Surrogacy

Background

Since 2010 Clemence Due and I have been writing on the topic of surrogacy. Our initial research in the field focused on Australian news media and parliamentarian debates on the topic. More recently we have also undertaken interviews with Australian parents (gay and heterosexual) who had undertaken an offshore commercial surrogacy arrangement (in India or the US). We brought together our work on surrogacy in a book: A Critical Approach to Surrogacy: Reproductive desires and demands (2018, Routledge). I have also written with Deborah Dempsey, where we explored gay men’s accounts of pregnancy in the context of surrogacy arrangements.

I have also written a piece for The Conversation on the topic of surrogacy. I have recently contributed to a new Australian Psychological Society information sheet on gay men and surrogacy, available here.

A full list of my research publications can be found further down the page, and are drawn on in the applications of research findings sections below.

In Australia, only altruistic surrogacy is legal, where no payment is made to the woman other than to cover her out-of-pocket expenses including medical bills. However, very few surrogacy arrangements take place onshore in Australia, with most occurring offshore. Offshore surrogacy arrangements are often commercial, with Australians engaging in commercial surrogacy primarily in the US. Laws relating to surrogacy are frequently changing and differ between states and territories in Australia.

Applications of research findings for specialists in clinics

The research findings indicate that intending parents entering into (commercial) surrogacy arrangements are likely to do a significant amount of their own research (including in relation to selecting agencies and clinics, selecting surrogates and egg donors, if required, and reading about other people’s experiences), yet this still does not fully prepare them for the experiences and challenges of undertaking surrogacy. In particular, the findings show that intending parents experience clinics as viewing surrogacy as a clinical transaction, which largely ignores the emotional processes for those involved. The findings suggest that specialists working in the area of surrogacy need to provide more transparent information about the process of surrogacy, and better prepare intending parents for challenges that may occur. One example of this from the research findings is the need for specialists to make intending parents aware that pregnancy loss is a possibility, and that if this does occur, specialists need to support intending parents (and surrogates) around this, rather than rushing them into trying again. The findings particularly indicate that clinics need to offer counselling for intending parents, so they can better cope with any potential challenges.

In addition, the research findings also highlight that a diverse range of people pursue surrogacy, for a wide range of reasons. This suggests that specialists and clinics need to provide services which are inclusive of all family forms (e.g. individuals and couples, heterosexual and same-sex relationships) with different backgrounds and experiences. The findings suggest that gay men’s desires for parenthood are not necessarily viewed as being as significant or strong as heterosexual people’s desires for parenthood. This suggests it would be useful for specialists to more empathetically take into account people’s desires to have a child, and their likely difficulties to have children via other means (including in relation to medical or social infertility). In addition, as the research findings show, specialists need to more fully explore with intending parents why surrogacy is desired and whether it is the best option for them. This is particularly important in light of the research findings which show that people pursuing surrogacy arrangements value being genetically related to their children (and have a desire to have children in the first place), which is a reflection of dominant social norms and privilege.

Applications of research findings for (intending) parents and families

The research findings show that intending parents who enter into surrogacy arrangements often frame this as their only or last option to have children, due to social infertility (e.g. in the case of gay men or single people), or medical infertility (e.g. in the case of heterosexual women who cannot carry a child). At the same time, the findings suggest that surrogacy may be preferred to other options which could be pursued (such as foster care and adoption) due to the significance that people place on genetic relatedness and the view that a genetic child is more ‘permanent’ than fostering or adopting a child. In arguing this, research participants tended to negatively portray modes of family formation where parents and their child(ren) were not genetically related. These research findings suggest it is useful for intending parents to think through the significance of genetic relatedness and, if it is important to them in building a family, why this is the case. In particular, it may be useful to reflect on whether having a genetically related child is important to them beyond the fact that this is a normative or culturally privileged way of having a child.

The findings also highlight that while intending parents may be aware that there are many children who need foster parents, undertaking surrogacy is constructed as the only possible choice. Similarly, media representations of surrogacy arrangements also draw on perspectives of parents who privilege surrogacy over other forms of parenthood (e.g. foster care or adoption) and view surrogacy as a more straightforward process, which can gloss over the difficulties and challenges involved in surrogacy arrangements, particularly when they take place offshore. Again, these findings encourage reflection on the meaning of parenthood and having children, as well as more thoroughly exploring a broad range of options for ways of becoming a parent, if this hasn’t already been pursued.

