World’s first study on surrogacy reveals high quality parenting and no problems

Fears about the impact of surrogacy on the well-being of children and families appear to be unfounded, according to findings from the world’s first controlled, systematic investigation of surrogate families, the annual conference of the European Society of Human Reproduction and Embryology heard on Monday 1 July.

In fact, the mothers of children born via a surrogacy arrangement show more warmth towards their babies and are more emotionally involved than is the case in families where the child is conceived naturally. Both the mother and father have better parenting skills than do the parents in non-surrogate families, and the babies themselves show no differences in their temperament and behaviour when compared with non-surrogate babies. Nor do there seem to be problems when the surrogate mothers hand over the babies to the mothers who have commissioned the surrogacy.

These are the main findings from a study conducted by researchers at the Family and Child Psychology Research Centre at City University, London, UK, under the supervision of Professor Susan Golombok, director of the Centre. Fiona MacCallum, a research psychologist at the Centre, told the conference: “Of all the treatments for infertility that have been developed over recent years, the practice of surrogacy, where one woman bears a child for another woman, remains the most contentious.”*

She said there were a number of concerns about families created through surrogacy arrangements. “It is not known, for example, how a child will feel about having been created for the purpose of being given away to other parents. Or, if the surrogate mother remains in contact with the family, what the impact of two mothers will be on the child’s emotional, social or identity development as he or she grows up. Neither is it known how the ongoing involvement of the surrogate mother with the family will affect the commissioning mother’s security in her mothering role, particularly when the surrogate is the genetic parent of the child.”

To find some answers to these questions, Ms MacCallum is studying 43 families with a child born through surrogacy arrangements**, and comparing them with 51 families with a child conceived through IVF with donated eggs, and 86 families with a naturally conceived child. This first phase of the study looked at families when the children were aged between nine and twelve months.

There are two types of surrogacy: partial (or straight) surrogacy where the surrogate mother and the commissioning father are the genetic parents of the child and conception is through artificial insemination, and full (or host) surrogacy where the commissioning mother and father are the genetic parents and conception is achieved through IVF.

Of the 43 surrogate families in the study, nearly two-fifths involved full surrogacy and just over three-fifths involved partial surrogacy. Two-thirds of the surrogate mothers were unknown to the commissioning couple prior to the surrogacy arrangement, while the remaining third of surrogate mothers were either a sister or a friend of the commissioning mother. This was closely comparable to the egg donor families.

Ms MacCallum and her team questioned the commissioning mothers about the surrogate’s reaction to handing over the child, about their own relationship with the surrogate following the birth and about their attitudes towards the surrogate’s involvement in the child’s life.

She said: “It is often assumed that surrogate mothers will have difficulties handing the child over following the birth. In fact, we found only one instance of the surrogate having slight doubts at this time, with all other mothers reporting no problems.

“Since the birth of the child, the majority of the families had kept in touch with the surrogate to some extent and 70% saw her at least once every couple of months. Ninety per cent of commissioning mothers reported that they still had a very good relationship with the surrogate, and no mothers described any major conflict or hostility between the commissioning couple and the surrogate. The concern about the commissioning mother’s feelings about the surrogate’s involvement with the child seems unfounded, with 90% reporting no anxieties about this aspect.”

When the researchers looked at five different aspects of parenting, they found that in four (warmth, emotional involvement and mothering and fathering qualities) the surrogacy families and egg donor families rated higher than families where the child was naturally conceived. For the fifth aspect, the sensitivity of the mother’s responding to the child, there was no significant different between the different family types.

Ms MacCallum said: “It should be noted that the natural conception families were all functioning well and were not getting low scores on these measures of parenting – rather the surrogacy and egg donation mothers were getting particularly high scores. These results are generally positive. The surrogacy families seem to be characterised by warm relationships and high quality of parenting. The high emotional involvement of these mothers with their children can also be positive, although it is possible that it reflects some tendency towards over-investment in the child.”

There were no differences between the three types of families in the children’s temperaments, as judged by fussiness of mood, adaptability to new situations, general activity and predictability of reaction.

There was a significant difference between the surrogacy families and the egg donor families when they were asked about whom they had told about their infertility treatment and whether they planned to tell the child. All the surrogacy mothers had told friends and family about the surrogacy arrangement, whereas 12% of IVF egg donor had told no one about the egg donation, 41% had not told their own parents and 26% had not told friends. All the surrogacy mothers intended to tell their children about their conception, but only 57% of the egg donor mothers said they definitely planned to tell their children.

Ms MacCallum said: “This could well be due to the fact that in the case of surrogacy, it is obvious that the mother is not carrying the child herself, whereas with an egg donation pregnancy there is no outward sign that it is not a natural conception.”

She concluded: “The findings of this study are generally reassuring with respect to relationships with surrogate mothers, quality of parenting and the temperament of the child. There is no evidence so far to support the concerns that have been voiced about the practice of surrogacy. However, these children were still in infancy and it remains to be seen how these families will change as the children grow up.”