The different manifestations of violence against women and girls in the context of surrogacy 6/

 

VI. Violence against women and girls in the context of surrogacy

 A. Economic violence 

25. Surrogate mothers are particularly vulnerable to exploitation and violence throughout surrogacy if they are unable to make ends meet79 or are in debt.80 While there are some altruistic surrogates who are well educated and financially stable 81 and may have had positive experiences, those from more impoverished backgrounds, who constitute the majority, lack the same capacity to voice dissent or reveal the harms that they face.82 

26. Numerous women were reportedly denied compensation and left without assistance when they miscarried or did not comply with all the requirements of their contract.83 In some instances, women who did not become pregnant were required to pay for fertility medications themselves. 84 In jurisdictions where surrogacy is permitted, it is often treated as a private arrangement between individuals, with little or no obligation on the State to collect or maintain the data necessary for monitoring and oversight.85

 27. In many contracts, surrogate mothers are required to waive, in advance, their right to make their own medical decisions, or to waive the confidentiality of information obtained by doctors during treatments. 86 Other examples of harmful practices reportedly justified using a contract include the implantation of the maximum number of embryos to increase the chances of successful birth, recourse to selective abortion, constant monitoring by the intended parents, including through uninterrupted camera surveillance, 87 and restrictions on freedom of movement, 88 thereby contravening the definition of “decent and productive work” 89 and the “reasonable limitation of working hours”.90 Surrogacy arrangements, therefore, situate this practice outside the realm of freedom of contract. 91

28. There is a risk of falling into a cycle of dependency on payments from surrogacy, especially if women lose or leave their jobs during the process. 92 This problem is particularly relevant in developing countries. 93 Women also sell their eggs between pregnancies or after they are no longer suitable to be a surrogate. 94 

B. Psychological violence 

29. Women experience psychological pressure amounting to violence in order to serve as surrogates. They are often pressured into surrogacy by its presentation as an exercise in demonstrating the values of “love” and “solidarity” – particularly in relation to homosexual couples. 95 Such pressures discourage women from seeking help or voicing dissent, as they may already feel bound by the commitment to transfer a child to commissioning parents with whom they may have emotional ties. 96 

30. A study of 50 women from India demonstrated that surrogate mothers have higher levels of depression during pregnancy and post-birth. In another research study, surrogate mothers reported difficulties in relinquishing their newborns in 35 per cent of cases and having negative emotions over their decision to go into surrogacy in 39 per cent of cases. Some 33 per cent were at risk of post-traumatic stress disorder or anxiety. Substantial stress was observed in 65 per cent of cases in negative in vitro fertilization outcomes. 97 They experience post-birth trauma linked to the release of high quantities of oxytocin after birth for the production of milk and the establishment of the bond, 98 a process abruptly interrupted by removing the newborn. 99 Surrogate mothers also report concern about their sexual lives during pregnancy, marital disturbance and their own childbirth planning. 100 There was only one study of surrogate mothers indicating no change in their well-being 10 years after surrogacy; however, it elicited methodological concerns. 101 

31. No regulatory framework can fully prevent the serious psychological harm that may result from the separation process. 102 Some surrogacy agencies offer detachment therapies to compel expectant mothers to emotionally separate from children, but the result might be cognitive dissociation between their body and their feelings, 103 rising to the levels of post-traumatic stress disorder.10

32. Surrogates are often denied time with the newborn after birth, including not being allowed to hold the baby, 105 and may be cut off from contact with the intended parents and the child after giving birth. 106 Some surrogate mothers report feeling like “an object of a scientific experiment”. 107 

C. Physical violence 

33. Although recruitment material portrays surrogacy as a medically safe process for eligible women, evidence suggests that surrogate mothers have their health jeopardized to a greater extent than other mothers. 108 Drugs such as Lupron, which surrogate mothers usually self-administer109 to synchronize their cycle with that of the egg donor before embryo implantation, are classified as hazardous and recommended to be administered only by healthcare workers wearing protective gowns and gloves. Such practice results in a higher rate of maternal health complications for surrogate mothers compared with others. 110 Surrogate pregnancies are more likely to be ectopic111 and to lead to caesarean section, maternal gestational diabetes, hypertension, pre-eclampsia and placenta previa.112 

34. Surrogacy contracts also change the dynamic in healthcare settings, particularly in countries where litigation is prolific. 113 Reports from India, 114 Mexico 115 and Nepal 116 indicate that delivery by caesarean section is arranged for surrogates regardless of medical indications or preferences, with risks for post-partum complications, particularly for impoverished women who live in rural areas. 

D. Reproductive violence 

35. Power imbalances between surrogate mothers and commissioning parents have severe consequences when the latter impose an abortion in cases of multiple pregnancies or fetal disability.117 Surrogate mothers have reportedly been pressured to terminate healthy pregnancies, including beyond the 12 weeks, through coercive tactics such as financial incentives, threats of legal action or the withdrawal of support to both the mother and the baby.118 Demands are often justified by claims that the child belongs to the commissioning parents. 119 

36. Multiple pregnancies, which are a common outcome of in vitro fertilization procedures, pose heightened health risks for the surrogate mother. 120 In some cases where a multiple pregnancy progresses, commissioning parents also enforce a selective reduction.121 

37. In societies with a strong cultural preference for male children, surrogacy may amplify existing sexist and gender biases through the incorporation of sex selection into in vitro fertilization service packages. 122 

