, Russia, from August 2014 until May 2015. My core research population included 33 surrogacy workers (between the age of 19 and 37 years), seven client parents, nine agency staff members from eight different agencies and 11 medical staff. A feminist approach to ethnography meant first taking gender relations as the starting point for my analysis of the power dynamics and inequities in the practice of surrogacy in Russia, and second, looking at how gender intersected with class, ethnicity, geographic origin and actors’ residence during surrogacy arrangements (Weis, 2017). I chose to put surrogacy workers’ voices at the forefront. That means, where participants’ testimonies conflicted or more powerful participants, such as agency staff, sought to silence surrogacy workers, I chose to empower the surrogacy workers and their voices over those of other participants. Taking into consideration that every truth is subjective, I took the accounts of surrogacy workers at face value and foregrounded their experiences/accounts in my analysis.

Surrogacy in Russia is practised on a commercial basis, which means that surrogacy workers receive financial compensation for their gestational service after the birth of a healthy child. Private fertility clinics have offered surrogacy arrangements since the 1990s under minimal legal requirements. Like in the United States (Jacobson, 2016; Smietana, 2017), there are two main arrangement options for clients to enter a commercial surrogacy agreement. One is employing a commercial surrogacy agency that undertakes the selection of suitable surrogacy workers and all necessary communication and steps with clinics and lawyers from the planning stage until completion of the surrogacy arrangement. The other option is the so-called direct arrangement, whereby client parents and surrogacy workers search for each other independently, customise their own contracts and organise the arrangement from fertilisation to finalising the surrogacy-born child’s documents after delivery.

Commercial surrogacy in Russia is highly stratified and structured by class and gender inequalities. All surrogacy workers in my study lived on a significantly smaller income and had less employment options than their client parents. They did not have access to the same level of reproductive care when pregnant with their own children, let alone the economic capacity to seek assisted reproductive technologies and treatment had they needed it. Many surrogacy workers were aware of surrogacy work’s toll on their bodies, yet accepted the risks of the hormonal treatment, a multiple pregnancy, miscarriage, Caesarean section, if clients demanded this, and possibly even infertility for lack of more lucrative alternative employment (Weis, 2015). In fact, in Russia, surrogacy is culturally framed as an economic exchange between two contracting partners, the surrogacy worker and the client parents, rather than a ‘labour of love’ or a ‘gift of life’ as in, for instance, the United States and Israel (Jacobson, 2016; Ragone, 1994; Teman, 2010). The consensus among surrogacy workers, client parents and agency staff to frame surrogacy as a work prompted surrogacy workers to consider themselves ‘employees’ and (reproductive) service providers, and to compromise with the inherent power inequalities in order to make sure they satisfied their ‘employers’ and earned full wages (Weis, 2015, 2017).

In 2013, a survey by the Russian Public Opinion Research Centre (WCIOM, 2013) found that 51% of respondents identified with the opinion that ‘surrogate mothers are doing something necessary and useful’. Nevertheless, only 16% of respondents regarded surrogacy as completely acceptable, whereas 26% of respondents rated surrogacy as ‘morally intolerable’. Analysing Russian print media, sociologist Nartova (2009) concluded that the widespread message was that ‘the only legitimate, normal and morally approved uses of surrogate motherhood […] are those related to overcoming infertility’ and to serve heterosexual married couples (p. 79). In addition, conservative and religious voices detest surrogacy (Kirpichenko, 2017) and are frequently featured in the media. Consequently, most of the surrogacy workers and client parents I met in St Petersburg preferred nondisclosure of their surrogacy-related activities. Surrogacy workers, although personally convinced that surrogacy gestation for a financial compensation is a morally right act, preferred discretion, fearing judgement by others and negative consequences for their own children. Russian client parents also preferred nondisclosure of their impaired fertility and feared discrimination of their surrogacy-born children. The majority of my research participants were not interested in meeting their peers for mutual support or exchange of experience, unless in the anonymous online sphere, hence there were no social surrogacy happenings as are common in the United States (Smietana, 2017) and in the United Kingdom. That meant that my access to the research population for recruitment was limited, strongly depending on the support of gatekeepers, and therefore potentially very challenging. Gatekeepers in the context of surrogacy in Russia were primarily agency staff and medical staff in private fertility clinics, as they worked with surrogacy workers and client parents daily.

