Research, carried out in 2021-2022 by ICASM and ENoMW on the use of women as “surrogate mothers”, oocyte donors or forced pregnancies in cross-border practices. (Study also available in PDF ENG Final Migration and surrogacy)

Migrant women and reproductive exploitation[1] in the surrogacy industry

Introduction

The International Coalition for the Abolition of Surrogacy (CIAMS-ICASM) and the European Network of Migrant Women (ENoMW) have become aware, through national and international media reports and social networks, of the existence of practices that amount to trafficking in human beings, namely, women, for the purposes of exploitation in the reproductive industry^[2] . These situations are inherently contrary to human dignity and equality between women and men as practices of exploitation of women’s bodies.

Noting the lack of research on the subject, CIAMS and ENoMW decided to jointly carry out a survey on women exploited as “surrogate mothers”, oocyte donors or forced to carry a pregnancy (forced pregnancies) in cross-border practices. The aim was to identify and document the presence of women who are led to act as “surrogate mothers”, oocyte donors or forced to carry pregnancies in a country other than their country of origin, or on behalf of foreign third parties, in order to be able to alert states, competent authorities and partner NGOs, to how the above-mentioned practices may manifest in the context of migration (voluntary or forced) putting at risk the fundamental rights and human dignity of migrant women.

More specifically, ENoMW and CIAMS have sought to document these practices, which include

Exploiting migrant women for reproductive purposes in a variety of ways, including egg harvesting, forced pregnancy and surrogacy.
Organising a network of trafficking in women with the aim of making them “surrogate mothers” against their will (forced migration of women from their country of origin to another to force them to carry pregnancies (cases of forced pregnancy)).
Moving “surrogate mothers” to organise their delivery in a country other than their country of origin for the convenience of the clients (purchasing parents) or to circumvent legislation (the infant is thus born in the country where the purchasing couple/individuals are based, thus simplifying the administrative procedures for recognising the filiation between the infant and the clients(s))

This study therefore aims to answer two questions;

Are migrant women recruited as “surrogate mothers”, egg donors or for forced pregnancies in their country of arrival and without this being the reason for their migration?
Are women forcibly or willingly moved from their home country to a foreign country specifically for the purpose of surrogacy, egg donation or forced pregnancy?

More specifically, we hypothesise that there is a phenomenon of human trafficking behind the practices of surrogacy, egg donation and forced pregnancy, as well as multiple trafficking networks that use women in these practices as well as the children born from them. Indeed, as mentioned above, many disturbing reports of trafficking, particularly in Asia but also in Europe, have emerged over the past decade. It would also seem that these networks of trafficking in women for reproductive exploitation and of the children born from this exploitation are similar in their methods and organisation to prostitution networks, a fact that is all the more worrying when one knows how the latter operate. ENoMW and CIAMS therefore intend, through this report, to combat such practices.

In an attempt to answer our research questions and validate our hypothesis, we conducted a field survey. Firstly, the data collected during the survey and the methodology adopted to do so will be submitted to the readers. Then, the results of the survey will be analysed and discussed. To help us in this task and to enrich both our data and our reflection, we will draw on academic sources which, while not addressing this specific subject, sometimes evoke related issues such as migration, trafficking or surrogacy. Finally, a conclusion will be proposed in which we will return to the elements supported in this report and present what we intend to achieve as a continuation of this investigation.

Theoretical framework

In order to understand and analyse surrogacy in the complexity of the relationships and relations it contains, the notion of women’s appropriation is the most effective framework.

Theorised by Colette Guillaumin, social appropriation is “the fact that individuals of a class are material properties”, and it constitutes a specific form of social relations. The particularity of this relation, at present, is that it exists only between classes of sex, and that it is made invisible by the refusal to consider that it can still characterise the relations between women and men. The appropriation of women, “the fact that it is their materiality as a whole that is acquired”, lies in their reduction to the state of a tool, and it concerns both the materiality of bodily and psychic individuality (“when one is appropriated materially one is dispossessed mentally of oneself”).

In the social, economic, legal and political processes that lead to and contribute to women becoming mothers in surrogacy one finds several of the means of appropriation identified by Guillaumin, namely:

the labour market – which, even today, in the 21^e century, forces mothers to endure inequalities (E. Cukrowska-Torzewska, A. Matysiak) in terms of salary, status and career, when it is not openly a place of violence against them.
confinement in space, which takes the form of women’s obligation to obey the wishes and instructions of the people in charge, either not to move or to move, as is the case in displacement and forced migration in connection with surrogacy. In women’s relationship to space and displacement, appropriation is also exercised through the ‘internalisation of the fence’ (Guillaumin), achieved through positive and negative injunctions. It thus appears that the paradox is constantly present for women exploited in surrogacy, as the same arguments can be formulated to forbid them to move, as well as to ask them to do so (for those who do so voluntarily and deliberately, as well as for those who are forced or coerced, as it is the case in Ukraine, it is less important which arguments are used to control women’s movement).
The legal arsenal and customary law – if the collective appropriation of women is not formulated and codified as such, private appropriation is fixed in contracts. Moreover, this legal formulation of the use of a woman’s body, which is accepted today in the states that legalise surrogacy, is also based on a paradox. On the one hand, the woman who signs the contract to become a mother in the context of surrogacy is considered to be acting as a subject of law, free to make her own choices (without questioning the conditions under which this choice is made); on the other hand, by signing the contract, she is considered to be a tool, losing any capacity to decide for herself; moreover, her choice to engage in this process directly and materially implies lives other than her own: those of her children and, possibly, of her life partner.

Given the essential role that the state plays in organising the labour market, through the development and guarantee of labour laws and the adoption of macroeconomic measures for access to work and socio-professional integration, state action for sex equality is crucial for women. However, when states accept and encourage legal approaches in which women contribute to their appropriation by others, it is neoliberalism and exploitation that are reinforced by these states, not the human rights of women (Falquet).

Neo-liberalism, as it characterises the functioning of contemporary economic and political systems, is “a programme of destruction of collective structures capable of standing in the way of the logic of the market” (Bourdieu). Motherhood, as an individual and collective experience of women, is always deeply rooted in the social structures – family and community – in which women, as individuals, live. The links, solidarities, individual, collective and institutional relationships that are part of the exercise of motherhood in contemporary societies are essential for any woman who voluntarily becomes pregnant in order to carry a pregnancy and give birth to a child. However, the imprint of neo-liberalism is now well marked in our societies, through the flexibility and individualisation demanded of individuals. This leads individuals to adopt “techniques of rational subjugation” that lead to an “over-investment in work” that is explicit in the behaviour and discourse of the mothers exploited in surrogacy, and even stronger among those who migrate for its purposes. Flexibility and individualisation “contribute to the weakening or abolition of reference points and collective solidarities”, which allows the markets – and by extension, as we also observe the globalised market of surrogacy – to have a “reserve army of labour of women made compliant by precariousness”.

Finally, appropriation is accompanied by a utilitarian view of being treated as a thing: ‘an object is always in its place and what it is used for, it will always be used for’ (Guillaumin). This intrinsically naturalistic dimension of what women are and should be used for, namely, to bear children for those who wish to obtain them from them, is at the root of the displacement and movement of exploited women in the globalised and neoliberal surrogacy market.

Women have long been considered absent or invisible in international migration, even though they have always participated in it.

Their presence began to be identified and made visible in studies of international migration from the late 1970s and early 1980s (Christou, Kofman). The invisibility of women in studies of migratory phenomena was due to the fact that these were viewed through the prism of the project’s motivations: in labour immigration, women were a very small minority (as they were in the labour market in general before the second half of the 20th century^e ); in family immigration, they remained mostly in the domestic sphere, and therefore, not very present in the public arena; finally, for a long time, the main figure of the asylum seeker was that of a man. On the other hand, from the 1990s onwards, the presence of women in international migration was mainly linked to global chains of care (Kofman). This approach, which highlighted the participation of migrant women both in the domestic sphere (in their families or elsewhere) and in the labour market, contributed to making migrant women visible, particularly with the exponential commodification of local services. Since the 2000s, the presence and specificity of female migration has been clearly identified and described (“Men and women circulate differently in the new global economy […] Men often constitute the ‘elite’ of migratory flows […] while women provide services largely associated with the traditional role of the wife – child and elderly care, domestic chores…” (Kofman).

The main role of migrant women thus appears to be linked to social reproduction, which includes both family and systemic reproduction. Migrant women are present, make possible or even ensure the systemic reproduction of the organisation and functioning of health, education or labour systems (by enabling women in the host country to work, for example), and also by participating in family reproduction, when this takes place outside the home, by participating in the commercialisation of services. Although academic studies and the concerns of international institutions have made these women visible, including their life experiences and their journeys, and such studies have analysed and deciphered the deployment of their migratory strategies (Roulleau-Berger), many of these women women remain invisible because of their personal trajectory or the fields in which they are involved.

This is the case of women who migrate – or become displaced – as part of a surrogacy process, and whose existence is ignored because of an accumulation of layers of invisibilisation. This happens, firstly, because of the status they are given. In terms of international or bilateral arrangements, it is the satisfaction of the clients that counts, and the mother is systematically ignored, considered as a tool (since she is appropriated by those who pay her); this leads to an epistemological gap: information and knowledge are only produced on what is considered important. The pregnant woman or the woman who is going to become pregnant is only important for the satisfaction of the clients, because giving birth to children is natural for her, as is her supposed generosity.

Migrant mothers giving birth to children on commission and handing them over to the clients are little identified, except in a few qualitative surveys (on a limited number of women, Nilsson). When the clients resorted to trafficking, women exploited in this way could be identified, as shown by the OSCE report on trafficking in human beings, which mentions, among the new trends, the trafficking of pregnant women for the purpose of selling their new-born babies.

Considering pregnancy and childbirth as strictly private reinforces the appropriation of migrant women within the framework of surrogacy regardless of the woman’s desire to participate in international displacement. These displacements lead to the loss of reference points and the fragility inherent in any migration, and even more so for women who migrate within the framework of surrogacy, due to their initial precariousness and the precariousness generated by the absence of protection both from their state of origin and from the state to which they travel to be inseminated and/or to give birth and/or to hand over the child to the clients. Multi-situated inequalities are characteristic of migratory trajectories in general, with the specificity, as far as women are concerned, that they also include sexual discrimination, which is doubly present (in the country of origin and in the host country, to which the status of foreign woman is added): “Inequalities are constructed in graduated invisibilities of resources and competences which can be related to forms of ethnic discrimination and sexual stigmatisation” (Roulleau-Berger).

The strict instrumentalisation of migrant women within the framework of surrogacy arrangements reinforces their invisibilisation: they are pregnant, but will not be mothers; their state of pregnancy may be denied to avoid administrative difficulties; their access to information and rights is not considered important since their presence on the soil of the country where they go to be inseminated or to give birth or to hand over the child to the sponsors, is not supposed to last.

Everything about their status as “surrogate mothers” and what they experience as such contributes to making them invisible, as pregnant women, as women giving birth, as foreign women, as mothers of children who are sometimes present at their side.

References

Bourdieu, Pierre, 1998, “What is neoliberalism?”, Le Monde diplomatique, March 1998.

Christou A., Kofman E., 2022, Gender and Migration, IMISCOE Research Series

Cukrowska-Torzewska E., A. Matysiak, 2020, “The motherhood wage penalty: A meta-analysis”, Social Science Research 88-89

Falquet, J., 2010, “The neoliberal state and women”, in Le sexe de la mondialisation. Genre, classe, race et nouvelle division du travail, Presses de Sciences Po.

Guillaumin, Colette, 2016 (1978), Sex, Race and the Practice of Power. L’idée de nature, ed. iXe

Kofman, E., 2008, “Genre, migrations, reproduction sociale et Welfare state. Un état des discussions”, in Les cahiers du CEDREF, 2008/16, pp. 101-124.

Nilsson, E., 2022, Thai Surrogate Mothers’ Experiences of Transnational Commercial Surrogacy. Navigating Local Morality and Global Markets, Uppsala Universitet

OSCE, Combating Trafficking in Human Beings: 2021 Survey Report Launch

Roulleau-Berger, L., 2010, Migrer au féminin, PUF.

Data and methodology

As a reminder, the aim of this study is to alert states around the world to this new phenomenon of trafficking in women for the purpose of reproductive exploitation. Whether it is surrogacy, egg donation or forced pregnancy.

In order to do this, we have tried to meet several objectives during the year 2021, such as:

Documenting this new type of trafficking through a field survey: To our knowledge, such surveys have never been conducted by anyone (neither associations nor states). Only the Council of Europe’s Bioethics Committee has attempted to document the issue somewhat by sending a questionnaire to multiple states at the international level on four occasions (in 2019, 2020 and 2021)^[3], asking them about their legislation on assisted reproductive technologies and surrogacy as well as the mechanisms put in place to ensure the proper application of their laws.
Raising awareness and sensitising states: Our intention was of course to collect data but also to raise awareness among states about this new trafficking phenomenon.
Identify actions and mechanisms that states have put in place to monitor and stop this type of trafficking.
Develop an action plan for 2023 based on the results of the survey to continue awareness raising and data collection.

The methodology adopted to conduct this study consisted mainly of a quantitative data collection carried out in three stages.

