Surrogacy Process Research Articles

The nexus between self-perception and behavioural responses of gestational surrogates’ risk experiences

Despite associated risk and public concern, commercial surrogacy remains a thriving business, and opportunities for gestational surrogates continue to exist. Surrogacy arrangements have been found to place gestational surrogates at risk, with little support or guidance to help them understand or mitigate these risk factors. This study aims to investigate the self-perception of gestational surrogates through their reflection of their own risk-related behaviours throughout the surrogacy process. Data were retrieved through interviews with fifteen Thai women who had first-hand experience of commercial surrogacy, and thematic analysis was used to interpret the data. Findings showed that the perceptions of ‘trust,’ ‘commitment to obligation,’ and ‘unacceptable actions’ reflected their behaviours exposing risks to detrimental behaviours, disempowerment, and isolation. Understanding these perceptions would be advantageous for health planning programmes or policies in surrogacy practice to promote women’s heath as a whole.

ETHICAL ASPECTS OF COMMERCIAL SURROGACY

Surrogacy is an initiated process, whereby intended parents wish to have a child by having an embryo carried in another woman’s womb and, after the birth, the baby is given to the intended parents. In Israel, giving birth and motherhood are perceived to great extent as a significant, essential and natural component of female identity and the existence of children is perceived as a vital and central element of couple-hood and family. The Israeli society encourages fertility and family expansion. This is illustrated by the support of surrogacy and fertility treatments pursuant to the Israeli Embryo Carrying Agreement Law (Agreement Authorization and Status of the Newborn Child) legislated in 1996. On the other hand, the government limits the supply of contraceptives that are included in the authorized list of medicines, pursuant to the State Health Insurance Law (Ministry of Health, 1994). Surrogacy constitutes a solution for people who wish to give birth to a child but they are unable to do so. The issue raises ethical dilemmas in the global village in which we are living. This dilemma has become more prominent in the present age, due to the corona virus crisis that entailed cancelling all flights and forcing each country to close its borders to foreign travelers. In this study, the aim is to explore and comprehend the process of surrogacy according to the economic sociological theory, called the agency theory; the relationships between the parties to the agreement; and the ethical issues stemming from this issue.

An Understanding of Surrogacy: A Legal Analysis in Indian Context

Surrogacy is a term used for the cases where couples who are unable to have a child rely on another woman who acts as a surrogate mother to carry their baby. Surrogacy was first introduced in the year 1980. And was legalized in India in the year 2002. But as the year progressed the GOI noticed some flaws and misuse of Commercial surgery. Observing this ICMR introduced some regulations to prevent the exploitation of surrogacy. As the years progressed several amendments were made to the bill. In the year 2015, the Government of India banned the practice of commercial surgery and also barred the foreign nationals, NRI’s from participating. According to a survey from the UN in the year, 2012 India was declared as the “World Capital of Surrogacy” and was known as the Cradle of the World. The iconic case of “Baby Manjhi Yamda vs. Union of India” where travel documents for a baby of Japanese parents who was conceived and born by an Indian surrogate mother revealed several flaws in the surrogate bill which further led in the several regulations of the act. In the latest Surrogacy Regulation Bill the key points focused were on facts such as the term defining infertility was revised and the process of commercial surrogacy was banned only a close relative of the couple would be eligible to become a surrogate mother and also post-delivery 36 months was defined where the couple needed to care of any medical complications that arose from the pregnancy of the surrogate mother. Even after all the amendments in the bill, India has still a long way to go to curb the presence of malpractices and misuse of surrogacy.

The social paradoxes of commercial surrogacy in developing countries: India before the new law of 2018

