5.30 Surrogacy
Health professionals must read this in conjunction with ‘Care in Surrogacy’ Guidance for the care of surrogates and intended parents in surrogate births in England and Wales and includes the following: legal context and guidance, pre-birth, birth planning and post birth, sources of advice and support, checklist for surrogacy documentation,
Guidance for the care of surrogates
Introduction
Surrogacy is legal in the UK, with reasonable expenses only being paid to the surrogate mother. Surrogacy arrangements are not legally enforceable.
It is illegal to advertise for a surrogate in the UK. Most people have a family member or friend willing to carry the child, others join a surrogacy organisation.
Definitions and Key Terminology
Intended parent(s) (IP(s))
These are couples who are considering surrogacy as a way to become a parent. They may be heterosexual or same-sex couples in a marriage, civil partnership or living together/co-habiting in an enduring relationship. To apply for a parental order (which is the way that legal parenthood is transferred from the surrogate to the IPs) at least one of the IPs in a couple must be a genetic parent of the child born to them through surrogacy. An individual may also apply for a parental order to transfer legal parenthood if they are genetically related to the child. IP(s) generally prefer to be referred to as the parent(s) of the child.
Surrogate
This is the preferred term for women who are willing to help IP(s) to create families by carrying children for them. A surrogate may or may not have a genetic relationship to the child that she carries for a couple. Surrogates generally do not prefer to be referred to as the mother or parent of the child.
Straight surrogacy
Straight (also known as genetic, full or traditional) surrogacy is when the surrogate provides her own eggs to achieve the pregnancy. One of the IPs, or the IP in the case of an individual applicant, provides a sperm sample for conception through either self-insemination away from a licenced setting or artificial insemination with the help of a fertility clinic. Self-insemination does carry risks if the sperm has not been screened for infections. If either the surrogate or IP has fertility issues or prefers a more clinical environment, then embryos may also be created in vitro and transferred into the uterus of the surrogate.
Host surrogacy
Host (also known as gestational or partial surrogacy) is when the surrogate doesn’t provide her own egg to achieve the pregnancy. In such pregnancies, embryos are created in vitro and transferred into the uterus of the surrogate using the gametes of at least one IP, or the IP if an individual applicant, plus the gametes of the other IP or a donor, if required.
More information about the use of donor gametes is available from the Donor Conception Network (DCN) (see Section 5).
Duty to Refer
A professional in any agency may become aware of the surrogacy arrangement and have concerns about:
- The suitability of the intended parents to care for the child;
- Conflict between the adults in a surrogacy arrangement e.g. that the surrogate mother is under pressure to relinquish the child against her will;
- The expenses for carrying the child being reasonably incurred" having regard to Section 54(8) of the Human Fertilisation and Embryology Act 2008 or not.
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An unborn or new-born child in these circumstances could be at risk of physical and emotional abuse and / or neglect. The concept of significant harm is defined, in Section 4.3 Significant Harm, as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family and may require a consultation with and/or referral to Surrey Children’s Services. See section 4.5 Contacts and Referrals Procedure. Children's social care responses should be proportionate to what are likely to be very individual circumstances, and legal advice should be sought.
If hospital staff become aware that a baby who is about to be born, or has just been born is the product of commissioning and have grounds to doubt the commissioners identity / suitability to care for the baby, or the degree of voluntarism (payment beyond reasonable expenses is unlawful), they should contact Surrey Children's Services See Section 4.5 Contacts and Referrals Procedure. The responses to any such contact should be proportionate to what are likely to be very individual circumstances and legal advice will probably be required. |