Today, ICAMS would like to warmly thank all its members for their valuable and necessary contributions in response to the call for papers issued by Reem Alsalem, United Nations Special Rapporteur on violence against . All these rich and diversified works enable us to highlight new arguments and critical perspectives on surrogate motherhood, while strengthening our argument for its worldwide abolition.
Among the contributions received, several major themes emerge, highlighting the systemic dimensions and violations inherent in the practice of surrogacy.
First of all, the main arguments are repeated. Surrogacy is denounced as a form of intrinsic violence against women, in line with the UN’s 1993 definition of violence against women. ICAMS members have insisted that the practice causes physical and psychological harm and deprivation of liberty, targeting women exclusively because of their reproductive capacity. Medical risks, forced separation of the child and economic exploitation are all specific forms of violence that only affect women, as man is exposed to such dangers.
Contributions also highlighted the economic and social exploitation associated with surrogacy. Members highlighted how this practice takes advantage of geopolitical inequalities and the feminization of poverty on a global scale. Vulnerable women, especially migrants or those in precarious situations, are particularly targeted by surrogacy agencies, who promise them financial benefits that are often derisory compared to the profits generated by this industry. The testimonies gathered reveal cases of deception, abusive contracts and economic pressure that nullify any possibility of free and informed consent.
On the medical front, ICAMS members have documented serious health risks for women involved in surrogate pregnancies. Invasive procedures such as ovarian stimulation, multiple embryo transfers and forced caesarean sections expose surrogate mothers to life-threatening complications. Experimental hormone treatments, such as Medrol, have been linked to cases heart failure and other serious pathologies. Contributions also highlighted the priority given to the “success of the embryo” at the expense of the health of the mothers, an approach that flouts medical ethics.
The psychological violence suffered by surrogate mothers was another focal point of the contributions. ICAMS members described the traumas associated with the forced detachment of the child, a practice often encouraged by contracts and agencies. Surrogate mothers are encouraged not to become attached to the child, leading to traumatic dissociation mechanisms comparable to those seen in victims of prostitution. The testimonies gathered illustrate cases of post-partum depression, unrecognized grief and lasting psychological suffering.
The rights of children born of surrogacy were also a central concern. ICAMS members recalled that these children are deprived of their fundamental right to know their origins, in violation of Article 7 of the Convention on the Rights of the Child. Cases abandonment of disabled children or “bad sex”, such as that of baby Gammy, were cited as flagrant examples of violations. Furthermore, the legal erasure of the biological mother on birth certificates denies the child’s identity and history, creating identity problems and emotional trauma.
The contributions also highlighted the links between surrogacy and human trafficking. ICAMS members argued that this practice should be analyzed as trafficking in human beings, in this case women. In fact, it meets the criteria for human trafficking defined by the Protocol, in particular because of the systematic deception of women recruited as surrogate mothers, their forced displacement and the exploitation of their economic vulnerability.
What’s more, women are often confined under strict conditions during pregnancy, under the surveillance of agencies, which constitutes a form of deprivation of liberty.
Finally, ICAMS members criticized the legal loopholes and complicity of states perpetuating this exploitation. Legal shopping”, where commissioning parents exploit legal loopholes between countries, was denounced as a common practice. Agencies and clinics operate with impunity, protected by lax or non-existent legislation. The contributions called for a binding international framework to ban surrogacy, drawing on existing instruments such as the Istanbul or the Palermo Protocol.
Economic exploitation and reproductive racism:
Surrogacy is part of a logic of commodification of women’s bodies, targeting vulnerable populations a priority. The data collected reveals a global market estimated to be worth $200 billion by 2034, where surrogate mothers, mostly from poor countries or in precarious situations, receive only a tiny fraction of the profits made by clinics and agencies. In the UK, for example, spending is capped at £985 (2024) for oocyte , with the possibility of serving up to 10 families, a financial lure for precarious women. This is particularly striking when you consider that 55% of UK surrogates report a family income of less than £40k/year (2022 study of 47 women). Deception is a common tactic, involving the promise of payments that are not fully made or that depend on arbitrary criteria. In Ukraine, India or Kenya, women are recruited under financial pressure, sometimes in debt, and subjected to abusive contracts. The stories documented show an exploitation based on geopolitical inequalities, where the bodies of racialized women become a mere reproductive resource at the service of rich countries. Paid less than 5% of the profits generated, surrogate mothers are subjected to organized precariousness, with fraudulent contracts and payments of conditional. The lack of contract transparency and women’s economic dependence place them in position of extreme vulnerability.
Medical and psychological violence :
The procedures imposed on surrogate mothers constitute serious attacks on their physical and mental integrity. Intensive ovarian stimulation, multiple embryo transfers and forced caesarean sections lead to increased risks of cancer, hyperstimulation syndromes and death. A Canadian study of 8G3,017 births (2012-2021) reveals that surrogate pregnancies (80G cases) triple the risk of complications. Documented cases: a 25-year-old Mexican woman died of post-partum haemorrhage; a British woman (Natasha Caltabiano29) died during her first surrogate pregnancy. Testimonies describe cases of post-partum depression, unrecognized grief and traumatic dissociation, comparable to those observed in victims of trafficking. The surrogacy industry systematically denies this suffering, prioritizing the “success of the embryo” over women’s health. Women are denied the right to attach themselves to their unborn child, are forced to meet the expectations of the ‘commissioning parents’ and are blamed in the event of complications. Clearly, women are deprived of their autonomy and control over their own bodies and reproductive decisions. It is also relevant to add that, although not a form of violence explicitly documented in all surrogacy cases, there is a latent risk of sexual violence. In contexts of exploitation and lack of autonomy, pregnant women can be vulnerable to sexual abuse.
