Surrogate Motherhood: A Christian Ethical Analysis

Editor’s Note: The following article appears in the Spring 2025 issue of Eikon.

Moral questions surrounding the issue of surrogacy were brought directly to my attention during an Uber ride in Dallas, Texas in 2019.^[1] Having attended a conference in the Dallas metroplex, I secured an Uber driver to take me back to the airport. As I sat in the back of a lovely Chevy Tahoe, the young woman driver began to open up about her life. Having completed college, she was supplementing her income by taking Uber fares, something she did to pay off her college debt. She then casually mentioned that she was considering becoming a surrogate to pay off her student loans. We had an engaging conversation in which I gently suggested some reasons why I had moral concerns about surrogacy, and I gathered she had not heard any of these counterarguments. I want to stress that our conversation was open and pleasant and not acrimonious, but the image of this bright young woman who projected herself very well and yet was considering surrogacy as a way of paying off student loans has remained with me.

Surrogacy was again pressed upon my mind in January, 2024. My wife and I vacationed on a cruise that docked at the Port of Galveston Island. As my wife Lisa and I were riding the shuttle bus from Galveston Island to the airport in Houston, we passed a billboard which promised women $60,000 for being a surrogate mother. As we exited the interstate and approached the airport we passed two strip clubs which advertised lewd entertainment provided by young women. In my mind, I felt that the billboard advertising surrogacy and the strip clubs had something in common: Both were exploiting the bodies of young women, promising them profit for selling themselves.

The modern practice of surrogate motherhood has brought with it a multitude of new moral and ethical questions. Surrogacy can be defined as the practice whereby one woman carries and delivers a child for another woman, another man, or another couple with or without payment and with the intention that the child should be handed over at birth.^[2] Surrogacy is connected with the broader field of artificial reproductive technologies in that various procedures such as in vitro fertilization or artificial insemination make surrogacy possible since these are the methods used to impregnate the surrogate.

What are we as Christians to make of surrogacy? Is the practice similar to the exploitation of women in various forms of sex clubs? Is it morally permissible to serve as surrogate in order for a woman to extricate herself from financial exigency? This essay argues surrogate motherhood conflicts with several principles of Christian ethics and the practice presents more problems than it solves. Biblical warnings against adultery, slavery, and exploitation of vulnerable people raise serious concerns about the morality of surrogacy. Furthermore, the sanctity of life principle intersects with the unstated assumption that the goal of a surrogate pregnancy is a child free from noticeable defects. To argue these points, this essay will begin by defining the various forms of surrogacy, then summarize various arguments in favor of surrogacy, and then analyze surrogacy from a Christian sanctity-of-life perspective.

Surrogacy: A Brief Introduction

 A surrogate mother or “gestational carrier” is a woman who agrees to carry a child through pregnancy and deliver it on behalf of another person or couple.^[3] The parents who contract the surrogate are variously called the “intended parents” or the “commissioning mother and father” or “commissioning parents.” If the intended parents provided both the sperm and the egg, they are also called the biological parents. The woman who actually carries the baby is called either the surrogate or the gestational carrier. Surrogacy can be divided into four categories, which often overlap: genetic surrogacy, gestational surrogacy, commercial surrogacy, and altruistic surrogacy.

Genetic Surrogacy

In Genetic Surrogacy, the surrogate is impregnated via artificial insemination with the sperm from a male partner in a couple hoping to have a child (the intended parents or contracting parents); the contracting parents may be married or unmarried, heterosexual or homosexual, but the two people are in some sort of permanent relationship. The surrogate, a third party, is artificially inseminated with the male partner’s/husband’s semen; the surrogate provides both an ovum and uterus for the couple to use. This practice is called genetic surrogacy because the surrogate herself is genetically related to the child. The surrogate conceives, carries, and gives birth to the child and surrenders her rights to the child to the contracting couple.^[4] According to the American Society of Reproductive Medicine, genetic surrogacy is “rarely offered by most programs, and is more ethically and legally complex.”^[5]

Gestational Surrogacy

In gestational surrogacy, the surrogate herself is not genetically related to the child, but only provides a womb; the surrogate has no genetic relationship to the child because both gametes are provided by the intended parents. An embryo is created via IVF and implanted into the surrogate who carries the baby to term. At birth, the baby is handed over to genetic parents. This is the most common type of surrogacy.

In another version of gestational surrogacy, the intended parents may acquire sperm from a sperm donor as well as eggs from an egg donor, and then use these gametes to create embryos in vitro. These embryos are subsequently placed in a contracted surrogate. In this case, the child in question has no genetic relationship to either the surrogate or the intended parents. 

Commercial or Contractual Surrogacy

Commercial or contractual surrogacy occurs when the intended parent or parents enters into a financial agreement in which the surrogate agrees to carry the baby to term for a fee. Contractual surrogacy is sometimes called third party surrogacy, though to be clear all surrogacy arrangements entail a third party. Usually, contractual surrogacy arrangements are between previously unknown individuals and arranged by agencies or brokers. It’s strictly business. 

Altruistic Surrogacy

In altruistic surrogacy, the surrogate mother agrees to carry the child for the intended parents without any financial compensation, though the intended parents usually pay for medical expenses associated with the pregnancy. It’s called altruistic because the surrogate is not carrying the child based on a profit motive but does so on behalf of a friend or family member. Nonetheless, even though the surrogate does not charge a fee, the child is given to the intended parents at birth.

The binary distinction between commercial and altruistic surrogacy is difficult to maintain since some sort of financial arrangement is almost always in view.^[6] Kirsty Horsey explains the difficulties in separating commercial from altruistic surrogacy and says, “Variations in the types of payment allowed, and to whom, as well as service models or activities undertaken by third parties in support of surrogacy arrangements, in conjunction with the type of contractual framework permitted, all affect whether an arrangement could be deemed ‘altruistic’ or ‘commercial’”^[7] Granting that the categories can overlap, I will basically follow Horsey and use commercial surrogacy to mean a framework in which profit-making entities such as surrogacy agencies or brokers are involved while noting that individual women can pursue surrogacy without the aid of a broker.^[8] Altruistic surrogacies do not involve such open, profit-based motives.

The four categories of genetic, gestational, contractual, and altruistic surrogacy are helpful but hardly describe the infinite number of arrangements that are possible with surrogacy. When considered in the light of legalized homosexual marriage in western countries, possible combinations include the following:

The surrogate is artificially inseminated with the sperm of a husband and the subsequent child is then raised by the husband and his wife.

The surrogate is artificially inseminated with the sperm from a male in a heterosexual couple who are not married. The subsequent child is then raised by the unmarried couple.

The surrogate is artificially inseminated with sperm from one male from a homosexual marriage. The subsequent child is then raised by the two married men but the child is genetically related to only one of them.

The surrogate is artificially inseminated with sperm from one male in a homosexual relationship, but the two men are not married. The subsequent child is then raised by two single men but the child is genetically related to only one of them.

The surrogate carries a child in which she is contracted by two women in a homosexual marriage. The egg of one of the partners is joined with sperm from a sperm donor in vitro to create an embryo placed in the surrogate. The two women then raise a child genetically related to only one of them.

