The Hidden Challenges of Ethical Practice in Surrogacy Services

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Surrogacy is an intensely sensitive field, not only because of the emotional and medical complexities involved but also because of the controversies and ethical dilemmas that arise naturally within it. Even the mere existence of negative examples — poorly managed cases, unethical practices, or legal disputes — casts a long shadow, affecting public perception and the confidence of those seeking these services. Professionals in the field must navigate this landscape carefully, balancing compassion, rigor, and resilience, while supporting the autonomy and meaningful choices of intended parents and surrogates. For many individuals and couples, surrogacy is the ultimate option for building a family, making the stakes profoundly personal and deeply significant.

Having observed global surrogacy practices for many years, I have come to see that what happens behind the scenes is often far more complex and emotionally charged than most imagine. Surrogacy is not merely a medical process — it is an intricate human journey that demands empathy, professionalism, and emotional endurance from everyone involved. Those who work in this field carry the weight of deep responsibility — to intended parents, to surrogates, and to the very principles of ethical care. While we often hear the perspectives of intended parents and surrogates, the voices of the professional support teams who navigate these complex journeys remain largely unheard.

Professionals in surrogacy services often face challenges that go far beyond medical or administrative issues. Legal uncertainties, unpredictable emotional reactions of intended parents, and the sheer human pressure of the process can be overwhelming. In moments of unexpected legal changes or emotionally intense interactions, staff members absorb enormous stress — striving to protect both sides, while receiving little recognition for their role. At times, they endure undeserved criticism or hostility, even when the baby is safely in the parents’ arms and the outcome should be a moment of joy. These experiences test not only professional endurance but also emotional resilience.

Not every agency or actor in this complex system fulfils their obligations responsibly. When others fail to uphold agreements or compromise ethical standards, dedicated professionals quietly step in — sometimes not only supporting psychologically but covering costs themselves — to ensure safety, fairness, and continuity of care. They do this not for praise, but from a genuine sense of duty and compassion toward intended parents and surrogates alike.

Ethical surrogacy work is not defined by kindness alone. It requires foresight, clear structure, and an unwavering commitment to accountability. True professionalism lies in anticipating problems, communicating transparently, and maintaining integrity even when external circumstances become chaotic. Every message, every meeting — whether with intended parents, surrogates, lawyers, or clinics — demands balance, honesty, and sensitivity.

Intended parents also play a vital role. Trust grows from mutual understanding, respect for process, and emotional patience. When both professionals and intended parents act as partners — aware of each other’s challenges and limitations — the journey becomes not only smoother but more meaningful.

Ultimately, ethical surrogacy is about more than successful outcomes — it is about humanity, dignity, and emotional strength. Behind every calm delivery, every well-coordinated transition, professionals are carrying invisible burdens, managing chaos quietly so others can experience joy and peace. Recognizing this unseen emotional labour allows us to honour those who uphold trust and compassion in one of the most sensitive areas of modern reproductive care, while also respecting the autonomy and meaningful choices of those who rely on these services as their path to parenthood.

 

Medea Khmelidze

Master of Social Work, Expert of Sexual and Reproductive Health and Rights

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