As a first step, CIAMS undertook research, using the Google search engine which identified press articles based on keywords (19 keywords)[4] in 72 countries as of January 2021 and targeting 5 languages: German, English, French, Italian and Spanish. In addition to the daily Google alerts, “manual” searches by country were carried out in order to identify surrogacy -related items and their context in each country, as broadly as possible, from the legislative, political and industrial angles through press articles, academic publications, scientific reports and other available sources. We also carried out an in-depth study on three countries where surrogacy is legal: Ukraine, Greece and Mexico. We are aware that, due to the lack of official data on surrogacy, we used the tools provided by Google, which pre-selects information according to opaque algorithms. It is therefore possible that the cases selected are not exhaustive. Nevertheless, these cases present a rich variety of situations that allow us to map the practice in a concrete way.

In a second step, we launched a questionnaire (Annex 4) which aimed at identifying cases in the field, and which are not published and therefore undetectable by the previous method. This questionnaire was sent to all non-governmental organisations, members and/or friends of ENoMW and CIAMS, which in total represents 2,613 people contacted throughout the world and 288 organisations in 37 countries[5] .

In a third stage, a second questionnaire for states (Annex 4) was sent by email to all the embassies of the countries represented in Paris as well as to all the representatives of the Member States of the Hague Conference on Private International Law (HCCH)[6], for which we had email addresses (standard email in Annex 4). In total, 115 states and the Europe Union (Directorate-General JUST Justice and Consumers) were contacted either through their Ministry of Justice, Foreign Affairs or Interior.

The aim of this questionnaire was to collect data on the management by these states of these practices but also on the means implemented to control them, enforce the laws regulating them as well as to obtain additional data such as the number of women forcibly displaced or migrated in their state and involved in these practices.

Finally, the study also draws on all available scientific literature addressing the issues of assisted reproduction and related technologies, surrogacy and human trafficking as well as migratory movements, thus providing a sound theoretical framework.

To date, extensive research on the legislative, political, economic and trafficking situation has been conducted in 72 states.[7] In addition, six states have been partially researched.[8] These 78 states are part of the 115 states to which our second questionnaire was sent. The following is a table summarising the legal frameworks on surrogacy in these 78 countries, categorised by the following criteria: Regulated , i.e. countries in which surrogacy is expressly legal and regulated; Illegal, i.e. countries in which surrogacy is expressly illegal; and Unregulated, i.e. countries in which surrogacy is not subject to a specific law regulating it.

*Regulated.**	Illegal	Non-regulated
South Africa	Germany	Algeria
Albania	Austria	Angola
Belarus	Bulgaria	Benin
Cyprus	Spain	Cameroon
Denmark	Finland	Ghana
Greece	France	Niger
Hungary	Italy	Nigeria
Netherlands	Latvia	Uganda
Portugal	Lithuania	Senegal
Czech Republic	Malta	Andorra
Regulated*.	Illegal	Non-regulated
United Kingdom	Norway	Belgium
Russia	Sweden	Bosnia and Herzegovina
Ukraine	Switzerland	Ireland
India	Saudi Arabia	Luxembourg
Israel	Azerbaijan	Poland
Thailand	Cambodia	Romania
Vietnam	Singapore	Afghanistan
Brazil	Costa Rica	Armenia
Colombia	Montenegro	Bangladesh
Ecuador	Dominican Republic	North Korea
United States	Turkey	South Korea
Mexico		Japan
Uruguay		Nepal
Australia		Philippines
New Zealand		Argentina
Georgia		Puerto Rico
Hungary		Croatia
		San Marino
		Taiwan

Presentation of results and discussion

Step 1- Research

In this research, we used Google search engine, keywords and Google alerts on 72 countries since January 2021. Among these 72 countries, 3 of them, considered as the most emblematic of the issue of migration linked to surrogacy, have been the subject of more in-depth analysis. These are Greece, Ukraine and Mexico.

Although a considerable amount of information has been collected – including numerous press articles on cases of trafficking in women in the cross-border practices of surrogacy, egg donation and forced pregnancy, too few academic elements or official reports on the migration (forced or voluntary) of women in the context of the above-mentioned practices have been uncovered. This reinforced our desire to carry out this investigation, which we feel is very relevant.

Summary of research data

The processing of the trafficking cases identified by ICASM and ENoMW was done as follows:

All updated trafficking cases are listed in alphabetical order in Annex 1. They number 46 and have been supplemented by the eight cases reported in the responses to the first questionnaire (see below and in Annex 4). These are also presented in Appendix 1. Our selection of cases does not claim to be exhaustive, but we believe that we have identified the most significant cases in the study period. They probably represent only a small part of the totality of such cases. The practices and networks of traffickers are clandestine and thus very difficult to trace. Moreover, it is impossible for us to list all the press or academic articles on this type of trafficking on our own. Indeed, the Internet and what is published on it constitute a “bottomless pit”, not to mention the fact that the geographical location of the researcher and the language in which the research is carried out will influence the results proposed by the search server. It would be impossible to perform keyword searches in the official language(s) of each of 72 countries, which also limits our searches and the results that are produced. For the time being, our ‘manual’ searches with more than 20 keywords have been done for each country covered in this survey in English, French and Spanish. If it was an Italian- or German-speaking country, we carried out an additional search in Italian or German respectively.

The analysis of these cases has enabled us to draw up a typology of cases. We could not present here a detailed analysis of all the cases that we have already been able to identify and from which we have drawn up this typology, as they are so numerous, but a complete list is available in Appendix 1. Below are several cases which best illustrate our typology:

1. Migrant women used as ‘surrogate mothers’ in the destination country

Europe

Migrant women who come to Greece to work as domestic and care workers are recruited as ‘surrogate mothers’ ^[9]
Migrant women from Bulgaria to Greece, recruited in Greece for eggs harvesting and then exploited twice as “surrogate mother”. of a woman from her country of origin (, Bulgaria), to a country of arrival, (Greece), with the intention of becoming a ‘surrogate mother’ to meet her financial needs.[10]

Asia

Chinese women, who have migrated to Japan, are recruited locally in a surrogacy process for Chinese clients. ^[11]

Transcontinental

Deceitful recruitment of a Venezuelan migrant woman by a client couple in Spain as part of a surrogacy.^[12]
A woman who immigrated to Belgium from Nigeria and became exploited as a ‘surrogate mother’ there.^[13]

2. Women recruited and then moved to another country to be exploited through surrogacy

In the context of mafia practices

Kazakh women displaced to Russia as part of surrogacy exploitation.^[14]

For the convenience of customers: the child is delivered to their home

Asia

Vietnamese women migrate to Thailand to become exploited as ‘surrogate mothers’ driven by financial needs and are then held captive and at the mercy of their exploiters.^[15]

Europe

Polish women moved to the Netherlands to be used as ‘surrogate mothers’. ^[16]
Roma women transported to France to be exploited as surrogates. ^[17]

To circumvent legislation

Asia

Relocation of Indian maternity centres to Cambodia following the 2015 surrogacy ban and recruitment of Thai, Vietnamese, Lao and Indian women. ^[18]

3. Moving women used as ‘surrogate mothers’ to another country during the gestation process, to circumvent legislation, for the convenience of clients or to benefit from medical techniques not available in the destination country

Asia
Recruitment of Indian women, impregnated in India and transported to Nepal for delivery, (and delivery of the child), to clients.^[19] .^[20]

Movement of Vietnamese women to China for illegal surrogacy. The embryo transfer is carried out in China, the women then return to Vietnam for their pregnancy and are transported to China for the delivery.^[21]
Thai women recruited as ‘surrogate mothers’ are moved to Laos for the implantation of the embryos and then brought back to Thailand to carry out the pregnancy before being moved to China, to the Chinese clients, for the delivery.^[22]
Irregular immigration of Cambodian women to Vietnam to give birth in surrogacy for Chinese clients.^[23]
Cambodian women moved to China to give birth as ‘surrogates’ to circumvent the prohibitions of the respective laws of the two states.^[24]

Europe

Ukrainian women recruited as “surrogates” are sent to Northern Cyprus (under Turkish control), a “grey” zone which, unlike Ukraine, gives access to surrogacy to same-sex couples and allows the intended parents to choose the sex of the child. The women are sent there for the implantation of the embryos and then returned to Ukraine for the first seven months of the pregnancy before being sent back for the birth. ^[25]
Travel of a Bulgarian woman, candidate to become a ‘surrogate mother’ in Cyprus, to then give birth in the country of her clients (France). ^[26]
Vietnamese women, taken to Cambodia for embryo transfer, returned to Vietnam during pregnancy and taken to China to give birth for Chinese clients. ^[27]

North America

Movement of Mexican women to give birth in the United States in the context of surrogacy.^[28]

4. Displacement of pregnant women to sell their children (illegal adoptions and baby trafficking):

Europe

Bulgarian, Georgian and Roma women were taken to private clinics in Greece to give birth before their babies were sold for illegal adoption. Others were taken to private clinics to have their eggs harvested and some were used as ‘surrogate mothers’.^[29]
Moving pregnant Bulgarian women to Greece to give birth and sell their babies. ^[30]
Movement of Bulgarian women to Greece to sell their eggs.^[31]

Asia :

Trafficking of new-born babies in Russia to Chinese citizens.^[32]

Case study of three countries

Ukraine

Ukraine is a major European hub for commercial surrogacy where migration and movement of women exploited through surrogacy to other countries was already present before Russia’s war against Ukraine, though the war accelerated the process. The legislation on surrogacy in Ukraine is based on two texts. The first is Article 123 of the Family Code of Ukraine from 2002, which states that if the embryo of a client couple is implanted in the body of another woman (the ‘surrogate mother’), the clients will be considered as parents from the moment of conception. The second text is the Order of the Ministry of Health No. 787 of 9th September 2013, which explicitly allows surrogate motherhood. The Ukrainian provisions allow the use of a surrogate mother in the framework of “infertility treatment” for foreign married couples of the opposite sex, which makes the country very attractive for those who come from countries where the practice is illegal. Under this law, a woman contracted to be used as a ‘surrogate mother’ must have had at least one healthy child previously. It is therefore legal in Ukraine to advertise surrogacy and to recruit and pay women to be used as ‘surrogate mothers’. As a result, many fertility clinics and agencies (including couriers and lawyers) have been established in the country- both native to the country, and those founded by foreigners to serve clients in their home country and abroad. The most obvious example is BioTexCom, founded by German Albert Totchilovsky in 2008, which presents itself as the largest agency in Ukraine, with multilingual staff to cater for the widest possible range of clients ^[33] . Fees for clients range from €30,000 to €55,000 which adds a new attraction for foreigners since in other countries where commercial surrogacy is legal, fees are much higher.

In Ukraine, the women used as ‘surrogate mothers’ are mostly recruited from the countryside and poor regions of the country, as the payment they receive in exchange for renting out their uterus – about €15,000 – is about five times the average annual salary. It is therefore vulnerable women, generally single mothers, or mothers from families in economic and/ or social difficulty, who resort to becoming used as ‘surrogate mothers’ in order to meet the needs of their families. Testimonies from recruiters (themselves often formerly exploited as ‘surrogate mothers’) who oversee canvassing other women for the trade, also mention their displacement to war-torn areas, notably to Crimea and the Donbass and Luhansk regions, as the women are destitute, often homeless, and very vulnerable ^[34] . Furthermore, Maria Dmitryeva, a Ukrainian human rights activist, revealed in March 2022 that women refugees from the ongoing conflict were targeted by fertility agency recruiters to be used as ‘surrogate mothers’^[35] . It is therefore clear that the victims and targets of this trade are vulnerable women. Additionally, women used as ‘surrogate mothers’ are often bound by the terms of the contracts they sign to move closer to clinics and hospitals^[36]. This forced migration of these women from the periphery to large urban centres could be done with their families before the war, but the war has changed the configuration of the arrangements and the way in which the agencies manage the women used as ‘surrogate mothers’ and their accommodations.

In addition to internal displacement, Ukrainian women used as ‘surrogates’ could also be moved to other countries that have similar regulations to Ukraine or to grey areas. For example, many Ukrainian women travel to Russia to be used as ‘surrogate mothers’ there ^[37] , although it can be assumed that these women are recruited and moved by agencies. There is also evidence of Ukrainian agencies offering their commissioning clients the possibility to move the mothers used as ‘surrogates’ to the Turkish part of Cyprus, a grey area in terms of surrogacy. This move allowed for the satisfaction of types of clients not allowed under Ukrainian regulations, including same-sex couples, single persons, or those who want to choose the sex of the child^[38] . When war broke out again following the Russian invasion on 24th February 2022, the issue of children born through surrogacy, and the views of the commissioning clients, was covered by the media. Few articles dwelt on the fate of the women used as ‘surrogate mothers’, and even fewer on the issue of their displacement and forced migration. Their displacement highlights the behaviour of two types of actors that can be interpreted as trafficking. Firstly, that of the agencies and the way in which they managed the contracted women, and secondly, that of the foreign clients who decide univocally on their displacements thus denying the women any capacity for autonomy.