The surrogate carries a child in which she is contracted by two women in a homosexual relationship but the women are not legally married. The egg of one of the partners is joined with sperm from a sperm donor in vitro to create an embryo placed in the surrogate. The two women then raise a child genetically related to only one of them.

The surrogate carries a child in which the sperm and egg from a husband and wife are joined in vitro to create an embryo placed in the surrogate. The contracting married couple then raise the child.

The surrogate carries a child in which the egg of a wife is joined with the sperm from a sperm donor in vitro to create an embryo placed in the surrogate. The contracting married couple then raise the child genetically related to only one of them.

The surrogate carries a child in which the egg of an egg donor is joined with the sperm of a husband in vitro to create an embryo placed in the surrogate. The contracting married couple then raise the child genetically related to only one of them.

The surrogate carries a child created via joining an egg from an egg donor and sperm from a sperm donor in vitro to create an embryo placed in the surrogate. The contracting married couple then raise the child genetically related to neither the husband nor the wife.

The surrogate carries a child created via joining an egg from an egg donor and sperm from a sperm donor in vitro to create an embryo placed in surrogate. But in this case, the contracting couple are two homosexual men or two homosexual women who then raise the child genetically related to neither member of the couple.

The sperm from an unmarried male is artificially inseminated into the surrogate and the subsequent child is then raised by the male as a single parent.

A single male uses a sperm donor and an egg donor to create an embryo via in vitro which is placed in the surrogate. The subsequent child is then raised by the contracting male though he is not genetically related to the child.

The egg from a single woman is joined with the sperm from a sperm donor in vitro to create an embryo which is then placed in the surrogate. The child is then raised by the contracting woman as a single mother.

A single female uses a sperm donor and an egg donor to create an embryo via in vitro which is placed in the surrogate. The subsequent child is then raised by the contracting female though she is not genetically related to the child.

Should human cloning become viable, any number of people, male or female, married or single, homosexual or heterosexual could have a clone created via somatic cell nuclear transfer and the subsequent embryo placed in a surrogate.

People affiliated in group relationships such as “throuples” could use in vitro fertilization to create embryos related to some or none of the people within the circle of sexual partners. The embryo could be placed in a surrogate and the subsequent child would be raised by the group.

In a scenario similar to the previous, the surrogate carries a child in which she is artificially inseminated with the sperm of one member of the group of sexual partners and the subsequent child is raised by the group.

The complexity and number of these scenarios could be multiplied several times by adding the variables of whether or not the surrogate receives financial compensation in each case.

How many surrogates? 

 Exact counting of surrogate arrangements transacted each year in the US is difficult to know. One review of data reported that between 1999 and 2013, there were 30,927 gestational surrogate pregnancies. Not all of these pregnancies came to full term as there were only 13,380 deliveries; 8,581 led to birth of one child, 4,566 were twin pregnancies, and 233 were triplet pregnancies, resulting in 13,380 deliveries, with a total of 18,400 infants born.^[9] In 2022, Global Market Insights predicted the global surrogacy market will increase to $129 billion by 2032, with the largest growth expected to be among gestational carriers.^[10]

Surrogacy Costs

 The costs for surrogacy have steadily increased. According to U.S. News and World Report, gestational surrogacy costs around $100,000 to $150,000 in 2020.^[11] Of that, surrogates took home an average $30,000 to $35,000, with a bonus if they carry multiple pregnancies. The remainder of the money goes to the middlemen involved in the transaction, covering agency fees, legal fees, counseling services, and health insurance. In 2017, if a surrogate carried the child nine months, the standard surrogacy fee worked out to around $5 per hour for the duration of the pregnancy.^[12] But by 2024, the average nationwide base pay for first-time surrogates has risen to between $45,000 and $55,000, with fees rising to between $60,000 to $70,000 for second-time surrogates.^[13]

Health of Children Conceived Via Surrogacy

Neonates born from commissioned embryos and carried by gestational surrogates have increased adverse perinatal outcomes, including preterm birth, low birth weight, hypertension, maternal gestational diabetes, and placenta previa, compared with singletons conceived spontaneously and carried by the same woman.^[14]

Legal Status of Surrogacy

The legal status of surrogacy varies widely around the world. In the United States, surrogacy laws vary state by state. California is considered the most surrogacy-friendly state because the process is allowed for everyone, whether married, unmarried, LGBTQ, or single parent.

In Europe, surrogacy laws trend much more conservative than in the US. In Great Britain, Ireland, Denmark, and Belgium, commercial surrogacy is illegal — you cannot pay someone to be a surrogate. But if a woman volunteers to be a surrogate (altruistic surrogacy), that is legal. Countries such as France, Germany, Italy, Spain, Portugal and Bulgaria prohibit all forms of surrogacy.

Poor women from India were so exploited in surrogacy arrangements that in 2021 the nation enacted the Surrogacy Regulation Act which prohibits commercial surrogacy. Furthermore, the act allows only married couples or women who have ever been married (widowed or divorced) to seek a surrogate. Only altruistic surrogacy is now allowed in India.

Arguments in Favor of Surrogacy

What arguments are leveraged in favor of surrogacy? Given that surrogacy is a global phenomenon, what moral reasoning is used to support the practice?

 Altruism: Surrogates help people who cannot have babies.

Surrogacy is presented as a benevolent way to help others who cannot have a baby. Altruistic surrogacy in particular is seen as a sacrificial way to help someone else. One surrogacy advocate cited Acts 20:35 in favor of the practice: “It is more blessed to give than receive.”^[15] The assumption in such reasoning is that the surrogate is giving the contracting parents something they desperately want — an infant. The argument that surrogacy helps infertile couples is the most common reason suggested for the moral legitimacy of surrogacy.

In India, some believe a surrogate mother may accrue good karma by helping infertile couples.^[16] This view is likely felt more strongly if the surrogate herself believes her birth in an underprivileged class or financial status is the result of bad karma in previous life. Surrogacy is seen as a way to bring other people happiness and to accrue merit.

By helping infertile couples have children, surrogacy is said to help build stronger families. Unlike adoption, surrogacy enables an infertile couple to have a child genetically related to them; she will have mom’s nose or dad’s smile. Surrogacy helps complete a family, and one surrogacy agency adds, “The disappointment and stigma of infertility can be harsh, which is why surrogacy gives parents a chance to overcome these issues and successfully have biological children.”^[17] In some cases, the problem goes beyond mere infertility to imminent danger to a woman’s health if she becomes pregnant.

For some women, pregnancy is not medically advisable, thus using a surrogate is much safer.

Surrogacy allows a woman for whom pregnancy is not medically advisable to have a child genetically related to herself. In some cases, a mother’s life may be in danger if she becomes pregnant, so it is considered statistically much safer to engage a surrogate who has a healthy body. Every pregnancy carries risks with it, but for some women certain physical problems may mean pregnancy carries heightened dangers. For example, diabetes can create serious problems in the mother and the baby. Or, a woman may have genital herpes, which can be passed to the baby during birth. Likewise, women with lupus are at increased risk for preterm birth and stillbirth.^[18] Surrogacy helps women unable to carry children on their own by engaging surrogates with healthier bodies to become pregnant on behalf of the women with health dangers.

