Social, legal, and ethical challenges of surrogacy

Risk of exploiting women

Sex selection
Exchange of money for a human being, technically a form of slavery
Child’s specific needs and emotional well-being are not considered

life is a creation of God and human beings should not attempt to play
God by interfering in the natural processes.
wastage of human embryo is
criticized as similar to murder

WOMEN objectification and

commodification

reproductive technologies risk

fragmenting the
reproductive process and
alienating women from their
own reproductive capacities
characterized as baby selling,
surrogacy treats children as
commodities that can be bought
or sold for a price

to participate in a surrogacy
process is equivalent to
95
prostitution or
adultery96 9
or slavery
Degrade the inherent
human dignity of a woman

a surrogate child may suffer

great psychological harm
when the child comes to
know about its parentage or
origin
100
commodification of child and
selection of child with certain
desirable traits
In cases where surrogacy
procedures or contracts are
banned, it can
cause the resulting children to
be stigmatized as the product of
a criminal act.
In cases
where surrogate contracts are
non- enforceable, it can lead
to the child being
subjected to years of litigation
to determine who will be
considered to be his or her
legal parents

 Women being coerced into surrogacy for economic gain

 Lack of awareness of the effects of surrogacy, especially for women in low-

income countries

 Risk of HIV or other diseases

 Views of surrogacy as “baby-selling” and women’s bodies as “baby factories”

 Artificial reproductive therapies threatening family structure

 Religious beliefs against surrogacy while supporting adoption

 Lack of regulations
  Inclusion of the surrogate may be confusing to the child as he ages

 Surrogacy for same-sex couple or singles

 Withholding genetic/donor information from the child

 Custody disputes

 Illegal commodification or objects of trade

 Intermediaries who connect intended parent(s) with surrogates can be viewed as

“pimps” of the surrogacy trade

For surrogacy to become ethically justifiable, measures must be put in place to protect both the
surrogate and the intended parent(s). Legal agreements or contracts are a necessity in order to
enforce proper custody of the child.7, 21 Regulations that assign parental status must be clear for
situations when intended parent(s) divorce one another or refuse to accept the child following
delivery because of an unexpected outcome in the child (e.g., Down syndrome, unanticipated
sex, and so on).

Risk
The surrogate mother takes certain physical, psychological, and emotional risks by becoming
pregnant,26 including the risks of miscarriage, ectopic pregnancy, and fetal anomalies.9 She risks
accruing long-term effects from the pregnancy and relies on the intended parent(s) to properly
take care of the child after birth. 

Nurse role
Surrogacy impacts health care providers in several ways: practice, education, and research.
Thorough history taking is required to determine health risks and provide adequate preventative
health care. Education about the process and impact of pregnancy on the surrogate and
intended parent(s) is an important responsibility, particularly of those working in women’s health,
obstetrics, maternity, and neonatology. Emotional support, social support, and communication
are key for the health and well-being of all parties involved. Administrators and clinicians,
including bedside nurses, advanced practice nurses, and physicians, must support surrogates
and intended parent(s), particularly in cases of loss, child separation, and custody battles.
Research on quality of life, stress, and coping of surrogates and intended parent(s), as well as
the ethical aspects of surrogacy, is limited; thus, it needs attention by health care professionals
to improve clinical practice and provide optimum care to the surrogacy triad.2

refer to the surrogacy contract and collaborate with a multidisciplinary team, including social
workers and legal professionals in facing several challenges in caregiving and identifying “the
right person” for making care decisions.

nurses focus on their priority: providing quality care to all within the surrogacy triad.
Practicing nurses need to understand that surrogate mothers are susceptible to a wide range of
psychological and physical problems that any pregnant woman would likely to go through. They are also
vulnerable to social ailments such as stereotyping from others who think that the emerging trend is not
right. Therefore, addressing the issues should be done in an ethical manner that does not discriminate
or look down upon them in any way

https://soar.suny.edu/bitstream/handle/20.500.12648/6743/honors/250/fulltext%20(1).pdf?
sequence=1

Practicing nurses should, therefore, be aware of the psychological risks in order to ensure that they are
provided with the appropriate psychiatric help and counselling. Nursing disciplines should understand
the role of social, physical, cultural, ethical, and spiritual needs of patients in order to direct the
appropriate type of care to them. nurses should be able to be open-minded to a wide range of problem
that may arise when they are taking of surrogate mothers.

To deal with this issue, every nurse that works in the maternity unit should provide a mental health
assessment. This health assessment would be extremely beneficial for surrogate mothers after delivery.
T