'Womb for work' experiences of Thai women and gestational surrogacy practice in Thailand

The surrogacy experience: a survey of psychosocial impacts on gestational carriers

AIMS/BACKGROUND

Surrogacy is a complex endeavour, with various medical, legal, financial, interpersonal, and emotional impacts. This study examines surrogacy from the Gestational Carrier (GC)'s viewpoint, with attention paid to motivation, relationship with Intended Parents, and the short- and long-term impacts to self and family members.

DESIGN/METHOD

Fertility clinic patients who carried a pregnancy for other person(s) at least one time were asked by the clinic health psychologist via letter to complete anonymous online/written survey data about their experiences. Data were gathered using a 49-item self-report questionnaire with collection occurring between January 4-March 1, 2019.

RESULTS

28 GCs responded, with last surrogacy ranging from current time (pregnant at time of survey completion) to 5.5 years prior. 93% of respondents were white and 78.5% were married/partnered, with a median age of 33.8 years and median number of own children being 2.6. Most carried 1-2 surrogate pregnancies. Subjects reported primarily altruistic reasons for engaging in surrogacy though 25% also endorsed monetary compensation as being important. GCs largely viewed the surrogacy experience favourably, with positive impacts to self-concept, partner relationships, and children, and reported generally positive interactions with Intended Parents. Almost 70% of GCs worked with a surrogacy agency, and about one-third of these found the relationship to be beneficial.

CONCLUSION

This study supports existing research indicating that surrogacy is generally satisfactory to the parties involved with few negative outcomes. A description of GCs' experiences with surrogacy agencies, seldom examined in previous literature, adds valuable insights. GCs' qualitative comments enhance the quantitative data.

Legalization of surrogacy? Opinions from more than 7700 residents in Taiwan

This study explores Taiwanese' perspectives on the potential legalization of surrogacy, an issue with diverse legal stances globally. Conducted between 17 December 2023 and 1 January 2024, this mixed-methods cross-sectional study employed Knowledge and Attitudes of Legalizing Surrogacy (KALS) questionnaire. This instrument assessed opinions and ethical considerations on various aspects including ethics and children's rights, surrogate health, offspring welfare, and social justice. Responses were quantitatively measured on a 5-point scale (with higher scores indicating more accurate knowledge or stronger perceived impact of surrogacy on society) supplemented by qualitative content analysis of open-ended responses. Out of 7780 predominantly female participants (82.8%), all scores were higher for those did not support the legalization of surrogacy (82.1% of respondents). Noteworthy concerns were raised about potential repercussions of legalizing surrogacy, underscoring the need for broader public education before any legal reforms are implemented. There is significant apprehension about surrogacy legalization in Taiwan, especially regarding its impact on women's health and children's welfare.

Travelling Thai Surrogate Mothers: Required and Restricted Mobility in Transnational Surrogacy

In response to the changing landscape of transnational surrogacy, the industry has introduced flexible business models requiring women to move within and across borders to act as surrogate mothers. However, knowledge about their experiences remain vague, particularly concerning women traveling abroad under illegal conditions. Building upon interviews with Thai surrogate mothers, I demonstrate how their im/mobility reveals critical insights into labor conditions and power relations and is formed within the global reproductive industry as well as the specific national context. I also argue that the women's im/mobility and flexibility are central when making themselves bioavailable for the global surrogacy market.

Womb to rent: the ethical and legal implications of surrogacy in Ireland

BACKGROUND

Surrogacy is a form of assisted human reproduction whereby a surrogate woman carries a pregnancy for a commissioning couple or individual. There are two types of surrogacy, traditional and gestational. Worldwide we have seen a rapid increase in the use of surrogacy. Despite this, there is a lack of consensus internationally on the laws governing surrogacy. In Ireland, surrogacy remains largely unregulated. Currently, there is no specific legislation for surrogacy. This review aims to discuss its current regulatory status and associated ethical issues.