BackgroundCommercial surrogacy is a highly controversial issue that leads to heated debates in the feminist literature, especially when surrogacy takes place in developing countries and when it is performed by local women for wealthy international individuals. The objective of this article is to confront common assumptions with the narratives and experiences described by Indian surrogates themselves.MethodsThis qualitative study included 33 surrogates interviewed in India (Mumbai, Chennai and New Delhi) who were at different stages of the surrogacy process. They were recruited through five clinics and agencies. This 2-year field study was conducted before the 2018 surrogacy law.ResultsSurrogates met the criteria fixed by the national guidelines in terms of age and marital and family situation. The commitment to surrogacy had generally been decided with the husband. Its aim was above all to improve the socioeconomic condition of the family. Women described surrogacy as offering better conditions than their previous paid activity. They had clear views on the child and their work. However, they declared that they faced difficulties and social condemnation as surrogacy is associated with extra-marital relationships. They also described a medical process in which they had no autonomy although they did not express complaints. Overall, surrogates did not portray themselves as vulnerable women and victims, but rather as mothers and spouses taking control of their destiny.ConclusionsThe reality of surrogacy in India embraces antagonistic features that we analyze in this paper as “paradoxes”. First, while women have become surrogates in response to gender constraints as mothers and wives, yet in so doing they have gone against gender norms. Secondly, while surrogacy was socially perceived as dirty work undertaken in order to survive, surrogates used surrogacy as a means to upward mobility for themselves and their children. Finally, while surrogacy was organized to counteract accusations of exploitation, surrogates were under constant domination by the medical system and had no decision-making power in the surrogacy process. This echoes their daily life as women. Although the Indian legal framework has changed, surrogacy still challenges gender norms, particularly in other developing countries where the practice is emerging.

Exequatur de sentencia extranjera relativa a gestación por sustitución: comentario al auto de la Audiencia Provincial de Barcelona (Sección 12ª-Civil), de 18 de diciembre de 2019

Este trabajo analiza un Auto de la Audiencia Provincial de Barcelona, de 18 de diciembre de 2019, por el que se estima el recurso de apelación interpuesto contra la inadmisión a trámite in limine litis de una demanda de solicitud de reconocimiento de una resolución extranjera. Dicha inadmisión se sustentaba en el hecho de que, al tener que ver la resolución extranjera con un proceso de gestación por sustitución, la misma fue considerada contraria al orden público español y, por lo tanto, desestimada la demanda. Sin embargo, conforme ha indicado el Tribunal Supremo en reiteradas ocasiones, tan solo cabe inadmitir a trámite una demanda en los casos y por las causas legalmente previstas, correspondiendo a los órganos jurisdiccionales garantizar el derecho fundamental a la tutela judicial efectiva.

Perceptions of Surrogacy Within the Socio-Cultural Context of Nigeria.

Background: Surrogacy might be a reproductive process that brings joy and fulfilment to many, but it also brings with it numerous ethical and legal concerns; it raises questions about the fundamental human rights, welfare and wellbeing of women and infants, especially within a context where it is barely regulated. This article examines the perception of surrogacy within the socio-cultural context of Nigeria. It brings to the fore various socio-cultural concerns that question the influence of surrogacy as a reproductive process on womanhood, motherhood and parenthood. It discusses, by analysing the narratives of the participants, how the surrogacy process is a dereliction of the sacredness and cultural sanctity of the family system, most especially in an African context. Methods: Fifteen (15) stakeholders (traditional birth attendants, medical gynaecologists and legal professionals within the social, medico-legal framework of reproductive health) in Nigeria were engaged in in-depth interviews to unravel the challenges which surrogacy might be facing or encountering as an ART in Nigeria. Results: There are various social, traditional, cultural, and religious beliefs that police the reproductive sphere of Nigeria, which have grave implications on fertility treatment. These socio-cultural and religious factors do not provide a fertile ground for surrogacy to thrive in Nigeria. Hence, it is important that the socio-cultural framing of reproducing in Nigeria become receptive to modern medical reproductive alternatives and innovations. Conclusions: For surrogacy to permeate the reproductive terrain of the country there is a need to jettison several socio-cultural and religious sentimental beliefs policing reproduction in Nigeria.

Perceptions of Surrogacy Within the Yoruba Socio-Cultural Context of Ado-Ekiti, Nigeria