Some agencies, such as Delivering Dreams, a US-based agency operating in Ukraine, announced that they had organised the movement of the women they used as ‘surrogates’ from mid-February onwards to Lviv and then to the border countries. Founder Kersh-Kibler in February stressed that these women were not happy with the move but had buckled under pressure from clients anxious about the worsening situation. The mothers used as ‘surrogates’, who were already several months into their pregnancies, had to go to Lviv alone because they did not want to uproot their families again, as they had done for the first migration in order to be closer to the clinic. But when Russian troops invaded the rest of the country, Kersh-Kibler wanted to move other newly impregnated mothers and even those who were only at the stage of undergoing hormonal treatment before implantation of the foetus. Here again, she encountered difficulties, as some women refused to be moved or to go to safe places separate from their families. They wanted to be able to decide what to do, whether to leave their home, or to migrate elsewhere, and under the conditions of their choice^[39] . Testimonies from the mothers exploited as ‘surrogates’ about their displacement by the Delivering Dreams agency were collected by Susan Dominus for The New York Times magazine and highlight their conflicting feelings of being displaced against their will and losing control over their bodies and their autonomy, while clients and agencies argue about logistics, displacement, delivery dates etc.^[40] . Relocations are therefore as a consequence of pressure from the agency, resulting in the women’s families being left to fend for themselves in Ukraine. The World Center of Babies agency, based in Kiev, also claimed to have moved the women they used as ‘surrogates’ to the city of Lviv and it can be assumed that these women were again acting under duress and without much room for manoeuvre^[41] . Furthermore, one of the agencies that saw women used as ‘surrogate mothers’ fleeing to the border countries demanded that they return to Ukraine for the delivery, regardless of the situation in the country, otherwise the surrogacy contract they signed in Ukraine would be null and void according to the laws making surrogacy illegal in the border countries^[42] . The Israeli agency International Fertility Group (IFG), which usually operates in Ukraine, has proposed to their clients to move Ukrainian ‘surrogate mothers’ to Georgia- another country that allows commercial surrogacy. The argument put forward is the possibility of organising the filiation between the newborn child and the genitor in conditions similar to those present in Ukraine, because Georgia allows foreign women to be used as ‘surrogate mothers,’ unlike Ukraine. The agency assures that the transfer of the existing administrative formalities will be carried out by their service, but that new documents will have to be drawn up, required by the Georgian clinic. The agency also promises to take care of the ‘surrogate mother’s’ travel and accommodation, assuring that if the pregnancy goes well she could go back to Poland, Romania or Slovakia, but says that if it is “problematic” – that is, if the mother’s health or life is in danger – she will have to stay in Georgia.^[43]^[44]

In other cases, it was the commissioning clients who arranged for the women they used as ‘surrogates’ to be moved to their own country. For example, one mother named Tatiana was moved to France by the client couple living in Paris, leaving her children and her husband in Ukraine, as he did not want the children to leave.^[45]^[46] . A lawyer appointed by clients cited the case of several Ukrainian ‘surrogate mothers’ who arrived in France, including in the Vendée, Rhône, Provence and Somme regions. One client couple from the Vendée explained the steps they took to bring Ella, the woman they used, and her two daughters to France: first by putting them on a secure convoy from Kiev to Poland, then by booking a flat in Warsaw and a Flixbus to France. Another mother acting as ‘surrogate’, Yullia, fled Ukraine in the hope of joining her husband in Poland, but due to lack of space in his accommodation, was picked up at Przemysl train station by the clients client^[47] . Katarina was also moved to France by the clients, first through Poland, to receive papers from the French embassy in Warsaw, before flying to Bordeaux alone, without her two daughters who remained in Ukraine with their grandmother. The clients claim that the agency no longer sends her payment and that they are the ones who pay her^[48] . French clients are not the only ones who have women exploited as ‘surrogate mothers’ move around: Spanish clients have arranged for Viktoria, the carrier of twins, to be moved first to Poland, before flying to Barcelona. But since surrogacy is illegal in Spain, it was decided that Viktoria would give birth in Georgia, for the same reasons explained above. This is also the case for Marina, whose Italian clients agreed with the agency that she would go to Poland before flying to Georgia^[49] . The UK has even taken a position on the issue of ‘surrogate mothers’ of “future British citizens” who have fled the war: they will be granted a three-year residence visa^[50] . This decision was taken following a letter from the lawyers of 24 clients asking the Home Secretary, Priti Patel, in early March 2022 to take into account the war situation and the fact that the foetuses are “future British citizens”^[51]. This visa grant circumvents all UK immigration laws, with the sole purpose of ensuring that mothers used as ‘surrogates’ carry the foetuses into the world and that the newborns are handed over to the clients. It is worth noting that although so-called “altruistic” surrogacy is permitted in the UK, commercial contracts such as those signed in Ukraine are illegal.

The situations described here are thus similar to trafficking as defined by the Palermo Protocol, with the recruitment, transportation and reception of persons who are very often deceived and in a vulnerable position in relation to the position of power of the buyer and/ or agency, with the aim of exploiting their reproductive capacity. These elements also provide answers to two of the questions posed by this survey. Additionally, it is also possible to observe situations in which women are recruited as ‘surrogate mothers’ and moved within their own country, either forcibly or voluntarily. However, free consent cannot be fully established as the women are in a vulnerable position, are moved to be closer to the clinics, and are dependent on the money received to support themselves. In addition, Ukrainian women are also moved from their country of origin to a foreign country in the context of surrogacy to give birth either in the country of the clients or in a country whose legislation also allows for surrogacy, e.g. Cyprus, where the rules are even more lax than in Ukraine, or Georgia, whose regulation of surrogacy is similar to that of Ukraine.

Greece

Greece has become another European hub for fertility treatment^[52], as well as for surrogacy and oocyte retrieval, due to its economic situation and geographical location (Davaki, 2017). Greece legalised surrogacy and, more generally, medical assistance in human reproduction in 2002 with Law 3089/2002, as the title of the law states. This law provides for the consent of the spouse or partner of the woman wishing to be a ‘surrogate mother’ or from whom the oocytes are taken and prohibits cloning and the choice of the sex of the foetus. This law also provides that both the commissioning client and the ‘surrogate mother’ must be permanent residents of Greece, which was intended to prevent Greece from becoming a country of reproductive tourism. The law provides that only so-called “altruistic” surrogacy is allowed. A subsequent law in 2005, Law 3305/2005 called “Application of medically assisted reproduction methods” provides for criminal and administrative sanctions in case of non-compliance with the law and created the National Supervisory Authority for Assisted Reproduction (ANRMA) which monitors the proper conduct of procedures and makes ethical decisions. This law requires future ‘surrogate mothers’ to be physically and mentally assessed before signing the contract. This law is based on individual liberties and the best interests of the child by ensuring that children born of surrogacy have the same rights as all others. This law also establishes the financial compensation of the mother used as a ‘surrogate’, which includes health costs and also related expenses such as transport to medical centres and compensation for loss of income in the event of cessation of activity. Non-monetary compensation is also allowed. In 2014, Law 4272/2014 abolished the need for ‘surrogate mothers’ and clients to be permanent residents in Greece as was required by the 2002 law. Now they can be temporary residents, with no minimum length of stay, which has accelerated the country’s tendency to become a place for reproductive tourism for surrogacy. Other legal provisions are present in Articles 1455 to 1464 of the Greek Civil Code. These articles stipulate that the client must prove her inability to bear a child or the risk of transmitting a genetic disease. The client must not be post-menopausal in order to prevent the parents from being too old. In addition, same-sex couples and single men cannot use surrogacy. According to Article 1458, the authorisation of a court is necessary beforehand to validate the procedure and the contract. It is also this article that defines ‘surrogate motherhood’ as “the transfer of fertilised eggs to another woman resulting in a pregnancy in the latter” (Addendum 2021). Article 1564 in particular deals with genetic material, and states that surrogacy can only be gestational, so that there is no genetic link with the ‘surrogate mother’ and she cannot claim parentage with the newborn. Decision no. 73/24.01.2017 of the Code of Ethics for Assisted Reproduction also ensures that the ‘surrogate mother’ must be over 25 years of age, have had a child and not undergone a caesarean section. As far as egg retrieval is concerned, there is no limit placed on the number extracted.

Despite these provisions, Greece is today one of the hubs of surrogacy and many of the women who become used as ‘surrogate mothers’ or from whom oocytes are retrieved are migrant women. Prostitution or surrogacy are seen as palliatives in a country where there is a lack of jobs, a decreasing average salary and difficult access to employment ^[53]. A significant number of women exploited as ‘surrogate mothers’ in Greece are migrants from Eastern Europe, especially from Bulgaria, Moldova or Georgia, who come to Greece as domestic workers. With the crisis, their employers dismissed them and, out of necessity, they had to become ‘surrogate mothers’, with 17% of ‘surrogate mothers’ in Greece previously being domestic workers^[54] (Davaki, 2017). The altruistic aspect, emphasised by the legislation, is difficult to observe. A survey showed that out of 92 surrogacy cases, only 13 were intrafamily surrogacy, the other 79 cases featured ‘surrogate mothers’ who were allegedly “best friends” of the client, often ten or twenty years younger than her and mainly from Eastern Europe (Hatziz, 2010). In view of these data, it is possible to question the reality of the emotional ties between clients and women used by them as ‘surrogate mothers’. Knowing that the compensation that these women receive can be around €20,000, it appears more likely that there are financial reasons for these women to become ‘surrogates’ (Davaki, 2017). The commercial and exploitative reality of surrogacy in Greece is revealed in the possibility for the women used in surrogacy to be exchanged during preparation according to medical criteria (Davaki, 2017:155). It should also be noted that surrogacy between relatives does not exclude psychological pressure and abuse of the ‘surrogate mother’ (Davaki, 2017).

Let us also underline the emblematic case reported in the documentary of Public Sénat which reveals the story of a young woman of 18 years old – i.e. below the legal age – of foreign origin forced to become a ‘surrogate mother’. The journalists met her through a “madam”, which suggests that this young woman is also a victim of prostitution. She explained to the journalists, unrecorded and, that she was not allowed to leave her home and that she had promised to return home with the money once the process was completed and she had given birth. Since this woman was under the control of a madam, it is possible to wonder whether the “madam” was not receiving a commission from the clinic for the exploitation of this 18-year-old foreign woman.There is also the testimony of Maria (mentioned in the previous list of cases) a Bulgarian woman who initially migrated to Greece for financial reasons and was hired as a domestic worker, but faced with economic hardship became a ‘surrogate mother’. Although she claims to have done so out of altruism, her son admitted to journalists that at the time of filming she was undergoing her second surrogacy to allow them greater financial comfort and to buy a flat in Athens. The documentary also reveals the existence of Greek mafia involvement in surrogacy, and a powerful doctors’ lobby that does not hesitate to bribe Greek parliamentarians to keep the state out of this market. Another example is Dr Pantos, the owner of a very famous fertility clinic, called Genesis, who has close links with the entertainment industry, the media, the Orthodox Church and right-wing and far-right political circles^[55] .

The trafficking in women for the purpose of reproductive exploitation for financial gain in Greece was exposed in 2019 by a Greek police investigation supported by the Europol agency. The investigation revealed that an organised crime group had recruited pregnant and vulnerable Bulgarian women, some of whom held surrogacy contracts, to sell their children in Greece for illegal adoption for €25,000 to €28,000 each. The payment included money for the woman used as a ‘surrogate mother’, administration fees, hospital fees and payment to the criminal group. The group was also involved in trafficking young women of Bulgarian, Georgian and Roma origin for the extraction of oocytes. It was estimated that the activities of the group, which included a lawyer, an obstetrician-gynaecologist, employees of clinics in Athens and Thessaloniki as well as intermediaries, generated approximately €500,000 laundered through financial institutions, via the purchase of luxury items and real estate. The article published by Europol clearly speaks of human trafficking for these criminal activities^[56]^[57] .

The exploitation and trafficking of women for egg retrieval in Greece, as well as for surrogacy, finds its victims among the poorest women who seek an economic alternative to the financial hardship they and their families face , while hijacking a system that claims to be altruistic. The Balkan Insight newspaper investigated the phenomenon and its findings highlight the system of exploitation of vulnerable young women, and especially migrant women. Like ‘surrogate motherhood’, egg “donation” is supposed to be considered an altruistic gesture; the reality shows young women who are paid but also intermediaries looking for poor and migrant young women to collect their eggs. This is the case of Lina (real name withheld), a Bulgarian woman who migrated to Greece as a waitress, and who admits to having accepted the harvesting of her oocytes for financial reasons. Lina was recruited by an intermediary paid by both the clinic and the “egg donors”. These intermediaries act illegally but seem to be widespread nonetheless. The demand for oocytes on the market far exceeds the supply, which leads clinics and doctors to be proactive in recruiting women willing to sell their genetic material. Because of the shortage of oocyte supply, doctors can put young women’s lives at risk by encouraging them to undergo maximum retrieval without informing them of the risks to their health. Lina remembers a friend who had a very bad experience with hormone treatments and developed serious complications as a result of over-stimulation of her ovaries. For the same reasons, many doctors resort to unethical practices, such as omitting to register all procedures, while some obtain women’s genetic material through organised crime groups that, in fact, practice human trafficking, as the 2019 case exposed. An employee of a fertility clinic states that she is aware of a doctor who uses Georgian migrant women to harvest their eggs and that they are also victims of prostitution. It can be assumed that there are many other cases like this. Indeed, clients look for foreign oocytes with a racist preference for oocytes from Poland or Romania because of the physical characteristics of the “donor”: skin colour, eyes, hair. According to Diane Tober, Bulgarian and Georgian women are the ones from whom most eggs are taken^[58] .

