Surrogacy in Ukraine is big but little-regulated industry

In Ukraine, thousands of babies are born to surrogate mothers every year.

Couples — both Ukrainian and foreign — use the services of dozens of surrogacy clinics and agencies in the country. And Ukraine is increasingly a world leader in the practice.

But for such a big market with numerous players, the surrogacy industry is highly controversial. With little legal regulation, surrogacy in Ukraine is something akin to the Wild West. 

For thousands of couples struggling to conceive, it is the opportunity to finally start a family. But the industry’s lack of oversight in Ukraine sometimes leads to abuse of all parties involved: the couples desperately trying to have a child, the children born through surrogacy and the women who become surrogate mothers as a way out of poverty.

While commercial surrogacy has been legal in Ukraine for over 16 years, regular scandals fuel an ongoing debate about the ethics of the practice.

That’s exactly what happened earlier this month. After the Ukrainian government closed its borders to prevent the spread of COVID-19, dozens of foreign couples found themselves unable to travel to Ukraine and retrieve their babies born to surrogate mothers. 

In one of the biggest clinics, BioTexCom, there are now 36 newborns separated from their parents and being cared for by staff and nurses. Their story has received broad media coverage and once again brought the controversy over surrogacy in Ukraine to the forefront of public attention.

Legalization

Infertility is a global public health issue. According to the World Health Organization, over 10% of women who have remained in a stable relationship for five years or more have tried unsuccessfully to conceive a baby. The estimates of infertility in men are unknown, the organization says.

Surrogacy was developed as an assisted reproductive technology in the United States during the 1980s. Couples who couldn’t have babies, but wanted genetically-related kids saw it as a solution to their problems.

Ukraine legalized the service in 2002 when the country adopted the Family Code, which established that the legal parents of a surrogate-born baby are its genetic ones. Two years later, the code came into force and so did the legalization of surrogacy.

Sergii Antonov, a lawyer and the head of Ukraine’s Medical and Reproductive Law Center, says that the first reproductive clinics that provided surrogacy services popped up in Ukraine in 2006-2007. 

With little regulation, the field’s players had to develop standards and draw up legal agreements between surrogate mothers and parents by looking at the experiences of other countries, mainly the U.S.

“The market was not organized,” Antonov told the Kyiv Post.

Since then, Ukraine’s Ministry of Health has issued medical guidelines for reproductive services.

Then surrogacy grew bigger. Antonov says that, domestically, it has been especially popular among Ukrainian officials and celebrities.

But for foreign clients, it only boomed a couple of years ago, after India, Thailand, Nepal and Mexico restricted or banned commercial surrogacy. With their major reproductive markets now shuttered, couples from around the world flooded Ukraine. 

Other countries where commercial surrogacy is legalized — Georgia, Russia, Belarus and Kazakhstan — experienced similar spikes, Antonov says.

Wild business

Today there are about 10 Ukrainian clinics that offer complete surrogate programs with legal support, recruiting a surrogate mother, all the medical procedures, medical care during pregnancy and labor services.

Dozens more provide reproductive procedures including surrogacy. And it’s difficult — if not impossible — to count all the agencies and agents offering assistance packages, taking care of organizational matters and serving as a link between the couple, the surrogate mother and the clinic. Countless English-language agency websites pop up during a casual online search for surrogacy in Ukraine. 

According to Antonov, about 3,000 foreign and 1,000 local couples use surrogacy programs in Ukraine every year.

Most of the couples come from the U.S., U.K., Spain and China. Some travel to Ukraine from as far as Australia and Argentina. 

Antonov says that the average foreign couple seeking surrogacy in Ukraine is older than 40. Many have tried various treatments for infertility over the years, but haven’t been successful. Others are unable to conceive for different medical reasons.

The lawyer says that surrogacy is a difficult decision for the intended parents to make, as they often feel flawed because of their inability to have children and the whole process poses many risks.

“It’s a psychological tragedy,” he says.

In a video published by one of the agencies based in Odesa, the Black Sea port city located 500 kilometers to the south of Kyiv, Sharon and Josh Gross, an Australian couple, say that they tried surrogacy in their home country for about a year unsuccessfully. In Australia, surrogacy can only be done voluntarily, meaning no monetary compensation is allowed. 

“Josh and I began to really get frustrated,” Sharon says in the video.

The couple had a baby boy born to a surrogate mother in Ukraine.

“We are very, very lucky,” Sharon says, as she rocks the infant.

According to Antonov, couples that choose Ukraine for surrogacy have an average income. They can afford a $40,000-50,000 program here, but paying at least twice as much in the U.S., for instance, is not an option.

Apart from that, Ukraine attracts couples because of its minimal visa requirements; close location to both the European Union and Asia, from which many couples come; wide choice of specialized clinics and agencies; and the anonymity of donors and surrogate mothers, meaning there’s no data and it will be impossible to track down this information.