AIMS

On surrogacy from an Irish legal perspective, this study is to (i) demonstrate the lack of legislation, (ii) describe the Health Bill 2022 and (iii) examine the challenges surrounding surrogacy and Irish case law. On surrogacy from an Irish ethical perspective, this study is to (iv) discuss the ethical issues surrounding autonomy, (v) discuss the ethical issues surrounding non-maleficence, (vi) discuss the ethical issues surrounding justice and (vii) evaluate ethical issues specific to commercial surrogacy: (1) child welfare and (2) commodification and exploitation of children and women's bodies.

CONCLUSION

Surrogacy has raised several ethical issues. There are issues surrounding autonomy of the surrogate and commissioning couple, child welfare, exploitation and commodification, non-maleficence and justice. There are also significant legal concerns with surrogacy. It is neither legal nor illegal in Ireland. This creates challenges for the commissioning couple particularly in terms of custody of the child.

Commercial surrogacy: Landscapes of empowerment or oppression explored through integrative review

The surge in demand for surrogacy treatments, combined with regulatory loopholes, has spurred the widespread adoption of global commercial surrogacy. This phenomenon poses potential risks to all involved parties, including surrogates and children, encompassing ethical, legal, physical, and psychological concerns. Although commercial surrogacy is under discussion in various jurisdictions, some countries may reintroduce legislation on the matter. In addressing this intricate landscape, the researchers performed an integrative review of existing literature with the intention of providing guidance to researchers and policymakers. The researchers emphasized notable legal and ethical challenges linked to commercial surrogacy. Surrogates often experience disempowerment and oppression, exacerbated by the contractual nature of these arrangements, perpetuating structural inequalities. Children born through commercial surrogacy, especially internationally, risk losing cultural heritage and future benefits. Banning commercial surrogacy may drive it underground, harming surrogates. Reconsidering prohibitions without penalizing surrogates could mitigate downstream issues and safeguard them from exploitation.

Commercial Surrogacy: An Overview

OBJECTIVE

 Surrogacy is the process in which a woman carries and delivers a baby to other person or couple, known as intended parents. When carriers are paid for surrogacy, this is known as commercial surrogacy. The objective of the present work is to review the legal, ethical, social, and cultural aspects of commercial surrogacy, as well as the current panorama worldwide.

METHODS

 This is a review of the literature published in the 21st century on commercial surrogacy.

RESULTS

 A total of 248 articles were included as the core of the present review. The demand for surrogate treatments by women without uterus or with important uterine disorders, single men and same-sex male couples is constantly increasing worldwide. This reproductive treatment has important ethical dilemmas. In addition, legislation defers widely worldwide and is in constant change. Therefore, patients look more and more for treatments abroad, which can lead to important legal problems between countries with different laws. Commercial surrogacy is practiced in several countries, in most of which there is no specific legislation. Some countries have taken restrictive measures against this technique because of reports of exploitation of carriers.

CONCLUSION

 Commercial surrogacy is a common practice, despite important ethical and legal dilemmas. As a consequence of diverse national legislations, patients frequently resort to international commercial surrogacy programs. As of today, there is no standard international legal context, and this practice remains largely unregulated.

Ongoing Commercialization of Gestational Surrogacy due to Globalization of the Reproductive Market before and after the Pandemic

Surrogacy tourism in Asian countries has surged in recent decades due to affordable prices and favourable regulations. Although it has recently been banned in many countries, it is still carried out illegally across borders. With demand for surrogacy in developed countries increasing and economically vulnerable Asian women lured by lucrative compensation, there are efforts by guest countries to ease the strict surrogacy regulations in host countries. Despite a shift toward “altruistic surrogacy”, commercial surrogacy persists. Recent research carried out by international organizations that seek to establish a legal relationship between the commissioning parents and children in cross-border surrogacy arrangements, under the guise of the “best interests of the child,” appears to promote a resurgence of overseas commercial surrogacy rather than restrict it. Further commercialization of surrogacy should be prevented by carefully investigating the reality of the surrogacy process.