Greece is a perfect example demonstrating that the regulation of the so-called altruistic surrogacy can only lead to a corruption of the system and the continued exploitation of women’s reproductive capacities. Greece wanted to put in place a strict framework to avoid any exploitation. However, over time, and under pressure from medical lobbies increasingly concerned with increasing their profits, a predatory system has developed based on the exploitation of women for reproductive purposes and trafficking in human beings. Due to its geographical position, Greece has become the ideal place to exploit the weakest, most economically, culturally and socially vulnerable categories of the population: migrant women, especially in a country that has experienced the worst economic crisis on the continent since the beginning of the century. The Europol agency recognises this, stressing that “we are dealing here with cases of human trafficking”.

Mexico

As Mexico is a federation of states, there is no national law on surrogacy and each federative entity decides on its own legislation. The states of San Luis Potosi and Querétaro completely prohibit surrogacy in all its forms and when surrogacy is discovered, the newborn child will be legally recognised as the child of the ‘surrogate mother’. The state of Coahuila had also banned the practice but lifted the ban in 2015, without any further legislation. In 2010, Mexico City, which has the status of a federal district, drafted a law allowing surrogacy, but the text was never officially published or put into force. The majority of the 32 federal entities have no legislation on the issue, neither prohibiting it nor expressly allowing it- with the exception of the two states of Sinaloa and Tabasco. In both states, however, the legislation is very lax, with a lack of protection and guarantees for the personal integrity, health of ‘surrogate mothers’, identity and best interests of the child. There is no monitoring system, no verification of the identity of the clients, and no mechanism to ensure that the practice is not used for trafficking, exploitation and/ or smuggling.

In June 2021, after the state of Tabasco tried in 2016 to restrict access to surrogacy to Mexican citizens only, the Supreme Court repealed this law, and by its judgement, recognised the practice of surrogacy across the whole country. Remuneration is prohibited; technically only “altruistic” surrogacy is allowed, but the agencies find ways to get around this prohibition. Indeed, the terms used to qualify the money given to the mothers used as ‘surrogates’ are: gratuity or compensation, but also economic assistance^[59] . Thus, the difference between “altruistic” and “commercial” surrogacy is theoretical and artificial. There is no public data on the number of children born to women exploited as ‘surrogate mothers’.

Throughout Mexico, private hospitals, regardless of the state, find ways to practice surrogacy despite the lack of regulation or the ban^[60] . For example, the city of Cancun is a popular destination for clients seeking to use women as ‘surrogate mothers’, in a state where there is no legislation governing the practice.

In general, the socio-economic class of women recruited as ‘surrogate mothers’ is much lower than that of the clients (Amador, 2011:202). The non-governmental organisation GIRE (Grupo de Información en Reproducción Elegida) points out that women exploited in surrogacy in Mexico may also be migrant women from South American countries and Mexican women fleeing gang violence in their region. She also notes that the women used as ‘surrogate mothers’ are often at risk of not being well informed about the contract and the risks they face (Fulda & Tamés, 2017).

It is worth highlighting the situation of Arely as reported by the IWRG, who migrated from Colombia to join family in Mexico City. She was unable to find work and was put on the surrogacy path by a friend. The IVF fertilisation was carried out in Mexico City before going to Cancun, staying in a surrogacy accommodation. She did not sign a contract, but the agency promised her $1000 at the beginning of the pregnancy and then about $600 per month until the birth. She became pregnant with twins but miscarried at 5 months. As a result, she did not receive the agreed amounts during the pregnancy and did not receive care afterwards. She does not know if she can still have children nor does she have access to her medical records. Since she did not sign a contract, she has no proof of her involvement in a surrogacy arrangement and does not know what legal recourse to take.

Journalist Melissa Amezcua of the newspaper EL Universal points out that there is a lot of internal migration related to surrogacy. In many cases, women recruited as ‘surrogate mothers’ are inseminated in private hospitals in their state of residence and then moved to Tabasco and Sinaloa for the delivery, with the aim of making the procedure legal and ensuring that the clients are related to the newborn^[61] . In another article, she describes the situation of Sandra, a resident of Mazatlán, a city in the state of Sinaloa, who was recruited as a ‘surrogate mother’ for a wealthy Mexican woman. For the insemination, she was moved to the city of Guadalajara in the state of Jalisco, where surrogacy is not regulated. Moreover, although she lives in a state where the practice is legal, she did not sign a contract according to state regulations and is afraid of having to appear in court. Due to pre-eclampsia, she had to give birth before her due date, so the doctor who should have handled the delivery was absent and the plan of the client and her family (to have Sandra return to the hospital under the name of the client to establish parentage directly in her favour) failed. She also suffered from post-partum syndrome after giving birth and medical problems, including hormone levels so high that she lost her hair. She did not have time to see the twins she gave birth to, except at the notary’s office, where she broke down in tears. The client refused all contact afterwards^[62]^,[63] .

In Mexico, through social networks, women advertise themselves as ‘surrogate mothers’, ready to be moved to the United States to give birth. This is the case of “Brenda” who advertises the fact that she is from Tijuana, on the border with the United States, and has a tourist passport that allows her to come to San Diego for the purpose of being used a ‘surrogate’. She gives her pregnancy history and the children she has had^[64] . The city of Tijuana is also known to be a place where agencies and clients seek out women for surrogacy because of its border location, making it easier for women to travel^[65]^,[66] .

The movement of Mexican ‘surrogate mothers’ to the US is even offered directly by several agencies. Ilaya offers a service where a woman is inseminated in Mexico, spends her first six months of pregnancy there and then is moved to the US for the remaining time and delivery^[67] . The MFC Surrogacy agency offers a similar programme^[68] . Finally, the Care Surrogacy Center agency, in the opposite direction, offers to use a US woman as a ‘surrogate’, move her to Mexico for insemination and then return her to the US^[69] . In all three cases, the agencies put forward two main arguments for this practice: cost reduction, as prices in Mexico are much lower than in the US; and legal access to parentage, especially in the state of California, whose laws are very advantageous to surrogacy clients. Women used as ‘surrogate mothers’ are also moved during their pregnancy, simply in order to give birth in a country more comfortable for the clients. Bertha O. Garcia in her speech at the NGO forum of the UN Commission on the Status of Women, reported the testimony of a man who was defrauded by a surrogacy agency in Mexico. Investigating his own case, he discovered the story of a Mexican woman exploited as a ‘surrogate mother’ who was moved to San Diego for the birth, but left behind by the agency, without a return ticket to Mexico, and having to pay for the hospitalisation herself^[70] . This situation shows how agencies use the women for the comfort of their clients, but also to avoid the costs involved in the practice, employing methods resembling those of organised criminal groups.

However, this type of behaviour is not limited to agencies. In 2017, Esthela Clark, a Mexican woman living in the United States, was brought to justice for human trafficking, as well as sex trafficking. In 2012 and over a period of several years, she participated in the trafficking of a young Mexican woman to be used as a ‘surrogate mother’ for herself and her partner. In 2012, Clark approached a young Mexican woman from the same village as her to become a ‘surrogate mother’, assuring her that the process would be legal and medically supervised. Clark hired “coyotes” (smugglers) to get her into the United States. When she arrived in Florida, where Clark lives, the reality was not what was promised: the young woman had to sleep on the floor, eat only beans and was subjected to inseminations with Clark’s partner’s sperm. Clarke collected her husband’s sperm in a condom before using a syringe to inject it into the young woman’s womb. The young woman was rescued by a neighbour in 2015 after she was seen washing a car in clothing that was not appropriate for the cold weather^[71] .

These situations of displaced women used as ‘surrogate mothers’ – both inside and outside the country – for the convenience of the agencies and clients, represent cases of trafficking, which take advantage of women’s vulnerable situations with the aim of gaining economic benefits for the agencies, or emotional and material benefits for the clients. It is also important to underline the fact that agencies manage to circumvent restrictive laws in countries to organise forms of commercial surrogacy. Finally, it is impossible not to notice the racial character of the practice of surrogacy in Mexico. The use of racialised women to enable the birth of white children to US citizens through gestational surrogacy aligns with the white supremacist policies promoted by some US political circles.

Analysis of the results

After analysing the various cases that have been identified, it is clear that there are many commonalities among the situations this study covers

Economic and social insecurity is a source of vulnerability and the recruiters’ terrain

First of all, it is clear that women – whether they migrate from their country of origin to another country to be used as ‘surrogate mothers’ or oocyte donors, or are recruited once there – present very similar profiles. The vast majority of them, if not all, are in a situation of great economic, professional and social insecurity. This explains why intermediaries find it so easy to recruit them in exchange for financial remuneration, or merely a promise of remuneration that is not always fulfilled.

We believe that the great precariousness in which these women find themselves also explains why it is so easy for traffickers to lure them (often by deceiving them about the reasons for their contact), to sequester them and to make them victims of human trafficking by moving them against their will from one state to another, and by forcing them to carry a pregnancy. These women become victims of human trafficking and reproductive exploitation through forced pregnancies, but also of sequestration and physical and psychological abuse. In the eyes of their traffickers, these women are nothing but machines for producing babies that can be sold on the illegal adoption market.

All the actors involved in this practice – intermediaries, clinics, laboratories, lawyers, bankers, psychologists, etc., and the clients who commission them – shamelessly take advantage of the vulnerability of these women to achieve their respective ends, which are, for the former, financial gains and for the latter, a child; a child which is bought as a commodity and also, in many occasions, is a victim of trafficking.

It should also be noted that the commissioning people are generally financially well-off and in a stable social, professional and financial situation, which places them in a dominant role in relation to the women recruited, whether or not they are forced to take part in this process of surrogacy and egg donation.

The analysis of the types of displacement to which the mothers used as ‘surrogates’ are subjected, opens a new chapter in human trafficking.

We note that the migratory movements (forced or not) of the women involved in the processes of surrogacy, oocyte donation and forced pregnancies are very particular and do not entirely overlap with the usual categories of migration.

Our observations identified the following cases:

Women are recruited in their country of origin and sent to another country to be used as ‘surrogate mothers’, to meet the demand^[72] where the practice is allowed or, in other cases, under illegal arrangements. This type of cross-border movement is of temporary nature and rarely results in permanent migration^[73] ;
Women who have already migrated are recruited for the purposes of exploitation through surrogacy and/or egg harvesting;
The surrogacy process, because it uses sophisticated medical technologies (IVF, pregnancy monitoring, etc.), requires the candidates for ‘surrogate motherhood’ to travel from their place of origin to a specialised urban centre to undergo preparatory treatments and embryo transfer. To escape social opprobrium or the curiosity of their neighbours, and often to satisfy the control requirements imposed by contract or by clients, they spend their pregnancy far from home and close to the hospital, which provides treatment, follow-up and delivery;
A final case is the movement of surrogate mothers during their pregnancy. In order to optimise costs, the industry assigns each production phase to a different geographical area. Similarly, the surrogacy process is divided into three phases: embryo transfer, pregnancy and delivery, each of which can be based in different locations in order to :
Access the reproductive technologies not available in the country of origin or are of better quality in another country;
Circumvent legislation ;
Offer “home delivery” of babies by having the mother used as a ‘surrogate’ give birth in the country of the comissioning clients;
Reduce costs^[74] for the clients;
Reduce the risks of non-recognition of parentage between the infant and its buyer(s) by organising the birth in the buyer(s)’ country where the justice system, in the name of the child’s best interests, will facilitate the recognition of parentage.

The prohibition or regulation of surrogacy does not prevent the trafficking of women for reproductive exploitation

The clientele is drawn from wealthy Western countries and the wealthy elite of poor and/or developing countries. The women exploited through the practice of surrogacy are women from the countries considered poor or from the less privileged strata of Western societies. They are subjected to one or more of the trafficking mechanisms listed above.

One might imagine that countries that have outlawed or restricted the use of surrogacy on their territory would not be familiar with these practices. This is not the case. No country is free from this form of exploitation. Countries that prohibit surrogacy on their territory see their citizens resort to reproductive tourism, an obvious source of trafficking: surrogacy agencies (e.g. Biotexcom) offer to organise childbirth in the country of the clients. Such cases have been detected to have taken place in a clandestine manner. More officially, France, Spain, Ireland and the United Kingdom brought in Ukrainian mothers used as ‘surrogates’, hired by their citizens during the Russian invasion.

Step 2 – Questionnaire 1 (to individuals and organisations) – Results :

Data from the questionnaire to individuals and organisations

We received 61 responses to this questionnaire out of the 350 questionnaires sent. 71.4% (= 43 responses) were from Spanish speakers, 14.3% (= 9 responses) from English speakers and 14.3% (= 9 responses) from French speakers (see graph below). The individuals and organisations that responded to this survey are based all throughout the world. ^[75]

Five individuals and six organisations out of the 61 individuals/organisations^[76] that participated in the survey stated that they had been aware of cases of surrogacy involving immigrant women in their country through social networks and the press (print and broadcast). Six acknowledged the same facts concerning cases of forced pregnancy and three concerning cases of egg harvesting. The countries concerned are Italy and Spain.

