Content Warning: This section of the guide includes discussion of pregnancy loss.

Abby’s inability to conceive naturally drives the plot of The Surrogate Mother. Through the protagonist, McFadden illustrates how infertility can profoundly impact individuals, affecting mental, emotional, and social well-being. The novel demonstrates how involuntary childlessness can lead to feelings of inadequacy, grief, and desperation.

At the beginning of the novel, Abby recounts her chronic disappointment over the years as repeated attempts to conceive a child failed. Her character conveys the all-consuming nature of attempting to get pregnant for those who face biological barriers to conceiving. Abby describes trying a variety of health products and visiting “every infertility forum [she] could find” in her quest to become pregnant (29). She also details her profound disappointment over failed cycles of in vitro fertilization and an early miscarriage. The lengthy process that Abby and Sam undergo to adopt a newborn baby is depicted as equally emotionally draining. The collapse of the adoption just weeks before they anticipated becoming parents leaves Abby frustrated and bereft.

While their childlessness is a source of sorrow for Abby and Sam, the novel also emphasizes how fertility is closely tied to the protagonist’s sense of identity.