The report investigates the practice of surrogacy and its implications for the human rights of women and girls, with a focus on the risks of violence, exploitation, and commodification. Surrogacy, particularly in its commercial form, is framed as part of a global industry that thrives on gender inequality, economic vulnerability, and demand from wealthier individuals or countries.
Summary
The report frames surrogacy as a human rights issue, questioning how the practice both produces and intersects with multiple forms of violence against women and girls. Rather than viewing surrogacy as a neutral arrangement, the Special Rapporteur situates it within broader structures of inequality and exploitation.
Globally, surrogacy, in both traditional and gestational forms, is expanding rapidly, with large cross-border flows and an increasingly commercialised market. The report notes that commercial arrangements predominate and documents the phenomenon of “forum shopping,” where intended parents seek out jurisdictions with the weakest protections for women and children.
A wide range of harms experienced by surrogate mothers are identified. These include economic exploitation, psychological trauma such as distress at relinquishing newborns, and physical risks linked to pregnancy, including higher rates of complications. Reproductive coercion is also highlighted, with cases of forced abortion or embryo reduction imposed on women by commissioning parents or agencies.
Children born through surrogacy face their own vulnerabilities. The report points to legal limbo around nationality and identity, disruption of early attachment, and some adverse perinatal outcomes, including preterm birth and low birth weight. In some arrangements, children are also denied the opportunity for breastfeeding, undermining both health and bonding.
The report underscores the role of intermediaries such as agencies, brokers, clinics, and even some medical professionals in facilitating exploitation. In multiple contexts, practices consistent with trafficking and child-sale dynamics have been documented. These intermediaries often profit most, while the risks and harms fall disproportionately on women and children.
Finally, the Special Rapporteur notes that the evidence base remains uneven. Much of the available information comes from submissions and consultations, and many studies suffer from methodological weaknesses. Nonetheless, the weight of evidence points clearly to systemic patterns of exploitation and violence inherent in commercial surrogacy.
Strengths of the report
- Human-rights framing: The report situates surrogacy within violence-against-women, which highlights structural drivers (poverty, gender inequality, commodification) that narrower legal/medical analyses often miss.
- Breadth of harms documented: Economic, psychological, physical and reproductive harms are clearly described with examples from multiple countries, and perpetrators are identified beyond just “parents” (agencies, clinics, medical staff). This provides a multi-dimensional picture for policymakers.
- Concrete policy recommendations: The report moves beyond diagnosis to propose specific measures (international instrument, Nordic-style model, decriminalization of surrogates, advertising bans), which helps translate human-rights concerns into policy options.
Key limitations and caveats
- Evidence gaps and methodology: The report itself acknowledges that high-quality, longitudinal empirical studies are limited, and some commonly cited studies suffer methodological problems (small samples, selection bias). That weakens the ability to quantify risks or to claim that harms are universal rather than common in particular contexts.
- Risk of over-generalisation: The report emphasizes harms especially associated with commercial and cross-border surrogacy and with vulnerable populations. However, it can underrepresent the heterogeneity of experiences, there are some surrogate mothers who report positive outcomes and systems that claim to operate altruistically and with protections.
- Policy feasibility and unintended consequences: Proposals to criminalize buyers, clinics and agencies (Nordic model) could push the market further underground if implemented without robust international coordination, increasing risks to surrogates and children. Cross-border enforcement and double-criminality problems are acknowledged in the report but remain practical obstacles.
- Children’s welfare trade-offs: Some recommendations (e.g., refusing to recognize parentage derived from surrogacy) aim to reduce demand but may create immediate legal/identity and welfare problems for children born into those arrangements unless carefully mitigated by child-protection mechanisms. The report offers interim measures (treating left-behind children as unaccompanied minors), but operationalizing this at scale is complex.
Practical implications / risks for policymakers
- If the goal is abolition: governments should plan for transitional measures (monitoring, support for surrogates, safe legal routes for vulnerable children) to avoid creating stateless or parentless children or exacerbating black-market risks.
- If the goal is regulation: regulators need enforceable cross-border mechanisms, robust data collection, independent legal/medical counselling for surrogates, and strict limits on intermediaries — but the report questions whether regulation alone can remove the structural drivers of exploitation.
Conclusions & Recommendations
- Surrogacy is characterised by exploitation and violence, it commodifies women’s bodies and exposes surrogate mothers and children to serious human-rights violations.
- Commercial surrogacy effectively amounts to the sale of children in many cases, because the child is transferred for payment; this creates criminal and protection issues.
- Regulation alone has not been shown to eliminate harms. The cross-border nature and enforcement gaps mean oversight often fails to protect surrogate mothers and children.
- Recommended policy package: the report urges steps toward abolition of surrogacy in all its forms, and pending abolition, proposes: negotiating an international legally binding instrument prohibiting surrogacy; adopting a “Nordic-model” style domestic approach that penalizes buyers/clinics/agencies while decriminalizing surrogate mothers; banning advertising; creating exit/support services for surrogates; and strengthening international cooperation and child-protection measures.
- Child-centred safeguards: recognize the birth mother as legal mother until after birth, restrict recognition of foreign surrogacy parentage, and treat abandoned/left-behind children as unaccompanied minors pending protective placement where needed.