• neonatology
• paediatrics
• social work

Surrogacy describes the practice whereby ‘…One woman carries a child for another person with the intention that the child should be handed over at birth’. How might this arrangement impinge on clinical care? Recent evidence indicates uncertainty in this area of practice.1

A married English couple, unable to conceive, entered a contract in America whereby for payment a surrogate mother was found, then successfully inseminated artificially with the husband’s sperm.2 When birth was imminent all three adults came to England; the baby was born in hospital in 1985. A few hours later, the mother left her newborn with the staff until she could be collected by her intended parents. They commenced proceedings seeking care and control. The court found that the child’s welfare was the central consideration, with ample evidence demonstrating that it was in her interests to be looked after by the applicant parents. The judgement caused a public commotion, precipitating serial English legislation; the Surrogacy Arrangements Act 1985 and Human Fertilisation & Embryology Act 2008.

Commonly, an infertile woman and her partner arrange for another woman to carry a fetus conceived by donor insemination using the partner’s sperm, with the intention of passing the child to the ‘commissioning/intended’ parents after birth; this is partial surrogacy. By contrast, complete surrogacy involves the in vitro creation of an embryo from an otherwise uninvolved couple’s gametes, to be implanted into the surrogate’s uterus. At the outset, the expectation of both surrogate and …