Psychological and social consequences of surrogacy in surrogate mother and the resulted child: a review study

Document Type : Review Article

Authors

1 Assistant professor, Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

2 PhD Candidate in Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Instructor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Introduction: One of the new assisted reproductive techniques is surrogacy, and the rate of using this technique is rising. However, the psychological and social consequences of this technique have not been thoroughly investigated. Therefore, this review study was performed with aim to investigate these outcomes following surrogacy in surrogate mother and child.
Methods: In this review study, to find the related articles between1990-2018, Persian databases of SID and Magiran and English databases of Pubmed, Scopus, Elsevier, Wiley online library, Web Of Science, and Google Scholar search engine were searched. To access all articles in Persian and English, the Persian keywords including: surrogate mother, mother-child relationship, mother-fetus relationship, relationship, psychological outcome, social outcome and English keywords including Surrogate mother, surrogacy, Maternal -Fetal relationships, mother-child relationships, surrogates' family, bonding, attachment, psychology outcome, social outcome, with all possible combinations of these words were used. From 500 articles, 18 articles were eligible for research and were selected for this study.
Results: The results of various studies indicated that the birth of the child for surrogate mothers and applicant’s family is a stressful phenomenon that can lead to depression in surrogate mother. There was no significant difference between children born as surrogacy and normal children in terms of evolution, psychological and social dimensions. The results of personality tests and psychological variables were normal in most surrogate mothers and no serious psychological harms were observed.
Conclusion: In general, surrogacy is considered to be a positive experience in most mothers. Born children also have a good feeling to their surrogate mothers and have no psychological differences with normal children. Of course, it's important to note that differences in the culture of the countries, their experiences and supportive systems may affect psychological and social consequences of surrogacy.