In addition, seven organisations and one individual reported their knowledge of cases of migrant women in their country being recruited as ‘surrogates’, egg donors or forced to carry pregnancies. The cases are presented below and in Annex 4:^[77]

An Italian association has been informed of immigrant women in Italy who have given birth in the country as part of a surrogacy. This association has also heard of cases of immigrant women in Italy who have been forced to carry pregnancies on behalf of others.
A Spanish association has also heard of immigrant women in Spain who have given birth in the country as part of a surrogacy. This association has also heard of cases of immigrant women in Spain who have been forced to carry pregnancies on behalf of others.
An international collective has learned of the cases of oocyte retrieval from migrant women as well as the cases of migrant women who have been forced into a pregnancy through surrogacy process.
A Spanish federation of libertarian youths has been informed of cases of egg harvesting from migrant women.
A Colombian association had the knowledge of women immigrants to Colombia who have given birth in the country in a surrogacy situation.
A US association said it had heard of cases of migrant surrogate mothers giving birth in the US and of women being forced to carry pregnancies in the US.
One person stated that she was aware of cases of immigrant women in her country who had oocytes harvested from them.
The co-president of ICASM (Spain and Latin America region), Berta O. Somnia, is aware of cases of oocyte harvesting from migrant women in Spain.

Three of these respondents became aware of these cases in the context of their professional activities and three in the context of their activism to combat violence against women. One of our respondents was informed of these cases by immigrant friends in her country where they sold their oocytes out of financial necessity. One of the organisations did not wish to disclose any additional details on the reported cases so as not to endanger the women concerned.

In total, 1/3 of the people who completed our questionnaire (seven out of 24 people) and 22.22% of the responding organisations (eight out of 36 organisations) were therefore aware of the practices studied.

Analysis of the results

As ENoMW and ICASM had anticipated, there were few responses to the questionnaires and even fewer useful responses acknowledging that they were aware, in one way or another, of the cases of migrant women being displaced for the purpose of their recruitment as ‘surrogate mothers’ or oocyte donors in the country of arrival, or being recruited locally for the same purpose, or being forced to carry pregnancies.

This may indicate, on the one hand, that this is a subject little explored by the media or feminist organisations and little known by the public. Few organisations and individuals, although sensitive to situations of exploitation of women’s bodies and human trafficking, would be aware of these various practices. It is certain that the communication power of the artificial fertilisation and assisted reproductive technologies market with its enormous financial resources[78] discourages any desire for criticism by presenting surrogacy in a glamorous way, adorned with the positive but false concepts of altruism and ethics.

On the other hand, it could also indicate a reluctance on the part of organisations to share their experiences and cases out of their desire to protect the anonymity of victims who have sought protection by confiding in these organisations.

Finally, while the issue of femicide was really taken into account as soon as the cases of “murder by spouse or companion” were counted and made public, giving an idea of the extent of the phenomenon, surrogacy suffers from the absence of data[79] . No one knows the number of children born each year from this practice[80] . No one knows how many mothers exploited as ‘surrogates’ have died in the process. No one knows how many children are born under contract, abandoned by the clients who ordered them[81] . In the absence of figures, and in the absence of analyses of the practices within the surrogacy industry, the use of surrogacy in the world risks remaining largely ignored and therefore neglected.

Step 3- Questionnaire 2 (to States)

Data from the questionnaire to the States :

We received 3 responses to this questionnaire:

3.1. Ireland :

On 25 June 2021, the Irish Department of Foreign Affairs contacted us by email to confirm receipt of our invitation to respond to the questionnaire we had sent them on 24 June 2021. On 3 August 2021, we were informed that our invitation would be forwarded to the Irish Department of Justice as they would be better placed to respond. We are currently waiting for the Irish Department of Justice to send back their responses to our questionnaire.

3.2. Denmark :

On 25 June 2021, the Danish Embassy in Paris contacted us by e-mail to confirm receipt of our invitation to reply to the questionnaire we had sent them on 24 June 2021.

We are currently waiting for the embassy to send back their answers to our questionnaire.

3.3. Australia :

On 6 August 2021, the Australian Department of Justice contacted us by email to acknowledge receipt of our invitation to participate in our questionnaire. They informed us that they were not in a position to respond to the questionnaire as the legislation and management of surrogacy processes, egg donation, forced pregnancy cases and cases of women forcibly or voluntarily moved to Australia to participate in the above processes are under the authority of the individual Australian states.

However, the Australian Department of Justice has provided us with a list of public documents issued by the Australian government compiling information on the issues of interest to us.

Analysis of the results :

To date, few responses to the invitation to participate in the survey have been received and no completed questionnaires have been returned. This is not a surprise to ENoMW and ICASM, who had anticipated this very low return rate from the beginning of the survey. That being said, and as mentioned above, the primary objective of this questionnaire was to raise awareness of the issues addressed in this survey. Indeed, few states seem to be concerned about trafficking through surrogacy, egg donation and forced pregnancy. Tracing and stopping these networks, when they are cross-border, requires inter-state coordination that is often complex and slow to implement because of the diplomatic protocols that need to be respected and insufficient technical means. It is also conceivable that some states did not wish to respond to us because ENoMW and ICASM are openly feminist and abolitionist organisations, believing that they were not “accountable” to us.

Conclusion

It is recognised that there are many networks trafficking women for reproductive exploitation and a black market in which the children born from this exploitation are sold. On 8 February 2021, Members of the European Parliament debated measures to combat trafficking in human beings. On this occasion, it was stated that human trafficking also applies to the process of surrogacy and illegal adoption.^[82] . Europol in its 2021 threat assessment^[83] of serious organised crime in the EU (SOCTA 2021), refers to “forced participation in criminal activities, forced begging and obtaining economic and social benefits by using their identity, trafficking for organ and tissue removal.” It points out that women are also trafficked to participate in illegal surrogacy programs, to sell their newborn babies, to enter into sham marriages and to be victims of domestic slavery.

It also appears that women used in surrogacy, egg donation and forced pregnancies are often very vulnerable economically and socially. The people behind these networks of trafficking in women and and trafficking and/or smuggling in children have full power over them and can confine them or move them at will. Despite this, it is still a little studied phenomenon, especially in Europe.^[84] It is more than urgent to bring these internationally organised trafficking networks out of the shadows and to analyse their workings so that the competent authorities can act. Human trafficking in all its forms is a complex phenomenon that follows the law of supply and demand.

In this study, we have also highlighted the displacement imposed on the women recruited as ‘surrogate mothers’: domestic displacement, displacement towards fertilisation centres, transnational displacement, for embryo implantation or for childbirth. This forced movement of women used as ‘surrogates’ contributes to their fragility and their vulnerability. Transferred far away from their home base, they lose their networks and their support, find themselves isolated, subject to the agencies that have recruited them, to the doctors who carry out IVF and to the demands made by the clients, throughout their pregnancy.

In the forms of human trafficking studied here, male clients, whether in heterosexual or homosexual couples or single, follow a patriarchal logic. They are looking exclusively for a genetic filiation with their offspring^[85] . Being a man, according to the codes of virility, means passing on these genes to ensure the continuation of the family line. Spermatic filiation takes precedence over oocyte filiation, which is totally ignored. The social injunction to reproduce^[86], leads to the provision of women’s bodies to others. Several women are mobilised: the egg donor, the mother used as ‘surrogates’, and the wife of the client (heterosexual) couple or the nanny who will be responsible for raising the child. Women who engage in surrogacy do so for financial reasons, but rarely to satisfy their own needs, always for the benefit of their family, sometimes even forced by the men around them (fathers, husbands, brothers, etc.).^[87] . Surrogacy, oocyte extraction and forced pregnancies constitute an attack on the human dignity of women, an attack on the free disposal of their bodies, an attack on the rights promoting and ensuring equality between women and men. Finally, when these practices are cross-border they often involve forced movement of women, whereas domestically, they often involve restrictions of movement, and, as such they are also an infringement on freedom of movement.

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Annexes

Annex 1. Cases of trafficking in women and children in the context of cross-border surrogacy, forced pregnancy and oocyte donation practices at the international level, as documented by ICMICA:

Press/academic articles :

– AFP, “Thailand: dismantling of a vast network of Vietnamese surrogate mothers”, in 20 Minutes, [online], published on 24.02.2011, accessed on 16.03.2021, https://www.20minutes.fr/675983-20110224-societe-thailande-demantelement-vaste-reseau-meres-porteuses-vietnamiennes.

– AFP, “Bulgarian babies for sale: the trade in misery that pays big”, in La Dépêche, [online], published on 18.02.2016, accessed on 10.08.2021, https://www.ladepeche.fr/article/2016/02/18/2279648-bebes-bulgares-vendre-commerce-misere-rapporte-gros.html.

– AFP, “‘Under the table’: Cambodia’s surrogate mothers risk jail for Chinese couples,” in Arab News, [online], published 21.12.2018, accessed 16.03.2021, https://www.arabnews.com/node/1424626/offbeat.

– AFP, “Grèce : démantèlement d’un réseau de trafic d’ovaires et de nourrissons”, in Le Figaro, [online], published on 25.09.2019, accessed on 10.08.2021, https://www.lefigaro.fr/flash-actu/grece-demantelement-d-un-reseau-de-trafic-d-ovaires-et-de-nourrissons-20190925.

– Anonymous, “India, surrogacy centres relocate to Cambodia”, in European Institute of Bioethics, [online], published 7.07.2016, accessed 15.03.2021, https://www.ieb-eib.org/fr/actualite/debut-de-vie/gestation-pour-autrui/inde-les-centres-de-maternite-de-substitution-se-delocalisent-au-cambodge-1111.html?backto=search.

– Anonymous, “Dutch gov’t advised to look for abuses around surrogacy”, in NL Times, [online], published 8.02.2021, accessed 12.08.2021, https://nltimes.nl/2021/02/08/dutch-govt-advised-look-abuses-around-surrogacy.

– Bhalla N., ‘India’s proposed surrogacy law raises trafficking risk for foreign women – expert’, in Reuters, [online], published 19.04.2017, accessed 18.03.2021, https://www.reuters.com/article/india-women-surrogacy-idINKBN17L0I1.

– Bangkok Post, “Thailand. En finir avec le trafic des mères surrogates”, in Courrier international, [online], published on 4.03.2011, accessed on 16.03.2021, https://www.courrierinternational.com/article/2011/03/04/en-finir-avec-le-trafic-des-meres-porteuses.

– Bernard V., “Le nouveau trafic des mères porteuses au Cambodge”, in Le petit journal, [online], published 25.12.2018, updated 26.12.2018, accessed 9.08.2021, https://lepetitjournal.com/cambodge/actualites/le-nouveau-trafic-des-meres-porteuses-au-cambodge-247016.

– Canellas C., ‘Un couple condamné pour avoir fait appel à une mère surrogée’, in Capital, [online], published on 1.07.2015, accessed on 8.09.2021, https://www.capital.fr/economie-politique/un-couple-condamne-pour-avoir-fait-appel-a-une-mere-porteuse-1052117.

– Cheang S., “Cambodian women face surrogate charges after Vietnam births,” in abcnews, [online], published 19.07.2019, accessed 9.08.2021, https://abcnews.go.com/Health/wireStory/cambodian-women-face-surrogacy-charges-vietnam-births-64436596.

– Cuong M., ‘Two women probed for running surrogacy ring to sell newborns to China’, in VN Express International, [online], published 12.04.2019, accessed 19.03.2021, https://e.vnexpress.net/news/news/two-women-probed-for-running-surrogacy-ring-to-sell-newborns-to-china-3908252.html.

– Cuong M., “Surrogacy ring busted in northern Vietnam,” in VN Express International, [online], published 16.08.2019, accessed 15.03.2021, https://e.vnexpress.net/news/news/surrogacy-ring-busted-in-northern-vietnam-3968055.html.

– Darwish R., “Are Babies Really Being Sold to Gay Couples in a Brussels Child Fair?”, in Albawaba, [online], published 12.11.2020, accessed 17.03.2021, https://www.albawaba.com/node/are-babies-really-being-sold-gay-couples-brussels-child-fair-1392439.

– De Abreu S., “Les dessous de la mondialisation Public Sénat: l’histoire bouleversante de Maria, mère porteuse en Grèce”, in Télé Star, [online], published on 28.05.2016, accessed on 10.08.2021, https://www.telestar.fr/culture/les-dessous-de-la-mondialisation-public-senat-l-histoire-bouleversante-de-maria-mere-porteuse-en-grece-211285.

– Duttagupta I., ‘Why surrogacy issue emerges after Nepal earthquake’, in ET The Economist Times, [online], published 5.05.2015, accessed 15.03.2021, https://economictimes.indiatimes.com/blogs/globalindian/why-surrogacy-issue-emerges-after-nepal-earthquake/.