A woman has a right to do what she wants with her body.

Autonomy-based moral reasoning insists a woman has a right to do what she wants with her own body and thus surrogacy should be permitted. If a woman chooses to volunteer or be paid as a surrogate, the use of her womb is her own business and no one else should tell her what she may or may not do with her body. Denying women the ability to be a surrogate is actually denying a basic human right and an intrusion on her bodily autonomy.

Individuals or couples have a right to their own baby.

 The right to have one’s own baby, especially a baby genetically related to both parents, is a basic human right and surrogacy enables couples to achieve this goal. If a wife cannot carry a baby to term, then the couple has the right to arrange for a surrogate to carry to term a child from the couple created via IVF. Denying infertile couples this right imposes needless harm on them when a method of alleviating their grief is at hand. Surrogacy gives some couples the only hope of having a child related to one or both of them.^[19]

Male homosexual couples also see the right to have children as a basic right. If they are granted the right to marriage, shouldn’t they be granted the right to enjoy the fruits of marriage, such as children? Since male homosexual couples do not share a womb, they must engage the use of a surrogate to enjoy having a child related to at least one of them. In these cases, the male homosexual couple may have the surrogate artificially inseminated with one of the men’s semen, and the resulting child will actually be the genetic child of the surrogate. In other cases, male homosexual couples may purchase an egg from a first woman, create an embryo using semen from one of the men, and then have the embryo inserted into a second woman, the surrogate mother.

Surrogacy allows the genetic mother to maintain physical attractiveness.

Some couples engage a surrogate so the wife can maintain physical attractiveness. Surrogacy makes it possible for the wife of the intended parents to avoid the changes to the body that result from pregnancy. Doing so means the intended mother can maintain a more youthful appearance and thus increase her self-esteem. Not undergoing the changes associated with pregnancy is seen as self-affirming, and for some women good looks are considered essential to career success. The intended mother can feel positive about her appearance and enhance her own emotional stability. Some husbands may want a wife to maintain a young appearance, and a surrogate potentially adds strength to the marriage of the contracting couple in the process.

The American Society of Reproductive Medicine’s statement on surrogacy does not address the issue of surrogacy to maintain the intended mother’s attractiveness. Their guidelines do say, “Gestational carriers may be used when a true medical condition precludes the [intended parents] from carrying a pregnancy or would pose a significant risk of death or harm to the woman or the fetus.”^[20] This statement indicates the group believes surrogacy should only be used for cases of infertility and not for lesser pragmatic reasons. The same document also provides several criteria for rejecting intended parents as candidates for using surrogacy but does not mention rejecting such intended parents because they hope to maintain the wife’s attractiveness.

Contractual surrogacy is a morally permissible way to earn money, especially for women in poverty.

Surrogacy is a financial windfall for surrogates. If a woman’s body is her own then she has a right to “rent” her body for nine months as a surrogate. Around the world, surrogacy is presented as a way for very poor women to earn more money than would otherwise be possible, thus the contracting couple is actually doing a good thing. Commercial surrogacy is presented as a win-win for all parties involved.

Surrogacy is no more dangerous than many other jobs.

If being a surrogate mother is dangerous, it is no more dangerous than other jobs. While some may say the surrogate is being engaged to incur life-threatening risks, surrogates may respond that other jobs are associated with a greater degree of risk, but those jobs do not receive moral censure. For example, several workers died building the great American projects of civil engineering — the Golden Gate Bridge and Hoover Dam — but no one makes a moral judgement on those workers for engaging in a risky job.^[21]

In January 2019, researchers with 24/7 Wall Street released a list of the most dangerous jobs in America. Fishers and fishing related workers were ranked as the most dangerous occupation in America, with forty-one fatal injuries in 2017 or 100 per 100,000 workers.^[22] These same workers earned an average of $28,310. Since surrogates typically earn over $30,000 and the fatal injuries occur at a lower rate than other dangerous careers, the practice should not be prohibited merely because of the risk to the surrogates.

If adoption is permissible, why not surrogacy?

The moral permissibility of adoption leads some to believe surrogacy is permissible as well. The strength of this argument depends on the degree to which adoption and surrogacy are similar. The purported similarities are that in both adoption and surrogacy the birth mother gives up a child to be raised by someone else. Furthermore, in adoption the adoptive parents are not genetically related to the child and in surrogacy one or both of the contracting parents may not be genetically related to the child.

Similarities between surrogacy and adoption noted, the moral permissibility of adoption does not entail the moral permissibility of surrogacy. First, in adoption the child is not created with the intent of being given to an adoptive couple, but instead biological parents are unable to raise the child because of exigencies of various kinds. But the intent was not to create a child who would be given away. Second, adoption is not procreation. Procreation occurs when a child is conceived via sexual intercourse. In contrast, as Oliver O’Donovan notes, “[Adoption] is a charitable vocation indicated to childless couples by the personal tragedy of their deprivation in this area. And although it may richly compensate for the sorrow and satisfy the desire to nurture and educate children, it is still a substitute for procreation rather than a form of procreation.”^[23]

Arguments Against Surrogacy

Arguments used to support surrogacy represent an inadequate framework for thinking about both procreation and surrogacy. Surrogacy raises deeply profound questions about the nature of human procreation or the begetting of children. O’Donovan commented, “We are asking about our human ‘begetting,’ that is to say, our capacity to give existence to another human being, not by making him the end of a project of our will, but by imparting to him our being, so that he is formed by what we are and not what we intend.”^[24] In contrast to begetting children, surrogacy seems very much to be viewed as making children, as if a child is a project to be completed like a model airplane.

Before offering several critiques of surrogacy, a word of clarification needs to be made about the manner in which we discuss surrogate arrangements. In some contexts, surrogacy is touted as a “treatment” for infertility. But surrogacy most decidedly is not a medical treatment for infertility. A medical treatment for infertility would correct the problems in either the husband’s or wife’s body that prevent the couple from becoming pregnant, allowing them to procreate in the normal manner. Surrogacy corrects nothing in the husband’s or wife’s body and thus should not be called a treatment. Surrogacy is, instead, a way of circumventing infertility.

Surrogacy is inseparable from moral concerns with IVF.

The morality of surrogacy is inseparable from the disconcerting number of “spare” embryos created via IVF. Precise data regarding the number of human embryos in storage in the US is difficult to ascertain, but one study of IVF cycles between 2004 and 2013 determined that by 2013 1,237,203 embryos were cryopreserved or were potentially still in storage.^[25] The fate of these embryos vary considerably, but some are abandoned by the parents while others are thawed and discarded as medical waste. The current practice of IVF in the US is in direct conflict with the principle of the sanctity of human life. Surrogacy facilitates and encourages the creation of more embryos than can be implanted and thus serves as a contributing factor to the destruction of human life. All other critiques of surrogacy should be seen in light of the overarching sanctity-of-life concern.^[26] In the process of devaluing the embryo, surrogacy contributes to the commodification of human life.

Surrogacy commodifies human life.

