What is Surrogacy: Understanding how it works and its effects
By Katemarthason Okudo, June 9, 2026Surrogacy is a reproductive arrangement where a woman carries a pregnancy for another person or couple who are unable to conceive or carry a pregnancy. It is part of assisted reproductive technology and is usually considered when natural conception is not possible due to medical or fertility-related challenges.
There are two main forms of surrogacy. Traditional surrogacy involves the surrogate’s own egg being fertilised, making her genetically related to the child. Gestational surrogacy, which is more commonly used today, involves creating an embryo through in vitro fertilisation (IVF) and transferring it into the surrogate’s womb.
In this case, the surrogate has no genetic link to the baby. According to the NHS health, gestational surrogacy is preferred because it separates legal and genetic parenthood more clearly.
The process includes medical screening, psychological assessment, legal agreements, IVF procedures, embryo transfer and continuous antenatal care during pregnancy.
Effects of Surrogacy
Surrogacy has both physical and emotional effects on the surrogate and intended parents. Physically, the surrogate undergoes the normal stages of pregnancy, including hormonal changes, pregnancy symptoms, and possible complications such as gestational diabetes or high blood pressure.
Emotionally, the experience can be complex. The surrogate may develop emotional attachment to the pregnancy, while intended parents may experience anxiety throughout the process. The emotional journey often requires counselling and psychological support. The Willow Health Media highlights that psychological evaluation is an important step before and during the process to ensure emotional readiness.
Advantages of Surrogacy
One of the main advantages of surrogacy is that it provides a path to parenthood for individuals who cannot conceive naturally due to infertility, medical conditions, or previous health complications. It also allows people with medical risks that make pregnancy unsafe to have a biological child through IVF.
Surrogacy can also give intended parents more control over the pregnancy journey, including medical monitoring and prenatal care decisions. In gestational surrogacy, the biological connection between at least one parent and the child is often maintained, which is important for many families.
In addition, surrogacy can be a fulfilling experience for the surrogate, especially in altruistic arrangements where the intention is to help others build a family.
Disadvantages of Surrogacy
Despite its benefits, surrogacy comes with notable disadvantages. The process can be emotionally demanding for both parties, especially after birth when separation occurs.
There are also health risks associated with pregnancy, including complications during childbirth. Legally, surrogacy can be complicated, particularly in countries where laws are unclear or restrictive. Disputes may arise over parental rights if agreements are not well-defined in advance.
Ethical concerns are also widely discussed, particularly around commercial surrogacy, compensation and the risk of exploitation. According to the World Health Organization Infertility , regulation is essential to protect all parties involved in assisted reproductive technologies.
Other important things to know about Surrogacy
Surrogacy laws vary significantly across countries, meaning what is allowed in one place may be restricted in another. Intended parents often seek legal guidance before beginning the process.
The National Assembly approved with amendments the Assisted Reproductive Technology (ART) Bill, 2022. The Bill seeks to create a legal framework for surrogacy and other ART services in Kenya. The approved version expressly prohibits commercial surrogacy while allowing only altruistic surrogacy confined to Kenyans who are divorced, widowed, or even single.
Medical screening is mandatory to ensure the surrogate is healthy enough for pregnancy, while counselling is recommended to prepare both parties emotionally. Financial arrangements also differ depending on whether the surrogacy is altruistic or commercial, but medical and pregnancy-related costs are usually covered.
Surrogacy also requires strong communication and trust between all parties involved, as the process can take many months from preparation to birth.
Overall, surrogacy remains a structured but deeply personal journey within modern reproductive health, offering hope while also requiring careful medical, legal and emotional consideration.