What Is Surrogacy? A Complete Guide for Intended Parents

In this article we are going to help you discover the meaning of surrogacy. It will help you understand it, what surrogate pregnancy is and the role of surrogate mothers. Whether you are looking at surrogacy due to medical conditions, fertility challenges, or social circumstances, it’s important for you to know how surrogacy works, learn what surrogacy entails and how it influences surrogate births. 

Overview of Surrogacy

Surrogacy is an assisted reproductive arrangement involving a woman who carries and delivers a baby on behalf of another person or couple. The agreement can be in the form of altruistic or compensated surrogacy, it can involve the surrogate’s own egg or the egg of an intended parent or donor.

The main reason for people to investigate the process of surrogacy is usually pursued when a person or couple are having issues with conceiving or carrying a pregnancy to full term because of medical, biological, or social reasons. It allows these people to become parents with the help of another woman, who we call a surrogate or gestational carrier and will carry and give birth to a baby.

Reasons for Surrogacy

Having issues with conceiving or carrying a pregnancy is not just because people cannot conceive or carry a pregnancy, there are various other reasons. Firstly, the medical conditions which can be a missing uterus or repetitive miscarriages. Then there are same-sex male couples who can also hope to be parents some day and this is a way to give them their dream. Another is when women cannot safely carry a pregnancy. Single men sometimes want to become fathers and surrogacy is their only option. Finally, some women have fertility issues, preventing them from conceiving naturally or via in vitro fertilisation (IVF).

In every case, surrogacy is a means to parenthood when other paths are unavailable to people.

Types of Surrogacy

There are two types of surrogacy, traditional and gestational surrogacy. It’s important to understand the differences relating to each type. These differences include the biological link, the method in which the baby is conceived, the legal clarity, emotional factors, cost and popularity. It is also good to note the negatives and positives in each type which will be discovered below.

Traditional Surrogacy

Traditional surrogacy is when the surrogate uses her own egg and is artificially inseminated with sperm either from the intended father or a donor. The surrogate mother will be the child’s biological mother. This type of surrogacy is usually used in an independent arrangement. This method was more common in the past, however, it is now rarely used due to complicated legal, emotional, and ethical concerns.

The positive points of choosing traditional surrogacy are it is less expensive as you do not need to use IVF, it has a simpler medical process due to a reduced number of hormonal treatments or procedures and it can be considered more natural by some intended parents or surrogates.

The negative aspects can be it has an emotional complexity for the surrogate. She may find it harder to separate from the baby due to the biological connection. In some countries and states, the surrogate may be seen as the legal mother unless the parental rights are formally transferred. Additionally, there is a higher risk of disputes due to it not being managed by an agency or a legal contract hasn’t been done correctly so it is not recommended for first time surrogates or high risk surrogates to take part in traditional surrogacy. It is also legally restricted and prohibited in many countries due to the complex emotional and legal risks involved, for all the negative aspects mentioned above this is why it is now rarely practiced in formally managed surrogacy journeys.

Gestational Surrogacy

Gestational surrogacy is the preferred and most widely accepted method in agency-managed and legally regulated surrogacy programs, primarily because the surrogate has no genetic link to the child. This legal clarity reduces the potential for custody disputes and simplifies parental rights assignment, making it the standard approach in most professional settings.

The positive aspects are the clear legal boundaries related to the arrangement, with the surrogate mother not having a genetic link to the baby it reduces the chance of any custody battles. It is preferred by agencies and clinics due to the legal clarity and safety involved. It is more appealing for intended mothers as they can use their own eggs. Additionally, this option is more suited to international surrogacy arrangements.

Of course, there are also negative points in gestational surrogacy like there is in anything. These are the fact it can be more expensive due to the costs of IVF, medications, and more intensive medical care. It is medically demanding for the surrogate mother, it has hormone treatments and embryo transfer procedures. It can also be a longer and more complex process involving legal, medical and psychological professionals, but you can be sure that the legalities will be covered.

Who may Benefit from Surrogacy?

There are many people that would benefit from choosing surrogacy as an option to grow their family. The type of people that approach surrogacy are women with uterine disorders, health conditions that make pregnancy unsafe, infertility issues in single women or couples, cancer survivors who lost fertility due to their treatment, LGBTQ+ individuals or couples and single intended parents.

Surrogacy really is a way for people who dream of being a parent or parents to raise their own child, even when conception via natural means is not an option.

How does Surrogacy Work

Surrogacy is a very structured process beginning with finding a suitable surrogate, independently or through an agency. Once a match is made, a legal arrangement is made to define the parental rights, compensation, and responsibilities.

It involves medical procedures like IVF and a high amount of costs, including legal fees and insurance. It presents physical, emotional, legal, and financial risks and it is advised to be prepared for the process. The laws and cultural acceptance of surrogacy vary all over the world. In some countries, it is legal and regulated but in others it is banned or restricted. The religious and ethical opinions also have differences due to ongoing debates about compensation, exploitation, and the emotional impact on all the people involved.

Medical Screening for Surrogates

It doesn’t matter which path you choose, whether it is traditional or gestational, the journey should always involve medical screening of a surrogate. These screenings evaluate the health, fertility history, psychological assessments, background checks, legal readiness, and ability to carry a healthy pregnancy. A surrogate mother usually has had at least one smooth full term birth with no complications and has to pass the medical and lifestyle criteria required to proceed.