However, also those in charge of surrogacy agencies and surrogacy-facilitating private fertility clinics preferred to remain un-investigated. Occasionally, doctors and agency managers offered interviews on behalf of their staff, or even their surrogacy workers and client parents, as Dr Alexey’s² response to my request to interview surrogacy workers and client parents illustrates. ‘It is not necessary to talk to them – ask me, and I will answer in their place. […] I will answer like they would answer’. Such a suggestion was presented to me as a gesture of goodwill to save my time or derived from an alleged commitment to client anonymity. However, it could also be interpreted as a desire to keep my ‘ethnographic penetration’ (Inhorn, 2004: 2096) at bay to maintain the control over what I should know about the social organisation of surrogacy and their own practice. Surrogacy agencies were even more reluctant to open their doors to critical investigation by a third party. Therefore, only three out of 13 agency managers I approached approved of my research and tentatively agreed to assist recruitment, and two of these agencies subsequently dropped out.

With those doctors who agreed to support my research and act as gatekeepers, the following protocol, which was approved by the ethical committee of De Montfort University, was implemented.

The doctor would inform me about appointments with surrogacy workers or client parents for the coming week. I would arrive at the clinic, notify the doctor and wait in the waiting area.

Prior to or after the appointment, doctors approached surrogacy workers or client parents on my behalf to inform them verbally about the study and request their participation.

Interested surrogacy workers or client parents who gave their permission were introduced to me on clinic premises by a member of staff and given a participant information sheet.

If a surrogacy worker or client parent/s declined to participate, I was informed and would leave the premises and their anonymity was maintained.

If they agreed to participate in the study upon reading the information sheet and asking additional questions, if desired, I documented their consent.

For recruitment via agencies, agency owners followed a similar protocol. They approached surrogacy workers on my behalf to inform them verbally about the study and invite them to participate. Interested surrogacy workers or client parents who gave their permission were then introduced to me by a member of staff.

Wearing out my welcome? Negotiating authority and access when recruiting participants through institutional gatekeepers

In this section, I present four cases where I negotiated access and authority with medical professionals and agency directors who acted as gatekeepers to recruit surrogacy workers and client parents. To remind, gatekeepers facilitate access as they stand between the researcher and a potential participant. Gatekeeper, however, equally can assume the power to control and sanction access. I describe the scenarios and their emerging ethical dilemmas, my reflections and considerations of how to conduct myself ethically and discuss consequences of my decisions and actions.

Case 1: Dr Andrey and the participant introduction in surgery recovery room

Dr Andrey was an embryologist and senior doctor at New Life Fertility Clinic who highly endorsed my research. Despite his busy schedule as one of Russia’s most renowned embryologists, he agreed to act as my gatekeeper. In our first meeting, we agreed on the above outlined recruitment protocol. Furthermore, we agreed that at the beginning of the week, I would remind him to check his weekly schedule for surrogacy-related appointments and inform me thereof. On the day of the appointment, I arrived at the clinic, notified the receptionist and waited for Dr Andrey or a nurse to come accompanied by a surrogacy worker who had agreed to meet me. If this happened, I invited the surrogacy worker to join me to sit in a more secluded waiting area upstairs to talk through the implications of research participation. If nobody came within an hour, I knew that the potential participant had declined participation and I left. Such an approach was time-consuming and emotionally draining. In approximately half of the visits to Dr Andrey’s clinic, I left without having met a potential participant.

Three months into my PhD fieldwork, Dr Andrey picked me up from the waiting area instead of accompanying a surrogacy worker to meet me. Without explanation he led me to the ‘recovery room’. The ‘recovery room’ is also the preparation room where women un/dress before/after their egg retrieval or embryo transfer. It has no windows and features two beds, each with a bedside table with magazines and tissues. He opened the door without knocking to a young woman in a blue-transparent hospital gown, who was sitting at the edge of one of the beds with her underwear still in her hands. Then Dr Andrey left me standing by the door, with the surprised woman, who we had interrupted in getting dressed, enquiringly looking at me. Not knowing what would have been a better response to the situation, I entered quickly and closed the door behind me to no longer expose her to the corridor.

