Tag Archives: mental-health

Words from a Surrogate Mother – Part 4: Clara*

Leave a reply

My name is Clara* and I am from Argentina. I have two daughters who are studying at a university in Argentina. Since 2023, I have been fighting to regain my place in my son’s life, with the help of my solicitor. This is my story.

In 2022, a very close friend of mine, whom I will call ‘G’, whom I met in 2007 when I was studying English, called me. He works in Europe and lives with his partner. They are both very wealthy.

At the time, I had recently separated, lost a child a few years earlier, and was not feeling well. During our conversation, G asked me to become the mother of his child. He said that the three of us would form a family. I was happy to help them become parents, and to become a mother again myself. I accepted this wonderful project. He mentioned the possibility of marrying me to make it easier for them to obtain papers in France. We would be a family of three in Europe. I would live on one floor of their large house and they would live on the other; we would raise the child together.

I know it may sound strange, but it felt strange to me at first too. I won’t lie — I didn’t want to upset him. I thought to myself, ‘Well, the world is changing so much that I’m going to become a mother this way.’ They brought me to France on a tourist visa. As I was in the early stages of menopause, they arranged for in vitro fertilisation in Spain using my friend’s partner’s sperm and donor eggs. The doctor suggested a donor with dark skin, like mine. However, ‘G’ insisted on a donor with fair skin and blue eyes. I refused.

It was a high-risk pregnancy: I was 41 years old at the time and had been diagnosed with high blood pressure and hypothyroidism. During the pregnancy, I had to go to hospital four times.

From the outset of my pregnancy, I found it extremely challenging to coexist with them. They argued a lot and started behaving very coldly towards me, as if it were a job. Gradually, the idea of a happy family life together disappeared. They decided that I should live in the neighbouring town and that I would only see the baby at weekends after he was born. G took my passport, but fortunately returned it to me four months later. I no longer recognised him; he had become a completely different person.

However, I thought I had to carry on since, after all, they were the parents and I was the mother, and we were going to start a family. I told myself that I had to put up with things, which unfortunately only got worse.

 The delivery was difficult and a caesarean section had to be performed. When the child was born, G presented himself to the hospital staff as my partner. They prevented me from holding my son, saying that I was tired. They told the nursing staff that I couldn’t breastfeed him because I was going back to work. That wasn’t true. They forced me to express milk. I agreed because I thought that if the baby became too dependent on me, it would cause him distress later on. There was also the €300 they sent every month for my daughters. I had no job and no connections. I didn’t speak French yet either. I had no money. They paid all my expenses, but my visa had expired, so I couldn’t go out without being very discreet. I couldn’t ask for help, and I had to keep my word.

When I dared to protest, the tension between us increased. They made me write a curriculum vitae and told me that they could no longer support me. I had not yet recovered from my caesarean section, so I asked them for a little more time as I was still finding it very difficult to walk. However, without consulting me, they organised my departure to Spain, where I knew nobody except a vague Facebook contact in Murcia. It took five car changes via BlaBlaCar and a bus journey to get there — a distance of 1,500 km. ‘G’ accompanied me to the bus in Barcelona to Murcia, then flew back immediately.

The person I stayed with helped me and put me in touch with a solicitor. By leaving my son like that, I risked being accused of child abandonment. I called ‘G’, begging him to let me return to France. I naively told him that I risked being prosecuted for child abandonment. I then learned that they had immediately filed a complaint against me for child abandonment.

While in Spain, I was put in touch with solicitors Ambroselli and Montesinos. They organised my repatriation to France and have supported me in all my efforts, including with paperwork, work and legal action to regain custody of my son.

Thanks to their efforts, I can now see my son for two hours every fortnight under social services supervision. However, for me, this is only a first step: I hope to be reunited with my son, who is now two years old, one day.

This speech was read by Clara* at FiLiA in Brighton on 11th October 2025. Clara* has used a pseudonym due to ongoing legal action.