38. Egregious abuses have been documented against egg donors, with hundreds reportedly exploited for months through the harvesting of their eggs. 123 Girls are also reportedly exploited for their eggs and their wombs. 124 Some reports, including from China, describe scenarios of egg retrieval and embryo transfers being conducted in unregulated, underground laboratories operated by biotechnology companies, where the women undergoing the procedures were identified by codes and categorized as “high-end” or “low-end” products, on the basis of their appearance and health status, with each egg priced accordingly.125 Women with disabilities are not being spared such exploitation and abuse.126 

E. Slavery and trafficking 

39. The profit-oriented behaviour underpinning surrogacy service provision increases the risk of human trafficking at every stage of the process, including to other countries for forced reproductive labour. 127 In Georgia, for example, at least 100 female victims were reportedly kept in confinement and forced to give up their eggs after being artificially stimulated to ovulate. 128 Even in countries where surrogacy is regulated, such as Greece, risks persist. Foreign women have reportedly been trafficked into the country to serve as surrogate mothers. 129 

40. Surrogacy arrangements can amount to or resemble slavery, as they place surrogate mothers in a position in which any or all of the attributes of the right of ownership are exercised over them. The commissioning parties exercise this right of usus over the woman’s body by requiring her to follow a specific diet, refusing her medical treatment or obliging her to undergo “embryo reduction” or abortion. 130 In Argentina, poorer women were reportedly recruited on social media to become surrogates in conditions that prosecutors described as the “reduction to servitude”. 131 In Ukraine, women were reportedly forced to live in small, overcrowded apartments, without access to hot water and with severe limitations on their freedom of movement.132 

41. While it has been argued that regulations and oversight can decrease the risk of the trafficking of women and girls in surrogacy arrangements 133 and reduce harm,134 existing evidence does not support such conclusions. 135 

42. Commercial surrogacy, which accounts for the overwhelming majority of surrogacy cases globally, constitutes the sale of children, which is a crime. 136 Without the transfer of the child, there would be no incentive for the surrogacy agreement. 137 Notably, in jurisdictions where commercial surrogacy is allowed, the main difference between the illegal sale of children and legal surrogacy is the point at which parental rights are transferred.138 

43. It becomes very complex to determine what exploitation and abuse have been committed against the surrogate mother and child after the latter has been transferred to the intended parents. Challenges also arise in determining who should be treated as a perpetrator, a victim or a witness.139 In some cases, impoverished families traffic daughters into surrogacy networks, including under the guise of employment or marriage.140 Issues of double criminality arise when surrogacy does not qualify as a criminal offence in all relevant jurisdictions, and transnational law enforcement remains challenging

79 The https://english.elpais.com/elpais/2017/01/02/inenglish/1483355190_156732.html.

80 Submission by Japan Coalition against Surrogacy Practices.

81 José Ángel Martínez-López and Pilar Munuera-Gómez, “Surrogacy in the United States: analysis of sociodemographic profiles and motivations of surrogates”, Reproductive BioMedicine Online, vol. 49, No. 4 (October 2024).

82 Submission by Luba Fein, Voices of Israeli Sex Trade Survivors.

83 Submission by Women’s Liberation Front.

84 See https://www.scielo.org.mx/pdf/conver/v31/2448-5799-conver-31-e20648-en.pdf.

85 Rosana Triviño-Caballero, “Caring for delivery: healthcare professionals’ ethical conflicts in

surrogate pregnancy”, Hypatia, vol. 38, No. 3 (Summer 2023).

86 Carlos Martínez de Aguirre, “International surrogacy arrangements: a global ‘Handmaid’s Tale’?”, in Fundamental Problems of Surrogate Motherhood: Global Perspective, Piotr Mostowik, ed. (Warsaw, Instytut Wymiaru Sprawiedliwości, 2019).

87 Berk, “The legalization of emotion”.

88 Joint submission by E. Bilotti, V. Calderai, S. Niccolai, I. Pretelli, N. Rueda.

89 International Labour Office, Report of the Director-General: Decent Work, 87th session (Geneva, 1999).

90 International Covenant on Economic, Social and Cultural Rights, art. 7 (d).

91 Adeline A. Allen, “Surrogacy and limitations to freedom of contract: toward being more fully

human”, Harvard Journal of Law and Public Policy, vol. 41, No. 3 (2018).

92 Expert consultations. 

93 Olga B.A. van den Akker, Surrogate Motherhood Families (Routledge, 2017). 

94 Fronek, “Current perspectives”. 

95 Submission by CQFD Lesbian Feminists. 

96 Submission by Not All Gays. 

97 Ansha Patel, Pratap Kumar and P.S.V.N. Sharma, ‘“The Miracle Mothers and Marvelous Babies’: psychosocial aspects of surrogacy – a narrative review”, Journal of Human Reproductive Science, vol. 13, No. 2 (April–June 2020). 

98 See e.g. Eliah Abasi and others, “Evaluating the effect of prenatal interventions on maternal– foetal attachment: a systematic review and meta-analysis”, Nursing Open, vol. 8, No. 1 (January 2021). 

99 Bandelli, Sociological Debates. 

100 Marjan Goli and others, “A reproductive health-care programme for surrogate mothers: a mixed methods study”, Journal of Education and Health Promotion, vol. 11, No. 1 (2022). 101 V. Jadva, S. Imrie and S. Golombok, “Surrogate mothers 

10 years on: a longitudinal study of psychological well-being and relationships with the parents and child”, Human Reproduction, vol. 30, No. 2 (February 2025). 

