Legal Framework of Surrogacy Legal Countries, Surrogate Mothers’ Rights and Interests Protection and Risks Full Analysis

Legal Policies and Core Differences of Countries Where Surrogacy is Legal

Countries and regions that explicitly allow commercial surrogacy

Ukraine

Legal Basis: The Family Code of 1997 clarifies the legality of surrogacy, allowing only married heterosexual couples to participate and requiring medical proof (if the woman is unable to conceive).
Parental rights: The birth of a newborn child is registered directly with the commissioning party as the legal parent, without the need for adoption procedures. The surrogate mother has no right to claim custody.
Cost Transparency: Single cycle costs approximately $40,000 – $60,000, including medical, legal and surrogate mother compensation (approximately $15,000 – $25,000).

Georgia

Legal inclusivity: married couples, singles and the LGBTQ+ community are allowed to commission surrogacy, with no restrictions on nationality.
Technical standards: PGT-A (embryo chromosome screening) technique, 60-70% live birth rate, surrogate mothers are legally required to be 20-35 years old and have had at least one healthy child.

Some U.S. States (e.g. California, Texas)

Differences in state laws: California allows commercial surrogacy, and surrogacy agreements are mandatory when approved by a court of law; Texas only allows “altruistic surrogacy” (surrogate mothers receive only a reasonable fee).
Contractual norms: the client must pass a psychological evaluation, and the surrogate mother must have medical insurance (≥$500,000) covering 20 pregnancy complications.

India and Cambodia (changing policy dynamics)

Policy risk: India banned commercial surrogacy in 2015, allowing only altruistic forms; Cambodia banned it completely in 2016, but the underground chain is still active.

Legal controversies and ethical challenges

Divergence of EU countries: France, Germany, etc. prohibit surrogacy and refuse to recognize the identity of transnational surrogate children, triggering international legal conflicts (e.g., Mennesson v. France).
Nationality determination dilemma: Surrogate children may face nationality conflicts, e.g., U.S. surrogate babies need to be 21 years old before they can apply for green cards for their parents.

Legal Protection Mechanisms for Surrogate Mothers

Contract terms and protection of rights and interests

The core content of the contract

Delineation of rights and obligations: It is clear that the surrogate mother needs to be under medical supervision, no smoking and drinking, and the commissioning party needs to pay compensation in stages (30% for contracting and 40% after delivery).
Medical liability: If the surrogate mother’s behavior leads to miscarriage, the collected money should be returned and liquidated damages should be paid; if the health damage is caused by medical malpractice, the agency should bear the compensation responsibility.

Health Management Standards

Medical Screening: The surrogate mother needs to pass the reproductive function assessment (AMH>1.1 ng/mL), infectious disease screening (HIV, Hepatitis B and other 8 items) and psychological assessment (SCL-90 scale).
Pregnancy monitoring: stay in a medically supervised apartment, daily monitoring of blood pressure (<130/85 mmHg), fetal heart rate (120-160 beats/min), customized high-protein diet (120 g/day) and iron supplementation.
Psychological support and privacy protection
Postpartum diversion: Cognitive Behavioral Therapy (CBT) is provided to alleviate mother-infant separation anxiety, and surrogate mothers are required to sign a lifelong confidentiality agreement, but anonymous letter delivery services are allowed.

Anti-Exploitation Provisions and Compensation Mechanisms

Economic security: compensation for surrogate mothers is paid directly to individual accounts, and agency commissions are ≤30% to avoid agency deductions.
Career transition support: some agencies provide baby sitter training, and surrogacy compensation is paid over 3 years to reduce the risk of returning to poverty.

Legal and Health Risks for Surrogate Mothers

Health Risks

Medical Complications

Ovarian Hyperstimulation Syndrome (OHSS): Ovulation stimulation drug abuse leads to bloating and blood clots, with an incidence of about 3%-8%.
Uterine damage: multiple embryo transfers or violent egg retrieval may trigger uterine adhesions, rupture, and even lifelong infertility of the uterus.

Psychological trauma

Postpartum depression: 35% of surrogate mothers experience symptoms of traumatic loss (e.g., anxiety, self-identity crisis) and require long-term psychological intervention.

Social and Ethical Risks

Class Exploitation: Surrogate mothers mostly come from poor areas and are forced to exchange their bodies for financial compensation, exacerbating social inequality.

Disputes over children’s rights and interests: Surrogate children may face identity dilemmas, such as the custody disputes exposed by the “Zheng Shuang surrogacy abandonment case”.

Risk Avoidance and Compliance Paths

Self-protection strategy of the client

Choosing a Compliant Organization

Qualification Audit: Confirm that the organization holds a license for assisted reproduction services and that the partner hospital has an ISO 9001-certified laboratory.
Successful Case Verification: Require more than 10 live birth cases and a rating of 4.5 stars or higher from a third-party platform (e.g. Trustpilot).

Complete legal documentation
Cross-border consultation: The client is required to consult with a lawyer in advance in her home country to confirm the nationality determination and settlement process of the surrogate child.
Insurance coverage: Ensure that the surrogate mother is insured for ≥ $100,000 medical insurance, covering complications such as eclampsia and preterm labor.

Call for Industry Norms

Global ethical standards: The UN Committee on the Rights of the Child has called for the harmonization of rules governing surrogacy and a ban on the sale of children in commercial surrogacy.
Legislative Refinement: The operational norms such as multiple pregnancy reduction and embryo freezing period need to be clarified to reduce the legal gray area.

Conclusion: seeking a balance between legality and ethics

Surrogacy legalized countries provide some families with the hope of procreation, but its sustainability relies on legal improvement and ethical supervision. The commissioning party should choose a compliant organization, scrutinize the terms of the contract, and prioritize the health and dignity of the surrogate mother. Countries need to strengthen international cooperation and establish uniform ethical standards for surrogacy to avoid the misuse of technology and the alienation of human nature, so that the transmission of life always carries respect and hope.