Surrogacy is a contractual relationship where a woman agrees to become pregnant, carry a child to term and give custody of the child (or children) to the prospective parents. The parent(s) may be single, married or unmarried, heterosexual or homosexual. Most surrogacy agencies and professionals encourage gestational surrogacy, where a surrogate has no genetic relationship to the child she is carrying to avoid a possible legal battle if the surrogate changes her mind. A commercial surrogate in the United States usually receives at least $25,000 compensation for “pain and suffering” to avoid language that could imply baby selling. An altruistic surrogate doesn’t receive a fee.

What are the different types of surrogacy?

Traditional Surrogacy – the surrogate carrying the child is artificially inseminated with the intended father’s sperm or possibly donor sperm. She is the genetic/biological mother of the child, but will not retain custody of the child after he/she is born.

Gestational Surrogacy – the surrogate has no biological relation to the child and essentially rents her womb to the intended parents for the purpose of gestating the child. In this instance, the parenting couple donates an embryo created by in vitro fertilization (IVF) with either their DNA or DNA from an egg and/or sperm donor. Gestational surrogacy is especially popular for male homosexual couples who want to have children with a biological connection to one or potentially both men.

How is surrogacy different than adoption?

There are some similarities that can be drawn between adoption at birth and surrogacy, but here’s the best way to think about it: Adoption takes place when a child is born into a family situation that the mother determines is not ideal for the child. Although that child will become attached to his or her biological mother in the womb, the best option is that the child is placed in an adoptive family.

Surrogacy usually occurs when an embryo is created in a laboratory and implanted in a surrogate’s womb – the womb of a woman who has no plans to be the child’s mother. A surrogate also usually receives some sort of financial payment.

Is embryo adoption surrogacy?

Embryo adoption involves surrogacy but differs greatly from surrogacy previously described. Embryo adoption is the early adoption of an embryo created by IVF when his/her genetic parents decide not to implant the embryo. The adoptive mother carries and gives birth to the child, though the child is not genetically hers. She is the biological and birth mother with the intent to be the child’s lifelong parent. It is estimated that there are approximately 60,000 frozen embryos in the U.S. that could be adopted.

What are the legalities surrounding surrogacy?

Right now, surrogacy is considered the “wild west” of law and medicine. There are only a handful of countries around the world that allow commercial surrogacy, where a woman receives financial compensation for her services, and many have made the practice illegal. The first country to legalize commercial surrogacy was Israel, though there are numerous restrictions in place that make it difficult to acquire a surrogate and is limited to heterosexual couples. As of April 2018, other countries that permit commercial surrogacy include the United States, Iran, Nigeria, Czech Republic, Ukraine, and some parts of Mexico. Commercial surrogacy, where a woman receives money, is banned in Canada, Denmark, New Zealand and Australia but altruistic surrogacy, where no money is exchanged, is allowed. Surrogacy is banned completely in France, Bulgaria, Germany, Italy, Portugal and Spain. Previously surrogate friendly countries like India and Thailand have banned the practice over concerns about female exploitation.

In the United States, surrogacy laws vary from state to state. The most permissive state in the union is California, which is where the majority of surrogacy arrangements take place. Several states like Colorado, Georgia, Idaho, and North Carolina don’t have any laws governing surrogacy. A handful of states like Nebraska, Michigan and Arizona, and surprisingly New York, outlaw surrogacy completely or outlaw commercial surrogacy.

What did surrogacy look like historically?

Infertility is an age old problem. According to an ancient Assyrian marriage contract written more than 4,000 years ago, around the time of Abraham, it was acceptable for a wife to purchase a slave for the purpose of building a family through the slave and her husband. After the slave had served her purpose, the clay tablet said, “He may then dispose of her by sale where-so-ever he pleases.”