102 Submission by Olivia Maurel. 

103 Submission by Soroptimist International. 

104 Clara Watson, “Womb rentals and baby-selling: does surrogacy undermine the human dignity and rights of the surrogate mother and child?”, The New Bioethics, vol. 22, No. 3 (2016).

105 Ilya Gridneff, Emily Schultheis and Dmytro Drabyk, “Inside a Ukrainian baby factory”, Politico, 23 July 2023. 

106 Submission by The Jamaican Network of Seropositives. 

107 Consultations with surrogate mothers. 

108 Submission by Collectif pour le Respect de la Medecine. 

109 See https://cbc-network.org/2020/04/lets-talk-about-lupron. 

110 Maria P. Velez and others, “Severe maternal and neonatal morbidity among gestational carriers: a cohort study”, Annals of Internal Medicine, vol. 177, No. 11 (2024). 

111 Expert consultations. 

112 See e.g. Jennifer Lahl and others, “A comparison of American women’s experiences with both gestational surrogate pregnancies and spontaneous pregnancies”, Dignity: A Journal of Analysis of Exploitation and Violence, vol. 7, No. 3 (2022). 

113 Van den Akker, Surrogate Motherhood Families. 

114 Amrita Pande, Wombs in Labour: Transnational Commercial Surrogacy in India (2014).

 115 April Hovav, “Cutting out the surrogate: caesarean sections in the Mexican surrogacy industry”, Social Science and Medicine, vol. 256 (July 2020). 

116 Carmen Shalev, Hedva Eyal and Etti Samama, “Transnational surrogacy and the earthquake in Nepal: a case study from Israel”, in Babies for Sale: Transnational Surrogacy, Human Rights and the Politics of Reproduction, Miranda Davies, ed. (London, Zed Books, 2017). 

117 Submission by Vita Alliance.

118 See e.g. https://edition.cnn.com/2013/03/04/health/surrogacy-kelley-legal-battle; https://www.dailymail.co.uk/news/article-12254637/Surrogate-claims-gay-dads-told-terminatepregnancy-24-weeks-cancer-diagnosis.html; and https://www.liveaction.org/news/surrogatemother-saved-abortion. 

119 See https://www.legalizesurrogacywhynot.com/melissa-cook-story. 

120 Raywat Deonandan, Samantha Green and Amanda van Beinum, “Ethical concerns for maternal surrogacy and reproductive tourism”, Journal of Medical Ethics, vol. 38, No. 12 (2012). 121 Arianna Vettorel, “Surrogacy contracts and international human rights law”, Deportate, Esuli, Profughe, No. 47 (2021). 

122 Submission by The Jamaican Network of Seropositives. 

123 See https://civil.ge/archives/659924. 

124 See https://www.scmp.com/news/people-culture/trending-china/article/3303939/shock-teensurrogate-gives-birth-twins-chinese-man-50-receives-us124000. 

125 See https://www.thinkchina.sg/society/chinas-underground-surrogacy-industry-operatingshadows. 

126 See https://www.scmp.com/news/people-culture/trending-china/article/3310495/china-villagecentre-illegal-surrogacy-probe-some-proxy-mums-being-deaf-mute-disabled. 

127 Ibid. 

128 See https://www.reuters.com/world/georgia-thailand-probing-human-egg-trafficking-ring-2025- 02-07/. 

129 See Communication No. AL GRC 2/2024, available at https://spcommreports.ohchr.org/ TMResultsBase/DownLoadPublicCommunicationFile?gId=29143.

130 Submission by Casablanca Declaration. 

131 See https://www.theguardian.com/world/2024/oct/22/surrogacy-ring-argentina.

132 Madeline Roache, “Ukraine’s ‘Baby Factories’: the human cost of surrogacy”, Al Jazeera, 13 September 2018. 

133 Submission of La Strada International.

134 Submission by Amnesty International et al. 

135 Submission by Voices of Israeli Sex Trade Survivors. 

136 Allen, “Surrogacy and limitations”. 

137 Submission by ADF International. 

138 Submission by the Heritage Foundation. 

139 See https://www.eurojust.europa.eu/sites/default/files/assets/files/surrogacy-leaflet-27-08-2024- v6.pdf. 

140 Submission by Centre for Criminology, Criminal Justice and Victimology. 

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The different manifestations of violence against women and girls in the context of surrogacy 5/

 

V. Causes and consequences

 A. Reinforcement of sexist stereotypes and commodification of female bodies

 19. Unlike other forms of labour, surrogacy entails the direct and exploitative use of a woman’s bodily and reproductive functions for the benefit of others, 53 often resulting in long-lasting harm and in exploitative circumstances. Furthermore, surrogacy does not distinguish between working time and personal life, as surrogate mothers cannot take leave from pregnancy. 54 Commercial surrogacy arrangements place monetary value on women’s capacity to bear and give birth to healthy children, 55 reinforcing harmful power imbalances in which individuals and entities with greater financial means exert control over the ability of females to become pregnant and give birth.56 

20. In contexts where women and girls face structural barriers to exercising basic rights and accessing essential services, surrogacy can further devaluate them, reduce them to solely their reproductive roles57 and perpetuate the idea that female biology and reproductive capacity are delegable and marketable. 58 Such a view is embedded in the language on surrogacy, referring to women in disembodied terms such as “womb”, 59 “a guesthouse” and an “incubator developing their cells”. 60 Surrogate mothers also report being infantilized as “good girls” when complying with surrogacy requirements.61 

