Most women who become surrogate mothers are motivated to “give the gift of life," to parents who could not otherwise have a child. However, a review of the research related to the psychological and social aspects of being a surrogate published in the January/February 2007 issue of “Human Reproduction Update,” reported that while surrogacy can have a positive impact on a surrogate’s self-confidence and self-esteem, being a surrogate presents many challenges as well.
There are two types of surrogates. A traditional surrogate donates her ovum and carries the developing child. A gestational surrogate carries a developing child conceived with someone else’s ovum and sperm cell. A surrogate can choose to carry a child for an individual, an opposite- or same-sex couple. Some women are surrogates for a relative or close friend. Commercial surrogates -- the focus of this article -- carry a child in exchange for financial compensation for an individual or couple they didn’t previously know. Commercial surrogacy arrangements are usually handled by surrogacy or assisted reproductive service agencies.
All reputable assisted reproductive and surrogacy agencies require that potential surrogates to have previously given birth to a healthy child. During the evaluation process, a potential surrogate must undergo medical tests and examinations to confirm fertility and overall physical health. Pregnancy, however, can be dangerous for any woman, so no matter what a woman's medical history may be, acting as a surrogate potentially puts her health at risk.
Surrogate compensation is not regulated. However, a review of various assisted reproductive service and surrogacy agencies websites reveal that surrogates can earn $18,000-$50,000 per pregnancy, in addition to a clothing allowance, health benefits and life insurance. The substantial compensation acknowledges the responsibility that comes with being pregnant and trying to deliver a healthy baby for someone else. In addition, a surrogate may suffer economic hardship as a result of the pregnancy if, say, she experiences complications and is unable to continue working.
Because there is no national surrogacy law in the the United States,each state can create its own laws allowing, limiting, or banning surrogacy. Contracts are used to establish: parental rights for the intended parents, terms of payment to the surrogate, conditions under which the surrogate may travel and more, and tend to favor the rights of the intended parents. According to some advocates, because surrogates tend to be of a lower socioeconomic status and thus less power, they are more vulnerable to exploitation and should have legal representation.
Surrogacy can be a controversial issue. Some feel giving away a genetic child goes against the societal expectations of a mother. Others feel that offering compensation for a child is inherently unethical. According to an October 2009 ethics committee report written by the American Society for Reproductive Medication, another ethical debate is whether assisted reproductive agencies that provide surrogacy services have the authority to offer or refuse to offer services to single parents or gay and lesbian couples.
While there are emotional benefits of surrogacy, there are also emotional risks. According to the review of the research published in “Human Reproduction Update,” both gestational and traditional surrogates report not “allowing” themselves to get attached to the developing child. This makes it less difficult for the surrogate to relinquish the child, but can't completely eliminate the possibility that maternal feelings may arise during the pregnancy. In addition, surrogacy can be an isolating experience if family or friends are conflicted or disapprove. Complications with the pregnancy or issues with the intended parents can also be stressful. Surrogacy support groups provide some mothers with an opportunity to bond with other surrogates, and some mothers also form meaningful long term bonds with the intended family and the children they birth.
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