Background: Surrogacy might be a reproductive process that brings joy and fulfilment to many but it also brings with it numerous ethical and legal concerns; it raises questions about the fundamental human rights, welfare and wellbeing of women and infants especially within a context where it is barely regulated. This article examines the perception of surrogacy within the Yoruba socio-cultural context in Ado-Ekiti, Nigeria. It brings to the fore various socio-cultural concerns that questions the influence of surrogacy as a reproductive process on womanhood, motherhood and parenthood. It discusses by analysing the narratives of participants how surrogacy process is a dereliction of the sacredness and cultural sanctity of the family system, most especially in an African context. Methods: 15 stakeholders (traditional birth attendants and gynaecologists) were engaged in an in-depth interview to unravel the challenges surrogacy might or is encountering within the socio-cultural context of Ado-Ekiti. Results: There are various social, cultural and religious beliefs that police the reproductive sphere of the Yoruba socio-cultural group, which has grave implications on fertility treatment. These socio-cultural and religious factors do not provide a fertile ground for surrogacy to thrive within the study location. Hence, it is important that the socio-cultural framing of reproduction within this cultural context become receptive to medical reproductive solutions and innovations if at all the processes are to thrive or at least become less stigmatised. Conclusions: The process of surrogacy is very complex and people’s attitude towards the practice is greatly influenced by their culture, religion and social belief systems about what is considered appropriate for procreation. Also, it is important to have clear-cut policy regulating surrogacy and all forms of ARTs in Nigeria, as this will protect women and infants, as well as, ensure that they are not to exposed abuse, commercialization and exploitation.

Cutting out the surrogate: Caesarean sections in the Mexican surrogacy industry

Childbirth practices shed light on cultural values, ideologies of gender and motherhood, and social inequalities. Transnational, commercial surrogacy presents a useful lens through which to view the social dynamics that shape childbirth experiences. Surrogacy challenges dominant views on the naturalness and inevitability of maternal-fetal bonds because it involves the separation of gestation from motherhood. What ideologies inform childbirth practices in the consumer-driven context of surrogacy in which the woman giving birth is neither the consumer nor the "mother"? Based on multi-sited ethnographic research between 2014 and 2017 and in-depth interviews with 120 participants in the Mexican surrogacy industry, I argue that doctors draw on normative ideologies of kinship, gender, and maternal-child bonding to justify and normalize the use of Caesarean sections among surrogates. The ideology espoused by these doctors reinforces the notion that maternal-fetal bonding is natural and inevitable, constructs women as irrational and driven by hormones, and presumes that bonding between surrogate mothers and the children they gestate is detrimental to the surrogacy process. Furthermore, the proffered justifications for the Caesarean sections reproduces stereotypes about poor Mexican women as risky patients, contributes to the "disposability" of their labor, and reinforces a hierarchy in which the perceived interests of intended parents and children are elevated above those of surrogate mothers. This article contributes to social science studies of medicine by demonstrating how classist and racist stereotypes, and folk notions of kinship, gender, and maternal-child bonding are biologized in medical practice.

Understanding gestational surrogacy in the United States: a primer for obstetricians and gynecologists

As gestational surrogacy (a process by which intended parents contract with a woman to carry a fetus that the intended parents will raise) increases across the United States, it is imperative that obstetrician/gynecologists understand the unique nuances of caring for patients who are gestational surrogates. Gestational surrogacy offers a route to parenthood for individuals and families who may otherwise have limited options. Understanding surrogacy requires multiple ethical considerations about the potential medical and psychosocial effects on gestational surrogates as well as the families built through surrogacy. There is a dearth of research on the subject, particularly in the United States and other countries that practice compensated surrogacy. Here we seek to review the process of gestational surrogacy in the United States, including the legal landscape, current trends in gestational surrogacy use, and what is known about the medical and social effects of this process on all participants. We also aim to highlight the limitations of available data and to identify topics for future research to provide optimal evidence-based and just care for these patients.

Mothers for Others: An Interpretative Phenomenological Analysis of Gestational Surrogates' Child Relinquishment Experiences.

Background:Previous studies have shown that surrogates reported high satisfaction with the surrogacy process and no psychological difficulties as a result of child relinquishment. However, the experiential dimension of child relinquishment is an understudied area.Objective:This study sought to provide a more detailed portrait of gestational surrogates’ child relinquishment experiences and the meanings they give to this experience.Method:Semistructured interviews were conducted with 3 women who experienced commercial gestational surrogacy for the first time. Interview transcripts were transcribed and analyzed using interpretative phenomenological analysis.Results:Three superordinate themes were generated from the transcripts: (1) undertaking an act of altruism, (2) going through a different kind of motherhood, and (3) promoting a positive body image.Conclusion:Such insights can provide essential knowledge for mental health professionals who are interested in the development of psychological support tailored to promote a smooth emotional transfer of the baby from the surrogate to the intended couple.

