Surrogacy is an arrangement in which a woman carries and gives birth to a child for intended parents, who then take on the legal and social role of raising that child. It is sought by people who cannot carry a pregnancy themselves, including those affected by infertility, people with medical conditions that make pregnancy unsafe, male same-sex couples, and single people. Countries regulate, restrict, or prohibit it to very different degrees, and it remains one of the most contested issues in reproductive ethics.
Types of surrogacy
The main distinction concerns genetic origin. In traditional surrogacy, the carrier's own egg is used, so she is the genetic mother of the child. Pregnancy is usually achieved through insemination, most often intrauterine insemination (IUI), using sperm from the intended father or a donor. This form has become rare, and many agencies decline to arrange it.
In gestational surrogacy, the carrier has no genetic link to the child. An embryo is created through in vitro fertilization (IVF) from eggs and sperm supplied by the intended parents, donors, or both, and is then transferred to the carrier's uterus. Gestational surrogacy is now the standard form in most clinics and agencies. The International Federation of Gynecology and Obstetrics (FIGO) has stated that it discourages traditional arrangements while supporting gestational ones that meet core ethical principles.
A second distinction concerns payment. In altruistic surrogacy, the carrier receives no compensation beyond reimbursement of reasonable expenses. In commercial surrogacy, she is paid a fee. Many legal systems permit only the altruistic form. Arrangements may also be domestic or cross-border, and cross-border cases raise particular problems of recognition and parentage.
Medical process
Gestational surrogacy requires IVF, which involves ovarian stimulation and egg retrieval from the intended mother or an egg donor, followed by fertilization and embryo transfer. The carrier takes hormone medication to prepare the uterine lining. Traditional surrogacy generally involves less invasive and less costly procedures, since IVF is not needed.
Both forms carry medical risks. Egg donors and intended mothers may develop ovarian hyperstimulation syndrome, and the carrier faces the risks associated with pregnancy itself. Multiple pregnancy, which is more likely after embryo transfer, increases the risk of premature birth and low birth weight. Agencies typically arrange medical screening of carriers, and treatment plans are set by qualified clinicians.
Legal frameworks
Legal approaches fall into several broad groups:
- Prohibition. Surrogacy is banned or severely restricted in countries including France, Germany, Italy, Spain, and China. Italy has made it a crime for its citizens to pursue surrogacy even abroad.
- Altruistic arrangements only. Frameworks permitting non-commercial surrogacy exist in countries such as the United Kingdom, Canada, and Greece. Canada has a federal ban on commercial surrogacy.
- Commercial arrangements permitted. Some countries and subnational jurisdictions allow paid surrogacy, including Ukraine, Georgia, and Iran, as well as several United States states. In federal systems such as the United States, Canada, and Mexico, rules often differ by state or province.
Classifications differ between sources, and some countries have changed their rules recently, so current law should be checked for any specific jurisdiction. Within the European Union, the Charter of Fundamental Rights prohibits making the human body a source of financial gain, and this provision has been cited against commercial surrogacy.
Parentage procedures also vary. Some systems require a court order before birth, as in Greece. Others use a parental order after birth, as in the United Kingdom, where the carrier is the legal mother at birth. Some countries register intended parents administratively, and others rely on adoption. Many jurisdictions impose residency or citizenship requirements on intended parents or carriers. Countries without such requirements often attract people from abroad, a pattern known as fertility tourism.
Industry and cost
Surrogacy involves clinics, agencies, lawyers, and international travel, and costs can be high. A 2025 commentary citing market research from Global Market Insights put the worldwide surrogacy business above US$22 billion. Such market estimates come from private research firms and should be treated cautiously.
Ethical debates
Supporters emphasize reproductive autonomy, the freedom of adults to make contracts, and the opportunity for people to become parents. They argue that bans can push the practice underground and restrict access for single people, LGBTQ+ people, and foreign intended parents. Research cited in a 2025 narrative review holds that restrictive bans can have unintended consequences, and it describes the move from a commercial market in India to a tightly regulated system as paternalistic and exclusionary.
Critics argue that surrogacy commodifies women and children. They point to unequal bargaining power between parties, contract terms that may require carriers to waive decisions about their own medical care or accept monitoring of their movements, and the health risks borne by carriers. In 2025, a report by the United Nations Special Rapporteur on violence against women presented to the General Assembly characterized surrogacy as exploitative and called for its abolition. Other scholars have criticized the report for relying on a uniform view of surrogacy as inherently exploitative. The European Parliament passed a 2025 resolution condemning surrogacy and calling for an end to the practice.
Child-centered concerns include the child's sense of identity and the implications of being contracted through a third party. Some studies suggest that children born through surrogacy do not face major additional health risks, but debate over identity and parentage continues. The traditional-versus-gestational distinction also shapes these arguments, since traditional surrogacy involves a genetic tie that can complicate the carrier's relationship to the child.
Opposition to surrogacy crosses ideological lines. Religious bodies, including the Catholic Church, have condemned it, and Pope Francis called for a global ban. Some conservative policy organizations describe it as a threat to family integrity, while some feminist groups oppose it as exploitative. Other advocates argue that international regulation is a more ethical response than prohibition.
Historical development
Surrogacy is generally dated to a first successful case in April 1986. In the United States, the 1987 New Jersey litigation known as the "Baby M" case brought the issue into national debate. The case was widely covered and later inspired a television miniseries. Gestational surrogacy became more common afterward because it separated genetic and gestational roles, which made parental rights easier to establish.
Limitations and open questions
Research on long-term outcomes for children, carriers, and intended parents is limited, and many studies depend on self-selected samples. Differences in national and subnational law can leave children in legal limbo, particularly when parentage is not recognized across borders. Contract enforceability also varies, and some systems allow the carrier to keep the child regardless of an agreement. Whether surrogacy should be regulated, restricted, or abolished remains unresolved, and positions often reflect differing views on autonomy, bodily integrity, child welfare, and the role of commercial markets in reproduction.
References
- Surrogacy laws by countryen.wikipedia.org
- Surrogacyen.wikipedia.org
- Surrogacy Laws by Country 2026: Where It's Legal or Bannedphysicianssurrogacy.com
- Legal Guide to Surrogacy by Country 2026globalstork.com
- Traditional vs. Gestational Surrogacy: Key Differencesgrowinggenerations.com
- Traditional vs. Gestational Surrogacy: What Is the Difference?hatch.us
- Gestational vs Traditional Surrogacy: What's the Difference?physicianssurrogacy.com
- Traditional vs. Gestational Surrogacyjoyoflife.com
- <fc>FIGO</fc> position statement on surrogacy: Ethical considerations - Zadykowicz - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online Libraryobgyn.onlinelibrary.wiley.com
- France’s Heated Debate: Can ‘Ethical’ Surrogacy Ever Work?medscape.com
- The Unlikely Alliance Forming to End Surrogacy - Newsweeknewsweek.com
- Surrogacy from a reproductive rights and justice perspective: a narrative review - PMCpmc.ncbi.nlm.nih.gov
- Contracting Babies: The Dark Side of Surrogacy and the European Union’s Recent Condemnation of the Practicejournals.law.umn.edu
- Opinion: Putting a Pause on the Practice of Surrogacyundark.org
- Marybeth Whiteheaden.wikipedia.org