Antonov says that many clinics, especially those that carry out the whole process from start to finish, have turned surrogacy into a very profitable business. Some of the biggest ones make up to $100 million a year. 

“It’s a wild market,” he says.

Antonov says there’s a huge “supply” of surrogate mothers in Ukraine. There are group chats in all kinds of messenger apps and on social media platforms where agencies and future surrogate mothers connect. Messages about seeking surrogate mothers pop up there almost on a daily basis.

The dire financial realities of life in Ukraine often drive local women to become surrogate mothers. Normally, they receive $15,000-20,000 in compensation after the birth and a monthly stipend during the pregnancy.

Hanna Kotyk, 29, is one of them. The mother of four used to work in a pet shop, where she earned just Hr 10,000 ($375) a month. Her husband, who works as a forester, makes even less, Hr 8,000 ($300) per month.

Kotyk previously donated eggs to receive extra income, but it didn’t make much of an impact on her family’s budget. To earn money to renovate her family’s house on the outskirts of Kyiv, Kotyk decided to become a surrogate mother for a Ukrainian family.

During the pregnancy, she made $400 a month and was paid $15,000 after she gave birth to a baby boy around a month ago. Now she is considering going for it again.

“It’s a significant sum,” Kotyk told the Kyiv Post. “No job will give you a salary for nine months and then such compensation in addition.”

Regulation

Surrogacy is guided by several orders and codes in Ukraine, but there is no specialized law. Technically, the field is regulated, but “it’s not enough,” says lawyer Olena Babych.

She says that the country needs to adopt a law that would define all the participants in the services and formulate their rights and obligations. According to Babych, because there is no mandatory template for an agreement between the participants and no law, all kinds of abuse can occur.

The lawyer also says that Ukraine needs to set criminal and administrative penalties for violations of such a law to hold industry players accountable.

Another legal contradiction that needs to be fixed is childbirth registration, Babych says. 

Although the Family Code states that genetic parents are the legal parents of a surrogate-born baby, a surrogate mother receives a birth document at the maternity hospital and has to give legal permission to the couple to receive a birth certificate and register themselves as a baby’s parents. That creates a risk for the biological parents to become the victims of extortion.

Abuse

Perhaps unsurprisingly, the history of surrogacy in Ukraine is pockmarked with scandal.

Around 20 court cases have dealt with the practice in Ukraine, Antonov says.

One of the loudest scandals occurred last year, when a Chinese couple discovered there was no genetic connection between them and a surrogate-born baby girl they were told was theirs. Because the DNA showed no relation, the couple couldn’t bring the baby to China, as it is against their law. 

Antonov says that, last year alone, there were at least nine such cases, but the actual number must be significantly larger, as most of the couples who discover that they are not genetic parents to surrogate babies don’t make it public. After years of trying to have a child, many decide to raise the baby as their own anyway, the lawyer says.

But it’s not only the intended parents who fall victim to the lack of regulations.

Some couples abandon their surrogate-born babies if they have disabilities or are born prematurely. 

Not only are these children left without parental love and raised in care facilities, but they also may face legal issues with citizenship.

“That puts the burden both on the children and the state,” says Maryna Lehenka, director of the legal department at the La Strada nonprofit.

One such child is four-year-old Bridget, who now lives in a childcare facility in Zaporizhia, an industrial city of 738,000 people located some 550 kilometers to the southeast of Kyiv.

Born prematurely with little chance to survive, Bridget was abandoned by her American parents. Although the girl has some developmental delays, she is doing much better than doctors predicted. But that didn’t change her parents’ mind.

If nobody adopts Bridget by the time she turns seven, she will be transferred to an orphanage where she is unlikely to receive the specialized care and attention she needs. 

There is also a long history of abuse of surrogate mothers. Some receive low-quality medical care and have health issues because of the hormonal drugs they take. Others are forced to live in poor conditions in apartments rented by agencies and clinics during the last months of their pregnancies. They are often isolated from their families and stay alone or share a space with strangers – other surrogate mothers.

These women often experience tremendous stress but rarely receive psychological support, Lehenka says. Around 100 women call La Strada’s hotlines every year regarding surrogacy issues.

Some of them are considering becoming surrogate mothers and seeking psychological or legal assistance. Others are dealing with trauma after giving birth and missing the baby.

Most of them, however, are pregnant surrogate mothers who are struggling with psychological issues, like the fear they won’t be able to give away the baby or anxiety about revealing that they are surrogate mothers to relatives and friends.

One such hotline caller said she wanted to abandon her family, move to a village and hide the baby she was carrying from its genetic parents.

“These women are not supported properly,” Lehenka says.

She believes that Ukraine needs to either ban surrogacy services outright or strictly regulate them to prevent exploitation. 

Whatever path the country chooses, Lehenka says the situation can’t remain the way it is now.