“Labour of Love”; “Magic Happens”; “The Greatest Gift”. These are just some recent Australian news headlines promising good news stories about surrogacy and happy families.

But nowhere in the stories are there discussions of the ethical and moral issues surrounding altruistic and commercial surrogacy. These stories lead us to believe that surrogacy is something in which we should all rejoice and agree.

This is also the impression I was left after reading the  Australian Law Reform Commission’s review of surrogacy laws issues paper. Judging from the review’s remit and June  issues paper, it appears the review was set up to examine easing and unifying surrogacy rules in Australia.

In particular, the ALRC will consider how to reduce barriers to altruistic surrogacy, including remuneration costs for the birth mother.

A final report will go to the attorney-general by July next year. Submissions are currently open.

I have ethical and moral concerns about surrogacy. These relate to the dignity and exploitation of surrogates and babies. Before I outline these, I need to write the following to avoid readers saying, “She doesn’t know what it’s like not to be able to have children. She shouldn’t write about this”. Firstly, I wanted children but was unable to; and secondly, people can still offer their hopefully informed views on ethical and moral questions without direct experience.

But what are  the surrogacy rules in Australia?

Australia allows altruistic surrogacy, and the birth mother’s costs are reimbursed by the commissioning parents. They also pay for fertility clinics to transfer embryos to the surrogate, although the  clinics only deal with gestational surrogacy: sperm and egg from the intended parents or from donors. In traditional surrogacy, the surrogate uses her egg.

Commercial surrogacy is banned because of concerns about the exploitation of surrogates. But in Victoria, South Australia and Western Australia, people are allowed to commission overseas surrogates, which wildly contradicts Australia’s stance on domestic commercial surrogacy. This is much more common than altruistic surrogacy that often takes place between sisters and best friends. Each year in Australia there are about 100 altruistic surrogacies and over 200 using overseas surrogates.

There are a host of rules related to domestic Australian surrogacy such as the surrogate must have already given birth to a live baby. Then, there are complex legal issues relating to all parties involved in the surrogacy and passport issues for babies born to overseas surrogates.

Some countries such as France, Italy and Spain ban all surrogacy. India and Thailand have cracked down on commercial surrogacy after high-profile cases of baby trafficking and the exploitation of the birth mothers – the surrogates. Georgia (which has 15 surrogacy clinics) and the US are popular destinations for intending parents wishing to commission surrogates. Ukraine used to be until the war.

I can understand the ache infertile heterosexual couples and gay couples feel when they can’t have children. But this longing for a baby can’t supersede the human needs, emotions and dignity of surrogates and babies.

From reading a cornucopia of sites devoted to surrogacy advocacy in Australia and overseas and literature from overseas companies that organise surrogacies, you could be forgiven for thinking surrogacy is mainly focused on intended parents’ needs. The Australian Rainbow Families site features happy surrogacy interviews with parents. One of the organisation’s founders is a parent of two daughters born of surrogates and an adviser to the ALRC review.

Tammuz Family, an Israeli surrogacy company which Australian intended parents have used, spruiks that “we make intended parents’ dream come true”, while World Centre of Baby says that for one couple, surrogacy was “not just a dream but a lifeline to parenthood”. The international Men Having Babies provides financial assistance to gay couples to help them “achieve biological parenting”. The woman, the surrogate, is left out of the equation.

And, herein lies a major problem I have about surrogacy: so much of the literature erases the birth mother/woman and therefore her dignity. These words are never mentioned, and even in the ALRC issues paper “woman” is erased: “Surrogacy is the practice of a person carrying and giving birth to a child for another person or couple.”

Some of the websites talk about the surrogate as if she were a dog being matched with an owner on the Australian TV show, The Dog House.  My Surrogacy Journey, a UK surrogacy agency which has also set up in Mexico, lets intended parents know, “All our surrogates will have a clinical assessment … to assess the uterine cavity … to ensure that there is nothing that will prevent your journey from going ahead”. In another statement intended parents are told, “we’ll match you in less than 12 weeks”.