Surrogacy commodifies human life and treats infants as products rather than humans. The surrogate mother gives birth to a child that was conceived and carried to term with the full intent of giving the child to another. The notion that a mother would undertake to become a parent — for the pregnant surrogate is a parent — with intention beforehand to alienate herself from the child implicitly converts the child from a person to a commodity.^[27] In this way, surrogacy further violates the sanctity-of-human-life principle by treating humans as something to be passed around via contractual agreements as opposed to receiving the child as a fellow human made in God’s image.

Surrogacy appears to be a case of selling babies. The surrogate carries a baby to term and then hands the child over to someone else for a fee. Both parties in the trade are purportedly acting voluntarily, though usually there are profound social disparities between the intended parents and the surrogate. The entire process is treated as a business transaction, and the key component is a tiny human being. To put it most brutally, surrogacy is a market with buyers — the intended parents — and suppliers — the surrogate mothers.^[28] If children were not involved, these parties would have no reason to interact with each other. Surrogacy is an economic exchange and it is big business.

But the commodification of children in surrogacy is welded to the practice of IVF. The reason multiple embryos are made at once when the technicians know only a few will be implanted is that doing so is more efficient — it is simply easier and more cost-efficient to create multiple embryos at once as opposed to creating and implanting one or two at a time. This is the language of industrialized manufacturing in which a child is treated as a product that can be produced more or less efficiently. In IVF, children are not procreated, they are made, and as O’Donovan noted forty years ago that “when we start making human beings we necessarily stop loving them,” adding as well, “that which is made rather than begotten becomes something we have at our disposal.”^[29] In surrogacy, a child is not procreated as much as it is the product resulting from a giant project involving contracting parents, gamete donors, the surrogate and her family, technicians, and physicians. And imperfect children are disposed of.

The notion of efficiency in producing children enables the idea that children with birth defects are treated as flawed products. The goal for contracting couples in modern surrogate arrangements is not just the birth of a child, but the birth of a perfect child with no anomalies, disorders, or birth defects. This too violates the sanctity-of-human-life principle. When procreation is within marriage, the assumption is that children are to be received regardless of their imperfections. But in surrogacy, the outlay of money and time is intended to achieve a perfect child, an attitude with eugenic overtones: If you are a perfectly healthy child you are wanted; if you are a child with a birth defect, you are a defective product.

In John 9, Jesus encountered a man born with the congenital birth defect of blindness. The apostles asked Jesus, “Who sinned, this man or his parents, that he would be born blind?” To which Jesus answered, “It was neither that this man sinned, nor his parents; but it was so that the works of God might be displayed in him” (John 9:2–3). Here we see the sovereignty of God over even disabilities of the most profound type. Children with the most profound difficulties are not faulty products to be thrown away but opportunities for God’s mercy and grace.

Surrogacy invariably treats children as products in numerous ways, but one observation from the American Society for Reproductive Medicine’s position statement on surrogacy is noteworthy. Discussing the health of a gestational carrier, the statement says potential surrogates should be examined to identify those “who might be at high risk of HIV, STIs, or other acquired infections that might be transmissible to the fetus.”^[30] Yet what is to be done if the surrogate contracts an STI after becoming pregnant? The unstated assumption is that in such cases the business transaction has gone awry and the product has potential to be damaged and should thus be discarded via abortion. The entire process treats the surrogate herself like a baby-growing machine.

Treating surrogate mothers like a baby-making machine.

Surrogacy not only commodifies the child but commodifies the surrogate herself by treating her like a baby-making machine. Some suggest the woman is merely renting her uterus the way one would rent out an apartment. But God did not design any human to be analogous to either a machine or an apartment. Surrogate mothers are real people who become attached to the babies they are carrying. A surrogate mother is not just a “gestational carrier,” she is a living, breathing person with emotions who can become attached to the child being carried.

Exploitation of surrogate mothers seems especially egregious when the intended mother is perfectly capable of carrying a child but finds the whole process of pregnancy bothersome. Or a husband may not want his wife to gain weight associated with pregnancy. In these cases, a couple wants a child but does not want the associated responsibility and concerns of pregnancy: A surrogate is used strictly for the purposes of convenience. As the 1984 Warnock report from Great Britain said, “In the first place we are all agreed that surrogacy for convenience alone, that is, where a woman is physically capable of bearing a child but does not wish to undergo pregnancy, is totally ethically unacceptable.”^[31] And yet the practice is common worldwide. And in countries where surrogacy for convenience is outlawed, the couples engage in surrogacy tourism and travel around the globe to find women willing to carry a child.

By treating another person as a living incubator, contracting couples are dehumanizing another human being.^[32] A widely accepted canon of ethics is that we should never treat other humans as a means to our own purposes or goals, but should place that person’s own worth as someone made in the image of God as primary. Some may perhaps limit this objection to contractual surrogacy alone and not to altruistic surrogacy, but in either case one woman’s body is being used to meet the goals of another person or couple. The surrogate’s usefulness and worth is severed from her personality and individuality and is directly tied to one purpose: producing a baby.

The degree to which surrogacy treats a woman as a baby-making machine was magnified by the Baby Gammy case from Thailand in 2014. In December 2013, a Thai surrogate named Pattaramon Janbua gave birth to twins — one boy and one girl — for an Australian couple, David Farnell and Wendy Li. During the pregnancy, it was discovered that the boy had Down syndrome. After the surrogate gave birth to both children, Farnell and Li left for Australia taking only the baby girl and leaving the little boy — Baby Gammy — with the surrogate mother in Thailand. To complicate matters, the surrogate then wanted custody of both children. In 2016, an Australian family court ruled the girl would remain with her biological parents and Australian Justice Thackray said in the decision:

Quite apart from the separation of the twins, this case serves to highlight the dilemmas that arise when the reproductive capacities of women are turned into saleable commodities, with all the usual fallout when contracts go wrong. The facts also demonstrate the conflicts of interest that arise when middlemen rush to profit from the demand of a market in which the comparatively rich benefit from the preparedness of the poor to provide a service that the rich either cannot or will not perform.^[33]

Indeed, when wealthy people secure middlemen to engage poor women as surrogates, the woman loses her identity and her worth is only tied to her ability to provide a functioning womb, and in many ways the entire process bears close resemblance to slavery.

Surrogacy resembles slavery.

In slavery, one human owns another human and uses the slave for purposes desired by the owner. Surrogacy is not exactly like slavery in that the surrogate is paid, but it bears some similarity to slavery in that one human owns the rights to what another human may do to her body during pregnancy. Even more deeply, the contracting couple claims ownership over the surrogate’s procreative ability.

This analogy to slavery is amplified when wealthy people contract poor women to carry their babies. It is rarely wealthy women who engage themselves as a surrogate. Instead, surrogates are usually women in need of cash, and in this sense they share with the slave the status of a person in a position of weakness who is open to exploitation by more powerful people.

