Even in the ancient Epic of Gilgamesh, the desire for immortality appears as a fundamental human impulse. Personal immortality, however, cannot be achieved. Humanity therefore fulfils the urge indirectly – by leaving behind offspring.
Desires and needs have always driven markets. Thanks to modern technologies, even infertile and homosexual couples can now realise their wish for a child. All it takes is money.
Demographics as a driving force of the market
The issue is not limited to same-sex couples, although public debate often focuses on them because they stand at the centre of the cultural and political discussion. A far broader – and commercially more significant – group is involved: infertile heterosexual couples, women postponing motherhood until later in life, financially secure singles and all those who increasingly see reproduction not as a gift but as a service that can be purchased, outsourced and technologically optimised.
In 2023, the World Health Organization (WHO) reported that infertility affects roughly 17.5 per cent of the adult population – around one in six people. At the same time, total fertility rates are declining worldwide. The average age of mothers is also rising and now stands at about 30.9 years.
Taken together, the figures show that assisted reproduction is not a marginal demand of a few vocal minorities but a growing market supported by powerful demographic trends: more infertility, later parenthood and a greater willingness to turn the desire for a child into a service for which people pay.
Surrogacy is the most controversial aspect of the entire field. At the same time it is usually the most expensive form of assisted reproduction. That fact alone opens the door wide to harsh market logic.
It therefore comes as no surprise that the clients of such services tend to come from wealthier social groups. Conversely, many women willing to carry a child for someone else live in poorer countries such as Ukraine, Cambodia, Mexico or India.
A mother’s love cannot be bought. In the case of surrogacy, however, the entire process from which it may grow is purchased. What is bought is not merely a medical procedure. What is bought is another woman’s time, body, risk, pain and emotional burden. Alongside that stands the assumption that the bond formed during pregnancy can be legally and financially transferred to someone else.
The market thus does not merely enter reproduction. It enters the very beginning of motherhood, which is why surrogacy has become a tough and expensive business.
The thin line between ethics and business
The French daily Le Figaro recently published a comprehensive article titled ‘My Life in Your Hands’. It presented the stories of women who decided to carry a child for someone else and offered a detailed analysis of surrogacy contracts around the world.
Once surrogacy is understood as a service, an immediate question arises: how much does it cost for a woman to give up a child who, while not entirely her own genetically, is nonetheless a being she carried in her body and nourished from within?
The answer depends largely on the country in which the process takes place. Broadly speaking, two main models exist worldwide: commercial surrogacy and so-called ethical surrogacy.
In commercial surrogacy the woman receives direct financial compensation. This approach is permitted, for example, in Russia, India, Ukraine, Cambodia, Mexico or certain states in the United States.
The level of compensation varies depending on the economic conditions of the respective country. In poorer countries it typically ranges from 1,000 to 6,000 dollars. In the United States a surrogate mother may receive between 30,000 and 40,000 dollars. Prospective parents must also cover additional costs such as medical care and legal fees, meaning the total expense may reach 80,000 to 200,000 euros.
So-called ethical surrogacy is intended to exclude profit as a motive. A woman who agrees to carry a child should do so purely for altruistic reasons. In theory this removes the main objection concerning commercialisation and transforms the process into a humanitarian act through which a woman helps a childless couple.
This model is permitted, for example, in the United Kingdom, Canada or Greece. In practice, however, surrogate mothers are entitled to compensation for expenses and lost income during pregnancy and after childbirth. As experts note, that effectively amounts to payment for bringing a child into the world.
Moreover, the ban on financial gain can often be circumvented. In Canada, for example, payments are sometimes channelled through hidden accounts held in the United States. Even here the boundary between a selfless gift and a hard-nosed business can be very thin.
A body bound by contract
What also emerges from the Le Figaro report is not merely a question of money but the extraordinary strictness of many contracts, which temporarily restrict basic personal freedoms.
A surrogate mother may lose the right to make decisions about her own body. She may not be able to choose independently whether to terminate a pregnancy and may even be contractually required to do so if the prospective parents request it, for example after the detection of a foetal abnormality.
Contracts may also impose strict sexual abstinence, allowing intercourse with a partner only after a doctor confirms that it will not endanger the foetus. Further restrictions can apply to diet and lifestyle. Alcohol and caffeine are banned, as are energy drinks, raw meat and even hair dye. Travel may also be restricted: women are sometimes not allowed to leave the city, board an aeroplane or, during the final months of pregnancy, they may be required to move to accommodation chosen by the agency.
Medical confidentiality and privacy may also be limited. Prospective parents often gain access to the surrogate mother’s medical records – a right not granted in the opposite direction – and may attend medical examinations and the birth itself. Random drug and alcohol tests are standard.
If a woman breaches the contract – for instance if she miscarries because of behaviour deemed negligent, refuses a requested abortion or attempts to keep the child – she may face severe financial penalties, including repayment of all costs and substantial damages.
Surrogacy is therefore, in essence, a tough business. Yet the service involved goes far beyond the boundaries of a typical employer–employee relationship. It can amount to the temporary surrender of control over one’s own body and life to strangers.
The ancient desire for immortality has thus become a business model in the modern world. Surrogacy shows particularly clearly what happens when market logic enters not only the sphere of services but the very beginning of human life: the child ceases to be a gift and motherhood becomes a contract.
Where body, time, pain and the surrender of a child are bought and sold, we are no longer dealing with progress but with a cold business.