B. Increased demand 

21. The high rise in infertility partly accounts for the demand for surrogacy. 62 However, an increased number of individuals and couples who do not experience infertility in the clinical sense, such as same-sex couples, single men and prospective parents beyond reproductive age, are turning to surrogacy. Some women have resorted to surrogacy when they do not want to be pregnant themselves for personal reasons.63 Surrogacy also offers the opportunity to be involved from the earliest stages of life and – compared with adoption – the possibility of a genetic connection to the child.64 Demand is also shaped by the largely positive coverage of surrogacy in the media 65 and its visibility among celebrities, 66 as well as broader social narratives framing the desire for a child as a legitimate dimension of the right to family life, including for men in same-sex relationships, for whom surrogacy and adoption remain the main pathway to parenthood. 67 

22. Globalization and advances in medical reproductive technology have further enabled surrogacy, facilitating access to surrogate mothers in other countries. 68 In international arrangements, surrogate mothers are typically nationals of low-income or developing countries, while commissioning parents tend to be wealthier individuals from Western States – a dynamic that risks reinforcing colonial and discriminatory patterns.69 If current trends continue, surrogacy will continue to be further normalized. For example, in the United States, large companies reportedly offer financial contributions towards the surrogacy arrangements of their employees.70 There are also ongoing debates on extending insurance schemes to cover surrogacy costs for commissioning parents with infertility issues. 71 

C. Increased marginalization and vulnerability 

23. Many surrogate mothers have experienced multiple and intersecting forms of discrimination and poverty long before entering surrogacy arrangements. 72 Surrogacy arrangements serve to capitalize on these stark inequalities, sharpened by globalization, whereby everything is for sale. Surrogate mothers are often trapped in unequal power dynamics with doctors and agency personnel 73 and have described feeling powerless and being treated “like a cow”. 74 Many lack access to independent legal advice and representation and may not receive information in a language that they understand75 – making it difficult to challenge exploitative contracts or unethical practices.76

 24. Poverty and conflict can further contribute to women’s decisions about becoming surrogates and amplify associated risks. 77 In Ukraine, the surrogacy agency  reportedly pressured surrogate mothers to leave, as the safe delivery of the child overrode the woman’s desire to remain. 78

53 Submission by Nordic Model Now. 

54 Joint submission by E. Bilotti, V. Calderai, S. Niccolai, I. Pretelli, N. Rueda. 

55 Submission by Melissa Farley. 

56 Submission by Feminist Legal Clinic Inc. 

57 Submission by Slovenia. 

58 Submission by Feministas Radicales. 

59 Submission by Natalia Rueda. 

60 Elly Teman, “My bun, her oven”, Anthropology Now, vol. 2, No. 2 (September 2010).

 61 Consultations with surrogate mothers. 

62 See https://www.gminsights.com/industry-analysis/surrogacy-market. 

63 See https://www.theguardian.com/lifeandstyle/2019/may/25/having-a-child-doesnt-fit-womensschedule-the-future-of-surrogacy.

64 Claire Fenton-Glynn, “International surrogacy arrangements: a survey”, Cambridge Family Law,

April 2022.

65 Consultations with surrogate mothers.

66 Elizabeth Logan, “22 celebrities who’ve used surrogacy to welcome children – and want to talk

about it”, Glamour, 1 February 2025.

67 Submission by Rainbow Families Australia.

68 Submission by Associazione Comunità Papa Giovanni XXIII.

69 Submission by Swedish Women Lobby.

70 Submission by AFRA Mujeres.

71 Melissa Goodman, “California’s SB 729: expanding access to IVF and family building for all”,

UCLA School of Law, October 2024.

72 See United Nations Educational, Scientific and Cultural Organization-International Bioethics

Committee, document SHS/IBC-26/19/2 REV, para. 155.

73 Malene Tanderup and others, ”Reproductive ethics in commercial surrogacy: decision-making in

IVF clinics in New Delhi, India”, vol. 12 (2015).

74 See https://www.aljazeera.com/opinions/2023/9/8/surrogacy-human-right-or-just-wrong.

75 Submission by PFAC and CIAMS.

76 Submission by the Centre for Bioethics and Culture.

77 Submission by Maria Dmytrieva.

https://docs.un.org/es/A/80/158

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The different manifestations of violence against women and girls in the context of surrogacy 4/

IV. Women and girls particularly affected by surrogacy

 A. Surrogate mothers 

12. Surrogate mothers are generally women or girls who have previously given birth to at least one child. Their motivations are often multifaceted, combining financial, empathetic and social considerations. Many express a desire to help others to experience parenthood while also emphasizing the opportunity that surrogacy provides to support them or their own families financially. 25 This is particularly relevant for single mothers, who frequently cite financial needs as a central reason for entering into surrogacy arrangements. 26 When they are described as “service providers” rather than mothers, it creates an impression that compromising their dignity and well-being could be justified by the existence of a contract. 