Keywords

References

  1. Casella C, Capasso E, Terracciano L, Delbon P, Fedeli P, Salzano FA, et al. Ethical and legal issues in gestational surrogacy. Open Med 2018; 13(1):119-21.
  2. Ruiz-Robledillo N, Moya-Albiol L. Gestational surrogacy: psychosocial aspects. Psychosoc Interv 2016; 25(3):187-93.
  3. Savabi-Esfahani M, Fathizadeh N. Why some men are infertile? Isfahan: Kankash; 2008.
  4. Burrell C, Edozien LC. Surrogacy in modern obstetric practice. Semin Fetal Neonatal Med 2014; 19(5):272-8.
  5. Go KJ. Gardner DK, Weissman A, Howles CM, Shoham Z, editors. Textbook of Assisted Reproductive Techniques: Laboratory and Clinical Perspectives: Andover, Hampshire, United Kingdom: Thomas Publishing Services, 2001: 1–768. Price: $125.00. Fertil Steril 2002; 78(6):1357-8.
  6. Soderstrom-Anttila V, Wennerholm UB, Loft A, Pinborg A, Aittomaki K, Romundstad LB, et al. Surrogacy: outcomes for surrogate mothers, children and the resulting families-a systematic review. Hum Reprod Update 2016; 22(2):260-76.
  7. Dar S, Lazer T, Swanson S, Silverman J, Wasser C, Moskovtsev SI, et al. Assisted reproduction involving gestational surrogacy: an analysis of the medical, psychosocial and legal issues: experience from a large surrogacy program. Hum Reprod 2014; 30(2):345-52.
  8. Gugucheva M. Surrogacy in America. Cambridge, MA: Council for Responsible Genetics Cambridge; 2010. P. 1-40.
  9. Patel NH, Jadeja YD, Bhadarka HK, Patel MN, Patel NH, Sodagar NR. Insight into different aspects of surrogacy practices. J Hum Reprod Sci 2018; 11(3):212-8.
  10. Utian WH, Sheean L, Goldfarb JM, Kiwi R. Successful pregnancy after in vitro fertilization and embryo transfer from an infertile woman to a surrogate. N Engl J Med 1985; 313(21):1351-2.
  11. Mohebbi Kian E, Riazi H, Bashirian S. Surrogacy: viewpoints of infertile women. Iran J Obstet Gynecol Infertil 2013; 16(49.50):23-32. (Persian).
  12. Söderström-Anttila V, Wennerholm UB, Loft A, Pinborg A, Aittomäki K, Romundstad LB, et al. Surrogacy: outcomes for surrogate mothers, children and the resulting families-a systematic review. Hum Reprod Update 2016; 22(2):260-76.
  13. Wang AY, Dill SK, Bowman M, Sullivan EA. Gestational surrogacy in Australia 2004‐2011: treatment, pregnancy and birth outcomes. Aust N Z J Obstet Gynaecol 2016; 56(3):255-9.
  14. Jadva V, Imrie S. Children of surrogate mothers: psychological well-being, family relationships and experiences of surrogacy. Hum Reprod 2013; 29(1):90-6.
  15. Jahani Shourab N, Latifnejad Roudsari R. A review of human rights, legal, ethical and religious aspects of Surrogacy in Iran with an emphasis on its counseling issues. Iran J Obstet Gynecol Infertil 2017; 19(40):33-44. (Persian).
  16. Jadva V, Blake L, Casey P, Golombok S. Surrogacy families 10 years on: relationship with the surrogate, decisions over disclosure and children's understanding of their surrogacy origins. Hum Reprod 2012; 27(10):3008-14.
  17. Jadva V, Imrie S, Golombok S. Surrogate mothers 10 years on: a longitudinal study of psychological well-being and relationships with the parents and child. Hum Reprod 2014; 30(2):373-9.
  18. Warnock M. A question of life: the Warnock report on human fertilisation and embryology. New York: Basil Blackwell; 1985.
  19. Morgan D. Changing conceptions of motherhood: the practice of surrogacy in Britain. London: British Medical Association; 1996.
  20. Van den Akker OB. Psychological trait and state characteristics, social support and attitudes to the surrogate pregnancy and baby. Hum Reprod 2007; 22(8):2287-95.
  21. Mancuso RA, Schetter CD, Rini CM, Roesch SC, Hobel CJ. Maternal prenatal anxiety and corticotropin-releasing hormone associated with timing of delivery. Psychosom Med 2004; 66(5):762-9.
  22. Tyagi P, Singh AK, Tomar S, Kumar N, Singh NK, Singh R, et al. Surrogacy-does it affect physiology of bonding between surrogate mother-fetus and biological mother-new born? Int J Health Sci Res 2015; 5(3):321-3.
  23. Ghelichi F, Roshan R, Khodabakhshi Kolaee A. Comparing of maternal-fetal attachment and pregnancy anxiety in surrogate women and normal pregnancy. Iran J Obstet Gynecol Infertil 2017; 19(39):46-53. (Persian).
  24. Fischer S, Gillman I. Surrogate motherhood: attachment, attitudes and social support. Psychiatry 1991; 54(1):13-20.
  25. Tieu M. Oh Baby Baby: the problem of surrogacy. Bioethics Res Notes 2007; 17(1):2.
  26. Jadva V, Murray C, Lycett E, MacCallum F, Golombok S. Surrogacy: the experiences of surrogate mothers. Hum Reprod 2003; 18(10):2196-204.
  27. Van den Akker OB. A longitudinal pre-pregnancy to post-delivery comparison of genetic and gestational surrogate and intended mothers: confidence and genealogy. J Psychosom Obstet Gynecol 2005; 26(4):277-84.