Surrogacy: A risky Business

1 Reply

As a new study from Dr Velez was just published, I review this and revisit the study from 2024. In doing so I quote both studies verbatim, despite the dehumanising language.

2024 Study

Published in September 2024, “Severe Maternal and Neonatal Morbidity Among Gestational Carriers: A Cohort Study” looked at over 863,000 births in Ontario, Canada over a nine year period (1st April 2012 to 31st March 2021).

The study concluded that surrogacy pregnancies are 3 times the increased risk, with severe postpartum hemorrhage, severe pre-eclampsia, and postpartum sepsis given as the medical risks. This is an alarming statistic but one we have seen from previous studies and it is important to understand the approach.

Firstly, Dr Velez (et al) created a baseline by making certain deliberate omissions.

  • 405,876 pregnancies were excluded because of history of cancer, miscarriage or abortion as well as invalid insurance, high risk diagnosis and the application of Intrauterine insemination (IUI) for conception.
  • 130 twin pregnancies for surrogate mothers were excluded. This amounts to 16% of the total sample of surrogacy pregnancies (806) but only 2.3% in the unassisted conceived pregnancies. It is worth noting that had multifetal (twins or triplets, etc) pregnancies been taken into account, the risk would have been even higher. Twins are common in surrogacy as multiple embryos are implanted, “surrogate pregnancies more likely to result in twin pregnancies: 33% vs. 1%.” ( Woo et al, 2017)
  • Home births were excluded and these make up around 1% of pregnancies in Ontario – Data was gathered Better Outcomes Registry & Network (BORN) Ontario database which holds 99% of all birth records. 

Secondly, following the omissions, 3 comparison groups were created. A group with Unassisted (natural) Conception, IVF conception and ‘Gestational Carriage’ or surrogacy.

The group of surrogate mothers were not categorised further into ‘gestational’ (IVF) and ‘traditional’ (conceiving with the surrogate mother’s own eggs) and was small within this study – at only 806 of the overall group (0.09%) – but it remains the largest study of surrogate mothers in the last decade and it draws out several interesting observations.

  1. A significant number of women (290) who undertook surrogacy pregnancies had a high BMI as the study measured that 36% of surrogate mothers were obese.

“Before weighting, gestational carriers were more likely to be parous, reside in a lower-income area, and have higher rates of obesity and chronic hypertension.”

Dr Velez weighted the obesity in surrogate mothers against obesity in women who were became pregnant naturally, but did not explore why surrogate mothers are almost twice as likely to be obese, though she notes that surrogate mothers are more likely to have already given birth and live in poorer areas. The surrogate mother group also had high blood pressure which can be linked to several underlying health conditions and can be a sign of stress.

  1. Nearly 10% (8.9%) of “gestational carriers” were first time surrogate mothers. This is disturbing for two reasons. Firstly it means that of the 806 births for surrogacy, nearly 90% of women had done this before. This could be for a ‘sibling journey’ or for multiple different commissioning parents. These women were likely to be undertaking the increased risk of a surrogacy pregnancy when they have children at home to care for. Secondly, we do not know if the women who became surrogate mothers for the first time already had the experience of labour and childbirth so we cannot know if they gave informed consent. 
  1. In maternal morbidity, across the 3 groups, the study assessed the risks to be 2.3% for unassisted pregnancy, 4.3% for IVF pregnancy, and 7.8% for surrogacy. This means that surrogacy is nearly double the risk of Severe Maternal Morbidity (SMM) than that of IVF. 

A different study involving in-depth interviews of 96 surrogate mothers in the USA published in 2022 found complications or adverse effects including:

“high blood pressure during pregnancy, preeclampsia or eclampsia, gestational diabetes, hemorrhage, infection related to pregnancy, pre-term labor, hyperemesis gravidarum, anemia, ectopic pregnancy, placenta previa, placental abruption, ovarian cysts, miscarriage, postpartum depression, and high blood pressure in the postpartum period. Not all surrogate pregnancies resulted in complications or adverse effects. The most complications that one woman faced during her surrogate pregnancy, that she did not experience during her non-surrogate pregnancy or pregnancies, was seven.”

