Editor's Note: This story has been updated. 

Pope Francis’ recent call to ban surrogacy caught many by surprise, particularly due to its vehemence.

“I deem deplorable the practice of so-called surrogate motherhood,” the Pope said during a formal speech to foreign ambassadors Jan. 8, “which represents a grave violation of the dignity of the woman and the child, based on the exploitation … of the mother’s material needs.”

The Holy Father was expressing a long-standing Church teaching, and this wasn’t the first time he has drawn attention to the surrogacy issue, having mentioned it in a speech to fertility experts last year, saying that “it is wrong … to resort to the practice of surrogate parenthood.” 

But this time, his words generated more news coverage because he called on the international community “to prohibit this practice universally.”

Pope Francis’ condemnation stung supporters of surrogacy in the United States, while opponents were encouraged by it. What impact the Pope’s words will have, however, remains to be seen.

What Is Surrogacy?

Surrogacy is an agreement between adults whereas a woman (known as the surrogate) carries and gives birth to a child on behalf of a couple (known as the intended parents) or a single person. 

Infertility is the typical motivator. The World Health Organization estimates that about one in six people during their lifetime experience infertility, which the agency defines as “the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.”

Infertile couples who want a baby can adopt. But some don’t like adoption because of the cost, the difficulty, the time it takes, and the chance that it will fall through at the last minute. Many couples also prefer a child who is genetically related to one or both of the intended parents.

Like adoption, surrogacy isn’t cheap. It can cost the intended parents more than $100,000. But intended parents go through the process with a contract ensuring the baby will legally be theirs at birth. 

The arrangement requires in vitro fertilization, in which conception takes place in a Petri dish by using a man’s sperm to fertilize a woman’s egg. (In vitro is Latin for “in glass.”) The embryo (or what supporters of in vitro fertilization call a “pre-embryo”) is then transplanted into the surrogate’s uterus.

The original method for surrogacy was to use a man’s sperm to fertilize an egg of the carrier, who was not his wife or partner. That is now known as “traditional surrogacy.”

In April 1986, a woman in Michigan gave birth to a baby not genetically related to her — conceived in a Petri dish using the sperm of a man and the egg of his wife and then transplanted into the uterus of the surrogate, who was not genetically related to the child she carried and delivered. This method, now far more common, is called “gestational surrogacy.”

Commercial surrogacy is illegal in many countries in Europe and Asia. Some countries, including Spain, Portugal, Italy, Germany and France, also ban surrogacy even if no money changes hands.

Surrogacy is not federally regulated in the United States. Policies in individual states vary. In about 10 states, commercial surrogacy is explicitly legal and courts issue pre-birth orders enforcing both paid and unpaid surrogacy agreements, with few restrictions on who can become intended parents.

 Some states offer either less sweeping protection for surrogacy. Some have no laws governing it.

Much of the surrogacy attention is now on Michigan, which currently bans paid surrogacy and does not enforce unpaid surrogacy contracts. The Michigan Legislature is currently considering a nine-bill package that would legalize commercial surrogacy. The state’s House of Representatives passed the package, 56-53, on Nov. 9, 2023. The state Senate has not yet taken action on the bill.

What Does the Church Say?

The Catechism of the Catholic Church acknowledges that infertile couples “suffer greatly” and encourages fertility research, but condemns both in vitro fertilization and surrogacy.

Techniques used to conceive a baby outside the womb “dissociate the sexual act from the procreative act,” the Catechism states (2376), adding that “the act which brings the child into existence is no longer an act by which two persons give themselves to one another.”

Surrogacy is morally wrong, a 1987 document from the Congregation for the Doctrine of the Faith states, because it is “contrary to the unity of marriage and to the dignity of the procreation of the human person” and undermines the integrity of the family.

“Surrogate motherhood represents an objective failure to meet the obligations of maternal love, of conjugal fidelity, and of responsible motherhood; it offends the dignity and the right of the child to be conceived, carried in the womb, brought into the world and brought up by his own parents; it sets up, to the detriment of families, a division between the physical, psychological, and moral elements which constitute those families,” the document states.

The Church also objects to the practice in some surrogacies of fertilizing more eggs than needed in case of failure, with unwanted eggs being frozen or discarded. 

Since the Church teaches that a fertilized human egg is a human being, discarding embryos or pre-embryos amounts to what the document calls “a deliberate destruction of human beings” and creates “a dynamic of violence and domination.”

One recent example is celebrity Paris Hilton, 42, who last year had a baby boy via a surrogate and told a reporter that she has frozen 20 pre-embryos, all boys, because she and her husband were trying to have a girl.

‘A Modern Miracle’?

Supporters of surrogacy don’t agree with the Church’s pronouncements. Barbara Collura, president and chief executive officer of RESOLVE: The National Infertility Association, calls surrogacy “a modern miracle.”

“In the United States, surrogacy is a bond between hopeful parents who cannot have a child on their own and a person willing and able to help bring a baby into this world,” Collura told the Register by email through a spokesman. 

“It’s simple: Many women who have had successful pregnancies want to help those who cannot. Provided that clinical, legal and mental health guidelines are followed by all parties involved, as well as state laws if applicable, surrogacy can and must remain a viable family-building option.”

Years of fertility problems, including multiple miscarriages, drew Judith Hoechst of Colorado to in vitro fertilization around 2000. She delivered a healthy baby, but suffered serious health problems during the pregnancy and birth.