As might be expected, the research findings indicate that clinics are unlikely to suggest intending parents should think about whether surrogacy is the best way for them to have children. This suggests that it is important for people considering surrogacy to think through why they have chosen this option and to seek support in making this decision from outside clinics and other places which benefit if surrogacy arrangements are undertaken.

The research findings suggest that intending parents do not always find clinics supportive and informative about the surrogacy process, and that challenges relating to surrogacy are often downplayed. These findings suggest that intending parents need to be more aware of the challenges involved in surrogacy, such as the potential for pregnancy loss and the complications of offshore surrogacy (such as the difficulties of distance and the intricacies of collecting the child and bringing them back to Australia). It is important to remember that for clinics surrogacy is a financial transaction, which is likely to be very different to how intending parents view the arrangement, particularly in terms of the emotional investments in having a child.

In addition, the interview findings suggest that there is a general lack of post-birth support from clinics. Similarly, the findings relating to media reports about Australians undertaking surrogacy offshore tend to portray intending parents as initially vulnerable (due to infertility) and then having agency as they undertake surrogacy and ‘solve’ the ‘problem’. However, these reports miss the ongoing challenges that parents are likely to face, both in terms of challenges that all parents may face when raising children and those specific to parenting after undertaking offshore surrogacy. These findings suggest that it is very important for intending parents to focus further ahead than just on the birth of the baby. In particular, it may help to seek further support, including in terms of caring for a newborn baby and adjusting to parenthood, from sources outside clinics.

The research findings show it can be useful to think through the implications for all those involved in the surrogacy process. In particular, the findings suggest that intending parents were mostly focused on their own needs, rather than other people’s needs, such as those of the surrogate. For example, the interview findings suggested that intending parents who undertook surrogacy arrangements in India framed the surrogacy arrangement as financially benefitting the surrogate and tended not to consider the impacts that surrogacy may have on surrogates (such as how it may fit with their family and religion, the impact on their own families, the impact on their own reproductive health, and the impact on their psychological health). It is therefore important for intending parents to reflect on how they view the process of surrogacy, including how they view the surrogate and the financial transactions that take place, and whether they are comfortable with these arrangements. It is also important to consider their own position of privilege in a capitalist market.

The research findings in relation to the analysis about picture books featuring surrogacy reinforce the norm of parents and children being genetically related, and view this connection as privileged over other parent/child connections. In other words, the books portray parents and children being genetically related as the most desirable way of forming a family. The books also tend to frame surrogates as ‘kindly strangers’ who ‘return’ children to their parents. As these books explain surrogacy in narrow ways to children, it may help to find more books which offer different explanations of surrogacy, and to more broadly talk about the diversity of family forms with children, without privileging certain forms over others.

Resources for practitioners

Australian

The Australian and New Zealand Infertility Counsellors Association. (2016). ANZICA surrogacy counselling guidelines. (Addendum 2017)

The Fertility Society of Australia

Fitzgerald, O., Harris, K., Paul, R. C., & Chambers, G. M. (2017). Assisted reproductive technology in Australia and New Zealand 2015. Sydney: National Perinatal Epidemiology and Statistics Unit, the University of New South Wales.

National Health and Medical Research Council. (2017). Ethical guidelines on the use of assisted reproductive technology in clinical practice and research. Canberra: National Health and Medical Research Council.

Montrone, M. (2017). Pre-Surrogacy Observation Scale (PSOS).

Surrogacy in South Australian Public Health Services: Clinical Directive

International

ACART (Advisory Committee on Assisted Reproductive Technology) (Aotearoa/New Zealand) – Proposed Donation Guidelines: for family gamete donation, embryo donation, use of donated eggs with donated sperm and surrogacy: consultation document.

