Surrogacy and religion

Surrogacy is always a hot topic of Internet forums, as it causes a lot of contentious questions from the ethical point of view. As a rule, among the arguments against surrogacy appears theological ones, which have quite strong influence on the people of faith, who suffer from infertility and are afraid to make the step forward that can help them to get the baby they are praying for. Let’s see how the assisted reproductive technologies and surrogacy particularly appear in the worldwide religious and how flexible these religious become with the passage of time and technological development of the society. 

Surrogacy and Christianity

The main book of all Christians – the Bible doesn’t mention surrogacy directly, as this technique that we use today (IVF) obviously was not known on the time when the Bible was written. So, the only one thing we can do is to find common rules relevant in this case and try to adapt them to the modern moral problems and interpret it according to the crux of the Holy Scriptures.

On the one hand, the Bible defines marriage as a union between two people and children can be a result of that union (Genesis 1:28, 2:24). In Psalm 127:3 we see that children are a gift to couples and not everyone is blessed with them.

What does the Bible say?

On the other hand, we can find few stories about something that we called nowadays “traditional surrogacy” and that is not used in IVF Clinics (traditional surrogacy is when the surrogate mother is genetically related to the child; nowadays we use “gestational surrogacy” when the surrogate mother is only a carrier of a baby, but has no genetic link to it).

Genesis 30:1-24 says: “When Rachel saw that she bore Jacob no children, she envied her sister. She said to Jacob, “Give me children, or I shall die!” Jacob’s anger was kindled against Rachel, and he said, “Am I in the place of God, who has withheld from you the fruit of the womb?” Then she said, “Here is my servant Bilhah; go in to her, so that she may give birth on my behalf, that even I may have children through her.” So she gave him her servant Bilhah as a wife, and Jacob went in to her. And Bilhah conceived and bore Jacob a son”.

Genesis 16:1-16 says: “Now Sarai, Abram’s wife, had borne him no children. She had a female Egyptian servant whose name was Hagar. And Sarai said to Abram, “Behold now, the Lord has prevented me from bearing children. Go in to my servant; it may be that I shall obtain children by her.” And Abram listened to the voice of Sarai. So, after Abram had lived ten years in the land of Canaan, Sarai, Abram’s wife, took Hagar the Egyptian, her servant, and gave her to Abram her husband as a wife. And he went in to Hagar, and she conceived<…>And Hagar bore Abram a son, and Abram called the name of his son, whom Hagar bore, Ishmael. 16 Abram was eighty-six years old when Hagar bore Ishmael to Abram”.

Do it all for the glory of God

So, in reality this is not exactly the cases we have today. We do not apply for traditional surrogacy, as surrogate mother is only a carrier of an embryo that was putted into her uterus in the lab, not because of the sexual contact with the Genetic father, as it described in the Bible and still acceptable, and this embryo is developing to the baby inside her womb. Yes, you were not promised by God to have a Child, but does it mean that you cannot fight for your wish to be a parent if technologies allow this?

We suggest that there is nothing wrong with surrogacy related to the Holy Scriptures rules we found and it must be 100% your own decision to undergo surrogacy as a way of infertility treatment or not. As whether you eat or drink or whatever you do, do it all for the glory of God (Corinthians 10:31).

Position of the Catholic Church

However, the Catholic Church expressed its official position in another way. In the Document called Donum Vitae prescribed that “Surrogate motherhood represents an objective failure to meet the obligations of maternal love, of conjugal fidelity and of responsible motherhood; it offends the dignity and the right of the child to be conceived, carried in the womb, brought into the world and brought up by his own parents; it sets up, to the detriment of families, a division between the physical, psychological and moral elements which constitute those families”.

Unfortunately, it is not specified there how exactly it damages the social institution of motherhood and the dignity of the Child who is carried in another womb. By the way, contraception and IVF are not allowed by the Catholic Church. “Such fertilization (IVF) is in itself illicit and in opposition to the dignity of procreation and of the conjugal union, even when everything is done to avoid the death of the human embryo. Although the manner in which human conception is achieved with IVF and ET cannot be approved, every child which comes into the world must in any case be accepted as a living gift of the divine Goodness and must be brought up with love”.

Catholic Church is one of the strongest churches in the World and it has great influence on the people’s mind. Maybe that’s why in the countries where Catholicism prevails surrogacy is banned.  