That led her and her husband to surrogacy for their second child, born in 2004 — and that experience led her to dedicate her current law practice to helping both intended parents and surrogate carriers. She has also helped draft legislation in Colorado to make surrogacy easier, and she would like to see the cost covered by health insurance.

Hoechst was raised Catholic and identifies as Catholic, though she stopped going to church in her early 20s because she feels disaffected by certain Church teachings and practices. She told the Register the Church is wrong about both in vitro fertilization and surrogacy.

“The fact that the Church is against IVF is out of touch with the world around us. It’s science. I believe after all the trouble I had conceiving and staying pregnant, God is present everywhere in our universe, that God has helped science to develop and technology to develop, and that I wouldn’t have either of my children but for science and for God being there,” Hoechst said.

She described carrying a baby as a surrogate as an act of love.

“There’s nothing more selfless and more loving than a woman who says, ‘Let me share my uterus with you. Let me do for you what you cannot do,’” Hoechst said.

The woman who carried and delivered Hoechst’s biological son, Chasity Beaver, currently an emergency room nurse and the wife of a now-retired U.S. Air Force officer, told the Register she was paid about $18,000 to carry and deliver the Hoechst’s baby and others. 

She said she did it to help infertile couples and that money was not a motivating factor for her. She said she disagrees with Pope Francis’ condemnation of the practice.

“I also really don’t see why he described it as ‘deplorable.’ Because I’ve had nothing but wonderful experiences with the surrogacies that I’ve done,” Beaver said. 

“I am still in touch with all three of the families I was a surrogate for. I think of them like my little nieces and nephews.”

A Violation of Dignity?

Opponents of surrogacy counter that many women who carry babies for others are in tough straits financially and submit to conditions that no one should live under.

Big Fertility, a 2018 documentary produced for The Center for Bioethics and Culture Network, describes the experiences of a hard-pressed woman in the Midwest, who acted as a surrogate three times, who calls herself “a broken woman who has been used, lied to and exploited.”

Jennifer Lahl, a surrogacy opponent who made Big Fertility, provided the Register with a redacted copy of what she said is a surrogacy contract in California. 

The contract prohibits the surrogate from dying her hair or undergoing “routine teeth cleaning” during the pregnancy without written permission from her attending physician. The contract also says the intended parents “will make all fetal reduction decisions” — meaning eliminating an unborn baby, which is sometimes done if the surrogate is carrying more babies than the intended parents want.

“I always tell people that if you read a surrogate contract, how can you say that this woman is not enslaved for nine months? How is that not a violation of her human rights? And it certainly robs the woman of her dignity,” Lahl said in an interview.

Even in more ideal circumstances, though, surrogacy opponents still find the practice morally unacceptable.

Katy Faust, an evangelical Protestant who heads Them Before Us, which opposes surrogacy, said surrogacy is one of several common modern practices that get the order of priorities wrong.

“Birth control, abortion, in vitro fertilization and surrogacy — they all stem from the same adult-centric mentality, which is ‘these kids exist for me; I don’t exist for these kids,’” Faust said.

Father Tadeusz Pacholczyk, senior ethicist at the National Catholic Bioethics Institute, told the Register that surrogacy “offers the veneer of a generous and selfless act” but “clearly involves using evil means to achieve good outcomes” and “tends to be motivated and fueled by the selfish slant of ‘entitlement thinking.’”

The problem comes, he said, when people think of having children as a right instead of as a gift.

“The powers of procreation are a very special gift, meant to be used in collaboration with God and our spouse in an absolutely exclusive manner. That we have the power to grab a hold of our sex cells and manipulate them to manufacture a new life is an example of misusing the powers God has given us,” Father Pacholczyk said by email. 

“A husband and wife ought to become pregnant, not through a fertility clinic employee mixing their sex cells and implanting embryos in exchange for valuable consideration, but only through the one-flesh, body-to-body spousal communion of their marital embrace.”

What Happens Now?

The Register asked advocates on both sides what effect they think Pope Francis’ call for banning surrogacy may have. 

Collura, a surrogacy supporter, said she is dismayed by the Pontiff’s comments but encouraged by backlash from it. 

“Harmful anti-family comments like these from such a well-known leader as the Pope will embolden people who are working to restrict or eliminate family-building options such as IVF or surrogacy. This gives oxygen to their efforts,” Collura said by email. 

“We are thankful for many in our community who have spoken out — affirming that the Pope’s opinions on this matter do not align with their own.”

Genevieve Marnon, legislative director of Right to Life of Michigan, told the Register that while she agrees with the Pope’s statements on surrogacy, she is worried that Michigan is about to become what she called “one of the most surrogacy-friendly jurisdictions in the world.”

“Sadly, while Pope Francis’ comments condemning surrogacy are rooted in protection of women and children, I’m afraid it will not be enough to stop this horrible practice,” Marnon said by email.

Even if that does turn out to be the case, Father Pacholczyk said Pope Francis’ words may help in the long run.

“I believe the Pope’s comments will have the beneficial effect of pulling surrogacy out of the shadows, where it has often been relegated, and shining some much-needed light on the children at the center of the process and their rights,” Father Pacholczyk said. 

“It’s very helpful that the Pope is refocusing our attention on the runaway train of IVF, surrogacy, and the problematic-but-widely-endorsed approach that strives to satisfy adult desires for children while largely ignoring the consequences to the kids.”