Surrogacy Arrangements Act 1985 (UK)

Resources for (intending) parents and families

Australian
Surrogacy/ART – government sources

Better Health Victoria – Surrogacy

Department of Foreign Affairs and Trade – Birth, adoption and surrogacy

Department of Foreign Affairs and Trade – Smart Traveller – International surrogacy bulletin

Department of Foreign Affairs and Trade – Child passports – Surrogacy

Department of Immigration and Border Protection. Fact sheet – International surrogacy arrangements

NSW Government – Health – Surrogacy

Pregnancy, birth & baby – Surrogacy

Pregnancy, birth & baby – Being a surrogate

Queensland Government – Surrogacy

Surrogacy/ART – additional sources

AccessAustralia – Australia’s National Infertility Network

AccessAustralia – Australia’s National Infertility Network – Fact sheet: IVF Surrogacy: A personal perspective

Australian Surrogacy and Adoption Blog (by lawyer Stephen Page)

Egg Donor Angels – Surrogacy

Essential Baby – Surrogacy

Families through Surrogacy

Fertility Connections

Gay Dads Australia – Surrogacy

Health Law Central – Surrogacy

Rainbow Families Council

Rainbow Families Queensland – Surrogacy

Surrogacy Australia

Victorian Assisted Reproductive Treatment Authority (VARTA) (Victoria) – Surrogacy

Victorian Assisted Reproductive Treatment Authority (VARTA) (Victoria) – Finding a surrogate

Forums

AccessAustralia – Australia’s National Infertility Network – Community forum

Bubhub – Adoption/Surrogacy

Fertility Connections Australia support forum

Raising Children Network forum – Parents with fertility issues

International

All About Surrogacy (US)

Fertility New Zealand (Aotearoa/New Zealand)

Human Fertilisation & Embryology Authority (UK) – Surrogacy

Infertility Network (Canada)

Information on Surrogacy (US)

NZ-Surrogacy.com (Aotearoa/New Zealand)

OPTS – The Organization of Parents Through Surrogacy (US)

Surrogacy in Canada Online (Canada)

Surrogacy UK (UK)

UK Government – Surrogacy: legal rights of parents and surrogates (UK)

Books/sources with personal stories

Gay Dads Australia – David and Glen

Griswold, Z. (2006). Surrogacy was the way: Twenty intended mothers tell their stories. Nightengale Press.

Health Talk Australia – Experiences of conceiving, IVF, surrogacy and adoption

Health Talk Australia – Becoming a parent (including through IVF, adoption and surrogacy): Preparation, information and support

Health Talk Australia – Experiences of health services during pregnancy, IVF and surrogacy

Hirschi, H. M. (2014). Dads: A gay couple’s surrogacy journey in India. Seattle: Amazon Digital Services.

Menichiello, M. (2012). A gay couple’s journey through surrogacy: Intended fathers. New York: Haworth Press.

O’Flaherty, C., & O’Flaherty, N. (2012). Baby Ava: An Irish surrogacy story. Dublin: Liberties Press.

Surrogacy UK – Intended parent stories

Surrogacy UK – Surrogate stories

Victorian Assisted Reproductive Treatment Authority (VARTA) (Victoria) – Personal story: Mother and son talk surrogacy

Victorian Assisted Reproductive Treatment Authority (VARTA) (Victoria) – Personal story: The surrogacy experience

Victorian Assisted Reproductive Treatment Authority (VARTA) (Victoria) – Personal story: Surrogacy perspectives: Mother, surrogate and child share their story

Warner, J. (2013). The journey of same- sex surrogacy: Discovering ultimate joy. Tennessee: Zygote Publishing.

Westoby, R. (2013). Our “journey”: One couple’s guide to US surrogacy. Seattle: Amazon Digital Services.

Picture books

Assisted Reproduction: Books for Children – Surrogacy

Creating a Family: The National Infertility & Adoption Education Nonprofit – Books for children conceived through surrogacy

My research publications

Riggs, D. W. (forthcoming). Diverse pathways to parenthood: Translating research to practice. Elsevier.

Riggs, D. W., & Due, C. (2018). A critical approach to surrogacy: Reproductive desires and demands. Abingdon, Oxon: Routledge.

Riggs, D.W., & Due, C. (2017). Constructions of gay men’s reproductive desires on surrogacy clinic websites. In M. Davies (Ed.) Global babies: Transnational surrogacy and the new politics of reproduction. London: Zed Books.

