Surrogate pregnancy: ethical and medico-legal issues in modern obstetrics


  • Celia Burrell MPhil, MRCOG, MRCP, Post Grad Diploma in Medical Law,

    Consultant Obstetrician and Obstetric Lead for Risk Management, Corresponding author
    • Barking, Havering and Redbridge University Hospital NHS Trust, Queen's Hospital, Department of Obstetrics & Gynaecology, Romford, Essex, UK
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  • Hannah O'Connor MBBS, MA

    Foundation Year 1 Doctor
    1. The Shrewsbury and Telford Hospital NHS Trust, Mytton Oak Road, Shrewsbury, UK
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Correspondence: Celia Burrell. Email:


Key content

  • This comprehensive literature review of the medico-legal challenges of surrogacy in modern obstetrics, highlights recent changes in UK law, the limited guidelines and legislation available, and the legal requirements for parenthood and parental rights.
  • UK legislation involving surrogacy and the medico-legal definition of parenthood is reviewed.
  • There is new UK surrogacy legislation affecting the parental order qualification, indicating that obstetricians will see more surrogate cases in the immediate future.
  • Conflicts can arise when surrogacy agreements are broken, since they are lawful but legally unenforceable in the UK.
  • There are ethical and legal dilemmas for healthcare professionals in managing surrogate pregnancies in the absence of professional guidance, and as a result the authors of this review introduced a practical guide and pro forma.

Learning objectives

  • To explain current legislation surrounding surrogacy in the UK.
  • To discuss ethical and moral concerns regarding the practice of surrogacy.
  • To apply medico-legal principles in the management of surrogate pregnancy.

Ethical issues

  • The exploitation versus empowerment and autonomy of women participating in surrogacy.
  • The commodification of reproduction through surrogacy.
  • The validity of consent with the possible presence of emotional or financial coercion, and the unpredictability of outcomes in surrogacy arrangements.