As assisted reproduction technology has evolved and become more effective, the number of parents using surrogacy has increased. It is estimated that over 500 children are born through surrogacy to UK parents each year (Brilliant Beginnings, 2020).
Surrogacy involves an individual intentionally becoming pregnant and carrying a child for someone else to become the intended parents (Payne et al, 2020). Surrogacy is a means of forming a family in a multitude of situations, including infertile heterosexual couples, same-sex couples, and women who have experienced multiple miscarriages, in addition to those who have congenital or medical conditions meaning they cannot carry children (Horsey et al, 2022).
In full surrogacy (also known as gestational or host surrogacy), pregnancy can be established through IVF or intrauterine insemination. A fertility clinic uses an embryo that the intended parents have created, either together or by substitution of one of the intended parent's gametes with egg or spermatozoa donation, meaning there is no genetic relationship to the surrogate (Horsey, 2024). Partial surrogacy (also known as traditional surrogacy) involves the surrogate being inseminated with an intended father's spermatozoa – in this case, the surrogate is genetically related to the baby being carried (Horsey, 2024).
Legal issues
Surrogacy is legal in the UK, although it is illegal to advertise for a surrogate or for a third party to profit from matching. A surrogate cannot be paid, except for reasonable expenses. Surrogacy arrangements in the UK are regulated by the Surrogacy Arrangement Act (1985) and the Human Fertilisation and Embryology Act (2008). It is important to note that if a surrogacy agreement is constructed, it cannot be enforced by UK law (UK Government, 2024).
» An ongoing longitudinal study identified that the psychological wellbeing of children born by surrogacy has been positive «
At birth, the surrogate is identified as the legal parent, and if they are married or in a civil partnership their spouse will be the child's second parent, unless they did not give permission. Legal parenthood can be transferred using a parental order or adoption post-delivery (UK Government, 2024). The surrogate is entitled to 52 weeks maternity leave and can return to their job after the birth. The intended parents may be eligible for adoption pay or leave and paternity pay or leave (UK Government, 2024).
It is important to note that if a surrogate is used abroad, legal advice should be sought in relation to the law in different countries. An ongoing longitudinal study identified that the psychological wellbeing of children born by surrogacy has been positive (Golombok et al, 2013). It has also been found that, in the long term, surrogates are generally resilient, with minimal effects on psychological health (Pizitz et al, 2013; Imrie and Jadva, 2014; Soderstrom et al, 2016).
Overall, it is important that health visitors are aware of the use of surrogacy in the UK to ensure they provide ongoing support to families. For medical professionals providing ongoing care for surrogates, intended parents and their children, there is guidance available from the Department of Health and Social Care (2021).
