Earlier this week, Pope Francis called for a worldwide ban on surrogacy, claiming that the practice, which helps individuals and couples have children, exploits the women who carry them.
"I deem deplorable the practice of so-called surrogate motherhood, which represents a grave violation of the dignity of the woman and the child, based on the exploitation of situations of the mother's material needs," the pontiff said in a speech to diplomats on Monday.
Surrogacy turns a child into "an object of trafficking," Francis added, saying a "child is always a gift and never the basis of a commercial contract."
That characterization couldn't be further from the truth for Sunshine Hanson, a three-time gestational surrogate and founder of the surrogacy agency Surrogacy Is.
"It's so disrespectful to the women who are doing this," Hanson said in an interview.
"I just think that it's so brave for a parent to trust somebody else to carry their baby," she said. "It's a really special and unique relationship that I don't think anybody who hasn't been through it can really fathom."
Gestational surrogacy, the most common form of modern surrogacy, occurs when a person carries another couple's embryo and gives birth to a child on their behalf.
The practice is legal in the U.S., but it's not regulated by the federal government. As a result, it's up to states to pass their own laws governing surrogacy.
Only some U.S. states expressly allow surrogacy, and not all of them allow surrogates to be compensated, a practice commonly known as commercial surrogacy. When a person is unpaid, it's typically referred to as altruistic surrogacy.
One study estimated that 18,400 infants were born via surrogacy in the U.S. between 1999 and 2013.
Outside of the U.S., some governments have taken a harder line. While unpaid surrogacy is legal in Canada, for example, countries such as Italy and Spain ban the practice altogether.
Critics have long said that surrogacy exploits people who become carriers for the financial benefit. A United Nations Special Rapporteur said in a 2018 report that "[c]ommercial surrogacy, as currently practised in some countries, usually amounts to the sale of children" and called for it to be regulated worldwide.
But Hanson says surrogates deserve to be paid for their efforts and that the compensation isn't supposed to be their main source of income. "It's intended to compensate you for the time and the effort and the sacrifice and the struggle of being pregnant and giving birth and going through postpartum recovery," she said.
Surrogates can earn roughly $40,000 and sometimes tens of thousands more, and all medical costs are typically paid for by the intended parent or parents.
Many surrogates in the U.S. also undergo rigorous screening processes and have added protections to reduce the likelihood they'll be exploited, Hanson said.
The American Society for Reproductive Medicine says in its recommended guidelines for surrogacy that potential carriers should have a "stable family environment with adequate support" and shouldn't show any evidence of "financial or emotional coercion."
For Hanson, her decision to become a surrogate for the first time stemmed from her desire to help a gay couple start a family. She carried twins for the two men and said it was "miraculous and empowering feeling" giving birth to their children.
"When they were born, I will never forget just the joy of seeing them become fathers," she said.
Hanson said after the delivery, she FaceTimed with the men's mothers, both of whom were sobbing. "They were so happy because their sons, who were gay and maybe they thought would never bring them grandchildren, were now dads."
Surrogacy has become more mainstream in recent years as celebrities have shared their stories of surrogate births. Model Chrissy Teigen and her musician husband John Legend welcomed a baby from a surrogate in June, and CNN anchor Anderson Cooper has had two sons via surrogacy.
Some states are also changing their laws around the practice. New York legalized gestational surrogacy and instituted new protections for surrogates in 2021. Lawmakers in Idaho, where surrogacy is common, are considering codifying certain best practices into law.
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