Concerns about the analogy between slavery and surrogacy are directly related to the issue of the exploitation of women who serve as surrogates. In commercial surrogacy, the contracting agency or surrogacy broker keeps much of the fee. Horsey says, “Furthermore, there is often a wide disparity between agency and other fees and the amount that surrogates are paid: in many cases what the surrogate receives is a small fraction of the total that intended parents spend.”^[34]

The analogy between slavery and surrogacy is amplified by concerns about human trafficking of potential surrogates. In Yuri Hibino’s analysis of the changing practices of surrogacy in India, she interviewed a surrogacy agent. This unnamed individual commented on the effects of more restrictive Indian laws and said, “We now have a plan to transfer Indian surrogate mothers to another country where embryo transfer and delivery can happen, as foreigners are prohibited from entering India to procure surrogacy.”^[35] One can imagine how such an unscrupulous person would deduct airline expenses, housing, and healthcare in another country from the poor surrogate’s fee. In worst case scenarios, a surrogate could be trafficked to another country where her abusers hold her identification papers promising to return them only if she will be a surrogate again and again.

Does surrogacy actually increase a poor woman’s net worth? Good data would compare poor women from a certain area who were not surrogates with poor women from the same area who were surrogates and compare and contrast their net worth prior to the surrogacy and perhaps one, three, and five years later. Five years later, would the surrogates have a higher net worth than women who were not surrogates? I know of no such data like this regarding surrogacy. What is certain is that sound education, good job opportunities, exercising sexual restraint, and staying away from drugs and alcohol are all strongly correlated with breaking free from cycles of poverty. Why not work to enable poor women to have these opportunities as opposed to a risky venture such as surrogacy? Nonetheless, the Scriptural account of Abraham and Hagar only amplifies concerns about the slavery-surrogacy analogy.

The case of Abraham and Hagar gives us reason to pause when we consider surrogacy.

Genesis 16:1 – 4 (NIV): Now Sarai, Abram’s wife, had borne him no children. But she had an Egyptian maidservant named Hagar; so she said to Abram, “The LORD has kept me from having children. Go, sleep with my maidservant; perhaps I can build a family through her.” Abram agreed to what Sarai said. So after Abram had been living in Canaan ten years, Sarai his wife took her Egyptian maidservant Hagar and gave her to her husband to be his wife. He slept with Hagar, and she conceived. When she knew she was pregnant, she began to despise her mistress.

The one biblical story most analogous to surrogacy is the story of Abram, Sarai, and Hagar in Genesis 16. Even though Abram and Sarai struggled with infertility, God promised Abram they would become pregnant and that “your very own son shall be your heir” (Gen 15:4). But the child would come on God’s timetable, not theirs. In unbelief and impatience, Abram and Sarai decided to introduce a third party into the reproductive relationship.^[36] Sarai said to Abram, “Behold now, the Lord has prevented me from bearing children. Go in to my servant [Hagar]; it may be that I shall obtain children by her” (Gen 16:2).

Hagar was forced to become a surrogate because she was a slave, being specifically identified as a maidservant.^[37] The Hebrew word שִׁפְחָה / šifkhah means Hagar was not a common slave but the personal servant of her mistress, Sarai.^[38] Abram reinforces Hagar’s lower status when he agrees that Sarai has authority over Hagar to make her have sex with him. Hagar is also referred to as an Egyptian on two occasions (16:1, 3), and as a foreign-born slave she had little significance in the eyes of the household. Hagar’s insignificance is accentuated by the absence of Sarai speaking directly to Hagar in the passage — the maidservant is almost disembodied and a vehicle for reproduction. Matthews says, “Sarai never speaks directly to Hagar or speaks her name; Hagar is a tool to relieve Sarai’s embarrassment.”^[39] After consummating the relationship, Hagar’s status may have been elevated from merely a slave. Fensham argued Sarai’s request in Genesis 21:10 that Abraham “drive out” Hagar indicates Hagar may have been viewed as a second wife to Abraham since “drive out”/ gērāš was used as a technical term for divorce in the Old Testament.^[40]

Hagar’s standing as a handmaid and later a type of second-class wife illuminates her lack of moral agency in the decision to have sex with Abram. Without affirming Delores Williams’ hermeneutic (with which I strongly disagree), she gets at the coercion implied in the passage when she says, “While Hagar had no choices in matters of forced motherhood, the law provided options for wealthy free women like Sarai who were barren.”^[41] Williams’ use of the word “law” is too strong for the context as the OT law had not been given yet and legal authorities and law codes were at best sparse in Abram’s Canaan. What she really means is custom. Yet her point that a wealthy woman takes advantage of a woman of lower social standing for the purposes of raising up a child should not be overlooked. The similarities to modern surrogacy in which wealthy women and couples invariably contract a surrogate from a lower socio-economic class are striking.

Hagar’s loss of moral agency alerts us to further reasons why surrogacy is analogous to slavery. Consider the stress that can occur in relationships between contracting couples and the surrogate. What if the biological mother and the surrogate have completely different perspectives on what is best for the developing baby? As Elly Teman notes, “Both women [biological mother and surrogate] straddle a delicate position vis-à-vis one another in terms of control: each has reason to feel loss of control during the process, just as each has reason to blame the other party for misusing her power.”^[42] Quite often, the contracting couple insists their wishes should be followed at every step, and in this sense, are dictating authority over what a woman may or may not do with her body, a situation much like Hagar who was not able to decide how her own body was used.

Hagar functioned as a primitive form of “surrogate mother.” Abram and Sarai asked God for a child, but when the child did not come as quickly as they had hoped, they took matters into their own hands and Abram had sex with Hagar. The rash actions of Abram and Sarai resulted in subsequent relational chaos within their family.^[43] As Bill Arnold comments, “But the narrative of Genesis 16 is clear that this was a matter of God’s people making other arrangements without his direction, trying to “help God out” of a predicament.”^[44] While we must be careful not to use Genesis 16 as a basis for a knee-jerk rejection of every new technology, the bad consequences of Abram’s choice in this matter challenges us to consider our options carefully before women are contracted as surrogates. Hagar was a slave and modern surrogacy bears strong resemblance to slavery as well.

Surrogacy and prostitution.

Similar to concerns about slavery, surrogacy bears striking similarity to prostitution. Prostitution is when one person sells his or her body for sexual use by another person and it is strictly forbidden in Scripture. Likewise, in surrogacy it is the surrogate’s body which is being sold for the temporary use of someone else. Surrogacy is closely related to sex because the child the surrogate is carrying comes from the reproductive cells of either one or both of the intended parents; she is accepting payment for the use of her body in an activity closely associated with sex.

A counterargument would say that surrogacy is not like prostitution and such a comparison is offensive. Unlike prostitution, no one actually has sexual intercourse in a surrogacy arrangement. But such counterarguments fail to acknowledge that in both prostitution and surrogacy, a woman’s body is temporarily used by another person or persons in an act of which the normal outcome is procreation. Furthermore, in both prostitution and commercial surrogacy, money is the medium of exchange for the use of the woman’s body. In both cases, the woman’s body is used to gain an intended outcome for someone else. In the case of prostitution, the woman’s body serves as an object for someone else’s sexual pleasure. In the case of surrogacy, the woman’s body serves as an object to carry a child to term.

Surrogacy is not like adoption.

