Why Do Individuals Seek Surrogacy Abroad? Motivations and Experiences of Intended Parents in Transnational Surrogacy Arrangements

Background: Despite the worldwide popularity of transnational surrogacy (i.e., the travel to a low-income country for a contractual agreement wherein a women agrees to carry and deliver a baby for another individual or couple to raise), little is known about the process of transnational surrogacy in a variety of contexts, the motivations of individuals who travel abroad for surrogacy, and the relationship formation between intended parents (IPs) and surrogates. The purpose of this qualitative study was to explore the relationship of IPs with their surrogate mothers in transnational contexts, detail the surrogacy process from IPs’ perspectives, and examine IPs’ motivations for using transnational surrogacy.

Method: Ten semi-structured interviews were conducted between January and June 2015 with individuals and couples who had participated in commercial surrogacy arrangements within the last 5 years. Only IPs living in the Global North who traveled for surrogacy were permitted to participate. Study participants were recruited through various transnational surrogacy networking non-profits. Information regarding the study was posted onto various social media sites, and interested parties contacted the researchers directly via email. Four participants lived in the U.S., 3 in Australia, 1 in Israel, 1 in Germany, and 1 in the U.K. Interviews were recorded, transcribed verbatim, and coded and analyzed for categories and themes. Analysis was guided by the principles of phenomenology with the goal of describing the phenomenon of transnational surrogacy from the perspective of IPs.

Results: Three major themes merged from analysis. First, motivations for pursing transnational surrogacy included health complications that made it difficult or impossible for pregnancy to occur and legal restrictions imposed in IPs’ home countries. IPs described how significant barriers and hardships were experienced before opting for surrogacy. Second, participants identified positive experiences with the transnational surrogacy process, such as affirmative interactions with medical staff and travel, but difficulties tended to emerge in relationship to agents who acted as “middlemen” between the surrogate clinic and IPs. Third, the relationship between IPs and the surrogate differed based on the surrogate country and agency regulations; however, there was typically minimal contact with the surrogate. IPs described the anxiety that they felt from being kept away from the surrogate and recognized the importance of keeping in contact with the surrogate.

Conclusions and Implications: IPs face medical and legal challenges in their own lives leading them to seek out transnational surrogacy. Additional complexities arise in the transnational surrogacy process that are not consistently addressed by clinical staff or legal assistance. Furthermore, the relationship between IPs and surrogates is heavily mediated by the surrogacy clinics, and IPs report that this can be distressing. Findings highlight the need for comprehensive health services for IPs and surrogates to address not only medical issues, but also mental health distress during the surrogacy process. Social workers are uniquely adept to provide international social services to both IPs and surrogates and, consequently, should be engaged in international surrogacy issues.