The Ethics of Surrogacy from a Gestational Carrier’s Perspective

When you think of surrogacy, what comes to mind? What assumptions do you have? What rumors have you heard? Everyone whose life has been touched by surrogacy has a very unique story to share; there is no “one size fits all” experience. However, I hope to provide some historical context and shed light on the reality of surrogacy from my lens as a recent gestational carrier.

How long has surrogacy been around?

Traditional surrogacy has been reported for hundreds of years, even back to biblical times (the surrogacy story of Sarah and Abraham is an article for another day!). Traditional surrogacy refers to a situation where the person carrying the baby is also biologically related to the baby because their egg was used with someone else’s sperm.

Traditional surrogacy differs from gestational surrogacy, where the person carrying the baby is not biologically related to the baby at all. The terms “gestational carrier” and “surrogate” are often used interchangeably, though “surrogate” is technically more of an umbrella term referring to anyone who carries a baby for another family, whether they are traditional or gestational in their method.

The development of gestational surrogacy 

These days, gestational surrogacy is far more common than traditional surrogacy. Gestational surrogacy is still a relatively recent development, as it is entirely dependent on scientific advancements in reproductive medicine, including in vitro fertilization (IVF). The first baby born using IVF was in 1978, and the first gestational surrogacy occurred in 1985. In the decade that followed, legal questions around surrogacy were featured in court rulings around custody disputes, making gestational surrogacy a more appealing and less ethically risky option for intended parents.

How surrogacy is different from adoption?

Surrogacy, whether traditional or gestational, is not the same as adoption. In surrogacy, the baby’s parents (called Intended Parents) are involved in the process from even before the pregnancy occurs. Intended parents and gestational carriers are matched together and all need to undergo extensive medical and psychological screenings along with thorough legal documentation prior to anything else happening. 

During adoption, the birth parent(s) sign consent forms for the adoptive parents to become the baby’s legal parents after the baby is born. In surrogacy, by contrast, legal documentation established before the pregnancy even occurs states the intended parents are the baby’s parents. It is always very clear who the baby’s parents are and will be in surrogacy, which is understood fully by the surrogate, the intended parents, and the law. This can be less clear in adoption processes.

Is surrogacy a career choice or an act of altruism?

Another sometimes mysterious and ethically murky question is that of compensation. Transparent discussion around compensation can be hard to come by in any workplace in the United States, and the world of surrogacy is no different. Some gestational carriers choose to carry a baby for no or low compensation. These are typically referred to as “altruistic” surrogacy journeys. 

You may be asking yourself why anyone would agree to carry a baby for someone else for free, and the answer is that most altruistic journeys occur when the surrogate knows the intended parents (though not all – some carriers feel that the feeling of helping a family in such a profound way is compensation enough). 

Even in altruistic journeys, though, the intended parents typically cover all surrogacy-related costs for the surrogate, including medical bills and legal fees.

Breaking the stereotypes of U.S. Surrogates 

So should someone expect money in exchange for agreeing to carry a baby for someone else? Doesn’t that negate the good deed? Are surrogates just financially desperate and looking for fast cash?

The truth is that surrogates cannot be on any type of government assistance to qualify, and it is not usually their family’s only source of income. 

Furthermore, between matching and medical screenings to undergoing IVF and embryo transfers, followed by an entire pregnancy and postpartum recovery, there is nothing “fast” about surrogacy. It isn’t just a quick way to make some extra cash, and the toll and risk to the carrier’s body can be significant. 

Many feel it is appropriate for the surrogate to be compensated for her time and physical sacrifice. It can be an opportunity for the surrogate to provide a secure financial backing for her own family while changing the lives of others at the same time – a real win-win!

Legal issues surrounding surrogacy in the U.S.

Although surrogacy laws continue to advance, there are still legal hurdles to overcome. While there are many states that are considered “surrogacy-friendly,” surrogacy is still not legal in all 50 states.

The ethics surrounding surrogacy are certainly complex, even within the diverse array of families who have been impacted personally by it. The stories that make headlines are typically the most salacious and legally complex, though the reality of surrogacy is much more regulated and far less dramatic.

As assisted reproductive technology continues to advance and legal conundrums continue to arise, we will further explore ethical questions around the different ways families are created and grow.

Questions about surrogacy?

The team at Family Source Consultants is always available to answer any questions you may have about the surrogacy process. Feel free to reach out to us at (815) 733-6742 or request a free parent consultation.

This article was written by Hannah, a gestational surrogate with Family Source Consultants. Hannah delivered a baby boy for her intended parents in July 2022. She lives in Illinois with her husband and two young children.