In a literal sense, Dr Andrey had followed the agreed recruitment protocol. His move of ‘introducing’ me to a surrogacy worker in the ‘safe space’ of the privacy of the ‘recovery room’ might have been well intended, but inappropriate nevertheless. It could also have been an act of carelessness. In either case, wordlessly and unannounced ushering a stranger into the recovery room was unethical and put me as well in an ethically dubious position. More questions raced through my head as I wondered how to address the woman. Had she been informed about my research? Had she given her informed consent to meet me? What had she given her consent to – to speak me in my capacity as a researcher? To speak about her involvement in surrogacy? Had she given her consent to be introduced to me while literally naked? The answer was that she had been told that there was a woman who wanted to talk to her about surrogacy, but not that I conducted research, and she did not expect that I would show up in the next minute, before she even had the chance to get dressed after just having had her embryo transfer. After I asked for her permission to stay, I introduced myself, explained my research and aims and gave her an information sheet. We agreed to meet the following week, to give her time to consider her participation, which she did. She did not come for the interview.

I tried to clarify with Dr Andrey before the next recruitment opportunity that such an approach was inappropriate. Unfortunately, time constraints on his side made it impossible, so the next occasion I saw Dr Andrey was again for a recruitment opportunity. As recruitment opportunities were rare, and as I hoped the previous scene to be a one-off occasion, I followed his next notification of a surrogacy appointment and opportunity for recruitment. On that day, a nurse fetched me from the waiting room instead of him, and I only saw him in his surgery gown and mask in passing, nodding to me and towards the same room. Most likely he was just coming from the embryo transfer and was heading for the next. To my dismay, the previous scene repeated, only this time the nurse opened the door to the recovery room. Once again, the woman was barely informed, but upon receiving my information sheet and chatting about my research until the agency’s driver arrived, she agreed to participate. The following week I visited her at her home for the first of a series of interviews.

Nevertheless, at this point, it was clear to me that I could not allow this mode of recruitment to become the established pattern. It would have been practical and complying with the needs of my gatekeeper, but it was unethical to me. Finally, I succeeded in talking to Dr Andrey. Careful not to affront him, as I did not want to risk upsetting an important gatekeeper and losing access, I expressed my concern that his approach in the previous two occasions could have been overwhelming for women and that the women needed to be better informed about my research agenda and identity as a researcher. Dr Andrey did not agree with my concerns, as both women had agreed to be introduced to me. In his opinion, they could just have declined. Not a native Russian speaker, I struggled to convey my concerns about how the gender dynamics and power hierarchies of an older, male senior doctor, renowned for his medical expertise on IVF (in vitro fertilisation), interplayed and could make young women, often from rural areas and doing surrogacy for financial reasons, feel obliged to ‘consent’ to not risk their participation in the surrogacy programme. Instead, I had to be content with asking him to not introduce me to surrogacy workers in the ‘recovery room’, but as before, in the common waiting room. That meant potentially losing out on chances of recruitment, but it was more important to me to prioritise my moral and ethical principles of not putting pressure on the surrogacy workers, not embarrass them or make them feel uncomfortable at refusing participation.

On the following two recruitment occasions, I was introduced to the surrogacy workers in the waiting room again. However, the women still had not been adequately informed that I was undertaking research. By then I had enough of this ethical dilemma of women not knowing what they are actually consenting to when consenting to do what Dr Andrey asked them to. I did not wish to continue this avenue of recruitment. Likewise, I did not want to discuss the procedure with Dr Andrey further. I did not want to appear too demanding and wear out my welcome to access the clinic premises for working with the surrogacy workers and client parents I had already recruited. I solved the situation by quietly retreating and no longer sending him the weekly reminders to check his schedule for surrogacy appointments and our exchange abated. Thus, I receded from gatekeeper recruitment in the busiest and therefore most potentially promising recruitment site for the sake of my potential participants’ well-being. Dr Andrey could have been the perfect gatekeeper, yet I preferred to not benefit from his authority at the expense of participants’ fully informed and voluntary consent. It is the strength of the situational ethics approach to consider the particular context of the recruitment scenario when evaluating it ethically. As described above, it had become obvious to me that as a feminist researcher, I had to pay the price of missing out on recruitment opportunities to conduct myself ethically.

Case 2: agency manager Alexander and his employment offer to collect data on surrogacy workers even without their consent

Alexander was one of the agency managers who initially agreed to act as a gatekeeper to surrogacy workers and client parents. However, for weeks thereafter, he did not come forward with any potential participants. Upon reminders and enquiries whether he had been successful in approaching his surrogacy workers, his responses alternated between excuses like ‘you know yourself that surrogacy is a delicate topic and the women don’t like to talk about it’ or ‘it is a very private project, the clients [= the client parents] are VIP’. On one occasion, he offered the opportunity for me to meet client parents at the initial screening interview if in return, I recruited a potential surrogacy worker for him.

