In either case, the surrogate mother carries the pregnancy until delivery, and then, per the contract, assumes no parental rights or responsibilities, and relinquishes the infant to the couple initiating the contract. The US Congress, Office of Technology Assessment estimated that by the beginning of 1988, approximately 600 babies had been born through surrogate mother arrangements. Although the total numbers are low, surrogate motherhood raises medical, psychological, ethical, and legal questions involving procreative privacy and the nature of parenting and family life. The desire to have and rear a child who is genetically related to at least one parent may make surrogacy a more attractive option than adoption for some couples. On the other hand, viewing genetic relatedness as essential to parenting underestimates the importance of the psychological and social bonds that characterize loving families, however created.
Every child is entitled to a permanent nurturing home.
Confusion or ambiguity about who is the mother, father, genetic parent, or rearing parent may be a problem for children resulting from surrogate arrangements. Potential problems surrounding custody of the child and stability of parenting are similar to issues encountered in adoption and foster care practices. While all medical professionals should be concerned about surrogate motherhood arrangements, several ethical concerns need to be addressed by the obstetrician in the context of the pregnancy. Specific ethical concerns involving surrogate motherhood arise because the surrogate mother herself must be personally involved in the pregnancy, labor, and delivery. Using a surrogate for reasons other than infertility raises concerns about depersonalization, assigning risk to others, the commitment of the couple to parenthood, and their qualifications for rearing children.