Surrogacy: the psychological issues

Abstract

Surrogate motherhood arrangements have increased in recent years and yet the practice remains controversial. The present paper evaluates the limited available research evidence. Issues discussed include: psychological stressors associated with surrogacy, attitudes towards the practice, motives of surrogate and commissioning couple and issues pertaining to their relationship, the question of the surrogate relinquishing the child to the commissioning couple and the child's subsequent development, and what the children are told of their origin. With regard to motives of surrogates, comparison is made with motives expressed by donors in other fertility‐related and biomedical contexts. The question of the surrogate relinquishing the child she bears is discussed in relation to attachment during pregnancy. Finally, with regard to the children conceived in this way, comparison is made with research findings relating to children conceived from IVF and DI. From the limited research and anecdotal evidence available a generally positive picture emerges of surrogates motivated largely by altruism, who express few concerns about separating from the child conceived as a result of the arrangement, with parents who are functioning well and the children themselves subsequently showing good adjustment. It is concluded that further systematic research is required to verify whether this picture is indeed correct.