Published December 18, 2025
Is a baby just like any other deliverable? Should gestation be treated like any other service rendered? Is labor just another form of, well, labor?
For decades, America has taken a fairly light touch to questions of bioethics. It’s not just social conservatives who refer to the U.S. as the “Wild West” of assisted reproduction— progressive historians and feminist legal scholars do the same. And mainstream journalists are increasingly realizing how the lack of regulation around the fertility industry leads to stories that range from the queasy to the nightmarish, with a batch of recent stories veering squarely toward the latter category.
In the public eye, surrogacy—the process by which a woman carries and gives birth to a baby intended for another parent or couple—is often associated with the celebrities who have used it to circumvent medical or biological factors preventing them from having a successful pregnancy (and some, it must be noted, do so purely for convenience). Kim Kardashian, Chrissy Teigen, Tyra Banks, Hilaria Baldwin, and others have turned to gestational surrogates to add children to their family.
But as the once-niche practice has grown, it has become an ever-thornier thicket of legal, contractual, and moral complications. The most high-profile scandal in recent days was the example of Chinese billionaire Xu Bo, who has reportedly fathered over 100 children via surrogates in the U.S., each able to claim citizenship as a result of having been born on American soil.
The potential geopolitical ramifications of elites in adversarial countries being able to enter into a contract for children with U.S. passports are self-evident enough. The story has roused the ire of many conservatives, including some who used the report to question birthright citizenship.
But that focus is incomplete. Reforming immigration law so that foreign nationals can no longer take advantage of surrogacy to, in effect, purchase U.S. citizenship as children would be an important step. But it would still leave the broader industry untouched, with the attendant abuses, heartaches, and legal complications of plunging forward into a world of “full surrogacy now.” The recent spate of coverage shines a light on the need to, at the very least, reform an ethically murky industry, if not think differently about how we treat gestational surrogacy in law.
In surrogacy, an embryo is created via IVF, then implanted in the surrogate’s uterus to grow and develop until delivery, at which point the child is given to its commissioning parents. Advocates frequently argue that this practice does not constitute the buying or selling of a baby, merely the compensation of the surrogate for the use of her body, her time, and her expenses during the pregnancy.
But that distinction—paying for services, not for a baby—is harder to uphold in a world where global commerce increasingly allows commissioning parents to select egg, sperm, and carrier to sufficiently “optimize” their offspring, with more technological advances on the horizon.
Skeptics of the practice will note that 15 states make it illegal for anyone to separate a puppy from the dog that bore it in order to sell it for the first eight weeks after birth, because of concerns about developmental delays. Yet somehow the same forbearance is not extended to very small humans in their first hours or days of birth, a signal of how they are treated as product, rather than person, in the logic of commercial surrogacy.
An embryo created via IVF may not have any direct genetic connection to the woman who bore it for nine months, but hers is the voice it heard in utero; hers is the body that has absorbed that fetus’ cells, which will remain with her the rest of her life. Celebrities who have posed in the delivery room with their surrogate-delivered baby have been criticized for ignoring the biological ties between mother and child; the international industry practices that same ignorance at scale.
Losing sight of the personhood of those involved leads defenses of the industry as practiced into some dead ends. A couple made headlines last year for forcing their gestational surrogate to get an abortion after discovering she had posted a picture of herself drinking what was apparently a shot of tequila on social media. If surrogacy is just another contractor providing another service, it could be considered within the commissioning parents’ rights to demand the end result be produced according to their specifications.
If we consider the needs of the other human being involved in the decision, not to mention the wishes of the surrogate mom herself, it’s less a contractual dispute than a moral tragedy. Rep. Andy Ogles of Tennessee introduced federal legislation in 2024 that would prevent any surrogate mothers from being required to get an abortion against their wishes. You might naively expect feminist groups, normally eager to protect the ability of women to exercise full autonomy over their reproductive decisions, to have jumped out to support the bill and prevent them from being contractually coerced into an abortion—you’d be wrong.