Four months into my fieldwork, he surprised me with the offer to join his agency in the capacity of an international coordinator, responsible for communication with international client parents and supervision of their surrogacy workers. I followed his invitation to meet for a ‘business dinner’ to discuss this further – not because I intended to follow up his proposal but to get insights into the way he runs his agency. At this meeting, Alexander remained cautious to not reveal too many details and avoided many of my questions. He discarded my concern that I was not in possession of a Russian work permit and work visa with ‘leave it to me’ and explained that he would be making ‘my job’ partly official and partly not, which meant, he would pay me a cash sum every month. Finally, he emphasised that his offer included the permission to use insights gained as a result of this role for my research and that my ‘employee’ status would provide me with the authority to obtain information about the surrogacy workers and make inquiries without seeking their consent. In his words, his offer was ‘the work you have asked us for! You could ask anything you want and even earn money for it! Pleasantly-useful [priyatno-polezno] – that’s what we call it in Russian!’ Then he laughed, and so did I. Yet, while his laughter arose from self-satisfaction, mine was a play-act of complicity for him as much as a coping mechanism with my discomfort and exasperation over such work ethos. Since I would never consider ‘buying access’ or gaining data without consent, I turned down the offer and ceased my request for his assistance with recruitment.

While it was an easy decision to give up this recruitment opportunity, because such employment role would have been a clear transgression of my researcher role and in opposition to all my research ethics, it was difficult to decide when was the right moment to withdraw. In their previous interviews, Alexander and his colleague presented their agency work and conduct with their surrogacy workers as proper and faultless. As they did not give me the opportunity to get their version confirmed or questioned by one of their surrogacy workers, I decided to negotiate access to complementary information via this job offer. By following the invitation to hear more about it, I could understand more about the legal grey areas that this and likely other surrogacy agencies operate in. This also increased by awareness of the need to pay attention to the interactions between agency staff and surrogacy workers. Despite turning down the employment offer, I was able to continue research with the agency management in return for sharing with them recent publications on surrogacy arrangements and news on specifically surrogacy-related developments in Germany, my country of origin. As Germany prohibits surrogacy in all forms, Alexander had a specific interest in advertising his agency in German fertility clinics.

Case 3: agency ‘Happy Baby’ and the research ban after 9 months of research

Agency ‘Happy Baby’, one of the largest surrogacy agencies in St Petersburg, granted me permission to conduct research with their surrogacy workers, client parents and staff members in my first research month under the condition that the people in question agreed. Yet, despite their research permission, agency staff made no effort to support me in recruitment. For instance, Dr Andrey once accidently called me in too late for an appointment with a surrogacy worker and I subsequently missed being introduced to a surrogacy worker who agreed participation in my research. This surrogacy worker was working for ‘Happy Baby’, so Dr Andrey notified the agency of the surrogacy worker’s consent to meet me and asked me to liaise with the agency to rearrange a meeting. When I called the agency, I was told that they were not aware of this circumstance.

Over time, a certain feeling arose that the agency’s initial welcome was wearing out. While the agency staff did not overtly express resentment towards my research, then began to not respond to phone calls or to greet me when I visited the clinic. The surrogacy workers, on the contrary, endorsed my research. They even explicitly stated that they took pride in contributing to knowledge and enjoyed my company at their gynaecological check-ups. In St Petersburg, surrogacy agencies and private fertility clinics are separate entities, but all fertility clinics and agencies had preferred partners for collaboration, such as ‘Happy Baby’ and the clinic where Dr Andrey worked. To not jeopardise my access as well as to spare myself the unpleasant emotions such non/encounters provoked, I withdrew from agency employers’ sight but continued meeting participants for interviews and observations at other locations. When possible, I met surrogacy workers working for ‘Happy Baby’ in other locations.

