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Surrogacy policy is a highly complex global policy that has important ramifications, yet it is unclear how a country’s socio-economic status can influence its surrogacy policy. This study quantitatively assessed the influence of economic development on surrogacy policy in 84 countries. Using an internet analytic search and comprehensive literature review, countries were identified for study. Each country’s surrogacy policy and economic development were characterized and an analysis of the relationship between economic development and surrogacy policy was conducted. The analysis demonstrated that economic development acts as a negative predictor for more liberal surrogacy policy, despite its positive impact on other social policies such as abortion and same-sex marriage. This disparity highlights the need for governments to more holistically examine their existing surrogacy policies and ensure greater internal alignment with their other social policies.

Surrogacy, public policy, economic development, assisted reproduction

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How to Cite
LIU, J., & BICE, S. (2021). SURROGACY, SOCIAL POLICY AND ECONOMIC DEVELOPMENT. Asian Journal of Advances in Medical Science, 3(3), 1-21. Retrieved from
Original Research Article


Brezina PR, Zhao Y. The ethical, legal, and social issues impacted by modern assisted reproductive technologies, Obstetrics and Gynecology International. 2012;1-7.

Cui L, Lei L, Adashi EY, Chen ZJ. Surrogacy: A family-building option in search of legitimacy, BJOG. 2016;65-69.

Soderstrom-Anttila V, Wennerholm UB, Loft A, Pinborg A, Aittomaki K, Romundstad LB, et al. Surrogacy: Outcomes for surrogate mothers, children and the resulting families—a systematic review, Human Reproduction Update. 2015;260-276.

Simopoulou M, Sfakianoudis K, Tsioulou P, Rapani A, Anifandis G, Pantou A, et al., Risks in Surrogacy Considering the Embryo: From the, Bio Med Research International. 2018;1-9.

Fitzpatrick K, Tuffnell D, Kurinczuk J, Knight M. Pregnancy at very advanced maternal age: A UK population-based cohort study, BJOG an International Journal of Obstetrics and Gynaecology. 2016;1097–1106.

Jacobsson B, Ladfors L, Milsom I. Advanced maternal age and adverse perinatal outcome. The American College of Obstetricians and Gynecologists. 2004;727-733.

Hank K, Wetzel M. Same-sex relationship experiences and expectations regarding partnership and parenthood, Demographic Research. 2018;701-718.

Costa PA, Bidell M. Modern families: Parenting desire, intention, and experience among portuguese lesbian, gay, and bisexual individuals, Journal of Family Issues. 2017;500-521.

Herron J. The Costs of Adoption vs. Surrogacy; 2013. [Online].

Wilson A. How Asia’s Surrogate Mothers became a Cross-Border Business; 2017. [Online].

Parisi I. Surrogacy world’s perspective – a review, Acta Medica Internationa. 2015;138-143.

Gleicher N, Kushnir V, Barad D. Worldwide decline of IVF birth rates and its probable causes, Human Reproduction Open. 2019;1-7.

Johnson L. Commercial surrogacy is the sale of children?: An argument that commercial surrogacy does not violate international treaties, Washington International Law Journal. 2019;3.

Jackson E. UK law and international commercial surrogacy: 'the very antithesis of sensible', Journal of Medical Law and Ethics. 2016;197-214.

Thompson K. Whoa, Baby! Why American Surrogates are in Demand for Chinese Families; 2016. [Online].
Available: 1/13

Ombelet W. Global access to infertility care in developing countries: A case of human rights, Equity and Social Justice, F,V & V in Obgyn. 2011;257-266.

Arvidson A, Johnsdotter S, Emmelin M, Essen B. Being questioned as parents: An interview study with Swedish commissioning parents using transnational surrogacy, Reproductive Biomedicine and Society Online. 2019;23-31.

Parry B, Ghoshal R. Regulation of surrogacy in India: Whenceforth now? BMJ Global Health. 2018;1-3.

Roache M. Ukraine's 'baby factories': The Human Cost of Surrogacy; 2018. [Online].

Carone N, Baiocco R, Lingiardi V. Italian gay fathers’ experiences of transnational surrogacy and their relationship with the surrogate pre-and post-birth, Reproductive Bio Medicine Online. 2017;181-190.

Abrams P. The bad mother: Stigma, abortion and surrogacy, The Journal of Law, Medicine and Ethics, Special Issue: SYMPOSIUM: Intersections in Reproduction: Perspectives on Abortion and Assisted Reproductive Technologies. 2015;179-191.

White C. The dark relationship between gay ‘marriage’ and surrogacy: Even Gay Activists are Worried; 2015. [Online].

Hopkins JJ. Sorensen A, Taylor V. Same‐sex couples, families, and marriage: Embracing and resisting heteronormativity, Sociology Compass. 2013;97-110.

