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Duke Medical Ethics Journal

Keeping The Surrogacy Miracle

by Zeqi Sun

Surrogacy, the practice of a woman carrying and delivering a child for another person or couple, has gained significant attention in recent years due to its ethical, legal, and health implications. While surrogacy offers a viable solution for individuals or couples struggling with medical conditions that prevent them from carrying a pregnancy, it also raises concerns about maternal health. This article will explore the complex relationship between surrogacy and maternal health, examining the potential benefits, challenges, and ethical considerations associated with this practice.


One of the primary arguments in favor of surrogacy is that it provides an opportunity for individuals or couples who are unable to conceive or carry a pregnancy to become parents. For those struggling with infertility, surrogacy offers a chance to fulfill many individuals’ dreams of becoming a parent and starting a family. Additionally, surrogacy also promotes equity and inclusivity efforts, as it also provides an option for same-sex couples or single individuals who wish to become parents [2]. Surrogacy can provide access to parenthood for those who may not have other viable options and can bring immense joy and fulfillment to all parties involved, including the surrogate.

The many options of surrogacy make it a miraculous solution for many couples. One popular form of surrogacy includes gestational surrogacy, where the surrogate carries a child conceived through in vitro fertilization (IVF) using the egg and sperm of either the parents or donors [3], making it possible for both the mother and father to share a genetic link to the child. This further emphasizes the potential of surrogacy.

“While surrogacy allows the birth of bundles of joy, the physical and mental health of the surrogate is an equally important issue to consider.”

However, surrogacy also poses maternal health challenges. Pregnancy and childbirth are complex physiological processes and carry risks for both the mother and the fetus. Surrogates face health risks, including gestational diabetes, preeclampsia, and other pregnancy-related complications [5]. In addition, the psychological and emotional well-being of the surrogate during and after the pregnancy may also be affected. Sadly, many surrogates are left on their own to adjust physically and physiologically after birth because many families don’t see the need to care about the surrogate after the baby has been delivered. Importantly, research has shown that surrogates have higher levels of depression, in comparison to a control group of mothers during pregnancy and post-birth [3]. The reality is that the reason for the higher levels of stress came from many surrogates’ need to hide their surrogacy and hide from others’ criticism. The root of this criticism comes from some people seeing surrogacy as selling one’s own body for profit. Although many surrogates just love being able to help others fulfill their dreams of starting a family, the reality for many surrogates is that they have to face malicious attacks.


One very important aspect of surrogacy that needs to be considered is the potential for exploitation and commodification of women's bodies. In some situations, women, often from socioeconomically disadvantaged backgrounds, may be coerced or exploited into becoming surrogates for financial reasons [1]. In these situations, these women often face inadequate compensation, lack of proper medical care, and limited legal protection. In many of these cases, surrogates may also find themselves having multiple pregnancies in a short period of time in order to make more profit, which can carry significant health risks to both the surrogate and the fetus.


While surrogacy allows the birth of bundles of joy, the physical and mental health of the surrogate is an equally important issue to consider. Some things that can be done to protect surrogate health include taking down the social stigma to reduce surrogate stress. We must also allow individuals and organizations to provide support for surrogates to ensure that contracts take into account the interest of the surrogate to eliminate the tragic reality of forced exploitation of women’s bodies.


Surrogacy is a miracle for many families to fulfill their dreams,

as well as a profession for many women to achieve self-

fulfillment. However, there is no doubt that the question of

what kind of choice should be made regarding the health of

the surrogate and the fetus is an ongoing discussion of ethics.

By becoming more knowledgeable and speaking up for

surrogates who do not have a voice, we will continue to make

these miracles possible for many in a safe and ethical manner.

Review Editor: Sam Shi
Design Editor: Harris Upchurch

[1] Guardian News and Media. (2017, March 28). Cross-border surrogacy: Exploiting low income women as biological resources? The Guardian. Retrieved February 12, 2023, from

[2] Jadva, V., Gamble, N., Prosser, H., & Imrie, S. (2019, March). Parents' relationship with their surrogate in cross-border and domestic surrogacy arrangements: Comparisons by sexual orientation and location. Fertility and sterility. Retrieved March 1, 2023, from

[3] Lamba, N., Jadva, J., Kadam, K., & Golombok, s. (n.d.). Retrieved February 27, 2023, from

[4] Marie, S. (2022, February 28). Gestational surrogacy: What is it, what to expect, Laws & More. Healthline. Retrieved March 5, 2023, from

[5] U.S. Department of Health and Human Services. (n.d.). What are some common complications of pregnancy? Eunice Kennedy Shriver National Institute of Child Health and Human Development. Retrieved March 1, 2023, from

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