  28. Wrobel GM, Neil E. Emerging voices–Reflections on adoption from the birth mother’s perspective. Int Adv Adopt Res Pract 2009; 10:245.
  29. Braverman A, Casey P, Jadva V. Reproduction through surrogacy: the UK and USA experience. London: Cambridge University Press Cambridge; 2012. P. 289-307.
  30. Golombok S, Murray C, Jadva V, MacCallum F, Lycett E. Families created through surrogacy arrangements: Parent-child relationships in the 1st year of life. Dev Psychol 2004; 40(3):400-11.
  31. Golombok S, Murray C, Jadva V, Lycett E, MacCallum F, Rust J. Non-genetic and non-gestational parenthood: consequences for parent–child relationships and the psychological well-being of mothers, fathers and children at age 3. Hum Reprod 2006; 21(7):1918-24.
  32. Golombok S, MacCallum F, Murray C, Lycett E, Jadva V. Surrogacy families: parental functioning, parent–child relationships and children's psychological development at age 2. J Child Psychol Psychiatry 2006; 47(2):213-22.
  33. Golombok S, Readings J, Blake L, Casey P, Marks A, Jadva V. Families created through surrogacy: Mother–child relationships and children's psychological adjustment at age 7. Dev Psychol 2011; 47(6):1579-88.
  34. Golombok S, Blake L, Casey P, Roman G, Jadva V. Children born through reproductive donation: a longitudinal study of psychological adjustment. J Child Psychol Psychiatry 2013; 54(6):653-60.
  35. Golombok S, Ilioi E, Blake L, Roman G, Jadva V. A longitudinal study of families formed through reproductive donation: Parent-adolescent relationships and adolescent adjustment at age 14. Dev Psychol 2017; 53(10):1966-77.
  36. Henney S, Ayers-Lopez S, McRoy R, Grotevant HD. A longitudinal perspective on changes in adoption openness: the birth mother story. Contact in Adoption and Permanent Foster Care. London: BAAF; 2004. P. 26-45.
  37. Shelton KH, Boivin J, Hay D, van den Bree MB, Rice FJ, Harold GT, et al. Examining differences in psychological adjustment problems among children conceived by assisted reproductive technologies. Int J Behav Dev 2009; 33(5):385-92.
  38. van den Akker O. The importance of a genetic link in mothers commissioning a surrogate baby in the UK. Hum Reprod 2000; 15(8):1849-55.
  39. Baslington H. The social organization of surrogacy: relinquishing a baby and the role of payment in the psychological detachment process. J Health Psychol 2002; 7(1):57-71.
  40. Poote A, van den Akker OB. British women's attitudes to surrogacy. Hum Reprod 2008; 24(1):139-45.
  41. Lamba N, Jadva V, Kadam K, Golombok S. The psychological well-being and prenatal bonding of gestational surrogates. Hum Reprod 2018; 33(4):646-53.
  42. Lorenceau ES, Mazzucca L, Tisseron S, Pizitz TD. A cross-cultural study on surrogate mother's empathy and maternal–foetal attachment. Women Birth 2015; 28(2):154-9.
  43. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 2014; 12(12):1495-9.
  44. Strengthening the reporting of observational studies in epidemiology. STROBE Website. Available at: URL: http://www.strobe-statement.org; 2016.
  45. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med 2007; 147(8):573-7.
  46. Sayehmiri K, Beigom Bigdeli Shamloo M, Khataee M, Rabiei Fakhr F, Azami M. Occupational exposure and biological evaluation of lead in Iranian workers-a systematic review and meta-analysis. Health Safety Work 2016; 6(3):1-14.
  47. Pizitz TD, McCullaugh J, Rabin A. Do women who choose to become surrogate mothers have different psychological profiles compared to a normative female sample? Women Birth 2013; 26(1):e15-20.
  48. Blyth E. “I wanted to be interesting. i wanted to be able to say ‘i've done something interesting with my life”: Interviews with surrogate mothers in britain. J Reprod Infant Psychol 1994; 12(3):189-98.
  49. Jadva V. Surrogacy: issues, concerns and complexities. Cambridge: Cambridge University Press Cambridge, UK; 2016. P. 126-39.
  50. Van Den Akker O. Genetic and gestational surrogate mothers' experience of surrogacy. J Reprod Infant Psychol 2003; 21(2):145-61.
  51. Imrie S, Jadva V. The long-term experiences of surrogates: relationships and contact with surrogacy families in genetic and gestational surrogacy arrangements. Reprod Biomed Online 2014; 29(4):424-35.
  52. World Health Organisation. Mental health: maternal mental health. Geneva: World Health Organisation; 2017.
  53. Edelmann RJ. Surrogacy: the psychological issues. J Reprod Infant Psychol 2004; 22(2):123-36.

The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 22, Issue 4
June 2019
Pages 73-86

Files

Share

How to cite

Statistics