Some argue surrogacy is no different from the long-accepted practice of adoption, pointing out that in both cases the birth mother or birth parents surrender a child to someone else who will raise the child. But comments from Oliver O’Donovan about Artificial Insemination by Donor (AID) are helpful in morally evaluating surrogacy. O’Donovan notes that AID is sometimes compared to adoption, but he shows at least two flaws in the AID-adoption analogy which are also relevant to the surrogacy-adoption analogy. First, in both AID and adoption, the biological parents never stop being the child’s parents in a certain sense. Likewise, in surrogacy the surrogate herself is referred to by all types of circumlocutions, such as “gestational carrier,” all in an attempt to deny that she is a parent. Second, AID is unlike adoption because in adoption the replacement of the birth parents with adoptive parents is occasioned only by the birth parents’ incapacity to fulfil their role. O’Donovan notes that adoption is quite different because the biological parents “do not act for adoptive parents; adoptive parents act for them.”^[45] Likewise, in surrogacy the pregnancy is created with the intention from the very beginning of giving the child to another family, fundamentally differentiating surrogacy from adoption. Surrogacy is less like adoption and perhaps more like adultery.

Surrogacy and adultery.

Collaborative procreation intersects with the moral rule against adultery. Adultery occurs when a married person has sex with someone who is not his or her spouse. Adultery not only distorts God’s purposes for sex, adultery introduces a third party into a marriage covenant intended to be exclusively between a husband and wife. The surrogate carries the child for a couple, which is intended to be done by the wife in marriage. Of course, many women face infertility problems and are unable to carry a child to term, but contracting a surrogate still brings a third party into the marriage. Furthermore, if the surrogate also provided the egg, the husband has technically fathered a child with another woman, which very much looks like adultery. Surrogacy introduces a third party into the process of procreation which should be confined to the loving partnership between two people, and is an attack on the value of the marital relationship.^[46]

Surrogacy can also resemble adultery when the surrogate herself is married. When a wife agrees to carry another couple’s baby, then the surrogate and her husband have taken the product of another couple’s conception into the wife’s womb. She is not carrying a child conceived with her husband, she is carrying someone else’s child. In this way, surrogacy is even more complicated than adultery. If a woman becomes pregnant in an adulterous relationship, the subsequent child has one father, a stranger who has intruded into the marriage relationship. But when a woman carries the embryo conceived via IVF from a contracting couple, two other strangers have intruded into the surrogate’s marriage covenant — the contracting husband and contracting wife.

A respondent could contend there are relevant differences between surrogacy and adultery. First, adultery is defined as sexual intercourse between a married person and someone who is not his or her spouse. In surrogacy, no sexual intercourse has occurred. Second, adultery is usually secretive and done by keeping the matter hidden from a spouse. In contrast, surrogacy is done with the consent of both the husband and wife. Indeed, surrogacy doesn’t involve sexual intercourse and is done, ideally, with mutual consent of the husband and wife. But the fact that surrogacy involves a third party and the sharing of gametes with someone outside of a marriage should give us pause before rejecting the relevancy of adultery-based concerns.

The concern about similarities is not limited to the contracting couple but extends to the surrogate herself. While some might argue that a surrogate is not performing something like adultery but an act closer to adoption, I think the appeal to a similarity to adoption is weak. In adoption one comes to the aid of biological parents who were unable to raise a child which was not conceived with such ends in mind; the original goal was not to conceive a child and then hand off the infant. Adoption is charitable intervention into a previously existing crisis. But a surrogate is intentionally inserting herself into a previously existing marriage. To take another’s child into one’s family is a totally different type of act from taking another person’s gamete or another couple’s embryo into one’s body and then handing a baby off.^[47]

Here the issue of surrogacy profoundly intersects with procreational and relational or unitive purposes of sex within marriage. Sexual intercourse is a gift which strongly bonds a husband and wife together in the marital embrace in joyful celebration of the love shared within the marriage covenant. When the bodies of both the husband and wife are not affected by problems of infertility, then children are procreated by the couple. The act of procreation occurs between the two of them within a marriage. It seems surrogacy drives a severe and unmerited wedge between the relational and procreative aspects of sex, harshly isolating the two in ways not imagined by Scripture. And because adultery involves a third party intruding into a couple’s procreation, I think concerns about adultery are relevant when discussing surrogacy even though no actual sexual intercourse is involved. I concur with O’Donovan that harshly bifurcating the relational and procreative aspects of sex in marriage invites us to think that “the procreative good may be fulfilled in any way at all, not necessarily by the exclusive communion of procreational power.”^[48]

An infertile couple may rebel quite fiercely at this reasoning and exclaim, “We are celebrating the unitive aspects of marriage but due to circumstances far beyond our control we are utterly incapable of procreating!” From the perspective of a couple unable to become pregnant, it may seem as if the procreative purposes of sex have already been bifurcated from their marriage, thus the use of alternative means of having children is permitted. But the underlying links between the relational and procreative aspects of sex are inherent in the design of marriage. The pain of infertility points to the ways in which the Fall has negatively affected our world at many tragic levels, but that does not change the nature of the covenant of marriage itself. Infertility’s grief does not justify the moral rearrangement of the very nature of procreation itself in any manner we see fit.

We have been discussing concerns about adultery as a moral warning for use of surrogacy in the context of infertile couples. But we must not forget that many couples seek surrogates for reasons unrelated to infertility. Many perfectly healthy couples completely able to procreate want a surrogate to maintain the contracting wife’s attractiveness or merely because pregnancy would impede career goals or is just viewed as an inconvenience regarding time management. In these cases, the warnings about adultery are amplified because the couple is inviting a third party into the act of procreation out of reasons which can only be described as self-centered. The couple’s gametes are placed in someone else merely for convenience or personal preference, much as adultery serves to meet idolatrous, self-centered desires.

Some forms of surrogacy are based on an idolatrous view of physical attractiveness.

When intended parents engage a surrogate not because of infertility but to maintain the wife’s physical attractiveness, unrealistic standards of physical beauty have become an idol. The effects of time, age, and children do not give a husband the excuse not to love his wife. Instead, husbands are to love their wives as Christ loves the church (Eph 5:25). To condition love or attraction to one’s wife on her maintaining a perpetually young appearance is to place something else in front of God’s command that “love never fails” (1 Cor 13:8).

Scripture never criticizes tasteful attention to one’s appearance in public. Concern for presenting oneself in the best light can be seen in Naomi’s instruction to Ruth in her romance with Boaz, “Wash yourself therefore, and anoint yourself and put on your best clothes, and go down to the threshing floor” (Ruth 3:3a). Likewise, the Shulamite’s lover in the Song of Songs adoringly refers to her as “the most beautiful among women” (Song of Songs 1:8). Yes, a woman’s sense of confident attractiveness is celebrated in Scripture, but this is not the sum of her worth. True beauty is found in a life surrendered to Jesus Christ. First Peter 3:3–4 describes this deeper beauty and says, “Your adornment must not be merely external — braiding the hair, and wearing gold jewelry, or putting on dresses; but let it be the hidden person of the heart, with the imperishable quality of a gentle and quiet spirit, which is precious in the sight of God.”