Risks Associated with Surrogacy

Of course, like anything, there are risks and understanding the challenges prior to proceeding with surrogacy is important, it helps you to be aware of any factors so you can make informed decisions, be prepared in case they happen, and plan accordingly.

One of the risks is the physical side of the pregnancy and delivery. It has the same risks as any other pregnancy, the conditions can include gestational diabetes, preeclampsia, high blood pressure, and any complications that can happen during labour or delivery. All healthy women with previous successful pregnancies can still experience complications because each pregnancy comes with differences and uncertainties.

Another risk is the legal disputes if contracts are not completed or the laws are unclear. The laws are different relating to surrogacy in each country or state. In the places where the law isn’t clear or regulated, disputes like parental rights, custody, or financial terms can arise. If the contracts are not completed correctly, disputes will arise with points like surrogate wanting to keep the baby, or the intended parents withdrawing from the agreement.

Finally, there are financial risks, they already have a high costs process so unexpected events like medical emergencies, premature delivery, bed rest, or multiple babies in the pregnancy can lead to additional expenses. Without the insurance and financial agreements, the costs can come up unexpectedly for the surrogate or the intended parents and budgeting for these complications and using a third party escrow service can provide the additional financial security.

Planning ahead is very important and working with the right experienced professionals will help reduce the risks and assist with the journey being smooth and positive.

Legal Considerations

When you are thinking about surrogacy, you must think about the legal considerations that come with it, especially if you are planning to do it internationally. Every surrogacy arrangement should have a legal contract that states the parental rights, the compensation and expenses, the medical and emotional responsibilities and what happens in the event of any complications.

We already know the surrogacy laws vary from country to country or state to state so it’s important to speak with a legal professional when you are going through the process in the country or state you will be proceeding in as they will understand the law in the surrogate’s and intended parents’ country. It will ensure that the child can get citizenship, a passport, and a full legal recognition. They will also guide you on the steps after the birth, like, applying for legal parental rights or travel documents. Without a legal professional and appropriate planning, it can lead to delays, denied documents, or a stateless baby.

Costs Involved in Surrogacy

Surrogacy comes with a lot of costs, such as agency fees (if you choose to work with one), medical procedures (IVF, embryo transfer, hormone treatments), compensation for the surrogate, legal services and insurance.

It depends on where you would like to carry out surrogacy, but in the U.S., the total cost can range between $80,000 to $150,000, depending on how complex the case is.

Challenges and Ethical issues

Surrogacy brings a number of ethical, legal and emotional challenges that have to be considered.

Questions arise legally, concerns develop ethically and the psychological impact for both parties are difficult to navigate throughout the process.

Cultural and Religious Perspectives

Religious Views on Surrogacy

There are multiple differences when it comes to religion. In Catholicism, they generally disagree with surrogacy as it interferes with natural conception. In Judaism and Islam, they offer more flexible interpretations and there is a variety of acceptance. In Hinduism and Buddhism, it is usually accepted when it is used to build a family.

Cultural Attitudes Towards Surrogacy

Culturally, surrogacy is seen as positive and supportive as it helps people build a family. In other cultures, it can be misunderstood and even criticised. The social acceptance also varies based on tradition, legalities and the dominant opinions of people.

Global Perspectives on Surrogacy

The law and attitude around the world vary. Countries like Ukraine, Georgia, and some U.S. states allow surrogacy and it’s legalised and regulated, whereas, others like France, Germany, and Spain have banned it completely. On the other hand, countries like India, Thailand, and Mexico have introduced inflexible restrictions in recent years.

International surrogacy, also known as cross-border or transnational surrogacy, has its own challenges. The legal arguments between countries can cause problems like denying citizenship or their legal parental rights. Also, the inconsistency in medical standards and the protection of surrogate mothers can be an issue.

Due to these potential issues, it’s highly advised to carefully plan, obtain strong legal advice, and understand the global laws.

Surrogacy Legislation in Different Countries

International surrogacy arrangements can be complicated so to help you we have created an overview in a table below to show you some countries or states where surrogacy is legal and regulated, restricted but used to be former hubs and where it is illegal.

International Surrogacy Issues

There are other international surrogacy issues that can come up. One of these is legal conflicts between countries due to the differences from one country to another. It could be legal in one country and illegal in another and this can cause serious legal disputes. If the intended parents live in a country where surrogacy is banned and the child is born elsewhere, the disputes can have a huge impact and make it difficult.

Another issue is citizenship can be denied for children abroad as it isn’t always automatically granted in the intended parents’ home country. If the country of birth doesn’t allow citizenship of the baby, and the parents’ country doesn’t recognise a surrogacy arrangement, the child can become stateless. This means they will not have any legal nationality or passport causing delays or preventing the baby from going home and complicating access to healthcare, education, or legal recognition.

Medical and ethical inconsistency in surrogacy arrangements can vary. Some countries may not offer good healthcare, psychological support, or ethical safeguards for surrogates. In less regulated countries, and as previously mentioned, there can be higher risks in exploitation, poor medical facilities, or lack of informed consent. For these reasons, ethical concerns are raised about how surrogates are treated and whether their rights are being protected.

Finally, the inconsistency in the protection of a surrogate is a concern for many due to there not being any standard surrogate rights. In some concerns, surrogates are protected legally and receive a good amount of compensation, healthcare, and counselling. However, in others, there can be little to no legal framework to protect the physical or emotional wellbeing of both parties. This puts surrogates at risk of being underpaid, coerced, or left without support if complications arise.