Mother to order

According to statistics, over a million couples in Ukraine cannot have children. Unofficial data, considered by doctors to be more realistic, are even sadder: one in five married couples in our country is infertile. This is mainly caused by poor environmental conditions, congenital diseases, and an unhealthy lifestyle. But a doctor’s diagnosis does not mean that a child’s merry laugh will never be heard in a couple’s home. Today, modern fertility methods can help solve most complicated problems linked to childbirth and achieve results that only a few decades ago were considered nothing short of a miracle. Surrogate maternity is one of them.

“I HAVE STILL DONE A GOOD THING”

Natalka decided to become a surrogate mother after reading an ad placed by a wealthy married couple in a Kyiv newspaper. She thought, “I am young and healthy. Why not try? I could earn plenty of money to buy an apartment. But what will my husband say?”

At first her husband Stepan took his wife’s talks about giving birth to “someone else’s” child in a very negative way. “Did you cheat on me?” he asked all the time. Then he got used to the idea: “We have children, and this child will have different blood. We can buy a house with the money.” So Natalka went to the clinic where she was given a thorough health checkup and met the genetic parents.

“That’s how I became a surrogate mother. I am living in a house in the country, which belongs to a very wealthy childless family. They treat me well and the food is good here: fruit and vegetables every day. Every week I have a checkup. The doctor says that the fetus is growing well. Yes, fetus. I cannot think of it as my child. My children are at home: I have to earn money so that they don’t grow up in a communal apartment,” Natalka wrote later in her diary, which she started to keep at the very beginning of her pregnancy.

“The baby boy was born during the night. He was immediately taken away and my heart started to ache. But the next day when I saw his beaming parents, who brought me a huge bouquet of flowers, I thought: ‘I’ve done a good thing. And I am sure that you, baby, will be happy!’ A few days later I returned to my children, who had missed their mother very much. We are moving to a new apartment soon.” The woman’s diary, which was given to The Day, ends abruptly at this point.

TEST-TUBE CONCEPTION

The head of Ukraine’s Institute of Reproductive Medicine is Prof. Fedir Dakhno. A Merited Worker of Science and Technology of Ukraine, he is also known as the father of the first Ukrainian test-tube baby conceived in the Kharkiv Medical Laboratory in 1991. He says that surrogate maternity is a great scientific achievement, because it enables new life when nature is powerless (for example, when a woman’s uterus has been removed).

The essence of this method is that egg cells are fertilized in a test tube and implanted into another woman’s womb. Every Ukrainian clinic with a license for treating sterility with additional reproductive methods has the right to conduct in-vitro fertilization. Women who have no uterus either from birth or following surgery, or who have pathological changes in their reproductive organs that have rendered them sterile can use the services of a surrogate mother. Surrogate maternity is also offered to families that have had no results with the latest methods of treating sterility.

According to Dr. Dakhno, six or seven children at his institute are born every year with the help of a surrogate mother. Considering that Ukraine has 20 fertility centers, the number of married couples using this method is low.

“The first surrogate mother appeared in my practice in the early 1980s, and we succeed in inseminating a female cell in vitro in 1984. We grew embryos and transferred them into wombs, but it was only on March 1, 1991, that the first test-tube baby was born. There is nothing illegal about these methods. Ukraine’s Criminal Code provides for responsibility of doctors who refuse to provide medical assistance. The main thing is to take all the parties’ interests into consideration. In Ukraine, a child born by a surrogate mother belongs to the client-parents according to the law,” Dakhno explains.

Experts say that most surrogate mothers are mainly guided by financial considerations. Only relatives or friends of the biological parents take this step for altruistic reasons.

“We had a case where a woman could not have a child because of a serious disease, and her twin sister bore a child for her. There was so much happiness in that family,” Dr. Dakhno recalls.

If a family does not know anyone who could become a surrogate mother, the clinic will help find one: practically every specialized medical institution in Ukraine has its own confidential list of potential surrogate mothers, but there is no nationwide database.

A FEW WORDS ABOUT NUANCES

Few women are willing to earn money this way, experts say. There are stringent requirements: surrogate mothers must be younger than 35, be healthy mentally and physically, have no bad habits, and they must have at least one child, so that they can shift their maternal feelings to their own children. Mostly wealthy people can afford the services of surrogate mothers: expenses for the surrogate-mother program total nearly 5,000 dollars, and the months that a surrogate mother devotes to the biological family should be compensated. The financial reward is discussed in advance and the agreement must be notarized. The services of a surrogate mother usually cost between 20,000 and 30,000 dollars.

The psychological nuances, which as a rule are not advertised by the participants of “surrogate programs,” are unknown. As Dr. Dakhno has noted, each of the parties to the agreement considers all the advantages and disadvantages of the program in advance. A surrogate mother is usually calm about the situation and gets ready for the birth. But doctors recommend obtaining her husband’s written consent to his wife working as an “incubator,” although Ukrainian legislation does not provide for this.

If doctors are satisfied with the surrogate mother’s physical state and her personal qualities meet the requirements of the biological parents, both sides sign an agreement. Any points can be included in it, but doctors advise mentioning the medical institution where the conception and labor will take place, the woman’s responsibility to comply with the doctors’ advice, her place of residence during the pregnancy, the consequences of giving birth to a physically or mentally challenged child, and financial expenses.

Ukraine’s chief fertility specialist says that citizens of countries where surrogate maternity is banned by the law, France and Germany, for example, have a particular interest in the work of Ukrainian fertility experts. Similar reproductive programs in Canada and Israel exclude the commercial component.

“REPRODUCTIVE TOURISM”

“In recent years the world has seen the emergence of so-called reproductive tourism. Our institute’s clinic has a worldwide reputation, so people from different countries come for treatment here. But this is done after a two- or three-month- long correspondence in order to clarify all the necessary information. We have to refuse patients from Germany because according to German legislation, children born to surrogate mothers are not recognized as German citizens.”

Stable demand among foreigners for Ukrainian surrogate mothers is explained by nuances of the judiciary process, which guarantee the rights of the potential parents to the child. For example, in Russia a mother who has given birth to a child for an infertile couple can change her mind and keep the baby, and in the West she can receive alimony after proving maternity. According to Ukrainian laws, a child conceived and implanted into another woman’s body belongs exclusively to the biological parents. Therefore, the courts will not even consider any action launched by a surrogate mother. Fortunately, no cases like this have ever occurred in Ukraine.

COMMENTARY

Serhii ZILOV, lawyer:

“Surrogate maternity in Ukraine is allowed by the current legislation. The main document governing the relationship between the program’s participants is the agreement that they draft and sign. This document must be notarized, because this will be able to prove the parties’ voluntary actions in case anybody has a complaint against the agreement. Every detail should be mentioned in the agreement: starting with remuneration, living conditions, and the surrogate mother’s daily regime, and ending with force-majeure circumstances (for example, if the woman will be unable to have children after a botched labor). Non-observance of any of the document’s points can become grounds for appealing to a court. If an agreement is signed with foreign citizens, there should be two copies of the document, in Ukrainian and the corresponding foreign language, and a notary must be present for the signing of the document. However, I cannot remember any case in which someone appealed to the courts in connection with surrogate maternity.”