Women who act as pregnancy surrogates are at an increased risk of experiencing health complications compared to those who carry their own babies, according to a recent study. The use of surrogates, also known as “gestational carriers,” has become more prevalent in recent years, with a significant rise in parental orders transferring legal parentage from the surrogate. This trend has raised concerns about the health and well-being of surrogates, prompting researchers to investigate the potential risks associated with surrogacy.
The Study
A study based on data from Canada revealed that surrogates are more likely to experience complications such as severe postpartum hemorrhage and severe pre-eclampsia compared to women who conceive naturally or through IVF. The research also found that babies born to surrogates were more likely to be born prematurely, although they did not have a higher risk of severe neonatal complications. These findings underscore the need for improved prenatal care for surrogates and the establishment of strict criteria and regulations for women interested in becoming gestational carriers.
Dr. Maria Velez, the lead author of the study from McGill University in Canada, emphasized the importance of counseling intended parents and gestational carriers about potential complications. She highlighted that these complications not only impact the health of the surrogate but also have implications for the intended parents and healthcare providers involved in the process. The study, published in the Annals of Internal Medicine, utilized the Better Outcomes Registry & Network (Born) database to analyze over 800,000 singleton births in Ontario from 2012 to 2021.
Risk Factors and Findings
The research team found that the rate of severe maternal health complications was significantly higher among surrogates compared to women who conceived naturally or through IVF. Surrogates had a 7.8% risk of severe complications, while the rates were 2.3% for unassisted conception and 4.3% for IVF pregnancies. Even after adjusting for factors such as age, income level, previous births, obesity, smoking, and high blood pressure, surrogates still had a significantly higher risk of severe postpartum hemorrhage and preterm birth.
While surrogates were more likely to have certain risk factors such as prior childbirth, residing in lower-income areas, obesity, and hypertension, these factors did not fully account for the increased risks observed in the study. Dr. Velez suggested that there may be other mechanisms, possibly involving immunological factors, contributing to the higher risk for gestational carriers. The study also compared the risks for surrogates with those who underwent IVF and found that surrogates had a higher likelihood of experiencing complications, albeit to a lesser extent.
Ethical Considerations
Jackie Leach Scully, a bioethics professor at the University of New South Wales, raised ethical concerns regarding the study’s findings. She noted that the research had limitations, including a small sample size of surrogates and the lack of comprehensive data on the risks and outcomes of surrogate pregnancies. Despite these limitations, the study shed light on the potential risks faced by women acting as surrogates and the need for a deeper understanding of the health implications of surrogacy.
Scully highlighted two key ethical issues arising from the study’s findings. Firstly, she expressed concerns about the potential exploitation of women serving as gestational carriers and bearing the risks of pregnancy on behalf of others. The lack of accurate data on the health risks faced by surrogates raises questions about how seriously women’s health is prioritized in the context of surrogacy. Scully emphasized the importance of considering the well-being of women involved in surrogacy arrangements and addressing any gaps in healthcare support for gestational carriers.
In conclusion, the study reveals the heightened risks of pregnancy complications faced by women acting as surrogates compared to those carrying their own babies. The findings underscore the need for enhanced prenatal care for surrogates and the implementation of stringent criteria to safeguard the health and well-being of gestational carriers. As the practice of surrogacy continues to grow, it is essential to prioritize the health of women involved in these arrangements and ensure that they receive adequate support and monitoring throughout the pregnancy journey.