13. Globally, most surrogate mothers come from lower-income backgrounds and have less social status compared with the commissioning parents. 27 Many lack access to effective legal remedies or advocacy mechanisms. 28 Reportedly, migrant women are either specifically targeted for surrogacy or transferred to other countries for the purpose of impregnation29 and childbirth, often to circumvent legal frameworks. 30 

B. Commissioning mothers 

14. Commissioning mothers are generally from higher socioeconomic backgrounds than most surrogate mothers.31 However, their experience is also frequently marked by uncertainty and emotional strain. Many commissioning mothers report anxiety regarding the outcome of the pregnancy, the nature of their relationship with the surrogate, societal stigma, legal complexities and the financial burdens involved. 32 Particularly in cross-border arrangements, they may fall victim to fraudulent practices by surrogacy agencies, resulting in substantial financial losses. 33 Some may feel exhausted by the prolonged attempts to have a child. In certain cultural contexts, infertile commissioning mothers experience additional external pressure and stigma related to expectations of fulfilling what are perceived as their primary social roles.34 

C. Women and girls who provide egg cells 

15. Women and girls who donate their eggs for surrogacy often come from backgrounds marked by economic vulnerability. They are typically young adults who may view egg donation as a means to meet their financial needs. 35 Agencies tend to prefer women with specific characteristics, which they promise to commissioning parents.36 The demand is frequently shaped by racist and postcolonial stereotypes, as young, white, Western women with higher education receive up to 100 times more for their egg cells than others.37 

16. Recruitment is commonly driven by online advertisement that frames egg donation as both altruistic and financially rewarding while omitting vital information about the discomfort of daily hormonal injections and harmful side effects and risks, such as anaesthesia complications, 38 ovarian hyperstimulation syndrome 39 or the emotional complexities of giving up one’s genetic child. 40 Women report the absence of health services after the donation. 41 Many, particularly girls, are groomed to register as egg donors to test their tolerance for medical procedures before entering a surrogacy arrangement.42 The digital nature of this reproductive market also enables the recruitment of surrogates and egg donors from countries where such practices are formally prohibited.43 

D. Infants, including girls, born through surrogacy 

17. Children born through surrogacy are often pursued and cherished by commissioning parents. However, from birth, they experience immediate separation from the woman who carried them and are transferred to the commissioning parents – a process that can be emotionally and developmentally significant. 44 Individuals with disrupted development of secure attachment are at higher risk of developing mental disorders.45 In some cases, the transfer of a child is also delayed or complicated by legal uncertainties surrounding the recognition of parentage, nationality or identity, leaving the child in limbo.46 18. Studies indicate that children born through surrogacy have lower mean gestational age at delivery, higher rates of preterm birth and higher rates of low birth weight.47 Assisted reproductive technology and multifetal pregnancy have reportedly been associated with an increased risk of birth defects. 48 Breastfeeding, which is prevented in surrogacy and even contractually prohibited, 49 is essential to an infant’s healthy development. 50 While research on the long-term emotional well-being of children born through surrogacy is limited, 51 it indicates that the lack of a gestational connection places them at increased psychological risk. 52

25 Submission by Axana M. Soltan. 

26 Submission by Procuraduría de Trata y Explotación de Personas Fecha of Argentina.

27 Jutharat Attawet, Ethar Alsharaydeh, and Mark Brady, “Commercial surrogacy: landscapes of empowerment or oppression explored through integrative review”, Health Care for Women International (2024). 

28 Submission by Alliance Pro Rodinu. 

29 See e.g. Maria Varenikova, “Mothers, babies stranded in Ukraine surrogacy industry”, The New York Times, 15 August 2020. 

30 European Network of Migrant Women and A Coalition for the Abolition of Surrogate Motherhood, Migrant Women and Reproductive Exploitation in the Surrogacy Industry: Joint Investigation (2022). 

31 Christopher B. Kleinpeter, “Surrogacy: the parents’ story”, Psychology Reports, vol. 91, No. 1 (2002). 

32 Mitra Zandi and others, “Nine centuries waiting: the experiences of Iranians surrogacy commissioning mothers”, Iranian Journal of Nursing and Midwifery Research, vol. 19, No. 3 (May–June 2014). 

33 Submission by 4Métrica. 

34 Submission by Amman Centre for Human Rights Studies. 

35 Polina Vlasenko, “Worker‑mothers between legitimation and discipline: ambiguities in egg donation and surrogacy in Ukraine”, Medical Anthropology: Cross-Cultural Studies in Health and Illness, vol. 43, No. 8 (2024). 

36 See https://www.donorconcierge.com/our-service. 37 Carolin Schurr, “The baby business booms: economic geographies of assisted reproduction”, Geography Compass, vol. 12, No. 8 (August 2018).

38 Carmel Shalev and others, “Ethics and regulation of inter-country medically assisted reproduction: a call for action”, Israel Journal of Health Policy Research, vol. 5, No. 59 (2016). 

39 Daniella Bandelli, Sociological Debates on Gestational Surrogacy: Between Legitimation and International Abolition (Springer, 2021). 

40 Eric Blyth and others, “Donor-conceived people’s views and experiences of their genetic origins: a critical analysis of the research evidence”, Journal of Law and Medicine, vol. 19, No. 4 (June 2012). 

41 W. Kramer, J. Schneider and N. Schultz, “US oocyte donors: a retrospective study of medical and psychosocial issues”, Human Reproduction, vol. 24, No. 12 (December 2009). 

42 Patricia Fronek, “Current perspectives on the ethics of selling international surrogacy support services”, Medicolegal and Bioethics, vol. 18 (2018). 

43 Submission by Jasmine R. de los Santos. 

44 Marcus Agnafors, “The harm argument against surrogacy revisited: two versions not to forget”, Medicine, Health Care and Philosophy, vol. 17 (2014). 