It was in spring, in the last weeks of my fieldwork, when surrogacy worker Olesya invited me for one of her routine check-ups, that it became very clear that my welcome had worn out. At the time, Olesya was in the fourth month of her second surrogacy pregnancy. She had been a research participant since the beginning. In the early autumn of the previous year, she had a successful embryo transfer for her first client mother Evgenya, who also became a research participant. Both women agreed for me to join their gynaecological appointments, until Olesya suffered a miscarriage in the second month. After a necessary curettage and recovery period, the agency matched her with new client parents and Olesya, on the same day she was told the date for her next embryo transfer, invited me to join the appointment. Olesya’s second client parents preferred to remain anonymous and neither meet nor communicate with Olesya via the agency. Disappointed by her client parents’ lack of interest in her beyond her physical well-being and pregnancy progress, Olesya appreciated sharing her surrogacy journey with me.

At one routine check-up appointment at a gynaecological unit affiliated with ‘Happy Baby’, I was delayed due to traffic problems. I notified Olesya that I would be 10 minutes late and she asked the gynaecologist on duty, who was new at the practice, to wait for me. While the usual two gynaecologists were aware of my research and used to my presence, the new colleague called the agency to check if she should wait and let me partake. She was then told that nobody else was to be given access. Next Valerya, one of the agency employees called Olesya to forbid her to continue allowing my presence. Olesya was upset. She had only intended the best for me (not to miss the appointment) and as a result, had severed my access. She was also upset that the agency took the authority to dictate who she associated with, especially since not knowing the client parents, she could not infringe any confidentiality on their behalf.³ Furthermore, she did not like the way Valerya ‘flipped out on me’ and accused her of misbehaviour.

After we left the gynaecologic practise together, Olesya asked me to call Valerya. ‘Why is she against it, and even prohibits it, if the director [Malvina] has given you permission and I myself permit you to come along with me?’ she asked as I dialled. This time, Valerya answered my call and immediately accused me of having deceived Olesya and obtained her permission on pretence of being a medical doctor. She spoke loud enough for Olseya to overhear her. Olseya then asked for the phone to clarify that she was fully informed and aware that Valerya’s manager Malvina had given me permission to research. Valerya denied. It was obvious that my research access was beyond recovery. It is likely that my research access would have been severed earlier if I had followed the recommended good practise of re-negotiating access to a research field in ethnographic research (Miller and Bell, 2002: 53). In apprehension of that and with the feminist agenda of wanting to know the surrogacy workers’ views, I chose to neglect re-negotiating access to continue research with those participants affiliated with ‘Happy Baby’.

After this outcome, Olesya offered to give me a final interview before my departure. However, the next day she texted me ‘I was forbidden to tell anything any more about the pregnancy … ’ Consequentially, we agreed to terminate our research collaboration, since Olesya was at risk of being fined as agencies in St Petersburg commonly do to discipline and intimidate their surrogacy workers. This example shows the extent to which gatekeepers can impact on professional and personal ties, as well as the extent to which they can impact the research population that we seek to reach through them – or without them. By deliberately not re-negotiating the agency’s consent to my research with affiliated surrogacy workers and client parents, I am aware that I infringed upon the good practice of re-confirming each participants’ informed consent. However, evaluating the situational context, I expected the attempt for re-negotiation to end with no more research access. Furthermore, I gauged that continuing research with the surrogacy would not only benefit me but them. As surrogacy remains controversial, the majority of surrogacy workers and client parents kept their involvement secret. Talking to me gave them support and emotional release, and the surrogacy workers in particular enjoyed being involved in a research project.

Case 4: surrogacy worker Gabriela’s defiance of her agency’s research ban

I found Gabriela’s advertisement of offering her surrogacy gestation service on an online platform and contacted her with the request to participate in my research. After a few email exchanges and clarifications, Gabriela agreed. At that time, her factory job tired her and allowed her very limited free time. Therefore, our initial research collaboration was limited to email conversation and phone calls. At the time of our acquaintance, she had already been in St Petersburg for a year. She had come from Moldova specifically for surrogacy, and after a lengthy and careful online search, found her first client parents from Murmansk, the Russia’s arctic port at the Barents Sea. Due to an error by the embryologist, the embryo transfer cancelled. As the client mother struggled to produce eggs, the next egg retrieval and embryo transfer was subsequently postponed for an indefinite period of time. Gabriela did not have indefinite time. She missed her children in Moldova and was searching for new client parents. From Gabriela, I also learned about the agency ‘Conceive’ who I then contacted. The first encounter in their office was friendly and informative, but without her manager present, the representative promised to call me back. I consciously waited for a call back for 2 weeks, but busy with other research opportunities and participants, I then forgot about ‘Conceive’.

