We are thrilled to announce that our research on gestational surrogate mothers in the U.S. has been published.

We have long known that peer-reviewed research on the health of surrogate mothers and the babies they carry is lacking and knew that because of our expertise, we needed to be part of the solution to protect women and the children they carry. In 1985 the first successful gestational surrogacy occurred in the United States and since that time the market on a woman’s womb has sky-rocketed. Meanwhile, #BigFertility has failed to provide sound research investigating the toll this practice has on the lives of surrogate mothers in the United States. 

Further, like egg “donation”, there is no national database to track the women, or the babies born from surrogate pregnancies to evaluate short-term and long-term risks to their health and well-being. Unfortunately, we’ve personally heard first-hand accounts of  surrogate pregnancies gone wrong: women with blood pressure so high they nearly die, women losing their wombs, children left motherless; the list goes on. However, medicine and our lawmakers don’t particularly care about anectodical evidence. They want research, data, and evidence.

We decided we would help provide this data to both the scientific community and public at large. In 2020, during the global pandemic, we set out to perform our first-ever scientific research on gestational surrogate mothers with hopes of publishing it in a peer-reviewed journal. Two years later, almost to the day, that paper has been published! Below is a brief synopsis of our study and what was found.

We interviewed 96 women that had completed both their own biological (or spontaneous) pregnancies as well as one or more gestational surrogate pregnancies. Of course, we encourage you to read the publication in its entirety, but here’s a brief breakdown of some important findings: 

  • Our data revealed that a woman was more likely to have a pregnancy that was high-risk during a surrogate pregnancy than during a non-surrogate pregnancy. It’s known that age and number of pregnancies increase a woman’s health risk during pregnancy, so our statistician controlled for the age and number of pregnancies and still found surrogate pregnancies to be high-risk!   
  • A surrogate pregnancy had three times higher odds of resulting in a cesarean section and was five times more likely to delivering the baby or babies early. 
  • Women in this study were significantly more likely to experience postpartum depression following the delivery of surrogate children than after delivering their non-surrogate children.
  • Surrogate mothers were more likely to have unfavorable outcomes during her surrogate pregnancy. These included: high blood pressure, hemorrhage, pre-term labor (going into labor before the baby was full-term), placenta previa, postpartum depression, and postpartum high blood pressure. 
  • Eighteen women stated that they had new illness or medical condition after their surrogate pregnancies. 
  • The rate of new post-surrogacy chronic health issues for women of color was significantly higher than for women identified as white. 
  • Women are motivated to become surrogate mothers for various reasons, one being the financial incentive promised by fertility clinics. Women in this study were divded into tax tiers based on their reported yearly family income, all participants were in the lower 4 (of 7) tax tiers. We found that women’s economic disadvantage was a major contributor to the decision to proceed with surrogacy. Women reported using the money they received largely to pay bills or get out of debt. 

We were inspired by a study published in 2018 by Irene Woo and her colleagues which demonstrated that surrogate pregnancies were, in fact, different (read: worse for the mother and infant), than spontaneous (or biological) pregnancies. Specifically, they found that infants carried by gestational surrogates have increased risks for preterm birth and low birth weight and surrogate mothers were found to have increased risks for hypertension, maternal gestational diabetes, and placenta previa. Our research builds on and adds to Woo’s work by evaluating the total experience of surrogate mothers, including much more than the direct health risks. Further, unlink Woo’s study, we had the opportunity to interview each mother about their lived experiences gaining insight through a structured survey that offered the participants an opportunity to say whatever they’d like about their experiences. This study gave surrogate mothers a voice they are often denied. 

Overall, our study, like Woo’s, confirms that health disparities exist for women with surrogate pregnancies compared to non-surrogate pregnancies, which can lead to long-term complications after a surrogate pregnancy. In terms of biomedical ethics, it raises important social, economic, and political issues related to surrogacy, all requiring further exploration.