The argument in favor of surrogacy to maintain the intended mother’s physical attractiveness incorporates at least three flawed ideas. First, an unstated assumption is that a woman who has had a child is less attractive than a woman who has not had a child. This assumption incorporates shallow cultural views of beauty and is based on our sex-crazed culture’s unrealistic expectations about the aesthetic value of a woman emerging from the influences of salacious and lascivious literature. Second, the contracting mother is perfectly happy for the surrogate to undergo changes to her body which the contracting mother has no desire to endure herself. In this way, the intended parents devalue the very act of pregnancy through which a child is born. Third, securing a surrogate in order to maintain physical attractiveness suggests pregnancy is reserved for unattractive women. Surrogacy reinforces misogynistic ideas that some women are of less value than other women because of unrealistic standards of beauty.

Surrogacy and new social agendas.

Homosexual men use surrogate mothers to produce children for their relationship. For example, Elton John and his same-sex marriage partner David Furnish have used surrogates to father two sons.^[49] Homosexual men either have the surrogate artificially inseminated and she carries the baby to term or homosexual men use their own sperm along with an egg purchased from an egg bank to create an embryo which is implanted in the surrogate mother. The surrogate carries the baby to term and then the infant is handed over to the homosexual couple. At the most extreme edges of the new social agenda, some lesbians suggest men may not even be necessary for reproduction in the future, and the DNA of two eggs can be used to create a human life.

Homosexual relationships are strictly forbidden by Scripture (Rom 1:24–27). Surrogacy further transgresses moral boundaries by encouraging same-sex couples to mimic the procreative purposes for marriage woven into creation. But we must be clear: A child conceived via IVF for a homosexual couple will only result from the gametes of one member of the couple, and in this sense same-sex couples never procreate.

Conclusion

I oppose the practice of surrogacy because it is directly connected to the sanctity-of-life concerns related to IVF, it resembles slavery, prostitution, and adultery, its analogy to adoption is flawed, and it commodifies both the infant and the surrogate. Though there might be an extremely rare case of altruistic surrogacy where the practice is not sin, I cannot see where it is ever advisable or wise.^[50] Even in a supposedly altruistic scenario from the most generous of motives, we must never forget that the birth mother is still the mother and the ensuing complications in family dynamics when the child delivered by one family member is then raised by other family members is loaded with an unlimited number of relational complications, all of which will add stress and confusion to the most important person in the entire arrangement — the child.

Confused argumentation about surrogacy abounds. On one occasion, it was suggested to me that the virgin conception of Jesus Christ in some vague manner justifies the modern practice of surrogacy. My interlocutor suggested Mary was a surrogate. But this analogy is quite flawed. A surrogate gives up a child to be raised by someone else while Mary never gave up her baby to someone else but raised the Lord Jesus Christ. Furthermore, God the Father never abandoned Jesus nor was Mary paid in any way for her services. Confused references to the virgin birth in an effort to justify modern surrogacy reflect the backwards moral reflection common in our culture; once an idea is embraced, then people search Scripture for anything vaguely justifying the choice without engaging in robust moral reflection.

Discussing the virgin birth and surrogacy illustrates the frustrating aspects of surrogacy discussions in what seems to be the perpetual lack of moral reflection or the sloppy use of motivational quotes to support surrogacy. For example, I once encountered a surrogacy website which cited quotes from both John Bunyan and Mother Teresa to inspire people involved in the surrogacy process, but the managers of the webpage seemed completely oblivious to the fact that both Bunyan and Mother Teresa would be appalled at the practice of surrogacy.^[51] Such faulty moral reasoning as citing Bunyan and Mother Teresa to support surrogacy reflects our culture’s even more confused manner of moral considerations. In many discussions of surrogacy, the assumption seems to be, “Well, if modern science makes it possible, then it must be acceptable.” But modern science makes any number of things possible which right-thinking Christians will oppose. We are not utilitarians and the ends do not justify the means for God’s people.

[1] This essay was originally presented as a paper at the Evangelical Theological Society, November 2024, and has been lightly edited for publication.

[2] Department of Health & Social Security, Report of the Committee of Inquiry Into Human Fertilization and Embryology, Dame Mary Warnock, DBE, Chairman (London: Her Majesty’s Stationary Office, 1984, reprinted 1988), 42. I modified the definition to include diverse sexual relationships now in vogue and consideration of pay.

[3] Megan Best, Fearfully and Wonderfully Made: Ethics and the Beginning of Human Life (Kingsford, NSW, Australia: Matthias Media, 2012), 366.

[4] This summary from Scott Rae, Moral Choices: An Introduction to Ethics, 2^nd ed. (Grand Rapids, MI: Zondervan, 2000), 149.

[5] Ethics Committee of the American Society for Reproductive Medicine, “Consideration of the Gestational Carrier: An Ethics Committee Opinion,” Fertility and Sterility 110.6 (November 2018): 1017.

[6] For example, see Alan Brown, “Surrogacy Law Reform In the UK: The Ambiguous Position of Payments to the Surrogate,” Child and Family Law Quarterly 33.2 (2021): 95–114.

[7] Kirsty Horsey, “The Future of Surrogacy: A Review of Current Global Trends and National Landscapes,” Reproductive BioMedicine Online 48.5 (May 2024): 2.

[8] Horsey, “The Future of Surrogacy,” 3.

[9] Kiran M. Perkins, Sheree L. Boulet, Denise J. Jamieson, and Dimitry M. Kissin, “Trends and Outcomes of Gestational Surrogacy in the United States,” Fertility and Sterility 106.2 (August 2016): 437.

[10] Global Market Insights, “Surrogacy Market,” November 2022, https://www. https://www.gminsights.com/industry-analysis/surrogacy-market.

[11] Susannah Snider, “The Cost of Using a Surrogate – And How To Pay For It,” U.S. News and World Report, November 24, 2020, https://money.usnews.com/money/personal-finance/family-finance/articles/how-much-surrogacy-costs-and-how-to-pay-for-it.

[12] Moira Weigel, “Made in America,” New Republic 248.11 (November 2017): 34.

[13] Megan Cerullo, “How Much Do Surrogates Make? People Describe the Real-Life Dollars and Cents of Surrogacy,” CBS News, January 12, 2024, https://www.cbsnews.com/news/how-much-do-surrogate-mothers-make-cost/.

[14] Irene Woo, Rita Hindoyan, Melanie Landay, Jacqueline Ho, Sue Ann Ingles, Lynda K. McGinnis, Richard J. Paulson, Karine Chung, “Perinatal outcomes after natural conception versus in vitro fertilization (IVF) in gestational surrogates: a model to evaluate IVF treatment versus maternal effects,” Fertility and Sterility 108.6 (December 1, 2017): 993–998.

[15] Acts 20:35 was actually listed on the American Surrogacy website as an inspiring quote for surrogate mothers.  American Surrogacy Blog, “21 Surrogacy Quotes to Share Today,” November 24, 2017, accessed October 9, 2019, https://www.americansurrogacy.com/blog/21-surrogacy-quotes-to-share-today/.

[16] Yuri Hibino, “The Advantages and Disadvantages of Altruistic and Commercial Surrogacy in India,” Philosophy, Ethics, and Humanities in Medicine 18.8 (2023): 2. Please note that I am not advocating belief in karma but only pointing out the varied religious reasonings offered for surrogacy around the world.

