Surrogate mothers are likelier to experience pregnancy complications
Surrogate mothers may face a higher risk of health complications than women who carry their own children, a new study has found.
About 8% of surrogates develop conditions like severe postpartum haemorrhaging (blood loss) and serious pre-eclampsia (high blood pressure during pregnancy and after labour). Babies were also more likely to be born prematurely to surrogates, although they weren't more predisposed to newborn problems.
Researchers from McGill University in Canada explored complications among 863,017 births in Ontario between 2012 - 2021. Of these births, 806 (0.1%) were born to surrogates, 846,124 (nearly 98%) were a result of unassisted conception and 16,086 (1.8%) used IVF. It is one of the first studies to compare outcomes between three different types of pregnancy.
According to the results, the rate of serious maternal health complications was 7.8% for surrogates, 2.3% among the unassisted conception group and 4.3% for pregnancies involving IVF.
Why were surrogates more likely to experience health problems?
They were more inclined to feature certain characteristics, like having given birth previously, being obese, having high blood pressure, and living in a lower-income area. However, these factors do not appear to explain the results completely.
After taking into account certain factors like age, income and smoking habits, the risk of heavy postpartum bleeding was 2.9 times higher for surrogates than women who had natural births, and the likelihood of preterm birth - before 37 weeks - was 1.79 times higher. The risks were greater, too, for surrogates than for women who had used IVF, though to a lower degree.
Dr Maria Velez, the study's lead author, said, 'It might be that there are other mechanisms, including an immunological mechanism, that could be involved in this higher risk [for gestational carriers].
'There are guidelines about the eligibility criteria to minimise the risk of pregnancy complications among gestational carriers,' Velez continued. 'However, these guidelines are not always strictly followed.'
Jackie Leach Scully, a professor of bioethics at the University of New South Wales, who was not involved in the study, said that the research had limitations like small sample size of surrogates, who may have had healthy pregnancies before with no issues.
However, she commented that the paper still raised valid issues, such as the principle of using surrogate mothers who weren't always in optimal health. 'This raises ethical questions about the potential exploitation of women who act as gestational carriers and who bear the risks of pregnancy on behalf of someone else,' she said to The Guardian.
'Second, the scarcity of accurate data on the risks and outcomes of surrogate pregnancies must really make us ask how seriously the health of women, as opposed to the health of the foetus or baby, is taken.'
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