Surrogacy is a booming business. Some say it’s ’empowering’, others believe it exploits women

The concept of surrogacy — carrying and giving birth to a baby for someone else — has been around for thousands of years, with biblical figures Abraham and Jacob gaining children through this practice.

Today, it’s a multi-billion-dollar international industry, bolstered by IVF technologies and global agencies that link hopeful parents with potential surrogate mothers. In 2022, the industry was valued at US$14 billion and, according to Global Market Insights, that’s set to reach US$129 billion by 2032.

But the ethics and laws around this practice remain incredibly complex.

Critics say surrogacy exploits women, particularly those in developing nations where regulations are lacking.

In 2024, Pope Francis called for an international ban on surrogacy, labelling it a “deplorable” practice that “represents a grave violation of the dignity of the woman and the child”.

However, supporters of surrogacy point out that, in many cases, women opt into these arrangements for altruistic reasons, not simply as commercial transactions. They say that, provided a contract is rooted in informed consent, women should have the bodily autonomy to become surrogates.

So, how exactly does surrogacy currently work in Australia? And can the rights of the child, surrogate mother, and prospective parents be upheld?

The true costs of surrogacy

Surrogacy legislation differs dramatically from one country to another.

Commercial surrogacy — when the surrogate is compensated for her time — is illegal in many nations, including Australia, New Zealand and Canada.

This means Australians are left with two options: altruistic surrogacy — where expenses are covered, but the surrogate doesn’t profit — or an overseas arrangement.

While the first option is legal in all Australian states and territories, there are caveats. For instance, in Western Australia, gay couples and single men aren’t permitted to enter into such arrangements.

But the number of Australians looking for a surrogate far outweighs those offering to carry a child for someone else.

In 2022, there were 131 babies born in Australia and New Zealand via surrogate. In a similar 12-month period, 213 Australian babies were born through international surrogacy. 

One-week-old baby baby in blue sheet.
Australian surrogate babies are more commonly born via international arrangements than local ones.  (Unsplash: Carlo Navarro)

Almost a third of those internationally born babies came from the United States, a country where surrogacy is commercialised and lucrative.

It can cost up to AUS$250,000 to have a baby through an American surrogate, with the costs split between compensation for the mother, psychological and fertility tests, legal and agency fees, and medical and travel expenses.

Other nations may have less costly arrangements, but they can come at greater risk to all involved.

For example, India was once home to “baby farms”, where 100 surrogate mothers would be housed together for the entirety of their pregnancy. Commercial surrogacy was banned in 2017.

In recent years, Cambodian surrogates were forced to keep and raise the babies they were carrying, or face jail time. Meanwhile a clinic in Greece — that has been used by Australian families — was raided on charges of human trafficking and the mistreatment of hundreds of surrogate mothers.

There have also been cases of Australian children, born via surrogacy, left behind in Thailand, India and Ukraine.

Is surrogacy exploitative?

For Margaret Somerville, professor of bioethics and law at the University of Notre Dame, the objectification of surrogates is one of the key reasons she believes the practice is “not ethically acceptable”. Listen to the episode

Photo shows Hand reaches through clouds with lightning extending from itHand reaches through clouds with lightning extending from it

Fertility science is advancing exponentially. God Forbid explores the ethics of of surrogacy and the multi-billion-dollar industry behind it.

“What we’re essentially doing is exploiting almost all of the surrogate mothers who do it because they’re poor,” she tells ABC Radio National’s God Forbid.

“They get a very small percentage of what it costs to have a surrogate, and you’ve got a huge commercial enterprise making massive profits.”

Sarah Jefford, an Australian solicitor specialising in surrogacy law, disagrees that the majority of surrogates are being exploited.

“For a woman to be told that she cannot carry a child and then hand it over to somebody else to raise really undermines her bodily autonomy and her agency,” she says.

She points to models in the United States and Canada, where women choose to become surrogates by choice and not out of financial necessity.

Ms Jefford herself is a former surrogate. She carried the child of a gay couple with whom she and her husband are lifelong friends, and she found the experience “empowering”.

“My experience as a surrogate is that I certainly wasn’t violated,” she says.

“The day that I gave birth to [their] little one, I felt stronger and more empowered than at any other time in my life [because] I was able to use my body to help somebody else.”

Sarah Jefford wears green dress leans against building with arms crossed.
Melbourne-based lawyer Sarah Jefford specialises in surrogacy and donor conception. (Supplied: Sarah Jefford)

Grace Kao, professor of ethics at Claremont School of Theology in California, also has concerns over categorising surrogacy in developing nations as inherently exploitative.

Like Ms Jefford, she was a surrogate for close friends after having children of her own.

