What You Need to Know About Surrogacy

Surrogacy involves a woman becoming pregnant and giving birth to a baby for another individual or couple through a pre-arranged agreement. There are two main types: traditional surrogacy, where the surrogate is the biological mother of the child, and gestational surrogacy, where the surrogate carries a child conceived via IVF using eggs from another woman.

Currently, gestational surrogacy is the prevalent method in Australia. This study specifically examined the health outcomes associated with gestational surrogacy.

Key Findings from the Study

Published in the Annals of Internal Medicine, the study analyzed data from 863,017 women who had a singleton birth between April 2012 and March 2021. It compared complications faced by women who conceived naturally, those who became pregnant through IVF, and those involved in gestational surrogacy arrangements.

The findings were significant: Women in gestational surrogacy had a severe maternal complication rate of 7.8%, more than three times higher than women who conceived naturally (2.3%) and almost double that of those who underwent IVF (4.3%). Risks included postpartum hemorrhages, severe pre-eclampsia, and serious infections following childbirth, with an increased likelihood of premature births in surrogacy cases.

Even after adjusting for factors like age, weight, prior health issues, and socioeconomic status, the risks for surrogates remained troublingly elevated.

Possible Reasons for Increased Risks

The heightened risks associated with gestational surrogacy might be tied to the genetic disparities between the mother and the baby. Pregnancy alters a woman's immune system significantly to accommodate the growing fetus, and this adjustment can be disrupted when the fetus has no genetic link to the surrogate. This could potentially lead to complications like preterm birth and pre-eclampsia, an unfortunate trade-off for opting to carry a child for someone else.

Limitations of the Study and Ethical Considerations

While the study offers crucial insights, it does have limitations. The research only included women with single births, excluding those with multiples, which are common in surrogacy scenarios and carry their own risks. There were also only 806 specific cases of gestational surrogacy included, raising questions about statistical reliability.

Moreover, with increasing global trends in surrogacy—driven by factors like declining adoption rates and evolving social norms regarding parenting—ethical concerns around the potential exploitation of women through commercial surrogacy become more pronounced. Notably, Australia permits only altruistic surrogacy; however, many Australian families turn to overseas arrangements where they can pay surrogates, which raises serious ethical questions.

Conclusion

This new research highlights the pressing need for thorough discussions regarding the risks associated with gestational surrogacy. Women contemplating this route and prospective parents must be fully aware of the potential health risks involved. As surrogacy continues to rise in popularity, ensuring informed decisions is essential for the well-being of both surrogate mothers and the children they carry. The implications of this study are vital in informing policy-making and supporting the health of women participating in these arrangements.