One Australian surrogacy advocate describes surrogates as “extreme babysitters” on TikTok while cradling a doll. This dehumanising descriptor underplays the medical risks surrogates face. These include women having to be on medication before the transfer of embryos and some clinics implanting women with multiple embryos. Research suggests that women implanted with embryos using other women’s eggs are at higher risk of the body rejecting them.

The “extreme babysitter” quip also underplays the extent to which contracts often take away the surrogate’s agency. _Business Insider_ recently reported that many surrogates can’t leave Georgia while they are pregnant. On TikTok, an American surrogate describes her 50-page surrogacy contract which included travel restrictions, that she only eat organic food and not have sex.  _The Atlantic_ has reported on the issue of surrogates and commissioning parents disagreeing on abortion. The common reason commissioning parents may want an abortion is when there is a multiple pregnancy and they want to abort one of the foetuses.

Behind the promises to intended Australian parents is the stark reality that overseas surrogates are usually poor. Even in the domestic US commercial market, surrogates need money. One Texan surrogate admits on TikTok that she was attracted to commercial surrogacy because she was “broke” and needed the money for her and her baby to live on.

This raises the question of the extent to which these impoverished women give consent. When women need money for housing or to feed other children, they may see no alternative but to enter a surrogate contract that promises money they could only dream about.

And then, there are questions about how surrogates fare after the babies they have given birth to are taken away. There is scant literature about this, but some journalists have found some of these women who have been prepared to talk. _Business Insider_ has reported on how some surrogates struggle after giving birth. “I carried a baby for nine months, and then they took him from me. It’s excruciatingly painful,” one surrogate said.

Women, mostly Americans, have also posted their “nightmare” experiences about being surrogates on TikTok. Many of these surrogates, both altruistic and commercial, tell how they became emotionally attached to the babies they carried for nine months and found it difficult when the babies were taken away.

Intended parents and surrogates must attend counselling sessions in Australia. But legislation and counselling can’t always ameliorate emotions and psychological damage. We will never know about the trauma countless Indian and Thai surrogates may have experienced after being separated from the babies they gave birth to.

This also raises questions about the impact on babies being removed from their surrogate, and the access to information about their surrogate when the babies are older. There have been some messy cases in Australia, Britain and the US where intended parents have said the surrogate can have contact with the baby but then renege on the agreement.

What all this boils down to is that the pretty advertising images and joyful surrogacy stories cannot hide the fact that surrogacy is built on the commodification of women and babies, whether altruistic or commercial. The babies are produced as a result of a contract and a money transaction. Some  intended parents are even crowdfunding to raise the money to commission a surrogate.

As part of the commodification of surrogacy, intended parents often scour for the cheapest overseas surrogate. This is highlighted in documentaries such as Made in India, about overseas surrogates, which also feature Australian couples shopping for the cheapest surrogate. Before the crackdown on commercial surrogacy in India, it was a popular destination for intended Australian parents because it was cheaper than the US.

Surrogacy is big business. Estimates suggest that the worldwide surrogacy industry was worth US$22 billion in 2022 and will grow to US$129 billion by 2032. There are the lawyers, fertility clinics, surrogacy agencies, doctors, counsellors and payments to surrogates. In this commercial world, you have to wonder the extent to which human rights are considered.

Last year the (late) Pope Francis called for a  global ban on surrogacy because he had concerns about the dignity of the birth mother and baby. “I deem deplorable the practice of so-called surrogate motherhood, which represents a grave violation of the dignity of the woman and the child, based on the exploitation of situations of the mother’s material needs,” he said.

A number of feminists on the left are also concerned about the exploitation of surrogates. But often the question of surrogacy is framed as a contest between conservatives and progressives. It shouldn’t be. It’s about the dignity and human rights of the surrogate and baby: there is no right to have a child.

Republished from Eureka Street, 3 July 2025

The views expressed in this article may or may not reflect those of Pearls and Irritations.