Some women genuinely feel empowered by their decision to act as a surrogate, even doing it altruistically (that is, without being paid) for friends or family facing medical complications. But for many others, the stipend associated with being a surrogate is a huge inducement, with fees stretching into the six figures. That amount of money, combined with the broadly libertarian approach to regulation, leads to uncomfortable outcomes.
Because the industry is so lightly regulated, money put in escrow accounts to pay surrogate parents has been embezzled by middlemen to invest in cryptocurrency and luxury clothing, among other alleged malfeasance, with almost no legal oversight. Surro Connections, a highly rated, Oregon-based firm that helped clients find surrogates from around the world, abruptly closed with no warning, leaving surrogates with bills to pay and would-be commissioning parents out tens of thousands of dollars, with little recourse. And across the globe, the tremendous power imbalance between rich commissioning parents and the firms they utilize, and the often poor or lower-class women they hire as surrogates, leaves those women vulnerable.
“In Georgia, intended parents from China can import Ukrainian eggs or semen from Denmark, create embryos in Tbilisi and use Thai wombs to bear and birth babies before bringing a child home to Shanghai,” reported the New York Times’ Sarah Topol. These approaches aren’t merely aimed at helping couples struggling to conceive. They’re turning the act of having children into an act of global commerce—reproduction as a service.
For now, that product is available only to the wealthy (though advocates continue to push to have surrogacy covered in insurance plans, and six U.S. states require some surrogacy-related expenses to be covered by insurers.) The practice is still sufficiently niche that American public opinion on it is amorphous. One in 4 Americans surveyed in a recent Ethics and Public Policy Center/YouGov poll said they saw paying for surrogacy as a “legitimate expression of reproductive freedom” that should be “widely available.” The other three-quarters expressed varying degrees of discomfort with the practice, ranging from a desire for stronger legal safeguards to seeking an outright ban.
Unsurprisingly, those who voted for former Vice President Kamala Harris in 2024 were most comfortable with an expansive approach to surrogacy, with one-third saying they wanted it “widely available.” Twenty-two percent of those who voted for President Donald Trump said the same—essentially the same number of his voters who wanted the practice banned outright.
Ultimately, a lightly regulated surrogacy industry showcases the limits of where a maximalist mindset of “reproductive freedom” can leave you. If the only criterion by which we can judge an action is whether this individual or couple wants a baby or not, then all sorts of uncomfortable moral and ethical doors must remain open—more forced abortions for breach of contract, more tech tycoons using surrogates to produce a “legion” of genetically-optimized children, more cases in which children conceived via the same sperm donor unknowingly inherit genetic mutations, and more.
If, instead, we can admit that justice for both the surrogates and the babies they carry demands something more than mere acquiescence toward the demands of the market, we could envision meaningful reforms. At the very least, ensuring that birthright citizenship cannot be abused via international parenthood-for-hire should be on the docket. So, too, should a requirement that commissioning parents be allowed to only take out one contract for surrogacy at any given time, perhaps with a reasonable overall cap.
An even more aggressive step would be to take a page out of Louisiana’s book, where contracts for gestational surrogacy are legally unenforceable, and thus remove much of the profit motive involved. That very well could cut the legs out from under the business of commercial surrogacy (how many would-be parents would be eager to have a handshake deal with a surrogate knowing she very well could change her mind after the baby was born?) while permitting for altruistic, noncommercial cases.
When it comes to surrogacy, a relatively small number of Americans take the maximalist position. The rest see an industry that far too often does not do right by the parents it tries to serve, or the children it tries to deliver. The uncomfortable, even gruesome stories about surrogacy gone wrong will continue to proliferate, unless lawmakers try to put commonsense guardrails around the practice.
Patrick T. Brown is a fellow in the Life and Family Initiative at the Ethics and Public Policy Center, where his work focuses on developing a robust pro-family economic agenda and supporting families as the cornerstone of a healthy and flourishing society.