[17] American Surrogacy, “The 13 Benefits of Surrogacy that You Need to Know,” https://www.americansurrogacy.com/surrogacy/benefits-of-surrogacy.

[18] National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, “What are some factors that make pregnancy high risk?,” November 6, 2018, https://www.nichd.nih.gov/health/topics/high-risk/conditioninfo/factors.

[19] Department of Health & Social Security, Report of the Committee of Inquiry Into Human Fertilization and Embryology, 45.

[20] Practice Committee of the American Society for Reproductive Medicine and Practice Committee of the Society for Assisted Reproductive Technology, “Recommendations for Practices Using Gestational Carriers: A Committee Opinion,” Fertility and Sterility 118.1 (July 2022): 66.

[21] The official number of deaths associated with building Hoover Dam is ninety-six. United States Bureau of Reclamation, “Hoover Dam,” March 12, 2015, https://www.usbr.gov/lc/hooverdam/history/essays/fatal.html#targetText=The%20%22official%22%20number%20of%20fatalities,equipment%2C%20truck%20accidents%2C%20etc.. Eleven workers died building the Golden Gate bridge. See “Frequently Asked Questions About the Golden Gate Bridge,” http://goldengatebridge.org/research/facts.php.

[22] Michael B. Sauter and Charles Stockdale, “25 Most Dangerous Jobs in America,” 24/7 Wall Street, January 2, 2019, https://247wallst.com/special-report/2019/01/02/25-most-dangerous-jobs-in-america-2/6/.

[23] Oliver O’Donovan, Begotten or Made? (Oxford: Oxford University Press, 1984), 40.

[24] O’Donovan, Begotten or Made?, 15.

[25] Mindy S. Christianson, Judy E. Stern, Fangbai Sun, Heping Zhang, Aaron K. Styer, Wendy Vitek, and Alex J. Polotsky, “Embryo Cryopreservation and Utilization in the United Sates from 2004 – 2013,” F & S Reports 1.2 (September 2020): 73. This number is an estimate and the researchers could not account for the fate of many of the embryos, thus the final count was undoubtedly a bit high.

[26] Something similar to IVF occurs in the ancient Hindu epic of the Mahabharata. One of the prominent characters is Gandhari, the princess of the Gandhara Kingdom and wife of Dhritrashtra. In the story, Gandhari has an unusually long pregnancy after which she gives birth to a lump of immovable flesh. This lump of flesh was divided into 100 pieces which were put into jars in which ghee (clarified butter) was added and incubated. Finally, 101 children were born one by one. One group of researchers commented on this story and said, “This narrative is strongly reminiscent of in vitro fertilization (IVF), with the multiple pregnancies that commonly occur with it. In Gandhari’s case, however, the description mirrors an extra-uterine gestation, a scientific fear that future researchers may be able to achieve.” Bharti Kalra, Manash P. Baruah, and Sanjay Kalra, “The Mahabharat and Reproductive Endocrinology,” Indian Journal of Endocrinology and Metabolism 20.3 (May – June 2016): 405. This is the oldest reference to something like IVF I can find in religious literature.

[27] Oliver O’Donovan, Begotten or Made? (Oxford: Oxford University Press, 1984), 37.

[28] Carol Sanger, “Developing Markets in Baby-Making: In the Matter of Baby M,” Harvard Journal of Law and Gender 30 (2007): 71, 75.

[29] O’Donovan, Begotten or Made?, 65.

[30] American Society for Reproductive Medicine, “Recommendations for Practices Using Gestational Carriers: A Committee Opinion,” 2022, www. https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-for-practices-using-gestational-carriers-a-committee-opinion-2022/.

[31] Department of Health & Social Security, Report of the Committee of Inquiry Into Human Fertilization and Embryology, 46.

[32] Some surrogates have said things as crude as, “I’m just the oven; it’s their bun!”

[33] Family Court of Western Australia, Farnell & Anor and Chanbua, (April 14, 2016): 175, paragraph 756. The case was complicated by claims from Pattaramon that the contracting parents asked her to abort the Down syndrome boy, claims the Australian court did not find compelling.

[34] Horsey, “The Future of Surrogacy,” 2.

[35] Yuri Hibino, “The Advantages and Disadvantages of Altruistic and Commercial Surrogacy in India,” 6.

[36] C. Ben Mitchell and D. Joy Riley, Christian Bioethics (Nashville: B & H Publishing Group, 2014), 124.

[37] Feminist/womanist author Delores Williams said, “Hagar had no control over her own body. It belonged to her slave owner, whose husband ravished Hagar.” Delores Williams, Sisters in the Wilderness: The Challenge of Womanist God-Talk (Maryknoll, NY: Orbis Books, 1993), 3.

[38] Kenneth A. Matthews, Genesis 11:2–50:26, The New American Commentary, vol. 1b (Nashville: Broadman & Holman, 2005), 184.

[39] Matthews, Genesis 11:27–50:26, 184.

[40] C. Charles Fensham, “The Son of a Handmaid in Northwest Semitic,” Vetus Testamentum 19.3 (July 1969): 318.

[41] Williams, Sisters in the Wilderness, 15.

[42] Elly Teman, Birthing a Mother: The Surrogate Body and the Pregnant Self (Berkeley, CA: University of California Press, 2010), 5.

[43] One surrogacy agency in Montanna claimed, “Sarah and Abraham raised that child [Ishmael] as their own.” From the narrative of Genesis, it is not clear that Ishmael was ever raised by Abram and Sarai together but he was raised by Hagar with the child being viewed as sort of an appendage to the family. Montanna Surrogacy, “A Brief History of Surrogacy,” July 10, 2018, https://www.montanasurro.com/blog/2018/7/8/history-of-surrogacy-a-timeline/.

[44] Bill T. Arnold, Encountering the Book of Genesis (Grand Rapids, MI: Baker, 1998), 96.

[45] O’Donovan, Begotten or Made?, 37.

[46] Department of Health & Social Security, Report of the Committee of Inquiry Into Human Fertilization and Embryology, 44.

[47] I am borrowing here directly from O’Donovan in his discussion of artificial insemination by donor. Begotten or Made?, 37.

[48] O’Donovan, Begotten or Made?, 39.

[49] Lady Gaga is the godmother for both children.

[50] Megan Best says something similar: “Even though I am hesitant to recommend legal surrogacy, I believe that if no donor gametes are used, altruistic surrogacy is not necessarily inherently immoral. This is not to say, however, that it is a wise choice.” Megan Best, Fearfully and Wonderfully Made (Kingsford, NSW: Matthias Media, 2012), 372. I am not addressing the issue of embryo adoption in this essay.

[51] See https://info.worldwidesurrogacy.org/blog/inspiring-surrogacy-quotes. The same webpage cites singer Sheryl Crow as saying, “Little souls find their way to you, whether they’re from your womb or someone else’s.” In context, Crow was referring to her adopted son Wyatt. Adoption is completely different from surrogacy! Concerning the use of sources by this webpage, I would suggest to the page managers that “a change would do you good” (to take Sheryl Crow out of context less egregiously).