Position of the Orthodox Church

The Russian Orthodox Church is not as strict as the Catholic one. For example, IVF (without donation) is allowed here as this procedure “does not appear to be any different from the natural conceiving and occur within family and marital relationships”. Regarding surrogacy, it is strictly forbidden by the Russian Orthodox Church even if it is done on the altruistic basis. On the other side, if the genetic Parents are ready to confess their sins, the Russian Orthodox Church is ready to baptize a baby born in such way. “The fact of a “surrogate birth” is not in itself an obstacle to the baptism of a person, because he is not responsible for the behavior of his parents”.

Nevertheless, nowadays Russia and Ukraine are the biggest surrogacy destinations for all desperate couples.

The Greek Orthodox Church suggests the infertile couples to have a well-defined spiritual orientation and be productive in various fields of social and spiritual life, making their faith in God stronger and their soul more mature. The Church also clarified, that it is difficult for them to bless the practice of ART (unnatural and asexual conception, preservation of embryos, PGD etc.) and childbearing that disturb the normal family order as it is against the Church’s Spirit. At the same time the Greek Church accepts homologous intrauterine insemination without egg-donation or IVF with the total amount of embryos created if all of them will be transferred into the Genetic mother’s uterus (of course, only for heterosexual married couples with infertility).

Surrogacy and Islam

In Muslim world surrogacy is a quite controversial thing, as it totally depends from which perspective you are observing it. The law and religion are closely related to each other in Muslim countries. The Sharia Law based not only on the main book of Muslims – the Quran, but also on Hadit or Sunna and thoughts of Islamic scholars.

There are two different schools there: Sunni and Shiite. Sunni are the followers of Mohammad and Shiite are the followers of Imam Ali, the cousin of Mohammad and the ruler of Islam after his death. Sunni scholars disallow surrogate motherhood, since the surrogate mother will carry the baby formed by other man’s sperm to whom she is not married. According to Islam, the legal marriage is the only precept for the procreation of life, so the third party reproduction is challenging in Islam.

On the other hand, Shiite scholars do permit surrogacy as a treatment of infertility, but only for married couples (that’s why it is usual practice in Iran or Lebanon), because they consider the embryo itself as a fetus, that is totally different from the genetic father’s sperm. At the same time, the embryo-transfer is considered as a transfer of an embryo from one uterus to another, so there is no sin in it.

There are a lot of infertile couples in Muslim world. Moreover, Islamic family law envisages wife’s infertility as the major ground for divorce, so childless women are always under the psychological and social pressure that their marriage will be destroyed. However, the marriage usually doesn’t break down on the ground of male infertility.

Donation is totally prohibited in Islam, as the importance of family, lineage and the blood relations is markedly noticeable in Quran: “It is He (Allah) who created mankind from water, then He has established the relationship of lineage and marriage for your Lord has power over all things” (Quran Sura Al-Furqan 25:54).

In genetic gestational surrogacy without donation, breakdown of lineage is impossible, as the biological parents are already known. There is no any adultery in the embryo-transfer procedure that is performed in the IVF Clinic. The only one question that arises here is who the real mother is: the surrogate mother who gives birth to the child or the genetic one?

Quran defines motherhood as: “Their mothers are only those who conceived them and gave birth to them (waladna hum) (Al Quran Surah al-Mujadalah 58:2).

So, there is a mention about the whole procedure from the fertilization moment, including the pregnancy period and the delivery. Thus, Quran denies unconditionally any rights to genetic mother in surrogacy agreement. On the other hand, there are a lot of examples when action was prohibited by Quran, but it was allowed anyway for the necessity and public benefits (usage of insulin made of pork or even transplantation of reproductive organs).

Prophet Muhammad says: “For every disease, there is a cure except senility” (Hadit, Bukhary and Muslaam). So, in case we are talking about surrogacy as about the way of infertility treatment and an absolute necessity for procreation, it is totally possible since both mothers (surrogate and genetic) agree with their roles in this process and legal system will help with the regulation of their legal status.

As it is written in Quran “We did send apostles, before thee, and appointed for them wives and children” (Quran Sura Al-R’ad 13:38).

Surrogacy and Buddhism

Buddhism spread throughout Asia and divided into three major branches, each with distinctive beliefs, practices and cultural nuances: Theravada Buddhism in Southern and Southeast Asia (Sri Lanka, Myanmar, Thailand, Laos, Cambodia and Vietnam), Mahayana Buddhism in eastern Asia (China, Korea and Japan) and Vajrayana Buddhism in Central Asia (Tibet).

