Popularly billed as either a “miracle” solution for involuntarily childless couples or as a “step too far” that should be halted in its tracks, surrogacy is becoming big business around the world, posing many challenges for social workers.
The fact is that social care agencies can and do get drawn in. They may get cases referred during the surrogate’s pregnancy because of concerns about her exploitation or the arrangements for the child. They may become involved if family difficulties later develop – in either the “new” family or the surrogate’s own family, or if parents separate. They may see any of the parties via mental health services. Care workers must be well informed if they are to recognise the human rights and social work principles that need to be respected in order to practise safely and ethically.
The history of social work is littered with examples of private arrangements that failed to adequately protect vulnerable parties. Nowhere more so than in adoption and fostering, both nationally and internationally, where children were too often seen as commodities to meet adults’ needs, even if those adults are well-intentioned “rescuers”.
Although not perfect, legislative changes and international conventions have brought such processes under public scrutiny and made the voice of the child stronger. The same protection is largely absent in surrogacy, which some have described as the “wild west” as far as regulation goes.
Adults whose “natural” route to parenthood is blocked – for medical reasons; because they are gay and so on – can find myriad websites telling them they have the “right to parent” and, in the process, sidelining the right of surrogate-born children to have safe and secure parenting. Many highlight vetting processes for surrogates – to ensure they produce “healthy” children and do not renege on the handover – but remain silent on vetting processes for intended parents.
The right to know
So what is the process? Would-be parents can recruit surrogates in either the UK or overseas, usually through agencies or personal networks (“advertising” is illegal). Although commercial surrogacy is banned in the UK and the law only allows “reasonable expenses” for surrogates, the reality is that financial transactions have proved difficult to police. The risk of child trafficking cloaked as surrogacy may not be great but warrants more vigilance by child protection agencies.
In genetic surrogacy arrangements, the surrogate is genetically related to the child as her egg is inseminated with the intended father’s sperm. With gestational surrogacy, the surrogate has no genetic link as an egg donor is used, or an embryo created from the intended parents.
The latter is often recommended on the grounds that the surrogate is less likely to want to keep the child but there is no evidence to back this up. Viewed from surrogate-born child’s perspective, gestational surrogacy is the more complicated of the two as it can mean having three “mothers”, rather than “only” two. This is significant as evidence points to the importance of children knowing about alltheir genetic and gestational origins from infancy and having good quality biographical information to make sense of their background.
But there are no requirements to make this clear to would-be parents, or prepare them to help their child, and no robust requirements to even keep records for later release to surrogate-born offspring. Neither are surrogacy arrangements automatically stopped – as would be the case in adoption – if the intended parents say they will withhold information from the child. All this flies in the face of children’s human rights to know their full identity, including all their parents.
Opportunities and dangers
Under UK law, the surrogate is the child’s legal parent until the intended parents are granted a parental order. They have to meet certain eligibility criteria and demonstrate to the court that the welfare of the child is secured. However, the Cafcass worker preparing the court report is only appointed well after the child has been born and started living with the intended parents (surrogate-born infants usually go straight into the care of intended parents). Hence their room for manoeuvre is limited but even at this stage it can be crucial to press reluctant parents to commit to openness with their child (including about the egg donor if used).
While there appear to be altruistic surrogates who relish their role in creating a new family and who maintain contact, there are others who feel they have been pressured into it, who are financially motivated or who regret it on reflection. Social care staff need to be alert to anyone contemplating surrogacy to ensure they are not being coerced or exploited and to assist those struggling in its aftermath.
Medical science creates opportunities; social workers need to ensure it does not create unnecessary dangers through surrogacy.
If you are interested in being a surrogate, please send an email to email@example.com. If you are interested in being matched with a surrogate, please send an email to firstname.lastname@example.org