Jennifer Lahl, MA, BSN, RN, is the president of the Center for Bioethics and Culture (CBC) who has written and researched extensively in the area of assisted reproductive technologies, especially third-party contractual arrangements using egg and sperm “donors” and surrogate mothers. She founded the international campaign StopSurrogacyNow and has written, directed, and produced two films on surrogacy and two films on egg “donation” that highlight the harms, risks, and exploitation of women and children.

Kallie Fell, MS, BSN, RN started her professional career in the Department of Obstetrics and Gynecology at Vanderbilt University Medical Center utilizing a Master of Science degree in Animal Sciences with an emphasis on Reproductive Physiology and Molecular Biology from Purdue University. While assisting in the investigation of endometriosis and pre-term birth, Kallie simultaneously pursued a degree in nursing and has worked for the past 6 years as a perinatal registered nurse. Kallie has worked with the CBC since 2018, first as a volunteer writer, then as staff Research Associate, and now as the Executive Director. In 2021, Kallie co-directed the CBC’s newest documentary, Trans Mission: What’s the Rush to Reassign Gender? Kallie also hosts the popular podcast Venus Rising and is the Program Director for the Paul Ramsey Institute.

Kate Bassett has her Bachelor of Science in Economics from the University of California, Berkeley and is an independent data scientist.

William M Briggs, PhD, is an independent research statistician with a PhD in statistics from Cornell University. He is author of Uncertainty: The Soul of Modeling, Probability and Statistics.

Francie Broghammer, MD, is a Board-Certified Psychiatrist and a Clinical Director of Inpatient Mental Health for the State of Minnesota. She completed her residency training at the University of California, Irvine, including a two-year tenure as Chief Resident. Her academic and clinical interest lie in medical ethics, education, and human flourishing. She is a former Leonine fellow, an American Psychiatric Association Leadership Fellow and is a board member for Pepperdine University’s American Project. Dr. Broghammer played Division 1 Women’s Lacrosse the University of Notre Dame, and graduated Magna Cum Laude with a degree in Science Pre-Professional Studies and Portuguese Language and Brazilian Studies. She attended the University of California, Irvine for medical school and was elected to the Alpha Omega Alpha Medical Honor Society.


This article evaluates the pregnancy experiences of American women by comparing their spontaneous or non-surrogate pregnancies with their gestational surrogate pregnancies. Data were collected through structured interviews using an online video platform. In total, 96 interviews were conducted. Data revealed that a woman was more likely to have a pregnancy that was high-risk during a surrogate pregnancy than during a non-surrogate pregnancy, independent of maternal age or gravidity (OR 11.4, 3.5-36.6; p<.0001). A surrogate pregnancy had three times higher odds of resulting in a cesarean section (p<.0001) and was five times more likely to deliver at an earlier gestational age (p<.0001). Women in this study were significantly more likely to experience postpartum depression following the delivery of surrogate children than after delivering their non-surrogate children (p=.01), and overall, they were more likely to have adverse outcomes during a surrogate pregnancy. The rate of new post-surrogacy chronic health issues for women of color was significantly higher than for women identified as white (p<.0001). We found that women’s economic disadvantage was a major contributor to the decision to proceed with surrogacy. This study confirms that health disparities exist for women with surrogate pregnancies compared to non-surrogate pregnancies, which can lead to long-term complications after a surrogate pregnancy. In terms of biomedical ethics, it raises important social, economic, and political issues related to surrogacy, all requiring further exploration. Future research will build on the present work in further helping us to understand the circumstances and consequences involved for women in surrogacy.

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