Ms Natalie Gamble:

Yes, I do acknowledge that. It is an important consideration in surrogacy to ensure that the women doing this are giving informed consent. All sorts of things may impair that consent. It could be pressure from a partner, or from the intended parent, if he or she is a relative, or it might be financial circumstances. The risk is heightened when we are considering jurisdictions where there is much poverty and therefore an imbalance between the intended parent and the surrogate. This does not mean it happens routinely. In my experience of surrogacy in many jurisdictions, this has not been something that I have seen a great deal of, if at all. The cases which worry me the most in respect of exploitation are those where the parents have limited information about their surrogate. I refer to situations where the intended parents are being matched with a surrogate by an agency. The whole relationship is then with the agency or the clinic and they do not know much about the surrogate.

The worry in those situations concerns the details of the woman who is the surrogate. Has she been given all the required preparation, support and screening and is she undertaking the surrogacy because of economic duress or real duress? We do not know in those cases. I can honestly say I have never seen a case where I have directly seen that kind of exploitation and duress and desperate poor women doing this because they have no other choices. The worry arises that this might be happening in those situations where we do not know much about the surrogate, however, and where there is not a strong direct relationship between the parties. This is one of the reasons I said that one of the core elements of ethical surrogacy is a direct relationship between the intended parents and the surrogate to enable us to see what is going on.