Violations of children’s rights:
Children born of surrogacy are deprived of their fundamental right to know their origins, in violation of the International Convention on the Rights of the Child. Cases of abandonment, particularly on grounds of disability or “bad sex”, are multiplying, while legislation facilitates the legal erasure of surrogate mothers. Longitudinal studies reveal alarming rates of psychological disorders in these children, who are confronted with a fragmented identity and artificial family ties.
State complicity through legal circumvention :
Despite official rhetoric, many countries turn a blind eye to transnational surrogacy, allowing it to expand. Incoherent legislation in France and Spain, for example, recognizes children born through surrogacy abroad, while prohibiting the practice on their territory. This hypocrisy encourages “reproductive tourism”, with the richest exploiting the legal loopholes in the countries of the South. Worse still, some countries, such as Israel and certain American states, partially regulate surrogacy internally, while outsourcing exploitation to less regulated countries.
Instrumentalizing LGBTQ+ struggles:
While surrogacy is often presented as “progress” for homoparental couples, the data show a very different reality. Gay male couples account for a growing share demand, while lesbians are solicited as oocyte or “solidaritysurrogate mothers. This dynamic reproduces patriarchal patterns, in which women remain instrumentalized in the service of male parenthood (G1% of British surrogacies (2022) involve male homosexual couples, fuelling an unregulated transnational market).
Human trafficking:
The links between surrogacy and trafficking are undeniable. Beyond the organized networks recruiting vulnerable women, the practice of surrogacy itself must be equated with human trafficking. The United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, popularly known as the Palermo Protocol, defines the constituent elements of human trafficking as follows: The recruitment, transportation, transfer, harbouring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of offre or acceptance of payments or benefits to achieve the consent of a person having control over another person, for finsexploitation.
In surrogacy, all women are recruited to become “surrogate” mothers through the following deception:
- That they are not the mothers of children they bring into the world.
- children they bring into the world are not their children.
- As they are not the mothers of these children, they neither sell them nor give them away, but return them to their parents.
- That process they about to undergo is an assisted reproduction technique, which gives the practice an authoritative character. However, surrogacy as such, with its many actors outside the medical field, cannot be qualified as a technique of assisted procreation.
It’s also important to note that the testimonies of Ukrainian, Argentinean and Indian surrogate mothers reveal conditions akin to modern-day slavery, with confiscation of papers, isolation and post-delivery violence, illustrating this phenomenon in an extreme version.
Institutionalized medical terrorism:
The research sheds light on chillingly brutal medical practices, a contemporary form of scientific barbarism. These include the systematic administration of experimental hormonal treatments to women used as surrogate mothers, often without informed consent. According to ENoMW data from 2024, these protocols have serious complication rates (pulmonary embolisms, liver failure eight times higher than those observed in natural pregnancies). Added to this are documented cases of 37 Ukrainian surrogate mothers who were subjected to late selective terminations, up to 28 weeks gestation, under the pressure of inhumane contractual clauses. There has also been massive detour of oncological drugs, such as methotrexate, used to perform multiple embryonic reductions. These procedures, carried out for the sake of reproductive profitability, often leave patients with irreversible neurological after-effects.
Transnational criminal networks :
The analysis reveals the integration of surrogate motherhood into the circuits of international organized crime. No fewer than 89 clinics were identified by the 2023 joint Interpol-GFI report as money laundering hubs. Systems for “rotating” surrogate mothers between several countries, notably Georgia, Cyprus and Mexico, enable the organizations involved bypass local regulations and escape prosecution. There is also strong evidence of collusion between certain surrogacy agencies and prostitution networks: in Greece, 14% of oocyte were recruited in strip clubs, underlining the porosity between reproductive and sexual exploitation.
Transhumanism:
Finally, a number of contributions warn of the transhumanist drift of artificial procreation. In the U.S., experiments with artificial wombs have been carried out on 23 women in a vegetative state, and are now at the heart of a high-profile trial in Texas. At the same time, the “WombChain” project aims to create an NFT-type platform, designed to commoditize reproductive capacities in the form of digital tokens, creating a speculative economy around the female body. Some biotech companies have even gone so far as to register patents for the rental genetically uteruses, crossing a new frontier in the commodification of the living.
Symbolic violence for all women:
Surrogacy reinforces and perpetuates deeply rooted and damaging sexist stereotypes. It reinforces the patriarchal idea that women are mere instruments of reproduction, whose primary function is motherhood and satisfying their husbands’ desires. Their generosity and money take precedence over any critical perspective on injunction to motherhood.
Having discussed all these elements, ICAMS reiterates and maintains its commitment to the worldwide abolition of surrogacy, an intrinsically violent and exploitative practice. Our members’ contributions enrich our understanding of the issues at stake. We call on the international community, states, and all individuals to understand the issues raised here and to recognize surrogacy as violation of human rights and take concrete steps to end it. Once again, we thank our members for their essential work, which continues fuel our fight for the dignity and rights of women and children.
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