Two months later, Gabriela reminded me about ‘Conceive’ when she told me in a face-to-face interview that she had changed her strategy from looking for a direct arrangement to signing up with ‘Conceive’. She had taken the decision because she was under time pressure and felt that her chances were higher with an agency. She was therefore willing to sacrifice having a choice of who her client parents would be. I then also called back to ‘Conceive’ to see whether I would be able to get them on board with my research – independently from researching already with Gabriela, and of course, without mentioning her research participation.

In my first phone call with the agency manager Tanya, she expressed her reluctance to act as a gatekeeper. ‘Understand!’ she said. ‘[The surrogate mothers] hide it, even from their families. Even if you will hide their names and all, I hardly believe they will talk to you’. Nevertheless, Tanya agreed to consider my request and asked me to call again. When I called again a couple of days later, Tanya acted in an annoyed manner and pronouncing every word carefully and slowly as if assuming I was slow on the uptake, she said, ‘as I have already told you and will now repeat: none of my surmamas will talk to you and it wouldn’t even make sense to ask them’. Then she stated clearly that she prohibited me from researching with ‘her’ surrogacy workers.

Now I was in the situation that ‘Conceive’ refused to participate in my research, but Gabriela, who I had recruited independently and who had signed up with ‘Conceive’ in the meantime, wanted to participate in my research. What was the best, and more importantly, the right thing to do?

In my ethical approval, I outlined that I would only conduct research if all participants gave their voluntary and informed consent. ‘Conceive’ manager Tanya had clearly withdrawn her consent and furthermore extended her sanction onto all surrogacy workers affiliated with her agency. Taking a deontological approach to my ethical approval would have meant that I would have been morally obliged to follow through with my initial intentions and step back from conducting research with Gabriela.

After thorough deliberation of the situation and discussing the developments with Gabriela, Gabriela not only agreed to continue but insisted on it. Her position was motivated by further developments on her side. She had been financially discriminated against by the agency because of her migrant status and poorly treated by staff members. Consequently, Gabriela felt strongly about reporting the agency’s misconduct and not being silenced. I made the decision to continue my research relationship with Gabriela, but made sure that Gabriela was aware of the risks involved for her. Unlike in Olesya’s case, Gabriela’s agency did not know about our ongoing research collaboration, and I undertook additional measures, such as changing her country of origin, number of children and relationship status, to protect her anonymity. I felt that empowering surrogacy workers to break with the perpetuation of inequities and ‘to deconstruct and undermine knowledge structures’ (Miller and Bell, 2002: 53), while making sure that Gabriela’s collaboration stayed confidential and ‘Conceive’s’ anonymity stayed protected was the most ethical choice to take.

Summary of cases and decisions

To summarise, in case 1 and case 2, institutional gatekeepers displayed unexpected, unethical behaviour that may have increased my recruitment success, but unacceptably at the expenses of surrogacy workers’ informed and voluntary consent, and autonomy. Dr Andrey and Alexander acted unethical and disrespectful in their role as gatekeepers. Alexander even was aware of the ambiguous character of his employment offer and the power abuse he offered within. In both cases, I chose to cede recruitment requests from these gatekeepers and devised a plan of how to do so without affronting the gatekeepers.

Prior to commencing fieldwork in St Petersburg, I expected the owners of surrogacy agencies and private fertility clinics to dominate the power hierarchy. By approaching them for access to my research field and requesting gatekeeping, I was liaising with them – or in other words, entering the hierarchical structures that permeate surrogacy arrangements in their ranks. Approaching them to act as my gatekeepers however was inevitable for three reasons. First, I needed their permission to access their premises overtly. In most premises, unauthorised visitors would not have passed the security guards and conducting covert research by pretending to be a surrogacy worker or client was out of question. Second, by asking managers and senior doctors for assistance with recruitment, I was following the necessary etiquette by paying respect to their position and acknowledging their authority. Third, I equally wanted their voices in interviews to juxtapose the stories and understand the dynamics of the surrogacy scene in St Petersburg from representatives of all involved groups. Furthermore, I expected medical professionals to abide by higher ethical standards and respect for patients and did not foresee the dilemmas I encountered.