“Yes, there have absolutely been abusive cases … but in some studies, the women are saying they actually prefer being a surrogate than other ways of earning a living,” she says.

“For some women, it’s not difficult being pregnant, or perhaps it’s less difficult being pregnant than it is working long hours in a garment factory.”

Viewing all surrogates as victims of exploitation raises a larger ethical issue, she believes.

“If you are prepared to say someone who is working class or poor cannot consent to be a surrogate … can they consent to anything?” she asks.

“Can they consent to janitorial services? Can they consent to work in meat packing farms? Can they consent to work in the garment industry?

“Why do we treat pregnancy as something that’s categorically different than other ways some women might choose to earn money?”

Asian-American, middle-aged woman smiling.
Dr Kao has thought deeply about surrogacy, and the intersection between Christian ethics, feminism and human rights. (Supplied: Grace Kao)

The ‘special status’ of pregnancy

Professor Somerville believes pregnancy cannot be compared to another form of labour.

“I see pregnancy and having your own child as something different from everything else that we do in society,” she says.

“It’s got a special status. It is, at the least, a secular, sacred relationship … and that means it must not be destroyed or laid waste.”

She believes all mothers — including surrogates — are innately connected to the child they deliver.

“The idea that the mother who gives birth to a child is unconditionally bonded to that child is at the base of a lot of our societal values, attitudes, and laws,” Professor Somerville says.

“Therefore, to the extent that surrogacy contravenes that, it affects those values.”

Professor Somerville believes that — as in the case of some adoptees — surrogate children may wish to know or connect with the woman who birthed them.

But Ms Jefford says Professor Somerville’s perspectives represent a “Hallmark idea of parenthood”.

“I had two children that I very much wanted,” she says.

“My experience of mothering them was very different. My second child, for example, I struggled to bond with.

“Then [as a surrogate] I gave birth to a third child that was very much wanted, but intended to be conceived so that somebody else could be her parents.

“I disagree with this idea that some sort of primal bond was broken between me and her.”

The belief that surrogate mothers must grieve the absence of the child they delivered remains widely held.

Dr Kao says she was commonly asked during her surrogacy pregnancy, “Aren’t you afraid you’re going to grow attached to this child and not want to give it up in the end?”

Her answer was always no.

“I did not bond with this child, I never wanted this child,” she says.

“I very much was invested in helping my friends have their first [child].”

Pregnant woman holding baby shoes next to her bare belly.
In Australia, altruistic surrogacy is legal, while commercial surrogacy is not. (Pexels: Daniel Reche)

Dr Kao believes surrogacy is so controversial because it threatens social and cultural norms.

“There is a widespread belief in the maternal instinct, that women crave motherhood and while they’re pregnant, they will naturally want to bring that pregnancy to term,” she says.

“But we know in the context of abortion and in the context of adoption, that that’s not always the case.

“It is frightening for people to believe that a woman can lovingly carry a [surrogate] child and gladly relinquish the child to the intended parents.”

The future of surrogacy

With the demand for surrogacy exponentially increasing, there are some measures that can be taken to ensure the industry is as ethical as possible.

Dr Kao and Ms Jefford both believe surrogates in Australia should be compensated for the time, energy, and risk involved.

Ms Jefford suggests a nominal amount, capped at $1,000 a month, to avoid rampant commercialisation.

“I think pregnancy and birth is work,” she says.

“We pay people to go into the mines and do other risky jobs … so I query why we’re not paying women for the time involved.”

She believes such a change would make the practice more viable in Australia.

“We have a situation at the moment where more Australians are travelling overseas [for surrogacy], sometimes to unregulated countries in jurisdictions where the child’s rights and the surrogate’s rights are not protected,” she says.

“We have so much against commercial surrogacy in Australia, [but] I think we need to have the conversation, rather than just shutting it down.”

The UN Special Rapporteur on the sale and sexual exploitation of children examined the practice of surrogacy in a 2019 report.

It identified “an undeniable need to develop standards, empirical studies and further research on its long-term impact on all stakeholders concerned, especially children”.

Dr Kao says there are specific measures that can be taken to ensure the practice isn’t — and doesn’t look like — the selling of a child.

For instance, she says, all payments should be made to the surrogate mother, or agency, before the child changes hands.

“The money should not be contingent upon … a healthy pregnancy or live birth,” she adds.

Currently, the tapestry of international surrogacy laws and regulations means that gaining citizenship for a child can be a bureaucratic battle.

“I do not anticipate that the world will come to one uniform policy on surrogacy,” Dr Kao says.

“I think the best thing we can hope for is a strong regulatory framework, like we have governing inter-country adoptions.

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