Surrogacy: what is it and what must be taken into account

Surrogacy is a way for people or couples to have a child when there are problems or limitations that prevent it from being achieved by natural means. However, this method remains controversial.

Last update: 15 September, 2022

Surrogacy is a method of assisted reproduction in which The woman who gestates a baby does not act as the mother of this. That might be the most general definition, which is also known as Surrogate motherhood either surrogate womb.

This method has been around since the 1970s, but has become popular in the last decade. Around surrogacy there is a series of controversies; not so much for the biological reasons, but for the social and ethical implications.

Recently, the debate returned to the public arena due to the case of Gammy, a baby with Down syndrome who was born in Thailand in a surrogacy. Her biological parents abandoned her because of her condition.

What is surrogacy?

Surrogacy is a reproductive practice in which a woman lends her uterus to receive and gestate the embryo conceived by another person or couple. The baby resulting from that pregnancy is legally the son of the person who provided the embryo.

This assisted reproduction method is used by people or couples who have problems conceiving or carrying a pregnancy to term. The woman who lends her womb is known as pregnant womanwhile those who contract with her are known as intended parents.

This practice is prohibited in most countries, while in others it has become a source of income. It breaks with the usual idea of ​​what a family is and sometimes gives rise to ethical and legal controversies.

How it is performed?

Surrogacy involves a process consisting of four basic steps:

  1. Medical diagnostic: The specialist makes an assessment of the situation from a medical point of view and establishes whether a person or a couple are suitable to use this method of assisted reproduction.
  2. Legal evaluation: it is established if the practice is legal in the place where it is going to be carried out. If not, it implies the search for a country and a medical center where it can be done legally. It also implies the signing of a contract.
  3. Evaluation of the pregnant woman: there is a detailed review of the woman who is going to lend her uterus, through examinations and medical tests.
  4. Gestation and delivery: It includes the pregnancy as such and its follow-up, as well as the delivery of the baby at the end of it.
The pregnancy is controlled in the usual way once it started, without differences with other gestations. The biggest changes are in the legal aspects of the practice.

Types of surrogacy

There are several types of surrogacy, depending on the way it is carried out and the motivation of the surrogate mother. In this way, we find three large categories.

By genetic link

Depending on the way in which the pregnancy is achieved, surrogacy can be in two ways:

  • Traditional or partial: the woman who lends her womb also provides the ovum. This is fertilized with the semen of the future father, through artificial insemination. Thus, there is a genetic link between the pregnant woman and the baby.
  • Gestational or complete: the pregnant woman does not provide her ovules. These come from the expectant mother or from a donor. In this case, there is no genetic link between the pregnant woman and the baby.

by family bond

The surrogate mother may or may not have a relationship with the intended parents. From that point of view, there are two varieties:

  • Intrafamily: The surrogate mother is a relative of one of the two intended parents. It is not common, since there may be medical problems of consanguinity.
  • Extrafamily: if the surrogate mother has no family ties with the parents.

According to economic interest

There is commercial and altruistic surrogacy. In the first case, the surrogate mother carries out the process in exchange for financial remuneration. In the second, she advances the pregnancy voluntarily, without consideration.

When can you go to surrogacy?

Surrogacy is an option for heterosexual couples who have problems conceiving or to carry a pregnancy to term. Also for homosexual couples who want to have a child or single-parent families, that is, a person without a partner who wants to be a mother or father.

The two usual medical reasons for which surrogacy is used are the absence of a uterus or uterine malformation. Also when pregnancy is contraindicated for medical reasons:

  • repeat abortions.
  • Diseases that prevent pregnancy.
  • Pathologies that pose a risk to the health of the mother or the baby.
  • Repeated failures in the fertilization processes in vitro (IVF).
  • Maternal pulmonary hypertension.
  • Uterine cancer.
Repeated failures when implementing assisted reproduction techniques can lead to the search for surrogacy as the only alternative.

Other data to be taken into account

The risks that surrogacy can generate are legal and ethical. In most countries this practice is prohibited and the contracts that are carried out to carry it out are considered null and void.

This leads to problems in establishing legal maternity. As a general rule, this is determined based on delivery; that is, the woman who gives birth is the mother of the baby, regardless of the other circumstances.

It is also possible that there are conflicts of nationality in the children. Many times, this involves wasteful paperwork, which is not always effective.

In addition to the legal implications of surrogacy, there may also be other consequences. When the surrogate mother has a genetic link with the baby, she may have doubts when fulfilling the contract and the law protects her.

Surrogacy is an expensive procedure which includes the medical expenses and the compensation required by the surrogate mother. The countries that currently have legalized this practice are the United States, India, Thailand, Ukraine, Russia, Mexico, Nepal, Poland and Georgia.

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