Annabel Maltman explores the ethics of surrogacy and the tension between commodity and choice.

Surrogacy can be a valuable service when provided for aspiring parents who are medically or physically unable to conceive, but tensions emerge when this market expands to include commercial preference. Nowhere is this more contested than in celebrity surrogacy. When high-profile figures cite ‘busy schedules’ as an incentive, the conversation moves away from necessity and towards personal convenience.  

From a critical or radical standpoint, this risks the commodification of female anatomy and dangers of exploitation in wage-coerced labour. On the other hand, arguments rooted in liberal, choice feminism, may defend this form of labour through the primacy of autonomy.  

At its best, surrogacy provides a viable option for intended parents to build a family, whether that is motivated by infertility, non-traditional family structures, medical conditions, or most disputed, social reasons. However, with its rise in popularity, at its worst health tourism – the act of travelling for medical treatments – has accelerated the practice into the global economy. In 2024 alone the global surrogacy market was estimated at $22.4bn (£16.58bn), with projections of it reaching a staggering $201.8bn (£149.39bn) by 2034.  

Any discussion of surrogacy remuneration must first address the unique nature of this work. 

After all, the task of carrying a baby for approximately nine months redefines the ‘full’ in full-time work. Dr Herjeet Marway identifies an added departure from traditional bodily work, being that the result of this labour is a living human child. The combination of the nature and ‘product’ of this labour conceives the risk of commodification in this context.  

In extension of what makes this work unique, some philosophers contend that the surrogates – who are usually women – are ‘intimately connected to their reproductive capacities’ in a way that is distinct from other purchased bodily services. The latter of this argument verges on gender essentialism; however, there remains fertile ground to observe surrogacy’s intrinsic and inequivalent links to female anatomy. In theory, removing payment avoids reducing both reproduction and children to market goods.  

The commodification of surrogacy also opens the practice up to emotional risks and financial exploitation, particularly in reference to lower-income women working for affluent individuals. The power imbalance between low-income surrogates and high-profile figures all but eliminates the bargaining power of the workers. With global expansion, enough wealth can grant you the ability to browse the world for ‘the finest sperm, eggs and wombs money can buy.’ 

Choice feminism offers a simple defence: to engage in this work is the woman’s decision. However, autonomy is compromised under the position of financial desperation; the concept of ‘wage-coerced’ labour challenges whether this is an autonomous decision made by a free agent. Considering wealth disparity and the health risks involved, it would be a crude reductionism to claim that choosing this work is fully absent from external pressures.  

Conversely, the critical feminist moral focus on commodification, while convincing, risks paternalistic determinations on commercial surrogacy. To call this work ‘wage-coerced’ is to indict the system that produces coercion, not the women who need this work to survive. 

If we set aside theoretical standpoints and instead look at lived experience, choice feminism oversimplifies context, whilst critical views, though valid in the broader conversation, threaten prioritising moral positioning over material harm reduction.  

For critics of commercial surrogacy, the altruistic model  – restricted to expense-only agreements – seems to promise a solution. To locate the issue within UK law, commercial surrogacy is prohibited and altruistic is the only option, with surrogacy agreements not enforceable in law. Whilst alleviating issues of commodification and exploitation, altruistic surrogacy nonetheless bears emotional risk. In a BBC article titled ‘The Joy and the Trauma of Carrying a Celebrity’s Baby’, experienced surrogate Shanna opens up about the negative emotional impact of the practice. Though previously having enjoyable experiences with surrogacy, Shanna dealt with a particularly cruel celebrity who blamed her for complications with the pregnancy. The celebrity continued to make scathing comments about surrogates on TV following Shanna’s final miscarriage. 

The issues of altruistic and commercial surrogacy culminate in the global nature of this market and trans-jurisdictional differences. Even with altruistic surrogacy being the practice in the UK – and many other countries – wealthy individuals possess the means to circumvent domestic laws and outsource these services to countries with lax regulations. The highly reported exploitation suffered by these hired women has led countries like India, in 2018, to ban commercial surrogacy by non-residents, with issues spanning from nonconsensual medical procedures to incomprehensible contracts.  

However, this ‘offshoring’ by wealthy members of the Global North reflects colonial and racial lines, pointing the issue to global capitalism. It is crucial to note that in any case of removing work borne from financial necessity, this is removing one more survival strategy for poor women. Sophie Lewis observes that the focus on surrogacy commodifying a woman’s body overlooks the broader underlying issues of economic pressures that will operate through capitalism regardless of whether commercial surrogacy is banned or not.  

Whilst the altruistic approach theoretically can incorporate the autonomy of choice feminism and guard against critical concerns of exploitation, the global market provides the top percent with the means to evade this. There are many valid ethical complexities of surrogacy, but Western feminist concerns on commercialisation risk overlooking the historical and structural conditions that invite the practice in the first place. The primary concern is a lack of protection for surrogates’ health, conditions, and rights, be it domestic or international.  

After addressing both sides of this theoretical tension, a harm reduction standpoint seems to be the most beneficial regarding women’s welfare, prioritising safe regulation over an outright ban. Commodification concerns are not invalid, but if the goal is advocacy for lower-income women, you cannot support the worker without also supporting the work.