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Surrogate Mother – Definition, Process & Legal Status

A surrogate mother is a woman who carries and gives birth to a child on behalf of another person or couple, known as the intended parents.

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Things worth knowing about "Surrogate mother"

A surrogate mother is a woman who carries and gives birth to a child on behalf of another person or couple, known as the intended parents.

What Is a Surrogate Mother?

A surrogate mother is a woman who agrees to carry a pregnancy and give birth to a child for another person or couple, commonly referred to as the intended parents. After the birth, the child is handed over to the intended parents. Surrogacy is a form of assisted reproductive technology (ART) practiced in many countries around the world, though it is governed by widely varying legal frameworks.

Types of Surrogacy

Altruistic Surrogacy

In altruistic surrogacy, the surrogate mother carries the child without receiving financial compensation. She acts out of goodwill, often for a family member or close friend. This form of surrogacy is legally permitted in several countries.

Commercial Surrogacy

In commercial surrogacy, the surrogate receives financial payment for carrying the child. This practice is banned or strictly regulated in many countries, but is available in places such as the United States and Ukraine.

Gestational Surrogacy

In gestational surrogacy, an embryo created through in vitro fertilization (IVF) is transferred into the surrogate's uterus. The embryo comes from the intended parents or from donors, meaning the surrogate has no genetic connection to the child. This is the most commonly used form of surrogacy today.

Traditional Surrogacy

In traditional surrogacy, the surrogate is artificially inseminated with the sperm of the intended father or a donor, making her the genetic mother of the child. Due to the complex legal and emotional implications, this method is rarely used today.

Medical Process

The medical process of surrogacy typically involves the following steps:

Medical screening: Both the surrogate and the intended parents undergo comprehensive health evaluations.
Hormonal preparation: The surrogate is given hormonal treatment to prepare her uterus for embryo implantation.
Embryo transfer: In gestational surrogacy, the laboratory-created embryo is transferred into the surrogate's uterus.
Pregnancy and birth: The surrogate carries the pregnancy to term and gives birth. Regular medical monitoring is required throughout the pregnancy.
Handover of the child: After birth, the child is transferred to the intended parents in accordance with legal and contractual agreements.

Reasons for Surrogacy

Surrogacy is typically considered when:

a woman does not have a functioning uterus or it has been surgically removed (hysterectomy),
there is a history of recurrent miscarriages or implantation failures,
a pregnancy would pose serious health risks to the intended mother,
same-sex male couples or single men wish to have a biological child.

Legal Situation

The legal status of surrogacy varies greatly around the world:

Germany, Austria, Switzerland: Surrogacy is prohibited by law. In Germany, the Embryo Protection Act (Embryonenschutzgesetz) forbids the transfer of an embryo to a woman who intends to give the child up after birth.
USA, Canada, Georgia, Ukraine: Surrogacy is legal under certain conditions and, in some cases, commercial surrogacy is also permitted.
United Kingdom: Altruistic surrogacy is permitted, while commercial surrogacy is prohibited.

Legal issues often center on parenthood, as in many countries the surrogate is initially recognized as the legal mother of the child. Intended parents may need to adopt the child or obtain a court order to establish legal parenthood.

Psychological and Ethical Considerations

Surrogacy raises a number of important ethical and psychological questions:

How does the surrogate emotionally experience handing over the child?
What rights does the child have to know about their genetic origins?
Is there a risk of exploitation of women, particularly in commercial arrangements?
How is the best interest of the child ensured?

Psychological support for all parties involved – the surrogate, the intended parents, and eventually the child – is recommended by medical professional societies.

References

Zegers-Hochschild F et al. – International Committee for Monitoring Assisted Reproductive Technology (ICMART): The ICMART and WHO revised glossary on ART terminology. Human Reproduction, 2009;24(11):2683–2687.
Söderström-Anttila V et al.: Surrogacy: outcomes for surrogate mothers, children and the resulting families – a systematic review. Human Reproduction Update, 2016;22(2):260–276.
Ethics Committee of the American Society for Reproductive Medicine (ASRM): Consideration of the gestational carrier: a committee opinion. Fertility and Sterility, 2013;99(7):1838–1841.

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