Is Surrogacy Ethical? Weighing the Arguments and the Evidence

Is surrogacy ethical? The short answer

Surrogacy can be practised ethically, but it is not automatically ethical. Studies of regulated arrangements are broadly reassuring for children and surrogates. Yet exploitation, trafficking and children left without legal parents are well documented where safeguards are weak, particularly across borders. How a programme is run matters more than the label.

If you are weighing whether surrogacy is right for your family, you deserve an honest picture rather than reassurance. This article sets out the main arguments on each side, what international bodies say, and what the research shows. It is a companion to our step-by-step guide to the surrogacy process, which explains how a journey works in practice. If contracts are your concern, read our post on surrogacy contracts abroad.

The case for surrogacy

Supporters argue that surrogacy lets people who cannot carry a pregnancy, including women without a functioning uterus, gay men and single men, build families, and that adult women can make informed choices about their own bodies. They say good regulation, not prohibition, best protects surrogates and children.

The reproductive-autonomy argument cuts both ways: it is about the intended parents' wish to have a child, and about a surrogate's right to decide what to do with her own body. Many surrogates describe their experience as meaningful and positive. Supporters also argue that bans do not end demand. They push it to places with fewer protections, where surrogates and children face the greatest risks.

Professional bodies have broadly taken a regulatory position. The International Federation of Gynecology and Obstetrics (FIGO) said in its 2025 position statement that it supports gestational surrogacy when it respects autonomy, informed consent, non-exploitation and the welfare of the child. The European Society of Human Reproduction and Embryology (ESHRE) concluded in 2025 that non-commercial surrogacy is an acceptable treatment for specific medical indications, with measures to protect all parties.

The main ethical concerns

Critics raise three linked concerns: exploitation of women, particularly poorer women recruited across borders; commodification, meaning that women's reproductive capacity and children are treated as goods to buy; and children's rights, including the right to an identity, to know their origins and to have legal parents and a nationality from birth.

Exploitation

Where women have few economic alternatives, consent may be shaped by need. Cross-border programmes can widen the gap in money and power between intended parents and surrogates, and recent criminal cases in several countries involved women recruited abroad, housed by clinics and given little say. ESHRE notes that commercial arrangements are more prone to exploitation, especially of economically vulnerable women.

Commodification

Critics argue that paying for pregnancy turns a relationship into a transaction. The ESHRE paper distinguishes reimbursement of costs, compensation for burden and payment that becomes an undue inducement. Where the line falls is one of the most contested questions in the debate.

The child's rights

A child can be harmed by the legal arrangements around their birth even when the pregnancy goes well. Children have been left stateless or in legal limbo when their parents' home country refused to recognise a foreign surrogacy. Other concerns include anonymous donation and records that make it hard for a person to trace their genetic and gestational origins.

What international bodies say

International opinion is split. A 2025 UN Special Rapporteur report calls for surrogacy to be abolished worldwide, while child-rights guidance such as the Verona Principles and medical bodies such as FIGO and ESHRE focus on safeguards. The Hague Conference paused work on a parentage convention in 2026, so no binding global framework exists.

• UN Special Rapporteur on violence against women and girls (2025). Report A/80/158 (opens in new tab), presented to the UN General Assembly in October 2025, describes surrogacy as a system of exploitation and violence against women and children and recommends its abolition, including through a binding international instrument. It is the view of an independent expert, not a treaty or a UN member-state decision.
• UN Special Rapporteur on the sale and sexual exploitation of children (2018). Report A/HRC/37/60 found that commercial surrogacy "as currently practiced usually constitutes sale of children", but said it may not do so if closely regulated in line with human rights standards.
• The Verona Principles (2021). Published by International Social Service after consultation with more than 100 experts, these 18 principles take no position for or against surrogacy. They focus on the child: best interests, non-discrimination, access to origins, regulation of intermediaries and prevention of the sale of children.
• Hague Conference on Private International Law (HCCH). After years of work on legal parentage, its governing council decided in March 2026 not to proceed to drafting a convention "at this stage", and asked for a report on developments before its 2028 meeting.
• European Union. Directive (EU) 2024/1712 added exploitation of surrogacy to the EU's anti-trafficking framework, with a transposition deadline of 15 July 2026.

What the evidence says about surrogates and children

Research from regulated settings, mostly the UK and North America, finds that children born through surrogacy do as well psychologically as other children into adulthood, and most surrogates report positive experiences. But gestational carriers face higher pregnancy risks than other mothers, and there is very little research on cross-border surrogacy.

• Children into adulthood. A Cambridge study following families from infancy to age 20 found no differences in young adults' psychological wellbeing or family relationships between families formed through surrogacy or donation and other families (Golombok et al., 2023). Young adults told about their origins before age 7 had more positive relationships with their mothers.
• Surrogates over time. A UK study of 20 surrogates found that 10 years after the birth, their psychological wellbeing remained good and none expressed regret (Jadva et al., 2015). The authors caution that the sample was small and may not be representative.
• Systematic review. A 2016 review of 55 studies found most arrangements went smoothly and found no evidence of harm to children, but noted serious methodological limitations and no studies of cross-border surrogacy (Söderström-Anttila et al.).
• Physical risk to surrogates. In an Ontario population study of births from 2012 to 2021, severe maternal morbidity occurred in 7.8% of gestational carrier pregnancies, compared with 4.3% after IVF and 2.3% after unassisted conception (Velez et al., 2024). Hypertensive disorders, postpartum haemorrhage and preterm birth were also more common.

Two cautions apply. The reassuring findings come largely from domestic, well-regulated arrangements, and they cannot simply be assumed to apply to international programmes. And the documented pregnancy risks are a reason to insist on excellent medical care and insurance for every surrogate. Our gestational surrogacy guide explains the medical side in more detail.

What ethical programmes do in practice

Ethical programmes operate lawfully in the country of birth, give the surrogate independent legal advice and counselling, respect her medical decisions, hold payments in escrow on a written schedule, insure her pregnancy and provide postnatal care, use single embryo transfer, and secure a clear legal route to parentage and nationality for the child.

• Screening and implications counselling for surrogates and intended parents, by separate professionals.
• Independent lawyers for the surrogate and the intended parents.
• No contract term that overrides the surrogate's right to make decisions about her own health and pregnancy.
• Transparent fees and a written compensation or expense schedule that is not conditional on handing over the baby.
• Health insurance, postnatal medical care and psychological support for the surrogate.
• Records of the child's genetic and gestational origins, kept for the child, and openness with the child as they grow.
• Home-country legal advice before treatment, so the child has legal parents and a nationality.

Our guide to choosing a surrogacy agency turns these principles into practical questions and red flags. Reasonable people will still disagree about surrogacy. What intended parents can control is whether their own journey meets the highest standard available.