45 Radovan Hrubý, Jozef Hašto and Peter Minárik, “Attachment in integrative neuroscientific perspective”, Neuroendocrinology Letters, vol. 32, No. 2 (2011). 

46 Seema Mohapatra, “Stateless babies and adoption scams: a bioethical analysis of international commercial surrogacy”, Berkeley Journal of International Law, vol. 30, No. 2 (2012). 

47 Irene Woo and others, “Perinatal outcomes after natural conception versus in vitro fertilization (IVF) in gestational surrogates: a model to evaluate IVF treatment versus maternal effects”, Fertility and Sterility, vol. 108, No. 6 (December 2017). 48 Ruohua Yan and others, “Assisted reproductive technology and the risk of birth defects mediated by multifetal pregnancy: evidence from the China birth cohort study”, American Journal of Obstetrics and Gynaecology, vol. 232, No. 6 (June 2025). 

49 Hillary L. Berk, “The legalization of emotion: managing risk by managing feelings in contracts for surrogate labour”, Law and Society Review, vol. 49, No. 1 (March 2015). 

50 Bandelli, Sociological Debates.

51 While some studies indicate positive experience, the most widely cited study suffers from methodological limitations such as a relatively small original sample, which became smaller by the time of its conclusion. See Susan Golombok and others, “Families created through surrogacy arrangements: parent–child relationships in the 1st year of life”, Developmental Psychology, vol. 40, No. 3 (May 2004); and Susan Golombok and others, “A longitudinal study of families formed through reproductive donation: parent–adolescent relationships and adolescent adjustment at age 14”, Developmental Psychology, vol. 53, No. 10 (October 2017). 

52 Susan Golombok and others, “Children born through reproductive donation: a longitudinal study of psychological adjustment”, Journal of Child Psychology and Psychiatry, vol. 54, No. 6 (June 2013). 53 Submissi

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 B. State policies

 8. There are primarily three regulatory models governing surrogacy: (a) explicit prohibition; (b) regulation and recognition, either full or limited to altruistic arrangements; and (c) unregulated, often resulting in legal ambiguity. Prohibition, adopted predominantly in some Western European countries, entails criminal sanctions at least for organizing or advertising surrogacy arrangements, although their prohibitions and enforcement vary significantly. In practice, as observed in Germany, surrogacy and related services, including egg donation, are reportedly still promo ted at public events without legal consequences. 19 By contrast, Italy passed legislation in 2024 designating surrogacy as a “universal crime” that exposes Italian citizens to prosecution for engaging in surrogacy abroad. 20 Typically, however, prohibition is combined with the recognition of the filiation of children to intended parents after birth, if found to be in the child’s best interests. 

9. Some countries, like Australia and India, adopt regulatory frameworks that permit only altruistic surrogacy. Others, such as Georgia, Israel, the Russian Federation and Ukraine, permit commercial surrogacy, although the Russian Federation recently prohibited international surrogacy.21 The majority of States do not regulate surrogacy or are silent on it. Surrogacy may therefore be tolerated in practice, even where legal recognition of parentage may be lacking. 

10. Enforcement and oversight mechanisms for surrogacy arrangements and the role of intermediaries are frequently weak or non-existent.22 Differing legal standards, as well as the lack of mutual recognition of parentage and contracts across jurisdictions, make the resolution of related disputes complex. Even when contracts designate parents, national authorities may refuse to register foreign birth certificates. 

11. Courts have also adopted different positions on the legality of surrogacy. For instance, the Supreme Court of Spain has held that article 8 of the Convention for the Protection of Human Rights and Fundamental Freedoms (European Convention on Human Rights) does not establish a “right” to become a parent by surrogacy23 and, in another decision, found that surrogacy contracts “violate the dignity and the free development” of both the surrogate and her child by treating them as “mere objects” – with the Court declining to recognize a surrogacy judgment. By contrast, in October 2024, the highest court of France reportedly upheld the recognition of a United States surrogacy order.24

19 Submission by “Lasst Frauen Sprechen!”.

 20 See https://www.senato.it/leggi-e-documenti/disegni-di-legge/scheda-ddl?did=57364. 

21 See https://www.theguardian.com/lifeandstyle/2020/jul/29/up-to-1000-babies-born-to-surrogatemothers-stranded-in-russia. 

22 Yingyi Luo, “Unravelling informality and precarity: new labour law strategies for the global reproduction network of cross-border surrogacy”, Asian Bioethics Review, vol. 16 (2024). 

23 European Association of Private International Law, “The Spanish supreme court on surrogacy contract and public policy”, 27 January 2025. 

24 See https://eapil.org/2024/10/08/french-supreme-court-rules-foreign-surrogacy-requires-noadaptation/.

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The different manifestations of violence against women and girls in the context of surrogacy 2/

 

Phenomenon A.

