Abstract
This study examined the contact arrangements and relationships between surrogates and surrogacy families and whether these outcomes differed according to the type of surrogacy undertaken. Surrogates' motivations for carrying out multiple surrogacy arrangements were also examined, and surrogates' psychological health was assessed. Semi-structured interviews were administered to 34 women who had given birth to a child conceived through surrogacy approximately 7 years prior to interview. Some surrogates had carried out multiple surrogacy arrangements, and data were collected on the frequency, type of contact, and surrogate's feelings about the level of contact in each surrogacy arrangement, the surrogate's relationship with each child and parent, and her experience of, and motivation for, each surrogacy. Questionnaire measures of psychological health were administered. Surrogates had completed a total of 102 surrogacy arrangements and remained in contact with the majority of families, and reported positive relationships in most cases. Surrogates were happy with their level of contact in the majority of arrangements and most were viewed as positive experiences. Few differences were found according to surrogacy type. The primary motivation given for multiple surrogacy arrangements was to help couples have a sibling for an existing child. Most surrogates showed no psychological health problems at the time of data collection.
Highlights
Surrogacy, the process whereby a woman carries and gives birth to a baby for a couple who cannot conceive naturally, has become an increasingly popular means of building a family in the UK in recent years (Crawshaw et al, 2012)
Where analyses are carried out comparing variables for couples by type of surrogacy, one heterosexual couple who had had one child through genetic surrogacy and one child through gestational surrogacy with the same surrogate were excluded from the analysis
For the variables relating to type of contact, relationships with the surrogacy families and the overall assessment of the surrogacy experience, differences between gestational and genetic surrogacy arrangements were assessed using chi-squared analyses or Fisher’s exact tests
Summary
The process whereby a woman carries and gives birth to a baby for a couple who cannot conceive naturally, has become an increasingly popular means of building a family in the UK in recent years (Crawshaw et al, 2012). Recent figures suggest that 46% of reported IVF cycles for surrogacy in the USA involve donor eggs (Bernstein, 2013) Both types of surrogacy arrangements are currently practised in the UK, medical practitioners and surrogacy agencies in the USA generally recommend gestational surrogacy as the preferred method; genetic surrogacy arrangements do occur and are legal in four states (Bernstein, 2013). Concerns have been raised about the lack of involvement of mental health professionals in genetic surrogacy arrangements as the procedure sometimes occurs without a clinic’s involvement ( a clinic’s involvement does not guarantee that mental health professionals will always be involved) This lack of involvement, coupled with the surrogate being the genetic mother of the child, may increase the risks of problems occurring (Edelmann, 2004). Studies of surrogates have found, that the type of surrogacy does not seem to influence satisfaction with the surrogacy experience (Ciccarelli, 1997; Jadva et al, 2003), with most surrogates reporting positive experiences and few regretting their decision to become a surrogate (Blyth, 1994; Ciccarelli, 1997; Jadva et al, 2003; van den Akker, 2003)
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