Bartholomaeus, C., & Riggs, D. W. (2017). Terms of endearment: Meanings of family in a diverse sample of Australian parents. In R. Harding, R. Fletcher & C. Beasley (Eds.), Revaluing care in theory, law and policy: Cycles and connections (pp. 182-197). Abingdon, Oxon: Routledge.

Riggs, D. W. (2016). Narratives of choice amongst white Australians who undertake surrogacy arrangements in India. Journal of Medical Humanities, 37(3), 313-325.

Riggs, D.W., Bartholomaeus, C., & Due, C., (2016). Public and private families: A comparative thematic analysis of the intersections of social norms and scrutiny. Health Sociology Review, 25(1), 1-17.

Riggs, D.W. (2015). “25 degrees of separation” versus the “ease of doing it closer to home”: Motivations to offshore surrogacy arrangements amongst Australian citizensSomatechnics, 5(1), 52-68

Riggs, D.W. (2015). Narratives of choice amongst white Australians who undertake surrogacy arrangements in IndiaJournal of Medical Humanities, 37(3), 313-325.

Riggs, D.W. & Dempsey, D. (2015). Gay men’s narratives of pregnancy in the context of commercial surrogacy. In N. Burton (Ed.) Birth and its meanings: Representations of pregnancy, childbirth and parenting. Toronto: Demeter Press.

Riggs, D.W., Due, C. & Power, J. (2015). Gay men’s experiences of surrogacy clinics in IndiaJournal of Family Planning and Reproductive Health, 41(1), 48-53.

Riggs, D.W. & Due, C. (2014). “The contented faces of a unique Australian family”: Privilege and vulnerability in news media reporting of offshore surrogacy arrangementsFeminist Media Studies, 14(5), 869-872.

Collins, C.R., Riggs, D.W. & Due, C. (2014). Constructions of the “best interest of the child” in New South Wales parliamentary debates on surrogacy. In M. Nash (Ed.) Reframing reproduction: Conceiving gendered experiences in late modernity. London: Sage.

Riggs, D.W. & Due, C. (2013). Representations of reproductive citizenship and vulnerability in media reports of offshore surrogacyCitizenship Studies, 17(8)956-969.

Riggs, D.W. & Due, C. (2012). Representations of surrogacy in submissions to a parliamentary inquiry in New South WalesTechne, 16(1)71-84.

Riggs, D.W. & Due, C. (2010). Gay men, race privilege, and surrogacy in IndiaOutskirts: Feminisms Along the Edge, 22.

Other research publications (selected)

Australian

Cuthbert, D., & Fronek, P. (2014). Perfecting adoption? Reflections on the rise of commercial offshore surrogacy and family formation in Australia. In A. Hayes & D. Higgins (Eds.), Families, policy and the law: Selected essays on contemporary issues for Australia (pp. 55-66). Melbourne: Australian Institute of Family Studies.

Dale, M., & Macdonald, T. (2015). Regulating surrogacy in Australia. Melbourne: Human Rights Law Centre.

Dempsey, D. (2013). Surrogacy, gay male couples and the significance of biogenetic paternity. New Genetics and Society, 32(1), 37-53.

Everingham, S. (2014). Use of surrogacy by Australians: Implications for policy and law reform. In A. Hayes & D. Higgins (Eds.), Families, policy and the law: Selected essays on contemporary issues for Australia (pp. 67-79). Melbourne: Australian Institute of Family Studies.

Hammarberg, K., Johnson, L., & Petrillo, T. (2011). Gamete and embryo donation and surrogacy in Australia: The social context and regulatory framework. International Journal of Fertility & Sterility, 4(4), 176-183.

Johnson, L., Blyth, E., & Hammarberg, K. (2014). Barriers for domestic surrogacy and challenges of transnational surrogacy in the context of Australians undertaking surrogacy in India. Journal of Law and Medicine, 22(1), 136-154.

Millbank, J. (2011). The new surrogacy parentage laws in Australia: Cautious regulation or “25 brick walls”? Melbourne University Law Review, 35(1), 165-207.

Millbank, J. (2012). From Alice and Evelyn to Isabella: Exploring the narrative and norms of “new” surrogacy in Australia. Griffith Law Review, 21(1), 101-136.