– Editorial Board, ‘Thailand to probe Chinese surrogate gangs’, in Asean Economist, [online], published 15.02.2020, accessed 15.03.2020, https://www.aseaneconomist.com/thailand-to-probe-chinese-surrogate-gangs/.

– EFE, ‘Dos hombres contratan a una mujer par hacer de vientrel de alquiler’, in Diari de Tarragona, [online], published 24.11.2018, accessed 9.08.2021, https://www.diaridetarragona.com/amp/catalunya/Dos-hombres-contratan-a-una-mujer-para-hacer-de-vientre-de-alquiler-20181124-0042.html.

– Franceinfo, “‘Baby factories’ in Nigeria, a human drama in West Africa,” in Franceinfo, [online], published 5.02.2015, accessed 18.03.2021, https://www.francetvinfo.fr/monde/afrique/nigeria/les-usines-a-bebes-du-nigeria-un-drame-humain-en-afrique-de-l-ouest_3065459.html.

– Ilaya medical company, “The new cross-border surrogacy program in the US with ilaya”, in Ilaya medical company, [online], published 10.11.2016, accessed 12.08.2021, https://ivf.ilaya.com/fr/le-nouveau-programme-de-gpa-aux-etats-unis/.

– Ishii R., “In pictures: Myanmar women trafficked as brides in China – Casting shadow on Belt and Road, victims share their ordeals,” in Niekkei Asia, [online], published 29.12.2019, accessed 18.03.2021, https://asia.nikkei.com/Photos/In-pictures-Myanmar-women-trafficked-as-brides-in-China.

– Jeffreys S., ‘Reject commercial surrogacy as another form of human trafficking’, in The Conversation, [online], published 11.08.2014, accessed 16.03.2021, https://theconversation.com/reject-commercial-surrogacy-as-another-form-of-human-trafficking-30314.

– Klimchuk O. & Cheretski V., “Ukraine’s surrogacy industry leaves parents in limbo,” in DW, [online], published 7.09.2018, accessed 15.03.2021, https://www.dw.com/en/ukraines-surrogacy-industry-leaves-parents-in-limbo/a-45371478.

– Kowitwanij W., “Thai organisation involved in trafficking in Vietnamese surrogate mothers uncovered,” in AsiaNews, published 3.02.2011, accessed 15.03.2021, http://www.asianews.it/news-en/Thai-organisation-involved-in-trafficking-in-Vietnamese-surrogate-mothers-uncovered-20916.html.

– The Editor, “How women’s slavery continues with impunity in Nepal,” in Les Inrockuptibles, [online], published 28.06.2018, accessed 18.03.2021, https://www.lesinrocks.com/actu/comment-lesclavage-des-femmes-perdure-en-toute-impunite-au-nepal-151732-28-06-2018/.

– Lao Dong N., “Vietnamese women arrested for surrogacy,” in Vietnam net, [online], published 11.04.2019, accessed 12.08.2021, https://vietnamnet.vn/en/society/vietnamese-women-arrested-for-surrogacy-521586.html.

– Leibowitz-Dori I., “Womb for Rent: The Future of International Trade in Surrogacy”, in Minnesota Journal of International Law, vol. 6:329, 1997.

– Moreau F., “Bordeaux: un couple condamné pour une GPA avec une mère porteuse bulgare”, in Sud Ouest, [online], published on 1.07.2015, updated on 2.07.2015, accessed on 10 April 2021, https://www.sudouest.fr/2015/07/01/bordeaux-deux-hommes-condamnes-suite-a-une-gestation-pour-autrui-1981209-2780.php?nic.

– Murdoch L., ‘Philippine police arrest surrogate mothers-to-be in human trafficking crackdown’, in The Sydney Morning Herald, [online], published 4.01.2017, accessed 16.08.2021, https://www.smh.com.au/world/philippine-police-arrest-surrogate-motherstobe-in-human-trafficking-crackdown-20170104-gtli45.html.

– Musca H., “Le business effrayant des mères surrogées en Inde”, in Terrafemina, [online], published on 4.04.2016, accessed on 16.03.2021, https://www.terrafemina.com/article/le-business-effrayant-des-meres-porteuses-en-inde_a308122/1.

– Ngamkham W., ‘Surrogacy gang arrests increase to 22, say police’, in Bangkok Post, [online], published 20.05.2020, accessed 17.03.2021, https://www.bangkokpost.com/thailand/general/1926532/surrogacy-gang-arrests-increase-to-22-say-police.

– Oswald K., ‘Earthquake throws spotlight on Israeli use of Nepalese surrogacy’, in Bionews, [online], published 5.05.2015, accessed 12.08.2021, https://webcache.googleusercontent.com/search?q=cache:6BoO1t9MUJEJ:https://www.bionews.org.uk/page_95016+&cd=16&hl=en&ct=clnk&gl=en

– Pascoe J., LegalWise 2nd Annual International Family Law Conference Cambodia: Intercountry Surrogacy -A new form of trafficking? Federal Magistrates Court of Australia, 19.09.2012.

– Petrakis P., “Greek police smash alleged €500,000 baby-smuggling network”, in Euronews, [online], updated 27.09.2019, accessed 19.03.2021, https://www.euronews.com/2019/09/27/greek-police-smash-alleged-500-000-baby-smuggling-network.

– Post Reporters, “Swoop on surrogacy network – Disguised for years as cleaning company,” in Bangkok Post, published 6.02.2021, accessed 19.03.2021, https://www.bangkokpost.com/thailand/general/2063455/swoop-on-surrogacy-network.

– Press Release, “66 suspected of arranging illegal adoptions and surrogacies, and human egg trafficking in Greece,” in Europol, [online], published 26.09.2019, accessed 19.03.2021, https://www.europol.europa.eu/newsroom/news/66-suspected-of-arranging-illegal-adoptions-and-surrogacies-and-human-egg-trafficking-in-greece.

– Shimbun M., “Investigation. Au Japon, des mères porteuses au service des riches Chinois”, in Courrier international, [online], published on 12.05.2016, accessed on 17.03.2021, https://www.courrierinternational.com/article/enquete-au-japon-des-meres-porteuses-au-service-des-riches-chinois.

– Solid Structure, “Who chose a surrogate for Pugacheva and Galkin detained for child trafficking?”, in Lenta.Ru, [online], published 16.07.2020, accessed 18.03.2021, https://m.lenta.ru/news/2020/07/16/doctor.

– Stewart W., ‘Three babies born to surrogates abandoned by mums due to pandemic’, in Mirror, [online], published 18.12.2020, accessed 17.03.2021, https://www.mirror.co.uk/news/world-news/three-babies-born-surrogates-abandoned-23186539.

– Tanutam Thawan, “Bangkok airport police stop Chinese with babies, seize fake birth certificates”, in The Thaiger, [online], published 30.06.2021, accessed 30.07.2021, https://thethaiger.com/news/national/bangkok-airport-police-stop-chinese-with-babies-seize-fake-birth-certificates.

– TNN, ‘Ex-Delhi doctor running illegal surrogacy operation in Nepal: Agra police’, in The Times of India, [online], published 17.07.2020, accessed 19.03.2021, https://timesofindia.indiatimes.com/city/agra/ex-delhi-doctor-running-illegal-surrogacy-operation-in-nepal-agra-police/articleshow/77006879.cms.

– Tran P., “Women, children and babies: human trafficking to China is on the rise”, in Asia news, [online], published 7.11.2019, accessed 10.08.2021, http://www.asianews.it/news-en/Women,-children-and-babies:-human-trafficking-to-China-is-on-the-rise-47513.html.

– Uchechukwu O., “#JusticeforAjimaandSusan: The Belgium press conspiracy of silence”, [online], published on 13.04.2021, accessed on 12.08.2021, https://www.icirnigeria.org/justiceforajimaandsusan-the-belgium-press-conspiracy-of-silence/.

– Varenikova M., “Mothers, Babies Stranded in Ukraine Surrogacy Industry, in The New-York Times, [online], published 15.08.2020, accessed 17.03.2021, https://www.nytimes.com/2020/08/15/world/europe/ukraine-baby-surrogate.html.

– VN Express, “Cambodia a top trafficking destination for Vietnamese surrogate mothers,” in The Cambodia Daily, [online], published 20.12.2019, accessed 15.03.2021, https://english.cambodiadaily.com/crime/cambodia-a-top-trafficking-destination-for-vietnamese-surrogate-mothers-157648/.

– Watcharasakwet W., “Bangkok Police Arrest Chinese Couple, 7 Thai Women in Surrogate Sting,” in BenarNews, [online], published 13.02.2020, accessed 17.03.2021, https://www.benarnews.org/english/news/thai/surrogacy-arrests-02132020163520.html.

Cases reported in Questionnaire 1 – “Questionnaire to Organisations and Individuals” (this questionnaire is presented in detail in the annexes):

N.B. Please note that we have guaranteed the anonymity of our respondents.

An Italian association has been informed of immigrant women in Italy who have given birth in the country as part of a surrogacy. This association has also heard of cases of immigrant women in Italy who have been forced to carry pregnancies on behalf of others.
A Spanish association has also heard of immigrant women in Spain who have given birth in the country as part of a surrogacy. This association has also heard of cases of immigrant women in Spain who have been forced to carry pregnancies on behalf of others.
An international collective has learned of cases of oocyte retrieval from migrant women as well as cases of migrant women who have been forced into a surrogate pregnancy.
A Spanish federation of libertarian youths has been informed of cases of egg collection from migrant women.
A Colombian association has been informed of women immigrants to Colombia who have given birth in the country in a surrogacy situation.
An American association said it had learned of cases of migrant surrogate mothers who had given birth in the USA and of women forced to carry pregnancies, also in the USA.
One person stated that they were aware of cases of immigrant women having their eggs removed.
The co-president of CIAMS (Spain and Latin America region), Berta O. Somnia, is aware of cases of oocyte retrieval from migrant women in Spain.

Annex 2. Phasing of the survey :

Phase 1:

Design of questionnaire 1 for organisations and individuals.
Design of the relationship to be organised with the States (Ministries of Justice, Interior and Foreign Affairs).

Phase 2:

Dissemination of the survey to our networks (members and friends of ENoMW and CIAMS).

Phase 3:

Organisation of communication on social networks.
Promotion and re-launch of questionnaire 1.

Phase 4:

Design of questionnaire 2 for States (their embassies and the ministry responsible for assisted reproductive technologies and surrogacy. This ministry is usually the Ministry of Justice, Foreign Affairs or the Interior).
Promotion and re-launch of questionnaire 2.
Data collection and analysis.

Phase 5:

Conducting further interviews.
Formalisation of results.

Phase 6:

Dissemination of results.
Dissemination of specific alerts to the authorities of the States concerned depending on the results of the investigation.

Phase 7:

Publication of results, design and production of materials.
Organisation of the public presentation of the results.
Dissemination of the survey results on ENoMW and CIAMS social networks and address books.

Phase 8:

Design of the 2022 action plan

è To date, phases 1 to 5 have been completed.

Annex 3. States surveyed in the course of the investigation :

Extensive research was conducted on 72 states.

African States :

South Africa
Algeria
Angola
Benin
Cameroon
Ghana
Niger
Nigeria
Uganda
Senegal

European States :

Albania
Germany
Andorra
Austria
Belgium
Belarus
Bosnia and Herzegovina
Bulgaria
Cyprus
Denmark
Spain
Finland
France
Greece
Ireland
Italy
Lithuania
Luxembourg
Malta
Norway
Netherlands
Poland
Portugal
Czech Republic
Romania
United Kingdom
Russia (Europe/Asia)
Sweden
Switzerland
Ukraine

Asian states :

Afghanistan
Saudi Arabia
Armenia
Azerbaijan
Bangladesh
Burma (Myanmar)
Cambodia
China
North Korea
South Korea
India
Israel
Japan
Nepal
Philippines
Singapore
Thailand
Viet Nam

American states :

Anguilla
Antigua and Barbuda
Argentina
Aruba
Brazil
Colombia
Costa Rica
Ecuador
United States of America
Mexico
Puerto Rico
Uruguay

Oceanian States :

Australia
New Zealand

In addition to these, partial searches were carried out on the following states:

Croatia (Europe)
Georgia (Asia)
Hungary (Europe)
Montenegro (Europe)
Dominican Republic (America)
San Marino (Europe)
Taiwan (Asia)
Turkey (Asia)

Appendix 4. Questionnaires used in data collection :

Questionnaire 1 – “Questionnaire to associations” :

This questionnaire was created by Google Form by CIAMS and sent by email to CIAMS and ENoMW member associations as well as to the associations that signed the CIAMS appeal against the work of the International Private Law Conference in The Hague. In total, the questionnaire was sent to 2,901 individuals and organisations and 60 responses (from 24 individuals and 36 organisations) were received.

Below is the link to the questionnaire which was issued in English, French and Spanish as well as screenshots of the questionnaire:

https://docs.google.com/forms/d/e/1FAIpQLSd71Obf9TJCuZV8j8YxV1vf3d8hzQR197X7RQV3SE1mnkJfqg/viewform?usp=sf_link

Screenshots :

English version :

French version :

Spanish version:

Questionnaire 2 – “Questionnaire to States” :

This questionnaire was made on Microsoft Word and was sent by e-mail to all the embassies present in Paris. It was also sent to the ministries in charge of the surrogacy issue in the Hague Member States whose email addresses we had. The questionnaire was locked before being sent, leaving only the possibility of answering the questions and avoiding any further modification by the recipients.