The experiences of surrogate mothers: A qualitative study

Background: Surrogates are women who bear a genetically unrelated child for another individual or couple. Experiences of surrogate mothers need further investigation. Objective: The objective of the study was to answer the questions of what were the experiences of surrogate mothers and what problems they confronted during the process of surrogacy. Methods: The present study was a qualitative content analysis. Purposive sampling was used in the study. Pregnant women with various ages and educational levels were invited for semi-structured interviews. Graneheim and Lundman's method was used for analyzing the data. Results: In this study, 15 participants were interviewed. The codes extracted from the interviews were categorized into five main themes and 13 subthemes. The main themes were: (1) desperation; (2) pain and suffering with the subthemes of physical pain, emotional suffering, suffering caused by others, and fears; (3) emotional involvement and self-alienation; (4) looking for the positive aspects of the surrogacy with subthemes of positive interpretation of the experience, and the sense of pride; (5) and supportive systems including the commissioning parents, the surrogate's family, the health system, and the community as subthemes. Financial motivations were the reason for surrogacy which made women endure many physical, psychological, and social problems. The women expressed some positive feelings about surrogacy and also mentioned several support sources. Conclusion: Surrogate mothers reported numerous physical, emotional, and social problems that require better counseling services. A supportive system, especially the health system, should provide better and more humanistic services for surrogate mothers.

Legality of Surrogacy with Special Reference to Surrogacy Bill 2019

This research paper deals with the surrogacy (regulation) bill 2019. According to 2(b) of The surrogacy (regulation) bill 2019, “altruistic surrogacy” means the surrogacy in which no charges, expenses, fees, remuneration or monetary incentive of whatever nature, except the medical expenses incurred on surrogate mother and the insurance coverage for the surrogate mother, are given to the surrogate mother or her dependents or her representative. The Surrogacy (Regulation) Bill 2019, which proposes to ban commercial surrogacy, was passed by Lok Sabha on August 5. The Bill was introduced by the Minister of Health and Family Welfare, Harsh Vardhan, in the House on July 15. This bill was to constitute National Surrogacy Board, State Surrogacy Boards and appointment of appropriate authorities for regulation of the practice and process of surrogacy and for matters connected therewith or incidental thereto. The main objective of the bill is to ban the commercial surrogacy. The surrogacy (Regulation) Bill, 2019 contains 8 Chapters and 51 section and this deals about Regulation of surrogacy clinics, Regulation of surrogacy and surrogacy procedures, Registration of surrogacy clinics, Constitution of National Surrogacy Board. The author discussed about the illegal surrogacy, surrogate mother and also who is eligible to be involved in surrogacy. A sample size of 1584 people were taken as samples for the research. The collected data were analysed using SPSS software and the acquired processed data were used for the empirical study. The study’s finding has revealed that there is significant in the Surrogacy process is commercial in nature in India.

Surrogacy in China: Public Opinion, Litigations, and Court Rulings

Culturally, commercial surrogacy has come to be viewed and criticized as immoral. Thus, many prefer it to be outlawed in China. At the same time, “to carry on the bloodline of the family” and having more children are also culturally celebrated in Chinese society.  The two cultural traditions, together with the implementation and gradual revocation of the one-child policy in the 21st century, have led to a dilemma modern Chinese parents are facing: more and more couples feel morally obligated to have more children after the revocation of the one-child policy but are too old to naturally reproduce. With the vagueness of regulations around commercial surrogacy in China, more couples have resorted to surrogacy in the past decade, which currently functions in a grey market. Within the unregulated market, both moral and legal concerns emerge. Through analysis of public opinion, litigations, as well as court rulings on surrogacy in China, this paper asks the following question: To what extent does the societal attitude in China on surrogacy align with that of litigations and court rulings on surrogacy in China? This paper hopes to provide insight into the Chinese surrogacy markets and responses from different actors within the process of surrogacy, leading to broader questions such as: How can litigations in China on surrogacy be improved? How can we ensure rights of all actors in a transaction concerning surrogacy? Should surrogacy be permissible at all? These are relevant questions relating to the structural violence prevalent in the seemingly peaceful modern China and have an impact on the direction of future feminist studies.