 Scale and trends

 6. The practice of surrogacy is on the rise worldwide, with a significant and growing proportion of arrangements involving cross-border dynamics: intended parents, often from wealthier countries, engage surrogates in jurisdictions where the practice is legally permitted. 10 In 2023, the global surrogacy market was valued at $14.95 billion and is projected to reach $99.75 billion by 2033. 11 Frequently, surrogate mothers receive only a small fraction of the overall compensation, with the majority of the payment going to intermediaries.12 Surrogates have reportedly received as little as 10–27.5 per cent of the total payment.13 Notably, there are incentives for those who refer a woman to a surrogacy agency. In some countries such as in the United States of America, a referring person can receive a bonus of between $1,000 and $5,000 on average.14 In India, it can be up to $100.15 

7. Except in the United States, surrogacy agencies are primarily involved in crossborder arrangements.16 Rising costs, longer waiting periods in traditional surrogacy destinations and increased regulatory restrictions, alongside crises and wars, have relaunched interest in identifying new destinations for surrogacy in Latin America. 17 With the inconsistency in legal and policy approaches, “forum shopping” emerges, whereby commissioning parents seek the least restrictive and least expensive locations to recruit surrogate mothers. 18 This reality is challenging the assumption that regulation is sufficient to prevent abuse in surrogacy arrangements.

10 A/HRC/37/60, para. 13. 

11 See https://www.sphericalinsights.com/reports/surrogacy-market. 

12 Submission by Japan Coalition Against Surrogacy Practices. 

13 See https://www.theguardian.com/world/2024/oct/22/surrogacy-ring-argentina; see also https://pmc.ncbi.nlm.nih.gov/articles/PMC9800153. 

14 See e.g. https://alceasurrogacy.com/surrogates/referral-program/. 

15 Sharvari Karandikar and others, “Economic necessity or noble cause? A qualitative study exploring motivations for gestational surrogacy in Gujarat, India”, Affilia: Journal of Women and Social Work, vol. 29, No. 2 (May 2014). 

16 Sam G. Everingham and Andrea Whittaker, “Trends in engagement in surrogacy by nationality 2018–2020: a survey of surrogacy agencies”, Global Reproductive Health, vol. 8, No. 1 (Spring 2023). 

17 Submission by the Human Rights Commission of Mexico City.

18 Submission by Coalition Against Trafficking in Women.

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The different manifestations of violence against women and girls in the context of surrogacy 1/

 

Terminology

 3. Surrogacy is defined as a practice in which a woman (the “surrogate mother”) becomes pregnant and carries a child for another individual or couple (the “commissioning parent(s)” or “intended parent(s)”). 2 Such arrangements may be made directly between the surrogate and the intending parent(s) or facilitated through a surrogacy clinic or agency. In international human rights law, a mother is defined as a woman, understood in its ordinary meaning to be a female of childbearing ability, 3 who gives birth to a child.4 After birth, the terms “intended mother” and “legal mother” are often used to refer to a woman who undertakes parental responsibilities towards the child.5 The present report uses the terms “surrogate mother(s)” and “surrogate(s)” instead of “gestational carrier(s)”, as the latter is sex- and gender-neutral, reducing women to their reproductive function and objectifying those involved. 6 

4. Surrogacy may be categorized as either traditional or gestational. In traditional surrogacy, the surrogate provides her own egg, which is subsequently fertilized with sperm from either the intending father or a donor, typically through artificial insemination. As a result, the surrogate is genetically related to the child that she carries. In gestational surrogacy, which has become an increasingly prevalent practice, an embryo created from the gametes of the commissioning parent(s) or donors is implanted in the surrogate, who therefore has no genetic connection to the child.7 

5. In a commercial surrogacy, the surrogate receives financial compensation beyond the reimbursement of medical and related expenses. In what is known as altruistic surrogacy, the surrogate receives no formal compensation other than reimbursement for reasonable costs. These distinctions are often blurred, particularly in jurisdictions where commercial surrogacy is formally prohibited but where reimbursement is so high that it effectively constitutes commercial payment. Few  jurisdictions that regulate surrogacy maintain frameworks that are genuinely non-commercial, 8 hence surrogacy arrangements are “almost invariably commercial” in nature.9

1 Viveca Söderström-Anttila and others, ‘“Surrogacy: outcomes for surrogate mothers, children and the resulting families – a systematic review”, Human Reproduction Update, vol. 22, No. 2 (March/April 2016). 

2 Ana Rita Igreja and Miguel Ricou, “Surrogacy: challenges and ambiguities”, The New Bioethics, vol. 25, No. 1 (2019). 

3 A/HRC/59/47, para. 4. 

4 International Covenant on Economic, Social and Cultural Rights, art. 10 (2).

 5 See David de Groot, “Surrogacy: the legal situation in the EU”, EPRS Briefing, No. PE 769.508, February 2025. 

6 Submission by Natalia Rueda. 

7 Igreja and Ricou, “Surrogacy: challenges and ambiguities”.

8 Claire Fenton-Glynn and Jens M. Scherpe, “Surrogacy in a globalized world: comparative analysis and thoughts on regulation”, in Eastern and Western Perspectives on Surrogacy, Jens M. Scherpe, Claire Fenton-Glynn and Terry Kaan, eds. (Intersentia, 2019). 

9 Law Commission of England and Wales and Scottish Law Commission, Building Families through Surrogacy: A New Law – Volume II: Full Report (2023). 

https://docs.un.org/en/A/80/158

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The Beijing Declaration and Platform for Action at 30

 Thirty years ago, world leaders made a promise at the Fourth World Conference on Women – equal rights, opportunities, power, and safety for women and girls everywhere.

The Beijing Declaration and Platform for Action enshrines that promise. It is still the world’s most comprehensive, visionary plan ever created to achieve equal rights of ALL women and girls.

The world cannot wait for another 30 years to fulfill the promise of gender equality. That’s why we developed a bold plan to bolster progress on women’s rights, equality and empowerment and achieve gender equality.

