According to the National Infertility Association, approximately 7.3 million individuals in the United States–one in every eight couples–struggle with infertility issues. The American Society for Reproductive Medicine says that one-third of those affected are women, one-third are men and one-third of the cases remain unexplained. For many of these couples, hiring a surrogate mother is one of the only ways they can bear a child together without the use of donor eggs or sperm or fertility drugs.
A surrogate mother is a woman who carries to term the infant of another couple and, after birth, gives the baby to the couple. While some infertile couples privately hire women to carry their child, surrogacy agencies, such as the Center for Surrogate Parenting, advocate the use of an agency as a mediator to protect the needs and interests of the couple and the mother. Surrogacy agencies are responsible for determining the eligibility of women interested in becoming surrogates and for matching couples with possible surrogates. Throughout the pregnancy, most surrogacy agencies provide support groups and intermediary counselors for the surrogate and their couple.
According to Becomeasurrogatemom.com, there are two options for surrogate mothers: artificial insemination and in vitro fertilization. (Some surrogacy agencies, however, such as The Surrogacy SOURCE, specialize in only in vitro fertilization.) As the Advanced Fertility Center of Chicago explains on its website, artificial insemination is the process by which the father’s sperm is injected into the mother using a catheter. In this procedure, the surrogate mother is the child’s actual biological mother. By contrast, in vitro fertilization involves the couple’s egg and sperm being fertilized in a laboratory situation and then implanted into the surrogate mother’s uterus.
Women interested in becoming a surrogate mother must meet a number of eligibility requirements. Although these requirements may be slightly different among surrogacy agencies, most agencies require that the potential surrogate have had at least one uncomplicated pregnancy and delivery and have at least one child living in her home, have no history of substance or alcohol abuse as well as no family history of genetic medical conditions, be living in a stable home (preferably with a supportive spouse or partner) and have medical insurance that will cover the pregnancy. In addition, the potential surrogate cannot smoke, have any criminal background or be dependent on any form of government assistance.
The process as detailed on the Center for Surrogate Parenting site–from surrogate mother application to the delivery of the baby after birth to the couple–is similar for all surrogacy agencies. After filling out the initial surrogacy application form, the potential surrogate will be screened for eligibility. If she is determined to be eligible, she will be put into contact with surrogate mother support groups in her area and will begin working with an agency counselor to choose a couple she would like to act as surrogate for. This decision is usually based on profiles the agency compiles of interested couples. When a couple is chosen–and the future mother and father agree on the arrangements–the medical procedures begin.
After the surrogate mother becomes pregnant, she is under the care of the obstetrician provided by her insurance company. Most couples remain in frequent contact with their surrogate throughout the pregnancy and are usually present for the baby’s birth.
According to the Indian Journal of Medical Ethics, one of the most profound controversies associated with surrogate motherhood is whether surrogate mothers should be paid for their services. Although many couples do pay substantial sums–often negotiated by surrogacy agencies–the Indian Journal article, “The Moral Implications of Motherhood by Hire,” wonders if allowing this type of surrogacy to continue will result in poorer women of every country “selling” their wombs for financial gain and ending up becoming nothing more than a class of “breeder women.”