Robertson JA. Legal change and stigma in surrogacy and abortion, The Journal of Law, Medicine and Ethics. 2015;192-195.

Psaki S, Seidman J, Miller M, Gottlieb M, Bhutta Z, Ahmed T, et al. Network, Measuring socioeconomic status in multicountry studies: Results from the eight-country MAL-ED study, Population Health Metrics. 2014;1-11.

United Nations. World economic situation and prospects, United Nations, New York; 2018.

Taș N, Hepșen A, Önder E. Analyzing macroeconomic indicators of economic growth using panel data, Journal of Finance and Investment Analysis. 2013;41-53.

Wallis S. Five Measures of Growth that are Better than GDP; 2016. [Online].

World Bank, Age Dependency Ratio (% of Working-Age Population); 2019. [Online].

World Bank. Fertility Rate, Total (Births Per Woman); 2019. [Online].

Roser M, Ortiz-Ospina E. Literacy: Our World in Data; 2018. [Online].

World Health Organisation, Infant Mortality; 2017. [Online].

World Bank, Current health expenditure (% of GDP); 2019. [Online].

World Bank, GDP Per Capita (Constant 2010 US$); 2018. [Online].

Phelps G, Crabtree S. Worldwide, Median Household Income About $10,000; 2013. [Online].

Peppers M. The rise of social surrogacy: The Women Choosing Careers or their Bodies Over Carrying Babies; 2014. [Online].

Kleeman J. Having a child doesn’t fit into these women's schedule': Is this the Future of Surrogacy?; 2019. [Online].

Crockin SL. Growing families in a shrinking world: Legal and ethical chalenges in cross-border surrogacy, Reproductive Bio Medicine Online. 2013;733-741.

Mendelsohn M. Straight, Single Men, Wanting Kids, Turn to Surrogacy; 2012. [Online].


Donnelly L. The rise of the modern family: Record numbers of gay couples and single Women opt for IVF; 2019. [Online].

Cunha D. The Hidden Costs of International Surrogacy; 2014. [Online].

UK Roundtable, International Surrogacy, Practice National Bulletin, UK; 2014.

Krieger L. Everything You Need To Know About Surrogacy; 2017. [Online].

Haijun L. The legal thought of surrogacy phenomenon, Journal of Liaoning Medical University (Social Science Edition). 2008;18-20.

Hibino Y. Implications of the legalization of non-commercial surrogacy for local kinship and motherhood in Vietnamese society, Reproductive Bio Medicine Online. 2015;113-114.

Smolin DM. Surrogacy as the Sale of Children: Applying Lessons Learned from Adoption to the Regulation of the Surrogacy Industry's Global Marketing of Children, Pepperdine Law Review. 2016;265-344.

Fenton-Glynn C. Outsourcing Ethical Dilemmas: Regulating International Surrogacy Arrangements, Medical Law Review. 2016;59-75.

Snow D. Criminalising commercial surrogacy in Canada and Australia: The political construction of national consensus, Australian Journal of Political Science. 2016;1-16.

Condon N. Fragmentary sexuality: The transnational gestational surrogacy market in thailand and the nationalist baby gammy scandal, Radicle: Reed Anthropology Review. 2016;1-20.

Hongladarom S. Surrogacy Law in Thailand, in Eastern and Western Perspectives on Surrogacy, Hong Kong; 2016.

Peng L. Surrogate mothers: An exploration of the empirical and the normative, Journal of Gender, Social Policy and Law. 2013;555-582.

Rotabi KS. Human Rights and the Business of Reproduction: Surrogacy Replacing International Adoption from Guatemala; 2010. [Online].

Huber S, Karandikar S, Gezinski L. Exploring Indian surrogates perceptions of the ban on international surrogacy, Journal of Women and Social Work. 2018;69-84.

Blincoe N. Why Men Decide to Become Single Dads; 2013. [Online].

Gates G. Same-sex and different-sex couples in the American community survey: 2005-2011, The Williams Institute, UCLA School of Law, Los Angeles; 2011.

Torres G, Shapiro A, Mackay TK. A review of surrogate motherhood regulation in South American countries: Pointing to a need for an international legal framework, BMC Pregnancy and Childbirth. 2019;1-12.

Wilkinson S. Exploitation in international paid surrogacy arrangements, Journal of Applied Philosophy. 2016;125-144.

Posner RA. The ethics and economics of enforcing contracts of surrogate motherhood, Journal of Contemporary Health Law and Policy. 1989;21-31.

Payne JG. Autonomy in altruistic surrogacy, conflicting kinship grammars and intentional multilineal kinship, Reproductibe BioMedicine and Society Online. 2018;66-75.

Martin O' Reilly. Should surrogacy be permitted in Ireland, Humanism Ireland; 2015.