Thinking about surrogacy? Do your research

For anyone contemplating surrogacy, thorough planning, thought and research is vital. Sam Everingham from Families Through Surrogacy discusses the current options.

Altruistic surrogacy

Countries such as the UK, Australia, South Africa and some US and Canadian jurisdictions have legislated to allow DIY altruistic surrogacy arrangements for decades now. However, few safeguards have been implemented. A hundred ‘what-ifs’ swirl when you add IVF processes, egg donors, high emotions, fertile ‘carriers’ and childless singles and couples to the melting pot of this modern family type.

Those engaging in altruistic surrogacy tend not to have access to agencies, which charge to recruit and screen surrogates. Instead, intended parents and surrogates must self-screen each other. ‘Friendship-based’ surrogacy arrangements are promoted by the non-profit Surrogacy UK. While it’s a terrific foundation, it does not suit those who lack confidence engaging with a surrogate directly on such intimate issues. There is no doubt that. locating someone to carry yourself can be incredibly daunting and for some, almost impossible.

Others baulk at altruistic surrogacy given the lack of legal certainty and the ban on compensating surrogates for their labour. There are increasing calls for more psychological screening and support of all parties, to assist in managing what can be a delicate relationship. Finding a surrogate at home is clearly not a solution for everyone. Many countries, including Ireland and much of Mediterranean Europe, simply have no access to altruistic surrogacy.

Compensated surrogacy

Many intended parents are more comfortable compensating a surrogate for her labour. Certain US states, lead by California (but now including Nevada, Oregon and Minnesota) were the early, reliable destinations and have remained a stalwart of best practice. However, for many, this means travelling outside their own country to create a family.

India rapidly overtook the US for a short while as the global hub of compensated surrogacy – offering far more affordable arrangements supported by good medical care. For a time the industry was worth over £275 million to the Indian economy. Thailand, Mexico and Nepal followed, though all came with other downsides – no surrogacy laws or laws that were abused, leaving both surrogates, intended parents and infants vulnerable if government policy changed or one party changed their mind.

With the recent closure of compensated surrogacy in Thailand, India & Nepal to foreigners, Ukraine, Canada and Georgia have become popular alternatives for those who cannot afford the USA. The introduction of ‘Obamacare’ healthcare reforms in the US has had some positive implications for the costs intended parents once needed to worry about post-birth. Ukraine has offered surrogacy since 2000, and the decimation of its once large adoption program pushed a number of adoption agencies to turn to surrogacy. In Canada, surrogacy is legal for foreigners in some provinces and like the UK, there is a strong culture of surrogacy.

Status of surrogacy by country

Country Legal Status Eligibility
US legal protection in some states
Canada legal protection in some provinces
Ukraine legal protection heterosexual only
Georgia legal protection heterosexual only
Greece legal protection heterosexual only
Russia Some legal protection heterosexual only
South Africa legal protection Must be resident
UK Legally sanctioned but contracts not enforceable Must be domiciled in UK for 2+ yrs
Australia Legally sanctioned but contracts not enforceable Must be resident
Israel legal protection Must be resident, heterosexual only
Mexico No legal protection
Cambodia No legal protection
Poland No legal protection
Kenya No legal protection
Cyprus No legal protection
India Closed to foreigners in 2015
Thailand Closed to foreigners in 2014
Nepal Closed in 2015


 How can surrogates give up a baby they have carried?

Prenatal attachment is influenced by factors such as maternal age and attitude towards the pregnancy. These help explain a properly screened surrogate’s ability to relinquish a baby after delivery. Surrogate mothers tend to be in their late twenties or older, and most believe they have completed their own family. Research has found that surrogate mothers are less attached to the fetus and less attached to the baby following delivery than are women who give birth naturally.

Are the commissioning parents the legal parents?

This is a complicated issue and depends on where the surrogacy takes place and whether Family Law within the commissioning parents’ home country recognises surrogacy which takes place within or outside its borders. Some countries allow a transfer of legal parentage from the surrogate to the commissioning parents post birth, where altruistic surrogacy was used. Some allow it where cross-border arrangements were utilised.

 Isn’t surrogacy exploiting fertile women?

Research with surrogates in the US, UK and India shows few report feeling exploited and many involve their own family in the surrogate process. Many argue that asking a woman to carry altruistically (uncompensated) poses a greater risk of exploitation of her own goodwill.

What about telling your child where they came from?

Surrogates in western countries expect commissioning parents to be open about their child’s origins, as they tell their own children about the surrogate baby being part of the intended couple’s family—not their own.

What post-birth contact do surrogates expect?

This varies greatly from culture to culture and from woman to woman. In western countries, many surrogates expect some contact to continue following relinquishment of the baby. Surrogates in countries far removed from the commissioning parents tend to have no or little expectation of post-birth contact. In India and Ukraine for instance, the newborn is separated from the surrogate directly following birth.

Does surrogacy involve the surrogate using her own eggs?

Where surrogates use their own eggs, this is called ‘straight’ or traditional surrogacy. In some cultures, it has been occurring for thousands of years. Where the intended mother’s eggs, or donor eggs are used, this is called gestational or genetic surrogacy. Some jurisdictions recognize only gestational surrogacy, some forbid both and others recognize both. In the UK it is estimated that approximately 50% of arrangements involve surrogates who volunteer not just their womb but their eggs.

What are the psychological outcomes for children born via surrogacy?

The first study worldwide to investigate parenting and child development on surrogacy families has been conducted in the UK. Children born via UK surrogacy followed up over 10 years showed no differences in levels of psychological problems at age 10 compared to those conceived with donor eggs or those conceived naturally.

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