Over the centuries, the practice of surrogacy likely continued in a similar form until technological discoveries of the 20th century enabled other reproductive options like IVF, gestation surrogacy and egg donation. The use of surrogacy gradually increased after the first IVF baby was born in 1978 as fertility treatments became more accepted. The most famous early example of surrogacy was the “Baby M” case.

In 1985, Mary Beth Whitehead entered into a surrogacy contract with William and Elizabeth Stern. Whitehead was artificially inseminated with William’s sperm and would receive $10,000 after the child was born. After she gave birth in 1986, Whitehead sued for custody of the baby. The ensuing court case brought surrogacy into the national spotlight, and highlighted some of the legal, ethical and moral concerns of the fertility option.

The rate of children born from surrogacy continues to increase with 2,807 births in 2015 up from 738 in 2004. It’s not uncommon to hear about celebrity couples, both heterosexual and homosexual, turning to surrogacy in order to have a baby or expand their families.

What does the Bible say about surrogacy?

The Bible contains what could be considered one of the earliest surrogacy stories in recorded human history, the relationship between Abraham, Sarah, and Hagar. As told in Genesis 16, due to her advanced age Sarah suggested that Abraham could conceive a child and build a family through her Egyptian slave, Hagar. After becoming pregnant, Hagar was filled with contempt and Sarah in turn was harsh to her. In response to Sarah’s behavior, Hagar fled to the wilderness and only returned after an intervention from an angel of the Lord. Hagar eventually had a son, Ishmael, and Abraham and Sarah were eventually able to have their own son, Isaac. Although there are other stories in the Bible of couples that struggled with infertility, this is the only passage in the Bible that specifically addressed surrogacy.

What is Focus on the Family’s stance on surrogacy?

The Family Q&A online article from Focus on the Family states: “On the whole, though we feel great compassion for childless couples and understand why some consider going to these extreme lengths in order to hold a child in their arms, we would discourage arrangements involving surrogacy. We would even go so far as to say that, in our opinion, surrogacy is morally wrong. We realize, of course, that in the absence of explicit scriptural pronouncements there is something subjective about judgments regarding the Lord’s will in this area. This is one of those issues which we can only view ‘through a glass darkly,’ not being privy to the fullness of the Divine Counsel. Nevertheless, these are the conclusions we have drawn after doing our best to think through the moral implications of this matter.”

What should I say if I know someone pursuing surrogacy?

This online series of articles contains facts and information that can provide you with material that you can share with friends and family members who might be considering surrogacy as an infertility option or to someone who is considering becoming a surrogate. Here are some questions that can help begin a conversation:

Questions for Possible Surrogate:

  1. Have the doctors, lawyers and/or intended parents informed you of all the physical, emotional and medical dangers of a surrogate pregnancy?
  2. Can you place the child in a home knowing that the intended parents haven’t had any type of home review and the child may go into a potentially unsafe environment?
  3. What would you do if the intended parents want you to abort the child because the baby has special needs or abort a child or two in the case of multiple embryos?
  4. Can you be a surrogate mother for a gay couple or a single man, knowing the child might never experience a mother’s love?
  5. Are you okay with renting your womb?
  6. Can you turn over a baby to someone else knowing that you will likely never see that child again?

Questions for Intended Parents:

  1. Have the doctors, lawyers and/or intended parents informed you of all the physical, emotional and medical dangers of a surrogate pregnancy?
  2. What made you choose surrogacy over adoption?
  3. Do you have the financial means to go through the surrogacy process knowing that the surrogate might become pregnant with twins or triplets? Is that something you are prepared for emotionally and financially?
  4. What will you do if the surrogate ends up pregnant with a child that potentially has disabilities or with multiple embryos, and the doctor suggests aborting some of the preborn babies?
  5. What will you do with the extra embryos that you don’t use?
  6. Do you have moral concerns about renting a woman’s body in order to have a baby?


Related articles:

Surrogacy: Legal Issues

Surrogacy: Ethical Issues

Surrogacy: Changing the Family​