Functions and responsibilities of organizations dealing with surrogate motherhood in the UK

The separation of maternity from social motherhood and progress in reproductive technology raise many social, psychological, medical and legal issues (van den Akker, 1994). The most recent British Medical Association report (BMA, 1996) acknowledged the practice of surrogacy and issued new guidelines for good practice and support for those involved. Surrogate motherhood services have increased around the country over the last decade, even before the formal British Medical Association acknowledgement of their necessity and existence (BMA, 1996). The present survey investigated the incidence, accessibility, and functions of such organizations, specifically, the legal, medical and psychological problems encountered and how they were dealt with, to discover what advice and support is given. Ten centres were interviewed. The incidence of surrogacy conducted through these organizations is widespread, but the processes involved and therefore the implications of the types of surrogacy dealt with are very different. The two major surrogacy agencies deal primarily with partial surrogacy, whereas the clinics are concerned almost exclusively with full (IVF) surrogacy. Information about the procedures involved appears to rely on experience; screening is generally carried out 'in house', and psychological factors are dealt with by counsellors on request by the couples. In general, although the roles of the organizations are disparate and clearly defined, no holistic or long-term care is provided by any of the organizations involved with surrogacy in the UK. The reasons for this are clear cut and stem from the nature of the organizations, and the behaviour of the clients. The data indicate that the current procedures used by the organizations are adequate but could be improved and standardized.