In case 3 and case 4 in turn, I circumvented and overrode agencies’ authority to challenge these very power structures and agencies’ monopoly in the construction of knowledge of how surrogacy arrangements look like by voicing the experiences and opinions of the surrogacy workers themselves. This decision was inspired by my feminist research epistemology. Estroff’s (1995: 78) justly provocative question, ‘Whose story is it anyway?’ in the context of researching chronic illness likewise applies to my research context, and my answer was and is as follows: In a research on the experiences of surrogacy workers, it is the surrogacy workers’ story. It is their stories of their reproductive labour, their choices, their experiences, their feelings, their pains and sacrifices, and the treatment they receive that I set out to explore and that committed to tell when I asked them to collaborate in my research.

All four examples demonstrate the need for situational ethics and their appropriateness. In case 1, Dr Andrey’s following procedural ethics was not ‘wrong’, but evaluating the ‘microethics’ (Guillemin and Gillam, 2004: 265) at stake, his conduct was wrong to me and as the researcher in action and with responsibility for the well-being of all my research participants, I had to make sure to be true to my conception of what ethically sound research was. In case 2, Alexander’s employment offer was a conflict of interest and accepting it would have been a breach of researcher impartiality and an ethical misconduct towards the surrogacy workers by violating their right to privacy. Made aware of the murky elements of his business model and being tantalised, but in the end not given ethically sound access to recruit surrogacy workers, temporarily negotiating over the employment offer gave me further insights into the functioning of his agency without impairing the surrogacy workers.

In case 3, even though I was aware that it is good practise of longitudinal research to reassess and reconfirm participants’ consent (Miller and Bell, 2002: 53), in the case of researching with surrogacy workers and client parents associated with the agency ‘Happy Baby’, I had a strong hunch that re-assessing the agency’s consent would have come close to a self-censorship that would not have benefitted the surrogacy workers but served the agency to maintain operating without scrutiny. I therefore exhausted their initial agreement to research until it had worn out.

Finally, in case 4, agency ‘Conceive’ was not the original gatekeeper that mediated access to surrogacy worker Gabriela but later moved to the position where interest conflicted. Evaluating the situation, and more importantly, in collaboration with Gabriela, I concluded it to be more ethical towards Gabriela and in line with my feminist approach to research to continue research even though my pre-approved ethics demanded having consent from all participants involved. Both in case 3 and 4, I kept Sluka’s (2012) rhetoric question in mind: ‘Do we need the consent of repressive authorities in order to do research with those oppressed by them?’ (p. 302) When conducting a feminist-inspired ethnography, my answer is no. Yet in doing so, I was careful to fully protect all participants’ anonymity and confidentiality.

Conclusions

In this article, I have addressed ethical dilemmas around negotiating access and authority when conducting ethnographic research with institutional gatekeepers in the context of surrogacy arrangements. By means of these examples, taken from my feminist ethnographic study on commercial surrogacy in Russia, I have argued for the need of situational ethics. Situational ethics can be unpredictable (Munteanu et al., 2015: 106). They take account of social, political and historical contexts and ‘[require] consideration of who gains and who loses from particular phenomena and how these losses manifest’ (McAreavey and Das, 2013: 114). While solid up-front ethics are important to ensure that the researcher has done their best to identify potential ethical issues prior to data collection and thought of strategies to put in action to overcome these issues, and thus offer deontological safeguards, empirical researchers, and ethnographers particularly, are familiar with the unanticipated that is bound to happen and that is often beyond control of the researcher. In such cases, when the proposed and committee-approved ethical conduct is no longer suited and researchers in situ must make new ethical choices, situational ethics that take the immediate context into consideration are crucial. My examples from researching with surrogacy workers in St Petersburg have further shown that situational ethics must be an extension of procedural ethics when the latter are no longer suited, in order to make the research empowering, reciprocal and transformative of existing disadvantaging power relations. Finally, I have shown that the process of negotiating access, even if unsuccessful in the sense of getting access, is not a sign or result of the researcher’s personal failure. Instead, it is a source of data about power relationships and (micro-)politics in the research field. With this article, I contribute to the growing literature that argues in favour of situational ethics.

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship and/or publication of this article.

Notes

Author biography

Christina Weis is a Research Fellow at the Centre for Reproduction Research at De Montfort University. Her PhD explored the social organization and cultural framings of commercial gestational surrogacy in Russia. She continues to research surrogacy in Russia and the former Soviet states, and also works on egg donation in Europe and menstrual health.

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