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Scandinavian attitudes to surrogacy – public policy should catch up

4 September 2017
By Sam Everingham
Sam Everingham is the founder of Families Through Surrogacy
Appeared in BioNews 916

During the planning of the global non-profit Families Through Surrogacy's first educational event on surrogacy in Sweden a few months ago, IVF professionals had suggested inviting a few leading Swedish infertility specialists. Unfortunately none were willing to attend, stymied by Sweden's conservative regulations around surrogacy. Unlike countries such as the UK, Canada, South Africa, Australia, Israel and the US, altruistic surrogacy has never been permitted in Sweden. In 2016 a government task force recommended that this ban be upheld, and Swedes also be blocked from international surrogacy. By contrast, Sweden's National Council on Medical Ethics has said altruistic surrogacy should be permitted.

Peak consumer infertility body Fertility Europe also declined to co-operate, given the political sensitivities around surrogacy. The European Parliament condemned all surrogacy in December 2015, and a year later over 100,000 Europeans even petitioned the Council of Europe to vote against recommended guidelines to safeguard children's rights in relation to surrogacy arrangements, including unresolved issues around legal parentage. This had me worried - was bringing altruistic and compensated surrogates to Stockholm to explain why they had chosen to carry even warranted?

What niggled were two things. Local infertility NGOs were in fact keen to attend, given they had been shrugging off surrogacy questions from infertile couples for many years without any reliable information. Further, research in 2015 showed that despite the absence of domestic access, hundreds of Scandinavians had engaged in overseas surrogacy each year. Sweden was the sixth largest and Norway the third largest user of international surrogacy proportionate to population - an estimated 800 Norwegians and Swedes created families via surrogacy from 2012 – 2014. This is despite a messy process of ensuring legal parentage.

So were those concerned citizens who had petitioned the Council of Europe really representative of community views in Sweden and Norway? To find out, in June 2017 we commissioned a Swedish research firm to conduct an online study of a statistically representative sample of 803 Swedes and Norwegians, aged 18-49 years.

The results showed the majority of participants in both Norway and Sweden were supportive of access to surrogacy in some form (over 80 percent). Compensated surrogacy was more popularly supported than altruistic, though the difference was not statistically significant.

Among the Swedish sample, the majority believed Swedes should be allowed to engage in surrogacy in their home country (89 percent). There was also majority support for the right to access surrogacy in countries which protected women's rights (73 percent), or had supportive surrogacy law in place (65 percent). Significantly fewer believed they should be able to access surrogacy in any foreign country (25 percent).

The Norwegian sample showed very similar results. Most believed they should be allowed to engage in either their home country (90 percent) or a foreign country which protected women's rights (87 percent), or had supportive law in place (72 percent). While there was less support for being able to engage in any foreign country (40 percent), this support was significantly stronger than amongst Swedes.

Within both the Swedish and Norwegian samples, there was equally high levels of support (over 70 percent) for women with a medical need (such as having no uterus) being able to access surrogacy. Support for gay couples accessing surrogacy was significantly lower with around half of each sample supporting this, and support for single men significantly less again (20 percent).

Clearly, amongst Swedish and Norwegian citizens of child-rearing age, there is fairly strong support for surrogacy, where the appropriate protections are in place. The higher level of support for compensated surrogacy may be due to the fact that citizens of these countries have little if any exposure to altruistic surrogacy.

Hence the socially conservative Scandinavian public policy on surrogacy is markedly out-of-step with Swedish and Norwegian community views. The mis-match is evident elsewhere. Australia for example provides no access to legal parentage following cross-border surrogacy. Yet a recent study of Australian community attitudes found close to two-thirds believed that Australians should be allowed to access surrogacy overseas. 

The main political arguments against surrogacy have been feminist concerns about objectification of women's bodies, and concerns about a lack of genuine autonomy in women's decisions. Opponents have typically been concerned to protect children's rights and well-being in the context of uncertainty about possible outcomes.

Certainly community support for social policy reform is inadequate on its own. Consideration of outcomes over time for both surrogates and children is also crucial. Fortunately the UK's Centre for Family Research has been following up such families in the UK for over ten years. Their multiple investigations have consistently shown no harmful effects of surrogacy on the psychological adjustment of either the conceived children or their surrogates.

Hopefully such evidence, in combination with supportive community attitudes, will encourage Scandinavian countries to be more responsive to arguments that surrogacy does not deserve to be forced underground. Instead, Scandinavia needs to hear far more from surrogates about why they choose to give couples the gift of parenthood. Only through such dialogue and understanding can falsehoods that 'all surrogacy is exploitation' be corrected and social policy reformed.
 
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