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  • Writer's pictureSociety of Bioethics and Medicine

The Cost of Commercial Surrogacy: Exploitation and Abuse

Written by Maisha Uddin

Edited by Ishraq Nihal

In 2016, Bridget was born prematurely, with multiple severe health issues, to a Ukrainian surrogate mother, along with a twin who died at birth. Despite Bridget’s survival, her American parents abandoned her, leaving her stateless with no legal ties to either the U.S. or Ukraine. Bridget’s case is not an isolated scenario. There have been, and continue to be, multiple cases where babies born via surrogacy have been abandoned by their parents.

In recent years, surrogacy has been on the rise, becoming an increasingly popular option for prospective parents. Surrogacy is an assisted reproductive technique where a third party, known as a surrogate, carries a baby to term for an individual or couple. There are two main types of surrogacy arrangements: altruistic and commercial. In the former, the surrogate does not receive monetary compensation, although their medical costs are typically covered by the parents. Meanwhile in a commercial surrogacy arrangement, the surrogate gets paid for their service.

The United States does not have any federal laws regarding surrogacy in place. Instead, policies vary from state to state, with states like Washington, California, and New York permitting both altruistic and commercial surrogacy, whereas Michigan only allows altruistic gestational surrogacy. Similarly, the legality of surrogacy on a global scale also greatly varies. Whereas countries such as France, Italy and Germany have outright prohibited surrogacy, altruistic surrogacy remains legal in the United Kingdom and Canada.

Countries like Russia and Ukraine have legalized commercial surrogacy, making them attractive options for prospective parents from places where surrogacy may be prohibited. The relatively inexpensive price of surrogacy in these countries also make them draw people on a global scale. While surrogacy costs on average around $100,000 in the United States, it costs approximately $50,000 in countries like Ukraine and Georgia.

While commercial surrogacy allows surrogates to gain monetary compensation for their services, it can be exploitative when unregulated, resulting in surrogate abuse as well as the abandonment of babies. Oftentimes, women become surrogates as a result of financial insecurity, and have to give up many of their rights when joining a surrogacy company. Ukrainian surrogates have reported facing forced abortions, poor living conditions, lack of health care, and underpayment.

Bridget’s case serves as a poignant example of how a lack of federal oversight can lead to the abuse of vulnerable groups. Following her abandonment, she was left stateless because without her parents she had no linkage to the United States. She also wasn’t considered a citizen of Ukraine due to the surrogacy arrangement made with her foreign parents and consequently was not eligible for adoption for multiple years. The legal status of children born via surrogacy greatly varies from place to place, with some countries viewing the surrogate as the child’s legal mother whereas others consider the intended parents to be the legal parents. There is a great need for more protective rights to be implemented for these children to ensure that they end up in a safe and stable home rather than being left in limbo.

A similar case in Thailand came under scrutiny when an Australian couple was accused of abandoning their baby born via a surrogate after he was diagnosed with Down Syndrome. This controversial case eventually resulted in the banning of commercial surrogacy in Thailand and the limiting of altruistic surrogacies to only Thai couples. While the banning of commercial surrogacy in countries like India, Thailand, and Nepal – all of which used to have a booming surrogacy industry – have been the governments’ attempt at curbing human trafficking and the exploitation of surrogates, it has only worsened the situation in countries like Ukraine as the demand for surrogates has heightened.

Despite the World Health Organization’s acknowledgment of the vast prevalence of infertility worldwide, it has not set forth any regulations for surrogacy. With countries worldwide having such varying laws regarding surrogacy, it is necessary for a global standard to be set to ensure the health and safety of surrogates and babies born via surrogacy. By ensuring that the surrogates and children are afforded legal protections on an international scale, the exploitation of these groups could be minimized and the practice of surrogacy could be conducted in a more ethical manner going forward.


- Hawley S. “Incurable” Bridget was born via surrogate in Ukraine and abandoned by her American parents. ABC News. 2019 Aug 19; Available from:

- Infertility. World Health Organization. Available from:

- Lamberton, Emma. Lessons from Ukraine: Shifting International Surrogacy Policy to Protect Women and Children. Journal of Public and International Affairs. 2020 May 1; Available from:

- Fenton-Glynn C. Surrogacy: Why the world needs rules for “selling” babies. BBC News. 2019 Apr 25; Available from:

Cheung H. Surrogate babies: Where can you have them, and is it legal? BBC News. 2014 Aug 6; Available from:

- Roache M. ‘Treated like cattle’: The human cost of surrogacy. Al Jazeera. 2018 Sep 13; Available from:

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