Womb for rent: More women are working as commercial surrogates as global demand rises

Dilara has lived in Tbilisi for several months and is now able to turn her hand to many types of work from hairdressing, shoemaking, waitressing, and more.

She really only wants one job: to have a baby.

The 34-year-old widowed mother of four fled her children to Uzbekistan last summer with her parents, in hopes of finding work in the country’s growing commercial surrogacy market.

"I had bank loan debts and have four children to care for. You know they have school and expenses. It's difficult on my own," Dilara said to CNBC.

Yes, I would love to be a surrogate mom.
Dilara

Commercial surrogacy refers to an arrangement in which a woman is paid a fee for carrying a pregnancy for another person or couple. This differs from altruistic surrogacy, in which a woman volunteers to carry a pregnancy without any compensation beyond medical reimbursements.

Typically, commercial surrogacy is gestational surrogacy, meaning the surrogate has no biological link to the child.

The laws around surrogacy vary widely from country to country and state to state. In the U.S., for instance, the practice is permitted in some states but banned in others, while in Canada and the U.K., only altruistic surrogacy is allowed. In Georgia, meanwhile, as in Ukraine and Russia, both forms are legal.

The commercial surrogacy market is growing

Dilara is just one of many women who are turning to commercial surrogacy for income due to the growing demand worldwide for carriers.

According to Global Market Insights, the global commercial surrogacy market was valued at $14 billion by 2022. However, exact figures are difficult to verify due to the private nature many of these arrangements.

By 2032, that figure is forecast to rise to $129 billion, as infertility issues increase and a growing number of same-sex couples and single people look for ways to have babies.

That demand is driven primarily by so-called intended parents in wealthy, Western nations. Many of these are seeking cross-border surrogacy services to avoid long waiting lists or higher fees at home, or because domestic laws forbid surrogacy or exclude particular groups — such as gay couples — from the practice. The end of Covid-19 travel bans also led to an increase in global surrogacy demand last year.

"The pandemic reduced international surrogacy, but we're now seeing all that pent up demand," surrogacy expert Sam Everingham, who's global director of Sydney, Australia-based surrogacy support group Growing Families, said.

Ukraine war pushes surrogacy into new markets

Ukraine, which was second in the world behind the U.S. as a surrogacy market, attracted foreign parents with lower fees. Importantly, this includes the naming of intended parents on the baby’s birth certificate.

But that all changed with Russia's full-scale invasion of Ukraine on Feb. 24, 2022. Reports quickly emerged of surrogate mothers relocating to bomb shelters and prospective parents trying to enter Ukraine to be united with their surrogates.

Olga Pysana (partner at Ukrainian surrogacy agency World Center of Baby), said that there were a lot of intended fathers who were at different stages of their process. The agency had at the time 37 surrogates and 130 intended mothers. "We had no choice but to quickly find an alternative."

The conflict pushed the industry into countries such as nearby Georgia, where the laws closely mirror Ukraine's. World Center of Baby, which already had operations in Cyprus in 2022, plans to open its Georgia office this month. Mexico and parts of Latin America, meanwhile, have also seen a surge.

Commercial surrogacy programs in Georgia and Ukraine cost between $40,000-$50,000. In Mexico, they range from $60,000-$70,000. This compares to an average cost of $120,000 in the U.S.

"Here in Mexico, we're having again the boom around surrogacy, because Ukraine is closed," Ernesto Noriega, chief executive and founder of Egg Donors Miracles, a fertility agency based in Cancun, Mexico, said, noting a 20%-30% increase in surrogacy arrangements last year.

A source of income for women

The global boom has driven an uptick in demand for surrogates, with Facebook groups and agency adverts appealing to women with the promise of sizable incomes.

Lauragh, from southeast Ireland, who had her son in October 2021, stated that her surrogate was capable of buying a house in Ukraine for her and her daughters with the help of her earnings from this program.

Whether it is in Ukraine, Georgia or Mexico, the main motivator behind it all is financial.

Pysana stated that surrogates are "the main driving factor in Ukraine, Georgia and Mexico -- all the major markets -- it is the financial motivation behind them."

Indeed, Dilara was attracted by the prospect of higher earnings when she was first introduced to surrogacy by a colleague working with her at a call center. "If you want to do surrogacy, they give you good money," she recalled being told by her younger female colleague.

However, the draw of women into the industry has raised concerns, not least for the often large disparity between agency fees and surrogates' ultimate earnings. In many cases, a surrogate may earn less than a quarter of the tens of thousands of dollars charged to intended parents.

"There is one thing I have been researching for two months about this job, and the doctors take $50,000, $60,000 from the parents and give from $12,000 to $20,000 to the surrogate mother," Dilara said. "It's unfair what they do."

Pysana, Noriega and their attorney, Noriega, claimed that their agency fees were justified by the high medical costs involved and the cost of housing surrogates and feeding them in the final weeks of their pregnancy. They acknowledged, however, that corruption can exist at other companies.

Ethical concerns, exploitation risks

Commercial surrogacy is not without ethical concerns. Critics argue that it exploits vulnerable women.

For agencies, one requirement is that potential surrogates be either single or widowed and have at least one child. This is to prove that a woman can be pregnant and avoid disputes with her partners, according to agencies.

This is a bad industry for women. They are, for me, victims.

"This is not a good business for women," stated Teresa Ulloa Ziaurriz (regional director, Coalition Against Trafficking in Women and Girls in Latin America and the Caribbean, CATWLAC). "For me, they're victims."

Ulloa Ziaurriz said that in her experience working as a women's reproductive lawyer across Latin America — chiefly in Argentina, Colombia, Ecuador and Mexico — agencies specifically target those facing financial hardship.

"After the pandemic, a lot of women lost their jobs. They looked for single women with children who desperately needed economic support," she said of agencies, describing the process as a form of human trafficking.

The surrogacy process is also physically and psychologically demanding, and while most agencies require prospective carriers to undergo mental and physical health checks before entering into an arrangement, a lack of regulation leaves scope for mistreatment.

"There are no international standards and new programs are being launched in unregulated places," Everingham said.

A call for surrogacy standards

Some countries are now trying to right these shortcomings. In the U.K., for instance, regulatory authorities are working on a review to improve domestic surrogacy safeguards.

"While there is little we can do to alter surrogacy laws abroad, what we can do is ensure that the regime in the U.K. is well regulated and in the best interests of the child, surrogate and intended parents," professor Nick Hopkins, family law commissioner at the Law Commission of England and Wales, said.

In the first three quarters of 2022, more than 400 parental orders were made for surrogate parents in the U.K. According to the Law Commission, the number of children born via surrogacy could be around 10 times higher today than it was a decade ago.

But with no international coordination, Lauragh said the onus is on intended parents to do their research and ensure that surrogate mothers are given a fair deal.

"If you're looking to undertake the process it's your responsibility to do the research," said Lauragh, noting that she insisted on having direct communication with her surrogate throughout the process. The two remain in touch today.

"There are some very cheap agencies out there, but if they're cheap you can be sure that the surrogate is paying the price for it," she added.

Still, surrogacy advocates insist that, aside from offering a path to parenthood for those who cannot conceive naturally, surrogacy can be enabling for women.

"If you speak to surrogates, they say that this is quite empowering," Pysana said. "They have a feeling that they're doing something great."

Dilara, meanwhile, said her surrogacy journey remains ongoing.