The list of states that were invited to respond to our questionnaire is as follows

Argentina; Armenia; Australia; Austria; Azerbaijan; Belgium; Burma; Bolivia; Bosnia and Herzegovina; Botswana; Brazil; Burundi; Cambodia; Canada; Chile; China; Colombia; Costa Rica; Croatia; Cyprus; Denmark; Estonia; Finland; France; Gambia; Georgia; Germany; Guatemala; Guinea; Greece; Hungary; Iceland; Iran; Ireland; Italy; Japan; Kazakhstan; Kosovo; Kuwait Estonia; Ecuador; Finland; France; Gambia; Georgia; Guatemala; Guinea; Greece; Hungary; Iceland; Iran; Ireland; Italy; Israel; Japan; Kazakhstan; Kosovo; Kuwait; Latvia; Lebanon; Liberia; Lithuania; Madagascar; Malaysia; Malta; Mauritius; Mexico; Moldova; Morocco; South Korea; United Arab Emirates; Monaco; Mongolia; Montenegro; Mozambique; Namibia; Nepal; Netherlands; New Zealand; Nicaragua; Niger; Nigeria; Norway; Pakistan; Panama; Paraguay; Peru; Philippines; Poland; Portugal; Qatar; Republic of Macedonia; Dominican Republic; Uzbekistan; Republic; Romania; Russia; Rwanda; El Salvador; Serbia; Sierra Leone; Singapore; Slovakia; Slovenia; Sri Lanka; Sweden; Switzerland; Suriname; Syria; Tajikistan; Tanzania; Thailand; Tunisia; Turkey; Turkmenistan; Ukraine; United Kingdom; Uruguay; Venezuela; Vietnam; Zambia; Zimbabwe

è 115 States were contacted in the context of this questionnaire, as well as the European Union’s Directorate-General for Justice and Consumer Affairs. None of these States, except for Denmark, Ireland and Australia, replied to our questionnaire or announced that they would reply. Indeed, the Danish embassy in Paris replied by e-mail saying that they would answer the questionnaire. The Irish embassy informed us that they had forwarded our questionnaire to the persons concerned. Finally, the Australian embassy replied that it was not possible for them or the Australian Departments of Justice, Foreign Affairs or Home Affairs to respond to our questionnaire, but pointed us to reports that could help us in our research and advised us to contact each of the Australian states, as the regulations on surrogacy are specific to each of them.

Here is the standard email sent to the states as an invitation to respond to our questionnaire:

Here is the questionnaire (English version):

International Coalition for the Abolition

of Surrogate Motherhood

ENoMW – ICASM Joint Study

–

“Migrant women and reproductive exploitation in the surrogacy industry

The International Coalition for the Abolition of Surrogacy (CIAMS-ICASM) and the European Network of Migrant Women (ENoMW) are seeking a study on the use of women as surrogate mothers, egg donors or forced pregnant in cross-border practices.

More specifically, these are practices that consist of:

– moving surrogate mothers as part of a surrogacy/egg donation/forced pregnancy process and to organise their delivery in a country other than their own in order to deliver the child or children they are carrying to third parties.

– hiring migrant women as surrogate mothers or setting up a network for trafficking in women with the aim of making them surrogate mothers against their will (cases of forced pregnancies).

– exploiting migrant women in multiple ways for reproductive purposes, including egg retrieval, forced pregnancy and surrogacy.

The aim of this survey is therefore to identify and document the presence of women who are led to act as surrogate mothers and egg donors in a country other than their country of origin in order to measure the link between the migration/displacement (forced or voluntary) of women and the practice of surrogacy, egg retrieval and forced pregnancy.

More specifically, we hypothesize that there is a phenomenon of human trafficking behind the practices of surrogacy, egg donation and forced pregnancy, as well as multiple networks of trafficking in women used in these practices and in the children born from them. Indeed, many worrying reports of trafficking, particularly in Asia but also in Europe, have been emerging over the past decade. It would appear that these networks of trafficking in women used for reproductive purposes and in the children born of them are similar in their jurisdictions and functioning to those of prostitution networks.

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PART 1: Surrogacy

1.1 Status of surrogacy legislation in your State

1.1.1 Is surrogacy legal in your country?

Yes, commercial and “altruistic/regulated” surrogacy are legal in our country.

Yes, but only “altruistic/regulated” surrogacy is legal.

Yes, but only commercial surrogacy is legal.

No, neither commercial surrogacy nor altruistic/regulated surrogacy is legal in our country.

Commercial surrogacy was neither legal nor illegal, as there was no legislation on the subject.

Surrogacy is not regulated in our country. It is therefore neither legal nor illegal, since there is no legislation on the subject.

In your country, is there currently a discussion at the political level on the legislation of surrogacy in your country?

Yes, discussions are under way at political level.

No, there is no ongoing discussion on the matter.

1.1.3 In your country, is the legislator currently discussing legislation on surrogacy issues?

Yes, discussions are under way at legislative level.

No, there is no ongoing discussion on the matter.

1.2 Data collection on surrogacy processes

1.2.1. Do you collect information about surrogate mothers giving birth on your territory?

Yes

If yes, which body/institution collects this information?

1.2.2. Do you collect information about your citizens born by surrogacy (abroad or on your territory)?

Yes

If yes, which body/institution collects this information?

1.2.3 What are you doing to get a global view of surrogacy processes and their effects in your country?

1.2.4 Is there organised monitoring of surrogacy in your country?

Yes

If yes, in what form?

1.2.5. Does your government have statistics on cases of legal disputes related to surrogacy at home or abroad but with your citizens involved?

Yes

If yes, what are these statistics?

Can you send them to us by email () ?

1.2.6. Do you organise a collection of information on contentious cases related to surrogacy involving nationals of your country?

Yes

If yes, which institution is responsible for this?

1.2.7. Does your government have statistics on the number of cross-border surrogacy cases (citizens of your country travelling abroad to use a surrogate mother)?

Yes

If yes, what are these statistics?

Can you send them to us by email () ?

1.2.8. Does your government have statistics on the countries (which countries, how often, etc.) your citizens go to use a surrogate mother?

Yes

If yes, what are these statistics?

Can you send them to us by email () ?

1.2.9. For States where surrogacy is prohibited: Since surrogacy is prohibited in your country, do you have any means to know and measure the possible use of this practice by your nationals in other countries?

Yes

If yes, what are they?

1.2.10. Does your government have statistics on the number of surrogate mothers present in your territory?

Yes

Yes, what are these statistics?

Can you send them to us by email () ?

1.2.11. Does your government have statistics on the number of births per surrogate mother in your territory?

Yes

If yes, what are these statistics?

Can you send them to us by email () ?

1.2.12. Does your government have statistics on the country of origin of intended parents in your territory?

Yes

If yes, what are these statistics?

Can you send them to us by email () ?

SECTION ADDRESSED TO STATES WHERE SURROGACY IS LEGAL:

1.2.13. Since surrogacy is legal in your country, do you have any means to ensure the safety of surrogate mothers and prevent their exploitation?

Yes

If yes, what are they?

1.2.14. Since surrogacy is legal in your country, do you have any means to prevent the sale of children?

Yes

If yes, what are they?

1.2.15. Has the legalisation of the practice of surrogacy given rise to systematic monitoring of the practice: monitoring of the conditions under which the practice is carried out, monitoring of children’s safety?

Yes

If yes, what means of follow-up have been put in place?

How is the practice of surrogate mothers regulated (maximum number of children per surrogate mother during a career, minimum/maximum wages, others?)

1.2.16. Is there a systematic collection of data on the number of:

– women involved in surrogacy arrangements?

Yes

If yes, what means of collecting this data have been put in place?

If yes, what is your data? Can you send them to us by email () ?

– the number of children born by surrogacy ?

Yes

If yes, what means of collecting this data have been put in place?

If yes, what is your data? Can you send them to us by email () ?

– the number of fertility agencies present on your territory?

Yes

If yes, what means of collecting this data have been put in place?

If yes, what is your data? Can you send them to us by email () ?

1.2.17. Does the State know the amount of profits generated by the surrogacy sector?

Yes

If yes, what is the amount of these profits?

How do you calculate them?

1.3 Immigrant women in your state and surrogacy:

1.3.1. Have you registered any cases of migrant women becoming surrogate mothers in your territory?

Yes

If yes, how much and how did you get this data?

1.3.2. Have you identified any cases of surrogate mothers who have been brought to your territory to give birth/spend their pregnancy in the country of the intended parents?

Yes

If yes, how much and how did you get this data?

1.3.3. Have you identified any cases of women who have been displaced within your territory to work as surrogate mothers?

Yes

If yes, how much and how did you get this data?

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PART 2: Egg retrieval

Ise gg donation legal in your country?

Yes, egg retrieval is legal our country.

If so, what legislation is in force?

No, egg retrieval is not legal in our country.

Egg retrieval is neither legal nor illegal, as there is no legislation on the subject.

2.2 In your country, is egg retrieval’s legislation currently discussed at the political level?

Yes, discussions are under way at political level.

No, there is no ongoing discussion on the matter.

2.3 In your country, is the legislator currently discussing legislating it on issues of egg retrieval?

Yes, discussions are under way at legislative level.

No, there is no ongoing discussion on the matter.

2.4. Have you set limits for egg retrieval procedures such as the maximum number of donations per woman?

Yes

If so, what are they?

2.5. Do you have any restrictive means to monitor compliance with the rules surrounding the practice of egg retrieval, such as the number of oocytes taken per woman?

Yes

If so, what are they?

2.6 What is the legislation in your country on access to personal origins?

2.7. How many fertility agencies do you have on your territory?

2.8. Do you have data on the clients of these agencies?

Yes

If so, what is this data?

Can you send them to us by email () ?

How did you get access to this data?

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PART 3: Forced pregnancies and inducement to abandon children

3.1. Does your legislation provide for the preventing or punishment of those who would be guilty of forcing a woman to carry a pregnancy?

Yes

If so, how?

3.2. Does your legislation provide for the preventing or sanctioning of incitement to abandon a child?

Yes

If so, how?

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PART 4: Involvement of NGOs

4.1. Does the State cooperate with non-governmental organizations with a view to respecting the “Convention on Protection of Children and Cooperation in Respect of Intercountry Adoption“?

Yes

What are these non-governmental organizations?

4.2. Does your State provide assistance measures for victims of human trafficking?

Yes

If so, which ones?

PART 5: Additional information to be provided

If you wish to add something you can write to us at or leave a comment here:

The end

ICASM warmly thanks you for taking the time to answer this questionnaire and will come back to you as soon as the first results of the survey are available.

Yours faithfully,

[1] By “reproductive exploitation” we mean the exploitation of women’s bodies, and in particular their wombs and uteruses, for reproductive purposes on behalf of others. Specifically, women provide (willingly or unwillingly) a reproductive service whereby their bodies and the materials derived from them are exploited for economic gain by and for others. In other words, women’s reproductive capacity is appropriated and exploited within what Melinda Cooper and Catherine Walby call the “international market for human reproductive labour”, a market that is not always legal but always exploitative. In “International Market for Human Reproductive Labour”: Melinda Cooper and Catherine Waldby, Clinical Labor: Tissue Donors and Research Subjects in the Global Bioeconomy, Ed. Duke University Press, Durham, 2014 quoted by Delphine Gardey, “Introduction. Quelle économie de la reproduction humaine pour quelle société?”, in Travail, genre et sociétés, n°38, February 2017, p. 31. It should be noted that we consider the notion of work applied to surrogacy to be totally inappropriate, but we understand the approach of the authors who position this practice within the framework of market relations.

^[2] By “reproductive industry” we mean the economic sector (and its actors) of medically and socially assisted reproductive technologies such as surrogacy, oocyte retrieval, IVF techniques, etc. We include both legal and illegal practices.

^[3] Council of Europe Bioethics Committee, “Surrogacy: Addendum to the replies to the questionnaire on access to medically assisted reproduction (MAP) and on the right to know one’s origins for children born after MAP”, DH-BIO/INF (2016) 4 Addendum, 23 October 2019; 28 July 2020; 23 October 2020; 14 June 2021.

[4] List of key words: egg donation; egg donation; reproductive exploitation; surrogate motherhood; surrogate motherhood; eggs harvesting; maternity traffic; reproductive exploitation; surrogacy; surrogate mothers; Vientres de alquiler; subrogación; explotación reproductiva; utero in affito / Leihmutterschaft

[5] List of the 37 countries whose non-governmental organisations were contacted: Afghanistan, Australia, Austria, Argentina, Belgium, Bulgaria, Brazil, Bolivia, Canada, Croatia, Colombia, Denmark, Dominican Republic, Ecuador, Estonia, France, Germany, Greece, Italy, Japan, Mexico, New Zealand, Peru, Poland, Portugal, Romania, Slovenia, Senegal, South Africa, Spain, Sweden, Switzerland, Turkey, Ukraine, United Kingdom, United States, Uruguay.