“Honey, I Want to Be a Surrogate”: How Military Spouses Negotiate and Navigate Surrogacy With Their Service Member Husbands

This article examines how military spouses negotiate the decision to become a surrogate with their service member husband and how the two navigate surrogacy together. It is speculated that military spouses are ideal candidates for surrogacy due to their particular status as a military spouse; however, military spouses face structural constraints in their everyday lives which in turn would prove challenging to their desire to become a surrogate. Based on in-depth interviews with 33 military spouses who had been surrogates, this article examines how military spouses discuss, negotiate, and experience surrogacy with their spouses all the while navigating the structural demands of the military and the contractual demands of surrogacy. Findings highlight egalitarian decision making between the spouses, and a mostly collaborative approach to the surrogacy process. Ultimately, this work illuminates how surrogacy is experienced by the women who participate in the practice and provides insight as to how military marriages function.

WHAT'S OUT THERE: SURROGACY FORUM BOOK REVIEW

WHAT'S OUT THERE: SURROGACY FORUM BOOK REVIEW

Being questioned as parents: An interview study with Swedish commissioning parents using transnational surrogacy.

This study sought to explore how Swedish parents who had commissioned surrogacy abroad experienced the process of parenthood recognition. The study consisted of in-depth interviews with five couples and 10 individuals representing 10 additional couples who had used surrogacy abroad, mainly in India. The construction of motherhood and fatherhood in the Swedish system contradicts how parenthood is defined in the surrogacy process. This study found that the formal recognition of parenthood involved a complex and frustrating process where the presumption of fatherhood and step-child adoption as grounds for parenthood make people feel questioned as parents, negatively affecting parental welfare. Policy makers need to take into account the consequences of an unregulated situation regarding surrogacy, and focus more on the child–parent relationship when regulating surrogacy.

The experience of canadian gestational carriers (GC) with the surrogacy process

The experience of canadian gestational carriers (GC) with the surrogacy process

Exploring the physical and emotional stress of surrogate pregnancy among transnational Indian surrogates

The purpose of this study was to explore surrogate women’s experiences of stress during the surrogacy process in India. We interviewed 15 women who had been a surrogate for an international couple at least once in their lives. The following themes emerged: stress regarding (1) physical health, (2) psychology well-being, and (3) the well-being of surrogates’ families and children. Transnational surrogates may experience more physical and psychological stress during pregnancy because their children and families continue to depend on them for support. Social workers must minimize the physical and emotional effects of surrogacy through counseling and psychosocial support.

Process of becoming a mother for Iranian surrogacy-commissioning mothers: A grounded theory study.

Little knowledge is available about the experiences of the commissioning mothers during the process of surrogacy; thus, the present study was conducted in order to explore and analyze this process. This study was conducted in a referral institute in Tehran with a qualitative approach and using grounded theory methodology. The data were collected through 39 unstructured, in-depth interviews that were conducted with 15 gestational commissioning mothers, two of their husbands, four surrogates, and five of the personnel at centers for assisted reproduction (some participants were interviewed more than once). Sampling started purposively and then continued theoretically. The analysis revealed the main concern of these mothers to be the feeling of "insecurity about becoming a mother" and their predominant strategy for dealing with it to be "seeking security about becoming a mother," which emerged as a core concept. The consequences of the mothers' adopted strategies and the effects of the intervening factors included "reaching a state of relative peace," "a continuing threat to one's identity," and "mental and physical exhaustion." Identifying the demands of this group of mothers can help medical personnel, particularly nurses, adopt better plans for the future and to optimize the care they provide to these patients.

Social Anxiety and Social Surrogacy in College Roommate Relationships

The social surrogate hypothesis proposes that people with higher social anxiety (HSA) recruit others to accompany them into social situations. We tested this hypothesis with college roommates using both hypothetical (Study 1) and retrospective (Study 2) measures, while assessing roommate's perceptions of recruitment and how social surrogacy might influence liking between roommates. Across two studies, we found that HSA participants were less likely to enter social situations alone (i.e. higher conditional entry); however, HSA was related to recruitment only when participants considered hypothetical scenarios, not when recruitment was assessed globally or retrospectively. There was little evidence that HSA participants’ roommates were aware of these behaviours, although there was preliminary evidence that less social anxiety might increase liking when roommates perceived more conditional entry. We also found preliminary evidence that social anxiety may be negatively related to liking when participants were less likely to recruit an alternate surrogate if their roommate was unavailable. Taken together, these preliminary findings emphasize the importance of studying the surrogacy process from an interpersonal/dyadic perspective and using methods that will differentiate between anticipated (which may be assessed by hypothetical scenarios) and enacted recruitment behaviours. Copyright © 2017 European Association of Personality Psychology