Surrogate mothers feel no remorse for babies

First detailed study into 'renting out' wombs finds adoptive mothers more loving than those of children conceived naturally

Surrogate mothers who are contractually obliged to hand over their newborn babies to another set of parents feel little or no remorse, according to the world's first detailed study of one of the most controversial aspects of infertility treatment.

The study also found that the adoptive mothers of the children born from a surrogacy agreement tended to be more loving and emotionally involved with their new babies than mothers of children who were conceived naturally.

The findings, which are to be released today at the annual meeting of the European Society of Human Reproduction and Embryology in Vienna, allay many of the initial fears over the relatively new practice of "renting" a woman's womb for the benefit of infertile couples.

Fiona MacCallum, of the Child Psychology Research Centre at City University, London, said interviews with 43 British families who used surrogate mothers had dispelled many of the myths surrounding the practice.

"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," Ms MacCallum said.

"Since the birth of the child, the majority of the families had kept in touch with the surrogate to some extent and 70 per cent 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 serious 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 per cent reporting no anxieties about this aspect," she added.

Surrogacy has grown rapidly in Britain since Kim Cotton became Britain's first known surrogate mother in 1985, because it is often the only way infertile couples can have children of their own. Commissioning couples are not allowed to pay the surrogate mother but they can give her "reasonable" expenses for the costs incurred through her pregnancy.

"Of all the treatments for infertility that have been developed in recent years, the practice of surrogacy, where one woman bears a child for another woman, remains the most contentious," Ms MacCallum said.

There are two types of surrogacy: partial surrogacy when the surrogate mother is inseminated artificially by the male partner, who is therefore the genetic father; or full surrogacy where the commissioning mother donates an egg that undergoes in-vitro fertilisation (IVF) with her partner's sperm. In this latter case, the surrogate mother is genetically unrelated to her baby.

Forty-three cases were studied, with two-fifths involving full surrogacy and the remainder partial surrogacy. Two out of three surrogate mothers were unknown to the commissioning couple prior to the surrogacy agreement, while the remaining third were either a sister or close friend of the commissioning mother.

Ms MacCallum conducted the study with Professor Susan Golombok who has done several investigations into the psychological impact on children and their parents of fertility treatments such as IVF and artificial insemination by donor sperm.

Professor Golombok published research last year showing that children born through IVF treatments were generally well adjusted, emotionally healthy and had better relationships with their parents than many other children conceived naturally.

The latest research from Professor Golombok's team compared 43 surrogate families with 51 families with a child conceived through IVF using donated eggs and 86 families where the children were conceived naturally.

A significant difference emerged when the families were asked about whether they intended to tell their children about their origins. All the surrogacy mothers had told friends and family and said they intended to tell their children as well when they are old enough to understand.

But in the egg-donor families, 12 per cent of the couples had told no one, 41 per cent had not told their parents and 26 per cent had not told friends. Only 57 per cent said they intended to tell their children that they were conceived using a donated egg.

"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," Ms MacCallum said.

Babies in the surrogacy study were only between nine and 12 months old so it was not possible at this stage to describe the longer-term impacts on the emotional well-being of children who had been created using surrogate mothers, she said. "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," Ms MacCallum said. "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.

"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," she said.

Answers to questionnaires demonstrated that the commissioning couples showed every sign of being excellent parents. When the researchers looked at aspects such as "warmth" and "emotional involvement", these couples scored more highly than parents whose children were conceived naturally, although they were on a par in terms of the mother's "sensitivity" towards responding to the child's needs.

Both mothers and fathers within commissioning couples demonstrated better parental skills than non-surrogate couples and the babies showed no difference in temperament and behaviour compared to non-surrogate babies, the researchers concluded.

Ms MacCallum said: "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 overinvestment in the child," she added.

"The findings of this study are generally reassuring with respect to relationships with surrogate mothers, quality of parenting and the temperament of the child."