Modern FamiliesThe Future of Surrogacy

The Future of Surrogacy

  • Cross-border surrogacy often involves surrogate, intended parent and clinic coming together from different cultures
  • Sam Everingham examines the changing face of global surrogacy
  • India, Thailand, Mexico and Nepal are closed to foreigners looking to access surrogacy
  • Altruistic surrogacy models outlaw agencies which charge a fee to recruit and screen surrogates

Cross-border surrogacy often involves surrogate, intended parent and clinic coming together from different cultures. Navigating foreign medical systems, surrogate relationships, acquiring citizenship, and the question of legal parentage are just a few complexities of cross-border arrangements.

But as 2016 begins, India, Thailand, Mexico and Nepal are closed to foreigners looking to access surrogacy. Hundreds caught in the turmoil of these changes were faced with highly stressful situations – prevented from entering India for the birth of a child, prevented from leaving Nepal or Thailand with children post-birth, frozen embryos in limbo far from home… What is extraordinary is the preparedness of many couples and singles to tackle these in the quest to build a family.

Cambodia is the ‘new’ destination in south-east Asia for surrogacy, shipping in Thai surrogates for embryo transfers and again for births. However, no laws are in place addressing the practice, leaving surrogates and intended parents alike open to exploitation. Similarly, Kenya reportedly accepts surrogacy clients in the absence of laws.

So what is the key learning from such turmoil? Undertake surrogacy domestically?

DIY Altruistic Surrogacy

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

Altruistic surrogacy models outlaw agencies which charge a fee to recruit and screen surrogates. Instead intended parents and surrogates alike are asked to self-screen each other. There are increasing calls for more psychological screening and support of parents and surrogates alike, given the ‘red flags’ can be ignored by intended parents desperate to make a baby. Intended parents face uncertainty around not only what are acceptable surrogate expenses and demands but legal parentage.

‘Friendship-based’ altruistic models, like those promoted by the non-profit Surrogacy UK, provide a wonderful solution to growing numbers of intended parents and the children created. But they don’t suit those who don’t feel confident engaging with a surrogate directly on such intimate issues, are not prepared to ‘join the queue’ or remain uncomfortable with legal uncertainty or the ban on compensation. Many other European countries, including Ireland and much of Mediterranean Europe, simply have no access to altruistic surrogacy.

There is no doubt that locating someone to carry yourself can be incredibly daunting, and for countries like Ireland, almost impossible. Finding a surrogate at home is clearly not a solution for everyone.

Cross-border Surrogacy

So intended parents are increasingly searching offshore. Certain US states, led by California (but now including Nevada, Oregon and Minnesota) were the early, reliable destinations and have remained a stalwart of best practice.

India rapidly overtook the US for a short while as the global hub of surrogacy, offering far more affordable arrangements supported by good medical care. Thailand and Nepal followed, though all these came with other downsides – no surrogacy laws, leaving both surrogates and intended parents exposed if government policy changed or the surrogate changed her mind.

None of these Asian destinations offered anything meaningful by way of intended parent/surrogate relationships (though this suited many who prefer to view surrogacy as a contractor providing a service). With the recent closure of Thailand, India, Nepal and Mexico to foreigners, Ukraine and Canada have become popular alternatives for those who cannot afford the USA. The recent introduction of the ‘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 programme has turned a number of adoption agencies into surrogacy providers. In Canada, surrogacy is legal for foreigners in some provinces and, like the UK, there is a strong culture of surrogacy.

Learnings from 2015

For anyone contemplating surrogacy, thorough planning and research is vital. Only engage in jurisdictions which have laws protecting the rights of both intended parent and surrogate.

I have summarised these below.


Families Through Surrogacy’s third EU conference (London, March 5th, and Dublin, March 6th, 2016) will bring together parents, surrogates and surrogacy practitioners from around the world. Best practice events such as these provide much-needed insights, legal advice and personal stories which uncover exactly how those who cannot have children of their own are adapting to this changing landscape to create families in an informed way.

Craig Reisser
Craig is the UK coordinator for ORM Fertility and a regular contributor to Fertility Road on third-party reproduction.

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