A meta analysis of similar studies over the last decade  (with smaller cohorts and different methodologies) shows that the medical risks in surrogacy pregnancies are 3 times the risk, so this supports the findings of the 2024 study.

2025 Study 

The latest study coming out of Canada looked specifically at maternal mental health. “New-Onset Mental Illness Among Gestational Carriers” published in the Journal of the American Medical Associated, an established and well regarded peer review journal, uses the same data from the 2024 cohort and Dr Velez concludes that “gestational carriers were more likely to be diagnosed with mental illness during and after pregnancy.” 

The number of pregnancies assessed initially drops from 863,017 in the 2024 study to 767,406 in the 2025 study. The additional omission is key. Women with a history of mental illness were omitted. Within these numbers, 758 eligible pregnancies were for surrogacy purposes. 178 women were surrogate mothers with a previous mental health condition and these women were initially excluded from the study but not from surrogacy. It’s important to understand that across Canada, a psychological screening of both the surrogate mother and the commissioning parents is required prior to conception. This is not a legal requirement but is considered mandatory according to the study.

(The UK model for so-called ‘altruistic’ surrogacy is broadly followed in Canada. Agencies here require a psychological assessment but suicidal thoughts or depression will not exclude women from undergoing a surrogacy pregnancy, or even several surrogacy pregnancies arranged through an established agency. ‘Independant Journeys’ – agreements made outside of the agency framework – are permitted.) 

The study suggests “that gestational carriers were more likely to be diagnosed with mental illness during and after pregnancy” as it measured that a “new-onset mental illness occurred in 236 ‘gestational carriers’.”

Remember the 2022 study of 96 surrogate mothers? This found that surrogate mothers were “significantly more likely to experience postpartum depression following the delivery of surrogate born children than their non-surrogate born children.” Given the omissions and that if you experience post natal depression you are likely to experience it again in any future pregnancies, we are glad that some further analysis was done. 

Dr Velez reintroduced the group of 178 surrogate mothers (19%) with a prior mental health condition..

“In the current study, 19.0% of gestational carriers had a documented diagnosis of mental illness before pregnancy. Among these, 10.7% had a prior history of mental illness diagnosed through an emergency department encounter or a hospitalization, which might have precluded them from being an eligible gestational carrier.”

But it didn’t preclude them. Importantly, a prior known mental health condition involving either an emergency assessment or a stay in hospital did not prevent 19 women proceeding under the psychological assessment and becoming pregnant for others. 

So if you didn’t have a mental health condition, a surrogacy pregnancy could mean you go on to develop one and if you did have a mental health issue before, you could still be cleared for surrogacy, despite the regulation in place which applies the ‘altruistic’ only model.  

The 2025 study appeared in The Guardian newspaper two days ago, quoting Dr Velez who said:

“Our findings underscore the importance of adequate screening and counselling of potential gestational carriers before pregnancy about the possibility of a new-onset mental illness, or exacerbation of a prior mental illness during or after pregnancy.”

But with medical risks measured at 3 times the risk and the increased likelihood of a new mental health issue occurring during or after a surrogacy pregnancy (43% compared to 29% in pregnancy not for surrogacy), is this not the time to consider the dangers for women and ban surrogacy, instead of calling for ‘adequate screening’? 

Surrogacy can never be ‘safe’ nor can it ever be ethical. It involves taking a newborn from their mother at birth. The study also found that:

“The findings of additional analysis suggest that some gestational carriers may experience grief from relinquishing the newborn, such as that described after adoption or removal of the child into foster care—something that needs detailed study.”

I welcome further research in surrogacy but don’t we already know enough to say, let’s just not do this anymore? We could just not put women through the physical and mental health risks to make other adults happy.