The wording of commercial surrogacy contracts is telling, the text reflecting the economic disparity between carrier and client.
“If Gestational Carrier suffers a loss of her uterus as a result of the performance of her obligations under this Agreement, she shall receive $5,000.00 from Intended Parents”, stipulates one contract.
It continues: “If Intended Parents jointly request Gestational Carrier to terminate the pregnancy because of the Child’s medical condition(s), she will do so promptly. If Gestational Carrier refuses to terminate, Gestational Carrier will have materially breached this Agreement and Intended Parents’ obligations under this Agreement shall cease immediately”.
Natalia Gamble, a director at Brilliant Beginnings, says the agency made an active decision “to only facilitate people going to places that we felt were ethical, secure, and safe”.
Although Ms Gamble is adamant that her approach is ethical, she helps clients go to Nigeria, Cyprus, and Ukraine, where commercial surrogacy flourishes.
“We made the active decision at Brilliant Beginnings to only facilitate people going to places that we felt were ethical, secure, and safe – we have very much focused on the US, but through our law firm (NGA Law) we have helped people go into places like Nigeria, Cyprus, and Ukraine because our role is much more not to help them do it in the first place but to help them bring their children home and resolve all the legalities afterwards,” she said.
Northern Cyprus even allows sex selection, with several clinics there advertising the service on their websites.
“The cases that are happening in Nigeria or Cyprus where it’s very unregulated and there’s no legal framework are a very, very small percentage of the overall international surrogacy landscape,” she said.
“We do need to be very alert to the risks of exploitation and those risks are greatest in places where there is no legal framework regulating how surrogacy is run […] but, it’s about not overinflating those risks when the majority of people are going to what you might call ‘good surrogacy destinations’.”
Ms Gamble is pushing for a change to UK law that would grant commissioning parent(s) legal rights to the child (embryo) at the point of conception.
“It’s in the best interest of the child,” she says. “If you speak to any surrogate mother they will say ‘Look, I am not the mother of this child, I’m always very clear that it’s someone else’s child that I’m carrying’ – no one wants the surrogate mother on the birth certificate, including her.”
But is that really true – are surrogate mothers really so detached?
I spoke to Liane, who said her own experience of surrogacy caused “a huge amount of grief and hurt”.
She described the market as being infected with a sort of “toxic positivity”.
She added: “It’s painted as a wonderful thing to do, a beautiful selfless act which can only bring joy when for me, I felt used, manipulated, and devastated”.
Ms Gibson of Surrogacy Concern says cases involving “coercion and regret” are not uncommon, even within the UK’s surrogacy model.
“Surrogacy prioritises the wants of the adults ahead of the needs of the child, and creates a societal sense of entitlement towards women’s bodies,” she said.
The practices of single men buying children abroad, white couples using black surrogate mothers, and the growing trend towards using cut price surrogacy destinations such as Mexico, Colombia, Kenya and Ghana are all on Surrogacy Concern’s radar.
Physical harms to surrogate mothers are real. Carrying a baby always involves serious risk but, for surrogates, those risks are often greatly magnified.
Linda Khan, an epidemiologist based in the departments of Paediatrics and Population Health at NYU, says surrogates run an “increased risks of all kinds of pregnancy complications, which lead to adverse outcomes for women and children”.
One factor, she says, is that the embryo is not biologically related to the woman and implanted via IVF. Another is that “many women are carrying multiples because it’s so expensive. They want two for the price of one”.
“Twinning is not safe, even when it occurs naturally. It is a huge burden on women’s bodies, it gets all the risks of complications sky-rocketing.”