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Paying for pregnancy? The cost of commercial surrogacy

Picture this: a loving couple in the delivery room of a maternity ward are witnessing the miraculous birth of their child. Miraculous, in part, because neither of them are in labour and the woman giving birth is not the biological mother. She’s a surrogate – a woman who has carried and is now birthing a child for another person.

How surrogacy works in Australia

People turn to surrogacy to have a child for many reasons, such as if a woman is unable to become pregnant, or if a male same-sex couple want to have a child. As the number of children available for adoption has declined in Australia, more would-be parents are considering the complex process of surrogacy.

A surrogate mother conceives, carries and births a child for another person or couple, agreeing to give them the child after birth. In most of Australia, a surrogate cannot have a genetic link to the child. Instead, the child’s genetic mother and father, or a donor, provide the egg and sperm used to form the embryo. Then the embryo is transferred to the surrogate mother’s womb.

In Australia, it is illegal for a surrogate to be paid to carry a child. Altruistic surrogacy is permitted, though heavily regulated. The laws vary by state, but in general the surrogate receives no financial gain, and the agreement between her and the intended parents may not be legally binding. If hopeful parents are unable to find a woman in Australia willing to carry their child, they often turn to options overseas.

Transnational reproduction

Andrew and David* are in their mid-30s. They’re married, financially stable and ready for children. But because they’re in a same-sex relationship, options for having a biological child are limited.

‘After 10 years together we really wanted to start a family. Many US states provide a clear legal framework, world-class doctors and kind gestational surrogates willing to help carry our baby.’

And so the process began; first via Skype, then at an IVF clinic and a surrogacy agency in California. They chose an egg donor from a catalogue of mostly 20-something-year-old students, many seeking to fund college degrees. Their first surrogate from the agency was unsuccessful twice. Both false starts were financially and emotionally costly. The second surrogate, and third pregnancy, has been successful, but the journey has been long – 36 months and counting. Their baby is due in May.

Andrew and David’s experience with regulated commercial surrogacy in the US will soon bear them a biological child, but they explain ‘other ways to start a family do not provide the same peace of mind to everyone involved’. Stories such as Baby Gammy – abandoned in Thailand by his intended parents when born with a heart condition and Down syndrome – highlight the ethical, emotional and financial risks of surrogacy.

Dr Dominique Martin, Senior Lecturer in Health Ethics and Professionalism at Deakin’s School of Medicine, warns, ‘The most vulnerable people may suffer harmful exploitation and have few – if any – means to protect themselves or seek redress. Parents, children and surrogates can all suffer serious economic, psychosocial and physical harm.’ Dr Martin explains surrogacy can expose ‘children to trafficking and abandonment, surrogates and egg vendors to exploitation and coercion, and intending parents to devastating loss as they struggle to bring home children caught in immigration tangles’.

'The most vulnerable people may suffer harmful exploitation. Parents, children and surrogates can all suffer serious economic, psychosocial and physical harm.'

Dr Dominique Martin,
Senior Lecturer in Health Ethics and Professionalism, Deakin University

 

Should Australia legalise commercial surrogacy?

Legalising commercial surrogacy in Australia may appear to be a solution, but Dr Martin points out it’s not that simple, ‘Domestic regulated markets within Australia are likely to recreate some of the issues experienced in poorly regulated markets overseas.’ These issues include a lack of transparency around processes and conditions, as well as the potential for exploitation in a commercial transaction.

Dr Martin suggests, ‘Why not make more of an effort to invest in the promotion, support and education of altruistic surrogacy in Australia? We should be trying to facilitate surrogacy but also to protect against potential risks, even though it may be more complicated initially and cost more than just offering a lump sum payment.’

‘Creating children is incredibly important. It’s worth the costs and energy to try and do this as responsibly and effectively as we can, with due consideration for all who may be affected by the choices that society makes,’ Dr Martin concludes.

* Names have been changed for privacy.

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Dr Dominique Martin
Dr Dominique Martin

Senior Lecturer in Health Ethics and Professionalism, School of Medicine, Deakin University
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