Surrogacy

Surrogacy is a third party reproduction arrangement whereby a woman agrees to become pregnant for the purpose of gestating and giving birth to a child for others to raise. She may be the child's genetic mother or not, depending on the type of arrangement agreed to.

The word surrogate, from Latin surrogatus (substituted), means appointed to act in the place of.

A surrogate mother is a woman who carries a child for a couple or single person with the intention of giving that child to that person/people once the child is born (also called surrogate pregnancy). The surrogate mother may be the baby's biological mother (traditional surrogacy) or she may be implanted with someone else's fertilized egg (gestational surrogacy).

Compensation

Contracted motherhood agreements can be divided into two categories: commercial and non-commercial, or “altruistic.” Commercial contracted motherhood arrangements are those in which the party seeking a child agree to pay a fee to the surrogate beyond the cost of her medical needs. In contrast non-commercial or “altruistic” contracted motherhood arrangements are those where the surrogate agrees to receive no payment or reward, although it is rare that a total non-commercial agreement is ever made as it is expected that the commissioning party will pay the pregnant woman’s medical bills. Altrustic agreements are often between parties who are family or friends prior to the arrangement.

It is estimated that in the United States, the payment for a surrogate mother ranges between US$10,000 and $20,000, the whole procedure can cost $45,000 to $60,000. According to a poll on www.surromomsonline.com, fees anywhere from $10,000 to 30,000+ are considered fair by the surrogates themselves; with most voting in the $17,000-$22,000 range. The fees for the rest of the process- including fertility clinics; lawyers; medical fees; and agencies and/or egg donors (if they're used) generally cost more than the fee going to the surrogate. Gestational surrogacy costs more than traditional surrogacy, since more complicated medical procedures are required. Surrogates who carry a baby for a family member (i.e. sister or daughter) usually do so without reimbursement.

In the United Kingdom it is an offence to pay a surrogate under the Surrogacy Arrangements Act 1985,[1] but it is permitted to reimburse expenses. Although no official statistics verify this, it is believed that by describing generous allowances as expenses, payment of surrogates occurs in the United Kingdom as well.

Contrary to popular belief, surrogate mothers are not all poor women being exploited for their fertility. Many are middle-class women who want to help make families. They come from all walks of life, some are done having children of their own, while some want more children in the future.

The same can be said of fertility tourism, when couples go abroad for surrogacy, notably India. And here too surrogates come from all walks of life. The benefits of doing so would be that it is far cheaper; around $12,000 will give one a surrogate, an egg donor and all medical and hospital bills paid for. IVF on its own is more than $3,000. Other benefits are a short waiting list (or none at all) and an unrestrictive embryo count implant.

Who chooses surrogacy?

Surrogacy is a method of assisted reproduction.

In some cases it is the only available option for a couple who wish to have a child that is genetically related to at least one of them. People who choose surrogacy may be:

• heterosexual couples who are unable to conceive children due to infertility suffered by either partner.
• a woman who is not able to carry a pregnancy to term; or
• women who don't want to go through pregnancy.
• single men or gay male couples;

Women may be unable or unwilling to go through pregnancy due to: absent or poorly functioning ovaries, an absent or malformed uterus, a disease which precludes pregnancy, recurrent pregnancy loss, or repeated IVF implantation failures.

It has been suggested that one of the major motivations for turning to this method of reproduction is the difficulties associated with adoption in contemporary society. These include the fact that changes in social attitudes and legislation have led to fewer women placing their children up for adoption, and couples may wish to avoid being asked to adopt a child of a different race or having to go through the difficulties of international adoption.

The biological connection

There are two major types of surrogacy:

1. Partial or genetic contracted motherhood (also known as traditional or straight surrogacy), in which the gestational mother is impregnated with the sperm of the commissioning father (usually through artificial insemination). In these cases, the gestational mother is both the genetic and gestational mother of the child, however she relinquishes her role of social mother to the commissioning mother.
2. Complete or gestational contracted motherhood (also known as host or gestational surrogacy). Using in vitro fertilisation (IVF), the intended parents produce an embryo that can then be transplanted into the surrogate mother for her to gestate and give birth to after nine months. In gestational contracted motherhood the pregnant woman makes no genetic contribution to the child, however she is the child’s birth mother. In some cases, particularly of infertility, this may be combined with the use of donor sperm or donor eggs in creating the embryo for transfer.

Emotional issues

The emotions involved in surrogacy are very strong on both sides. Mothers should make sure they have appropriate support before choosing surrogacy. Support organizations exist for couples choosing this option.

Research carried out by the Family and Child Psychology Research Centre at City University, London, UK in 2002 showed surrogate mothers rarely had difficulty relinquishing rights to a surrogate child and that the commissioning mothers showed greater warmth to the child than mothers conceiving naturally.

Most surrogacies end without problems, with the parents getting their child(ren). Most stories (especially movie dramas) about the subject focus on the problems of the practice, and on the conflicts that may arise from it, but this is not so common in reality.

Ethical issues

There has been some debate over the ethics of surrogacy.

The clearest argument for supporting surrogacy is that it allows couples who want a family, but who were prevented from having one by infertility, to have a child. Another argument is that people should be allowed to make personal arrangements with a surrogate as long as this arrangement does not harm others. As well, supporters claim that the child's rights can be protected if legal provisions are adequate and enforced. Supporters also argue that if a couple would go to such lengths to have a child, this child would very much be wanted and loved. Finally, proponents of surrogacy believe that most surrogate mothers are motivated by altruistic concerns for other women to have children, and that even if receiving payment, most entered the industry on the grounds of helping others.

The arguments against surrogacy include a consideration of the interests of the surrogate mother and the rights of the child. Some issues include:

• What happens if the surrogate mother or commissioning couple change their mind?
• What happens in the case of miscarriage or multiple births?
• What happens if the child has serious disabilities?
• What are the rights of the child?
• Should payment be involved?

Surrogacy arrangements involve not only the couple and the surrogate mother, but the child as well. Therefore, some argue that society has a right to prohibit surrogacy in order to prevent the child from undesirable circumstances. Some also argue that surrogacy arrangements are in reality contracts for the purchase of a child, which are quite unacceptable .

There has also been some religious opposition to surrogacy. For example, the Vatican has issued a statement rejecting surrogate motherhood, finding that it is not morally licit because it is contrary to unity of marriage and the dignity of procreation of the human person.

External links

• Surrogacy UK - The organisation formed to support and inform anyone with an interest in surrogacy within the UK
• Industry Standards, Licensing, and Regulations for Third Party Reproduction
• Personal Accounts of Surrogate Mothers & Intended Parents
• Surrogacy - the issues
• An Online Community of Surrogate Mothers, Intended Parents and Egg Donors
• A Virtual Meeting Ground for the Surrogacy Community
• 1-in-6.com Fertility Tourisms, IVF and personal blog of one such couple attempting Surrogacy

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