Outsourcing surrogacy: It takes a global village

Russia is “a sort of reproductive paradise,” according to Konstantin Svitnev, the general manager of Rosjurconsulting, a Russian law firm specializing in surrogacy. The country has one of the most liberal surrogacy laws in the world, as well as some of the cheapest rates. Svitnev estimates that the procedures cost, on average, between $15,000 to $30,000. In 2012, surrogate mothers in Russia reportedly gave birth to around 1,000 children, although there was no data on how many of those were for foreign couples.

Then, last fall, the tide shifted. Russian pop diva Alla Pugacheva, 65, and her husband had twins through a surrogate, rattling conservative corners of the country. A Russian Orthodox Church official decried surrogacy as a “mutiny against God” and “very happy fascism with a contract,” reported Russia Today. Elena Mizulina, the architect of the nation’s infamous gay propaganda law declared that surrogacy was “threatening not only Russia, but humanity as a whole with extinction,” likening the practice to nuclear weapons, according to BuzzFeed.

As part of a conservative surge in the country, Russian parliamentarians drafted a bill in April that would ban commercial surrogacy entirely, and restrict its use to married people. The bill excludes gay couples, as same-sex marriage isn’t recognized in Russia.

Lax surrogacy laws and its European locale have made Ukraine one of the newest Meccas of international baby-making. For foreign couples, the price tag reportedly ranges from $30,000 to $45,000, less than half what it costs in the U.S. Only written consent is required, and Americans and Europeans don't even need a visa.

As long as parents are infertile, legally married and straight, the laws in the post-Soviet nation are stacked to protect the rights of the intended parents. Couples can select their baby’s gender and scoop up the birth certificate of their surrogate-born kid, almost as soon as he or she takes a first breath, essentially extinguishing the rights of the surrogate mother entirely.

But this breezy arrangement can hit a few snags. For example, French couple Patrice and Aurelia Le Roch had twins through a Ukrainian surrogate in January 2011. Surrogacy is illegal in France, and the country doesn’t grant French citizenship to surrogate-born infants. So Patrice Le Roch and his dad, Bernard, tried to smuggle the stateless babies across the border to Hungary, but were busted and fined a couple thousand dollars a piece. The couple finally managed to get Ukrainian citizenship for their children, the AFP reported, and went home after eight Kafka-esque months stranded in Kiev.

But India's big business of renting wombs has raised thorny ethical concerns. Many surrogates come from crushing poverty, but stand to earn $5,000 to $7,000 in nine months – a huge sum for women who would otherwise bring in well under $1,000 annually. Some surrogates, however, are lured into contracts they don’t understand or are cheated by shady middlemen. Others are confined to sometimes crowded shelters near the fertility clinics, where their personal freedoms -- like family visits -- are restricted.

Some clinics have introduced more out-patient care models for surrogates, and there have been attempts to monitor and regulate the growing industry. A bill to reduce exploitative practices has gone unsigned for more than four years, but in that time, one major regulation has taken effect. In 2012, India’s Home Ministry decreed that foreigners seeking a surrogate must be a man and a woman, pushing same-sex couples and would-be single parents to look elsewhere for help. But some Westerners have gotten around the rule by hiring Indian or Nepalese women to get in vitro fertilization in India, only to deliver the babies in Nepal.

In the United States, surrogacy is a two-way street. While Americans head all over the world to hire surrogates for a fraction of the cost at home, the U.S. also plays host to thousands of reproductive tourists. All forms of surrogacy are banned in countries such as Germany, Sweden, Italy and Norway. Others like Australia, Greece, Denmark and the Netherlands have outlawed commercial surrogacy. In a way, America's patchwork of state laws about surrogacy make it a microcosm of the rest of the world.

With its network of sperm banks, fertility clinics and laws favoring would-be parents, California is the capital of commercial surrogacy in the U.S., attracting the likes of Elton John and his partner. According to a 2012 Berkeley Journal of International Law study, a U.S. surrogacy arrangement can cost anywhere from $80,000 to $120,000. Of that, the surrogate receives between $14,000 to $18,000.

Some states that permit surrogacy require intended parents to be married, which excludes single people and many same-sex couples.

A 2013 American Society for Reproductive Medicine study estimated that one in 20 surrogacy deliveries in the U.S. are to foreigners. On the other hand, the "incidence of U.S. patients traveling abroad for care is estimated to be far lower than the rate of patients coming into the United States." To put that in context, there were only an estimated 1,400 births via surrogacy in the U.S. in 2010.

For people who live in countries such as China, where surrogacy in banned, there are some added bonuses to hiring an American surrogate or participating in so-called birth tourism. The child can get a U.S. passport, which can lead to citizenship for the parents down the road.