What is Ethical Surrogacy?

When you see the term “ethical surrogacy” in an ad or on a website, what does that mean? Does everyone mean the same thing when they use this terminology? Deciphering all the information and terms while navigating your fertility journey can very challenging. Uganda used the American ethical standards for surrogacy for their legislation. Below you will find a list of what you should find in an ethical surrogacy program. If you are considering surrogacy, be sure to ask about these items to ensure that your parental rights are protected and so are the rights of your surrogate.

Autonomy – Your surrogate should have autonomy over her body. This means that the surrogate makes decisions about things that happen to her body. It is fine to agree in contracts about eating healthy foods and following the doctor’s orders, but the surrogate always needs to have control over her body, she is never forced to do something she does not agree with.

Separate Attorneys – Do you each have your own attorney? Do they work for different firms? Even though the Intended Parent pays for the surrogate’s attorney, it is important that she be represented by her own attorney.

Negotiated Contract – Each surrogacy agreement will be unique. Be wary if the IVF clinic gives you a surrogacy contract to sign that is a form. While every contract needs to follow the law and will have certain items in them, there are always negotiated portions. Even when the financial terms are already agreed upon, terms regarding behavior, termination, travel, Intended Parents in the delivery room, etc. are just a few examples.

Medical Records – Were medical records for your surrogate’s pregnanc(ies) collected and reviewed by a doctor? Were they approved to proceed before her profile was shown? This is for the safety of the surrogate and your baby. It is important that there is no history of complications that might impact future pregnancies. It is also important to ensure that another pregnancy is safe for you and your baby.

Living at home – Will your surrogate live at home with her family? If she does not live in a safe, supportive home, then she is not a good candidate for surrogacy. If she needs to relocate only shortly before delivery to be near your chosen hospital, then that is acceptable as long as it is her choice and she agrees. Surrogates should not live in facilities provided by the hospital, IVF clinic, or agency for the entire surrogacy journey or pregnancy.

Transfer no more than 2 embryos – MultiplePregnancies (twins, triplets, etc.) are more risky to the surrogate and the babies. Ethical practice dictates that no more than two embryos be transferred at one time.

Only Medically necessary c-sections – Some will try and convince you that a c-section will help keep the surrogate from bonding with the baby. This is not true. Bonding does not happen at the moment of delivery and a c-section is major abdominal surgery. It is important that cesarean sections only happen when they are medically necessary. A vaginal delivery is better for your baby and for the surrogate. Pain medications can be offered for a vaginal delivery if the surrogate prefers.

 Mutual Contact – The surrogate and Intended Parents should know the identity of each other and be able to communicate. If translators are needed these sessions can be facilitated by the agency, but the identity of the Intended Parent nor the Surrogate should be hidden from each other.

Mutual Selection – Surrogates and Intended Parents should be able to select each other. Information on the profile should include where the person is from, their first names, and basic information including marital status, relationship status, etc. A match call should be conducted and after this call each party should have an option to move forward with the match or not without any penalty.

Payment spread throughout the pregnancy – If your surrogate gets most of her compensation after delivery, this is not an ethical practice. A surrogate should be compensated throughout the pregnancy, typically monthly once there is a viable heartbeat detected by ultrasound. If your surrogate has a miscarriage then her compensation should be pro-rated for the amount of time that she carried the pregnancy.

Psychological Evaluation – The surrogate and her partner/ husband should be thoroughly examined by a mental health professional looking for understanding of the process, possible attachment issues, family support, no psychological or emotional issues, reliability and dependability, no pressure by others in their life, no undue financial inducement, and ensure fully imformed consent.

Legal Age – Surrogates should be of legal age, and at least over the age of 21.

Contract directly between surrogate and Intended Parents – You should have a contract directly with your surrogate that includes her name, the name of her attorney, your name(s), the name of your attorney, the terms of the agreement, including fee structure, and verifies her autonomy.

Funds held in Escrow – All funds should be held in an escrow account separate from the IVF Clinic or agency. Payments should be made directly into a bank account in the surrogate’s name. Funds should not be disbursed by the IVF Clinic.

Background Check – Both the surrogate and the Intended Parents should have a thorough background check done. Surrogate background checks should be done prior to their profile being shown to any Intended Parents.

Must have prior successful pregnancies and deliveries – A surrogate should have had at least one child within the last ten years and be raising that child. All prior pregnancies must have no complications that might impact a surrogate pregnancy.

Financially Stable – Surrogacy income is not to be used in place of employment. A Surrogate must be able to pay all of her bills and support her family without any surrogacy income.

Surrogate Compensation – Surrogate Compensation should not be so high that women are trying to become a surrogate even if there are requirements they do not meet; nor so low that only those not living above that country’s poverty line would consider it adequate compensation for the risk of pregnancy and delivery. Host Moms Uganda feels that the average annual salary of a college-educated woman working in the city is typically a fair basis for base compensation.