Millbank, J. (2013). Resolving the dilemma of legal parentage for Australians engaged in international surrogacy. Australian Journal of Family Law, 27(2).

Millbank, J. (2015). Rethinking “commercial” surrogacy in Australia. Journal of Bioethical Inquiry, 12(3), 477-490.

International

Bailey, A. (2011). Reconceiving surrogacy: Toward a reproductive justice account of Indian surrogacy. Hypatia, 26(4), 715-741.

Bergman, K., Rubio, R. J., Green, R.-J., & Padrón, E. (2010). Gay men who become fathers via surrogacy: The transition to parenthood. Journal of GLBT Family Studies, 6(2), 111-141.

Berkowitz, D. (2013). Gay men and surrogacy. In A. E. Goldberg & K. R. Allen (Eds.), LGBT-parent families: Innovations in research and implications for practice (pp. 71-85). New York: Springer.

Cohen, E. (2015). Surrogacy as international business and national disgrace of Thailand. Asian Anthropology, 14(2), 115-132.

Cook, R., & Day Sclater, S.,,with Kaganas, F. (Eds.). (2003). Surrogate motherhood: International perspectives. Oxford: Hart Publishing.

Crawshaw, M., Purewal, S., & Van den Akker, O. (2013). Working at the margins: The views and experiences of court social workers on parental orders’ work in surrogacy arrangements. British Journal of Social Work, 43(6), 1225-1243.

Golombok, S., MacCallum, F., Murray, C., Lycett, E., & Jadva, V. (2006). Surrogacy families: Parental functioning, parent-child relationships and children’s psychological development at age 2. Journal of Child Psychology and Psychiatry, 47(2), 213-222.

Golombok, S., Murray, C., Jadva, V., MacCallum, F., & Lycett, E. (2004). Families created through surrogacy arrangements: Parent-child relationships in the 1st year of life. Developmental Psychology, 40(3), 400-411.

Golombok, S., Readings, J., Blake, L., Casey, P., Marks, A., & Jadva, V. (2011). Families created through surrogacy: Mother–child relationships and children’s psychological adjustment at age 7. Developmental Psychology, 47(6), 1579-1588.

Imrie, S., & Jadva, V. (2014). The long-term experiences of surrogates: Relationships and contact with surrogacy families in genetic and gestational surrogacy arrangements. Reproductive Biomedicine Online, 29(4), 424-435.

Jacobson, H. (2016). Labor of love: Gestational surrogacy and the work of making babies. Rutgers University Press: New Brunswick.

Jadva, V., Blake, L., Casey, P., & Golombok, S. (2012). Surrogacy families 10 years on: Relationship with the surrogate, decisions over disclosure and children’s understanding of their surrogacy origins. Human Reproduction, 27(10), 3008-3014.

Jadva, V., Murray, C., Lycett, E., MacCallum, F., & Golombok, S. (2003). Surrogacy: The experiences of surrogate mothers. Human Reproduction, 18(10), 2196-2204.

Markens, S. (2007). Surrogate motherhood and the politics of reproduction. Berkeley: University of California Press.

Murphy, D. A. (2013). The desire for parenthood: Gay men choosing to become parents through surrogacy. Journal of Family Issues, 34(8), 1104-1124.

Murphy, D. A. (2015). Gay men pursuing parenthood through surrogacy: Reconfiguring kinship. Sydney: UNSW Press.

Pande, A. (2010). Commercial surrogacy in India: Manufacturing a perfect mother‐worker. Signs: Journal of Women in Culture and Society, 35(4), 969-992.

Rudrappa, S. (2015). Discounted life: The price of global surrogacy in India. New York: New York University Press.

Rudrappa, S., & Collins, C. (2015). Altruistic agencies and compassionate consumers: Moral framing of transnational surrogacy. Gender & Society, 29(6), 937-959.

Teman, E. (2010). Birthing a mother: The surrogate body and the pregnant self. Berkeley: University of California Press.

Van den Akker, O. (2003). Genetic and gestational surrogate mothers’ experience of surrogacy. Journal of Reproductive and Infant Psychology, 21(2), 145-161.