Issue Analysis: Surrogacy

What is surrogacy?

Surrogacy is the practice by which a woman (called a surrogate mother) becomes pregnant and gives birth to a baby in order to give it to someone who cannot (or will not) bear children of their own. A surrogate mother is a woman who carries and gives birth to the child of another woman, who is usually infertile, by way of a pre-arranged legal contract.

There are two main types of surrogacy, gestational surrogacy and traditional surrogacy. Additionally, if the surrogate mother receives compensation beyond the reimbursement of medical and other reasonable expenses, the arrangement is called commercial surrogacy; otherwise, it is referred to as altruistic surrogacy.

What is traditional surrogacy?

In traditional surrogacy, the surrogate mother is impregnated naturally or artificially, but the resulting child is genetically related to the surrogate mother. A traditional surrogate is the baby's biological mother since the child was conceived from the union of her egg and the father's sperm.

What is gestational surrogacy?

In gestational surrogacy, the pregnancy results from the transfer of an embryo created by in-vitro fertilization (IVF), in a manner so the resulting child is genetically unrelated to the surrogate. Gestational surrogate mothers are also referred to as gestational carriers.

Is surrogacy legal?

The laws forbidding or allowing both altruistic and commercial surrogacy vary from country to country and, within the U.S., from state-to-state. The law also varies based on whether the surrogacy is commercial or altruistic.

Is surrogacy ethical?

Almost all Christian bioethicists agree that most forms of surrogacy are theologically and morally problematic. The moral qualms generally concern the exploitation of women (e.g., “womb-renting”), the selling of children, the violation of the marital covenant, and the use of embryo-destructive reproductive technology.

Concerns about exploitation of women

In a commercial surrogacy arrangement in the U.S., the surrogate mother is typically paid $20,000 to $25,000, which averages to approximately $3.00 per hour for each hour she is pregnant, based on a pregnancy of 266 days or 6,384 hours. Few women who have the financial means are willing to undergo the pain, trauma, and grief of surrogacy for such low wages. Women who have low-income or a lack of financial resources are typically recruited to be surrogates.

In addition to being exploited for their wages, such women are rarely fully informed about the potential health risks associated with surrogacy (e.g., hormone injections) or with the emotional damage that can come from giving up a child. Many are unaware, for example, that during pregnancy, the female body is biologically, hormonally, and emotionally programmed to bond with the child.[1]

Selling of children

Children are a gift from God (Psalm 127:3) and not a commodity that can be bought and sold. Traditional surrogacy is always immoral if the mother gives up her child for payment. Likewise, gestational surrogacy is always immoral when the embryos or games used in the surrogacy are “purchased” for the purpose of implantation.

Many, if not most, Christian bioethicists and legal scholars would agree that commercial surrogacy is morally and legally problematic since it constitutes the sale of a child. Some even claim it is a form of human trafficking.[2] The general consensus is that such arrangements violate the human dignity of the child and the gestational mother.

Violation of the marital covenant
As Scott B. Rae and Paul M. Cox explain, surrogacy violates the creation norm for marriage, family, and procreation, by introducing a third-party contributor, either in the form of a womb donor or a womb and an egg donor.[3]

For instance, the use of donor gametes is an act that includes a third party in an event that was meant to remain strictly within the marriage covenant. It also prevents infertility from being a burden shared by both spouses. As Dawn McColley explains,

Because of the special union in marriage, problems such as infertility are shared by both spouses and should be borne by both. Our traditional marriage vows say, ‘for better for worse, … in sickness and in health.’ By using the gametes of a donor, the fertile spouse refuses to share the burden.

This refusal to share burdens is not a Biblical response to God's will, nor is it the way Christian spouses ought to treat each other. Children are not the sole, sacred purpose of marriage. If God has chosen to withhold that blessing from one spouse, He necessarily chose to withhold it from the other.[4]

General concerns about embryo-destructive reproductive technology

On average, only about 25 percent of embryos that are created by the use of IVF and transferred to the womb develop until birth. Because of this high failure rate, surrogacy often involves creating more embryos than will be implanted in the womb. The embryos are usually kept in a state of suspended animation (i.e., cryogenically frozen) until their death (which usually occurs in less than 10 years).

 Several passages in the Bible strongly suggest that human life begins at conception

(Job 31:13-15; Ps. 51:5; 139:13-16; Matt. 1:20). The Bible is also clear about the taking of innocent life (Exod. 20:13; Deut. 5:17). For these reasons, Christians should not support any reproductive techniques that create embryos that will not be implanted in a womb.

Doesn’t the Bible mention surrogacy?

There are two cases of surrogacy mentioned in the Bible. In Genesis 16, Sarai tells Abram, “The Lord has kept me from having children. Go, sleep with my slave; perhaps I can build a family through her” (Gen. 16:2). In Genesis 30 very much the same scenario occurs but this time it was Rachel who said to her husband Jacob, “Here is Bilhah, my servant. Sleep with her so that she can bear children for me and I too can build a family through her” (Gen. 30: 3).

Neither of these accounts provides an example for Christians should act. Both cases illustrate the distortion of family relationships and society that result from breaking the marital bond in order to overcome infertility.[5]

Are there any forms of surrogacy that are ethical?

One surrogacy arrangement that many Christian bioethicists believe may at times be morally acceptable is “rescue surrogacy.” In this situation, a surrogate mother volunteers her womb to save an IVF-created embryo that has been frozen and is destined for destruction. While concerns such as the violation of the marital bond are still applicable and should be taken into account, the rescue of an innocent child may be a morally justifiable overriding consideration.