Today we stand stronger, more united, more diverse, and determined to become the first generation to achieve gender equality.

Join UN Women’s global campaign #ForAllWomenAndGirl

https://www.unwomen.org/en/get-involved/for-all-women-and-girls

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COP 30 Presidency should place gender justice at the heart of negotiations

 

Dear COP30 President-Designate André Aranha Corrêa do Lago,

 On behalf of the Women and Gender Constituency (WGC), one of nine official observer constituencies representing civil society under the UNFCCC, we write to you today in your role as COP30 Presidency. At this decisive moment for global climate action, we bring forward clear, urgent, and feminist expectations. Gender justice must be placed at the heart of the COP30 negotiations. Importantly, we call on your leadership, as mandated, to lead an inclusive and transparent process towards the development and adoption of a transformative and ambitious Gender Action Plan (GAP) following the adoption of the 10-year Enhanced Lima Work Programme on gender at COP29. Now is the time to move beyond rhetoric and deliver real structural change and implement climate actions that center the human rights, agency, and leadership of women and girls in all their diversity. 

The climate crisis is fueled by entrenched systems of exploitation, extraction, and inequality that concentrate power and resources in the hands of a privileged few. Women, girls, and gender-diverse people, particularly those facing multiple and intersecting forms of discrimination in frontline communities, bear the disproportionate brunt of its impacts. Yet, they are systematically pushed to the margins of power, with the least access to and control over resource, decision-making spaces, and planning and implementation capacity, further deepening their vulnerability. 

The new GAP must confront gendered power relations at all levels and dismantle the structural barriers that have excluded, marginalized and discriminated against women in all diversity, particularly those from the Global South. This demands bold leadership, concrete commitments, the allocation of and direct access to dedicated resources, robust accountability and monitoring mechanisms, and the full, equal, and meaningful participation of women and gender-diverse people at all levels. It also requires the integration of gender-responsive approaches across all climate workstreams to ensure systemic, transformative change. The COP30 Gender Action Plan must be intersectional, inclusive, measurable, human-rights based, responding to communities’ needs and cohesive across all areas of climate action, and adequately funded. 

We take this opportunity to firmly remind the Presidency that promoting and protecting women’s human rights and gender equality is not an optional add-on to climate action, it is a fundamental prerequisite for achieving effective, just, and sustainable climate solutions and transitions. The persistent and systemic exclusion of women and gender-diverse people from climate decision-making has not only entrenched inequalities within and between countries but has also severely weakened our collective capacity to confront the climate crisis in ways that are equitable, just, transformative, and sustainable. 

The Women and Gender Constituency will judge the success of your Presidency not merely by the final outcomes of COP30, but by the ambition you demonstrate throughout the process - ambition that aligns with science, respects local and indigenous knowledge systems, and is rooted in gender justice and respect for human rights. This ambition must be evident in how you engage with Parties, Constituencies, and stakeholders during preparatory meetings, and throughout the negotiations themselves. Your leadership must place gender just climate action at the center - in your public communications, the design and structure of preparatory processes, the setup of the COP30 venue, the allocation of resources, and your response to any attempts to weaken or roll back gender equality commitments. 

As the COP30 Presidency, you carry both the power and the responsibility to ensure that gender just climate action is not simply acknowledged, but actively prioritized, resourced, and operationalized at every step. We, the undersigned organizations, stand ready to engage fully and constructively in this process, but we do not come as supplicants. We come as rights-holders, demanding that our aspirations, needs, voices, and leadership be centered and respected in the fight for climate justice.

 In solidarity and determination, 

The Women and Gender Constituency Signed by 197 organizations (as of 13 May 2025)

https://womengenderclimate.org/cop30-presidency-this-will-not-stand/

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USA 2023 : General Social Security Statistics

 

General Social Security Statistics

Social Security is a huge program in the U.S., consuming trillions in tax dollars to provide for those who can’t work. However, many retirees and disabled Americans find that their Social Security check is cutting it close at best and inadequate for monthly expenses at worst. Here are the facts:

• 25.2% of all American adults receive some form of Social Security.

  That means just over a quarter of all Americans rely on Social Security for monthly payments. More specifically, around 18% of Americans with Social Security are retirees, 3% are disabled, and 2.3% are survivors.

• 6.2% of Social Security is funded through a mandatory payroll tax.

  This entails employers and employees each paying 6.2% out of wages up to the taxable maximum of $147,000. This program was first founded in 1935 as the Federal Insurance Contributions Act (FICA), and the percentage paid in tax hasn’t changed since 1990.

• The projected gap between Social Security payouts and the income it receives is 1.2% over the next 75 years.

  Unfortunately, Social Security isn’t currently earning enough income from taxes and other forms of funding to meet promised benefits.

  For example, Social Security may promise to pay out $1.5 trillion dollars in 2025 but will only make around 1.48 trillion in income. In future years, this will create a major budget deficit that the U.S. government will have to address.

• The average monthly disability benefit is only $1,280.

  Yearly, that means a disabled individual who relies on Social Security as their primary source of income would only make $15,360 per year. That’s only half of the official U.S. family poverty threshold of $31,661.

• As of October 2022, the average Social Security benefit is $1,550.48 per month.

  With the maximum Social Security benefit at $3,345. However, on average, recipients will earn just under $20,000 a year. That puts them over $10,000 under the U.S. family poverty threshold.

• https://www.zippia.com/advice/social-security-statistics/

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