Buddhism adheres to the basic Indian view, one shared with Hinduism and Jainism, that human existence is a part of ongoing cycle of multiple lifetimes (samsara) the circumstances of which are governed by one’s deeds or actions (karma). Not surprisingly, Buddhist texts offer little direct guidance in such modern issues as artificial insemination and IVF.

Since Buddhism typically value renouncing ideas and consider marriage or divorce as cultural or civil rather than religious affairs, there is no biblical injunction here to be fruitful and multiply. Meanwhile, Buddhism, unlike Christianity, Judaism or Islam, doesn’t make procreation a moral duty.

From the point of view of Buddhist monks, surrogacy is not prohibited by Buddhist teachings. If surrogacy is done with the spirit of generosity, then surrogacy would be considered as a good thing. Many of Thai women, as followers of Theravada Buddhism, have a strong sense of desire to be useful to their fellow women suffering from inability to bear children. There are also those who possess a strong altruistic motivation to help people in a state of suspended atonement for their sins for the purpose of thamboon (accumulating virtue). The Thai populace, of whom 94% believe in thamboon and reincarnation, have a tolerant attitude toward commercial surrogacy.

However, if surrogacy is made with an unwholesome intent, using the procedure to bypass nature, and conceive a baby for personal advantage intent to abuse of natural order as well as lowering the dignity of humanity is would be considered wrong.

According to the Buddhists traditions, children have the right to know their origin since they reach maturity. The same situation is with Hinduism, where surrogacy is allowed, but unknown donation is not, because the child would not know its lineage.

Surrogacy and Judaism

Nowadays three sects of Judaism exist: the Orthodox Jews (around 10%), the conservative Jews (about 5%) and reformed Jews (85%).

Procreation is the first command in the Torah: “Be fruitful and multiply and fill up the Earth”. Torah has the same stories of third party intervention (surrogacy) as the Bible. In this light, today’s children who are born without violating the sacred sexual intimacy of marriage, as well as artificial insemination by a donor are not considered as an act of adultery by halakhic authorities.

The other category of third-party intervention presented in the Torah, demonstrates the willingness to redraft familial lines to overcome infertility. Familiar continuity and having a child was so great value that it overrode the societal norm of familial boundaries. When a man died childless, his next of kin was commanded to procreate with the widow in order to perpetuate the deceased’s name and memory. When Tamar’s husband, Er, died without issue, her father-in-law, Judah, said to his second son, Onan: “Join with your brother’s wife and do your duty by her as a brother-in-law and provide offspring for your brother” (Genesis 32:8).

So, in principle Halakha rejects the all-encompassing conception that everything must be “realized in the conjugal act wherein the spouses cooperate as servants and not as masters in the work of the Creator, who is love.” And for all sects of Jews IVF is allowed if it is mandatory for procreation reasons. Even possible to do PGD as the soul does not enter the body until 40 days (there is no body yet and the embryo is considered as “bare water”).

Rabbis universally accept the use of medical technology, as “just as tree does not grow if it is not fertilized, plowed and weeded – and even if it already grew, but then is not watered it dies. So, the body is like a tree: the medicine is the fertilizer and the doctor is the farmer”.

Nevertheless there are still some ethical controversies regarding the process of surrogacy. For example, there is such question as who is the halakhic mother of the child: is the biological mother or gestational one? It is not clear when motherhood starts: is in the moment of conceiving or in the moment of birth? That’s why Jews prefer that both mothers, gestational and genetic, are Jewish so to avoid any problems in the future regarding the question if the baby is Jewish or not.

The same situation is with sperm collection for any form of assisted reproduction, because masturbation is forbidden. But in fact even TESE is allowed in case of infertility, as the main rule still “be fruitful and multiply”. In some sources is even mentioned that it is possible to make sex-selection if the couple have at least four children of the same sex.

Anyway, surrogacy is not recommended to anyone according to the Judaism. Otherwise, it is better to find a good Rabbi for each infertile couple to get proper advice about it.

In conclusion, we want to say that primary sources of religious texts are of course very important for understanding the moral and ethical values, protected by humanity for ages as sacred and immutable truth. Meanwhile, we need to take into account that we live in a rapidly developing world imbued with technical progress, which gives us abilities to treat diseases in a new way, as we have never done before. And if nowadays we can treat infertility using assisted reproductive technologies, we do not pretend to be God, we are trying to understand this World and at least to help God to bring new life to it. As even if the embryo is done in laboratory conditions, the life to its first cells must be given by God.

Author: Sukhanova Anna, legal adviser of Pons Medical Group