Surrogacy: the experiences of surrogate mothers Vasanti Jadva 1 , Clare Murray, Emma Lycett, Fiona MacCallum and Susan Golombok City University, London, United Kingdom 1 To whom corresponding should be addressed at: Family and Child Psychology Research Centre, City University, Northampton Square, London EC1V 0HB, UK. E-mail: V.Kerai@city.ac.uk BACKGROUND: This study examined the motivations, experiences and psychological consequences of surrogacy for surrogate mothers. METHODS: Thirty-four women who had given birth to a surrogate child approximately 1 year previously were interviewed by trained researchers, and the data rated using standardized coding criteria. Information was obtained on: (i) reasons for the woman's decision to become a surrogate mother; (ii) her retrospective view of the relationship with the commissioning couple before the pregnancy, during the pregnancy, and after the birth; (iii) her experiences during and after relinquishing the child; and (iv) how others reacted to her decision to become a surrogate mother. RESULTS: It was found that surrogate mothers do not generally experience major problems in their relationship with the commissioning couple, in handing over the baby, or from the reactions of those around them. The emotional problems experienced by some surrogate mothers in the weeks following the birth appeared to lessen over time. CONCLUSIONS: Surrogate mothers do not appear to experience psychological problems as a result of the surrogacy arrangement. Key words: experiences/motivations/psychology/surrogacy/surrogate mother Introduction The practice of surrogacy, whereby one woman bears a child for another woman, is one of the most controversial procedures in the ®eld of assisted reproduction. Media coverage of surrogacy arrangements has tended to focus on the negative aspects of surrogacy, such as the `Baby M' case in the United States where the surrogate mother refused to relinquish the child (New Jersey Supreme Court, 1987). There are two types of surrogacy: partial (genetic), and full (gestational). With partial surrogacy, the surrogate mother is also the genetic mother of the child, and conception usually occurs by arti®cial insemination using the commissioning father's sperm. With full surrogacy, the commissioning couple are the genetic parents of the child and conception takes place at a clinic through IVF. There has been considerable unease regarding the potentially adverse effects of surrogacy for surrogate mothers. For example, it has been suggested that relinquishing the child may be extremely distressing and may result in psychological problems (British Medical Association, 1996). It has also been feared that the surrogate mother may form a bond with the baby prenatally that would make it particularly dif®cult for her to hand over the child to the commissioning parents. On the other hand, it has been proposed that surrogate mothers may tend to distance themselves from the unborn baby, believing that the child they carry is not theirs (Ragone Â, 1994). Such a detachment may make them more likely to put themselves and the unborn child's health at risk (British Medical Association, 1996). For those women who do relinquish the child, the risk of post-natal depression, as well as feelings of anger or guilt, may add further strain to the woman's psychological health. Whether or not the commissioning couple was known to the surrogate mother prior to the surrogacy arrangement, and whether or not the surrogate mother is the genetic mother of the child, are also factors that may in¯uence the psychological well-being of surrogate mothers. Furthermore, it has been argued that surrogacy may exploit women from a more economically disadvantaged background (Blyth, 1994), such that women may enter into a surrogacy arrangement because of ®nancial hardship without being fully aware of the potential risks (Brazier et al., 1998). Other concerns relating to surrogacy include the impact on the surrogate mother's partner, her parents and any existing children. The British Medical Association, in its review of surrogacy practice in the UK, emphasized the importance of partners of surrogate mothers giving their full support during the arrangement and after the birth of the baby. Where the surrogate mother has children of her own, the British Medical Association suggests that children should be informed about the arrangement beforehand, as the disappearance of the baby after the birth may cause them distress (British Medical Association, 1996). It has also been suggested that surrogate mothers may become ostracised or be shunned by disapproving neighbours and friends (Blyth, 1994), which may have an adverse effect on the psychological well-being of some surrogate mothers and their families. Human Reproduction Vol.18, No.10 pp. 2196±2204, 2003 DOI: 10.1093/humrep/deg397 2196 Human Reproduction 18(10) ã European Society of Human Reproduction and Embryology 2003; all rights reserved by guest on February 26, 2016 http://humrep.oxfordjournals.org/ Downloaded from