[6] Link to the website of the Hague International Organisation: https://www.hcch.net/fr/states/hcch-members

[7] See “Annexes 3” for a list of the states concerned.

[8] See “Annexes 3” for a list of the states concerned.

[9] https://www.publicsenat.fr/article/societe/grece-le-commerce-lucratif-de-la-gpa-75298

[10] De Abreu S. Les dessous de la mondialisation Public Sénat: l’histoire bouleversante de Maria, mère porteuse en Grèce”, in Télé Star, [online], published on 28.05.2016, accessed on 10.08.2021, https://www.telestar.fr/culture/les-dessous-de-la-mondialisation-public-senat-l-histoire-bouleversante-de-maria-mere-porteuse-en-grece-211285.

[11] Shimbun M. Investigation. Au Japon, des mères porteuses au service des riches Chinois”, in Courrier international, [online], published on 12.05.2016, accessed on 17.03.2021, https://www.courrierinternational.com/article/enquete-au-japon-des-meres-porteuses-au-service-des-riches-chinois.

[12] EFE, ‘Dos hombres contratan a una mujer par hacer de vientrel de alquiler’, in Diari de Tarragona, [online], published 24.11.2018, accessed 9.08.2021, https://www.diaridetarragona.com/amp/catalunya/Dos-hombres-contratan-a-una-mujer-para-hacer-de-vientre-de-alquiler-20181124-0042.html.

[13] Uchechukwu O., “#JusticeforAjimaandSusan: The Belgium press conspiracy of silence”, [online], published on 13.04.2021, accessed on 12.08.2021, https://www.icirnigeria.org/justiceforajimaandsusan-the-belgium-press-conspiracy-of-silence/.

[14] Stewart W. , ‘Three babies born to surrogates abandoned by mums due to pandemic’, in Mirror, [online], published 18.12.2020, accessed 17.03.2021, https://www.mirror.co.uk/news/world-news/three-babies-born-surrogates-abandoned-23186539.

[15] AFP, “Thailand: dismantling of a vast network of Vietnamese surrogate mothers”, in 20 Minutes, [online], published on 24.02.2011, accessed on 16.03.2021, https://www.20minutes.fr/675983-20110224-societe-thailande-demantelement-vaste-reseau-meres-porteuses-vietnamiennes.

[16] Leibowitz-Dori I. Womb for rent: The Future of International Trade in Surrogacy”, in Minnesota Journal of International Law, 1997, pp. 329-354.

[17] Ana-Luana Stoicea-Deram, co-president of ICASM, was informed about the issue by some of her sources.

[18] Anonymous, “India, surrogacy centres relocate to Cambodia”, in European Institute of Bioethics, [online], published 7.07.2016, accessed 15.03.2021, https://www.ieb-eib.org/fr/actualite/debut-de-vie/gestation-pour-autrui/inde-les-centres-de-maternite-de-substitution-se-delocalisent-au-cambodge-1111.html?backto=search.

[19] Oswald K., ‘Earthquake throws spotlight on Israeli use of Nepalese surrogacy’, in Bionews, [online], published 5.05.2015, accessed 12.08.2021, https://webcache.googleusercontent.com/search?q=cache:6BoO1t9MUJEJ:https://www.bionews.org.uk/page_95016+&cd=16&hl=en&ct=clnk&gl=en

[20] Duttagupta I., ‘Why surrogacy issue emerges after Nepal earthquake’, in ET The Economist Times, [online], published 5.05.2015, accessed 15.03.2021, https://economictimes.indiatimes.com/blogs/globalindian/why-surrogacy-issue-emerges-after-nepal-earthquake/.

[21] Lao Dong N., “Vietnamese women arrested for surrogacy,” in Vietnam net, [online], published 11.04.2019, accessed 12.08.2021, https://vietnamnet.vn/en/society/vietnamese-women-arrested-for-surrogacy-521586.html.

[22] Watcharasakwet W. , “Bangkok Police Arrest Chinese Couple, 7 Thai Women in Surrogate Sting,” in BenarNews, [online], published 13.02.2020, accessed 17.03.2021, https://www.benarnews.org/english/news/thai/surrogacy-arrests-02132020163520.html.

[23] Cheang S., “Cambodian women face surrogate charges after Vietnam births,” in abcnews, [online], published 19.07.2019, accessed 9.08.2021, https://abcnews.go.com/Health/wireStory/cambodian-women-face-surrogacy-charges-vietnam-births-64436596.

[24] Bernard V., “Le nouveau trafic des mères surrogues au Cambodge”, in Le petit journal, [online], published 25.12.2018, updated 26.12.2018, accessed 9.08.2021, https://lepetitjournal.com/cambodge/actualites/le-nouveau-trafic-des-meres-porteuses-au-cambodge-247016.

[25] Maria Varenikova, “Mothers, Babies Stranded in Ukraine Surrogacy Industry, in The New-York Times, [online], published 15.08.2020, accessed 17.03.2021, https://www.nytimes.com/2020/08/15/world/europe/ukraine-baby-surrogate.html.

[26] Moreau F., “Bordeaux : un couple condamné pour une surrogacy avec une mère porteuse bulgare”, in Sud Ouest, [online], published on 1.07.2015, updated on 2.07.2015, accessed on 10 April 2021, https://www.sudouest.fr/2015/07/01/bordeaux-deux-hommes-condamnes-suite-a-une-gestation-pour-autrui-1981209-2780.php?nic.

[27] VN Express, “Cambodia a top trafficking destination for Vietnamese surrogate mothers,” in The Cambodia Daily, [online], published 20.12.2019, accessed 15.03.2021, https://english.cambodiadaily.com/crime/cambodia-a-top-trafficking-destination-for-vietnamese-surrogate-mothers-157648/.

[28] Ilaya medical company, “The new cross-border surrogacy program in the US with ilaya”, in Ilaya medical company, [online], published 10.11.2016, accessed 12.08.2021, https://ivf.ilaya.com/fr/le-nouveau-programme-de-gpa-aux-etats-unis/.

[29] Press Release, “66 suspected of arranging illegal adoptions and surrogacies, and human egg trafficking in Greece,” in Europol, [online], published 26.09.2019, accessed 19.03.2021, https://www.europol.europa.eu/newsroom/news/66-suspected-of-arranging-illegal-adoptions-and-surrogacies-and-human-egg-trafficking-in-greece.

[30] AFP, “Bulgarian babies for sale: the trade in misery that pays big”, in La Dépêche, [online], published on 18.02.2016, accessed on 10.08.2021, https://www.ladepeche.fr/article/2016/02/18/2279648-bebes-bulgares-vendre-commerce-misere-rapporte-gros.html.

[31] AFP, “Grèce : démantèlement d’un réseau de trafic d’ovaires et de nourrissons”, in Le Figaro, [online], published on 25.09.2019, accessed on 10.08.2021, https://www.lefigaro.fr/flash-actu/grece-demantelement-d-un-reseau-de-trafic-d-ovaires-et-de-nourrissons-20190925.

[32] Solid Structure, “Who chose a surrogate for Pugacheva and Galkin detained for child trafficking?”, in Lenta.Ru, [online], published 16.07.2020, accessed 18.03.2021, https://m.lenta.ru/news/2020/07/16/doctor.

[33] BioTexCom website, accessed on 27.04.2022, https://biotexcom.com/.

[34] Foreign Correspondent “Motherland” ABC [online] published 20.08.2019, accessed 27.04.2022, https://www.abc.net.au/foreign/motherland/11432194.

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[56] Press Release, “66 suspected of arranging illegal adoptions and surrogacies, and human egg trafficking in Greece,” in Europol, [online], published 26.09.2019, accessed 19.03.2021, https://www.europol.europa.eu/newsroom/news/66-suspected-of-arranging-illegal-adoptions-and-surrogacies-and-human-egg-trafficking-in-greece.

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[67] Ilaya medical company, “The new cross-border surrogacy program in the US with ilaya”, in Ilaya medical company, [online], published 10.11.2016, accessed 12.08.2021, https://ivf.ilaya.com/fr/le-nouveau-programme-de-gpa-aux-etats-unis/.

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[70] Intervention by Bertha O. Garcia, co-president of ICASM, at the seminar “Gender equality public policies and the choice to become a surrogate mother” on 19.03.2022, Abolition surrogacy, published on 22.03.2022 , accessed on 10.05.2022, https://www.youtube.com/watch?v=NJx7MoBf9EA.

[71] Bever, L. “Smuggled to the U.S. to be a surrogate, one woman claims she was abused and used for her womb” The Washington Post [online], published 01/04/2017, accessed 10.05.2022, https://www.washingtonpost.com/news/morning-mix/wp/2017/04/01/smuggled-to-the-u-s-to-be-a-surrogate-one-woman-claims-she-was-abused-and-used-for-her-womb/.

[72] “The Underbelly of Globalisation: Greece-the Price of a Child”, https://www.youtube.com/watch?v=JHwKiCS3gyI, June 2016.

[73] Duttagupta I. Why surrogacy issue emerges after Nepal earthquake”, Op. cit.

^[74] Ilaya medical company, “The new US cross-border surrogacy programme with ilaya”, Op. cit.

^[75] List of countries from which the respondents to the questionnaires came: Bulgaria; Quebec; Brazil; Italy; Spain; France; Sweden; USA; Argentina; Australia; Galicia; Colombia.

^[76] 24 individuals and 36 organisations responded to our questionnaire.

^[77] Please note that we have guaranteed the anonymity of our respondents, which is why we do not name the organisations and the person who made these statements in our questionnaire, except for Ms Berta O. Somnia, whom we know personally and whose explicit agreement we have obtained to quote her.

[78] The surrogacy market was worth more than USD 4 billion in 2020 and is estimated to be worth USD 33.9 billion by 2027, according to a Global Market Insights report. -> Global Market Insights, “Surrogacy Market Size By Type (Gestational Surrogacy, Traditional Surrogacy), By Technology (Intrauterine Insemination {IUI}, In-vitro Fertilization {IVF} [Classical/Standard IVF, Intracytoplasmic Sperm Injection (ICSI)]), By Age Group (Below 35 Years, 35-37 Years, 38 – 39 Years, 40-42 Years, 43-44 Years, Over 44 Years), By Service Provider (Hospitals, Fertility Clinics), COVID19 Impact Analysis, Regional Outlook, Application Potential, Competitive Market Share & Forecast, 2021 – 2027”, published in June 2021, accessed on 6 September 2021, https://www.gminsights.com/industry-analysis/surrogacy-market. https://www.mysurrogacyjourney.com/blog/surrogacy-trends-for-uk-nationals-our-exclusive-findings/

[79] The only known official census is the one carried out in the United Kingdom:

[80] A report by Silvia Blanco indicates that commercial surrogacy accounts for 98% of all cases of surrogacy in the world, and its limited version under the guise of altruism, ethics or any other restrictive motive; only the remaining 2%. Blanco, S. (2017): ‘Gestación subrogada, el dilema de gestar al hijo de otros’, in EL PAIS, 19/2/2017. https://elpais.com/politica/2017/02/17/actualidad/1487346402_358963.html

[81] In Ukraine, half of the children entrusted to orphanages are said to be children born of surrogacy, which the clients have renounced. Maria Dmitryeva in https://youtu.be/5-SaT3VsAwA

^[82] The Editor, “Trafficking in human beings: the European Parliament calls for a revision of the directive”, in Vie Publique, [online], published on 17.02.2021, accessed on 18.03.2021, https://www.vie-publique.fr/en-bref/278567-parlement-ue-reviser-la-directive-sur-la-traite-des-etres-humains.

^[83] Europol report

https://www.europol.europa.eu/cms/sites/default/files/documents/socta2021_1.pdf

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FORCED CRIMINALITY AND OTHER FORMS OF EXPLOITATION

Traffickers abuse their victims to force them into begging, to involve them in forced crime, to force organ and tissue harvesting and, sometimes, to obtain financial and social benefits by using their identity. Women are also trafficked to participate in illegal surrogacy programmes, to sell their newborn babies, to enter into sham marriages and to be victims of domestic slavery. As with other types of human trafficking, recruitment of victims is increasingly taking place online.

Victims are lured by false job offers, advertisements for marriage to strangers and offers to buy babies. Most victims of trafficking are homeless, mentally or physically disabled, single parents with children, or elderly.

^[84] Akm Ahsan Ullah and Faraha Nawaz, ‘Surrogacy-led migration: reflections on the policy dilemmas’, in Public Administration and Policy, vo. 23, no. 2, 2020, p. 157.

^[85] Aurélie Carton, “Olivia Gazalé: ‘L’homme ne naît naît viril mais le devient'”, in La Chronique d’Amnesty International, [online], published on 8.03.2018, accessed on 6.09.2021, https://www.amnesty.fr/discriminations/actualites/olivia-gazale-lhomme-ne-nait-pas-viril-mais-ledevient.

^[86] Anne-Françoise Praz, Marianne Modak and Françoise Messant, “‘Produire des enfants’ aujourd’hui: un défi pour l’analyse féministe”, in Nouvelles Questions Féministes, vol. 30, January 2011, p. 6.

^[87] Martine Segalen, ‘Why so-called “ethical” surrogate motherhood cannot be’, in Travail, genre et sociétés, n°38, February 2017, p. 59.