“Now Sarai, Abram’s wife, had borne him no children. But she had an Egyptian slave named Hagar; so she said to Abram, “The LORD has kept me from having children. Go, sleep with my slave; perhaps I can build a family through her.” Abram agreed to what Sarai said.” Genesis 16:1-2 NIV
Introduction
Waiting for a child is one of the most painful experiences a married couple can face. Few things test a marriage as deeply as longing for a child who does not come. In my years of pastoral ministry and counselling, I have sat with many couples who have prayed fervently, fasted, sought medical help, and exhausted their savings, yet the cradle remains empty. In such moments of disappointment and uncertainty, one term surfaces more frequently today than it did in the past: surrogacy.
Some see surrogacy as God’s gift through science. Others see it as a dangerous road. The truth is that surrogacy has a good side, a bad side and an ugly side. This article looks at all three in simple language, so that couples, parents and church leaders can think clearly and pray wisely.
What is surrogacy?
Surrogacy is an arrangement in which a woman agrees to carry a pregnancy and give birth to a baby for another person or couple. After the birth, she hands the child over to them to raise as their own. The woman who carries the baby is called the surrogate (or gestational carrier). The people who will raise the child are called the intended parents.
There are two main types:
Traditional surrogacy: The surrogate’s own egg is used, usually fertilised with the intended father’s sperm. She is therefore the biological mother of the child she carries.
Gestational surrogacy: An embryo is created in a laboratory through IVF (in vitro fertilisation), using the eggs and sperm of the intended parents or of donors. The embryo is placed in the surrogate’s womb. She carries the baby but is not genetically related to it. This is the most common type today.
Surrogacy can also be described by how money is involved:
Altruistic surrogacy: The surrogate receives no payment beyond her medical and pregnancy-related expenses. She does it out of goodwill, often for a relative or friend.
Commercial surrogacy: The surrogate is paid a fee for carrying the child, usually through an agency or clinic.
Surrogacy is not entirely new. As can be noted from the scripture reading from Genesis 16, Sarah gave her maidservant Hagar to Abraham so that she could “obtain children by her.” In Genesis 30, Rachel did the same with Bilhah. What is new is the science that now allows a woman to carry a child who is not genetically hers.
The good
It brings hope to couples who cannot carry a pregnancy. Some women are born without a womb. Others have lost theirs through surgery or have medical conditions that make pregnancy life-threatening. For them, surrogacy may be the only way to hold a child who carries their own blood.
Consider a practical example. Kwame and Efua (not their real names) married in their late twenties. After two difficult pregnancies ended in loss, Efua had an emergency hysterectomy to save her life. Her ovaries were healthy, but she no longer had a womb. Through gestational surrogacy, an embryo formed from their own egg and sperm was carried by Efua’s cousin. Today they have a son. Efua told me, “I could not carry him, but he is fully ours.” For this couple, surrogacy did not replace God; they saw it as an answer to years of prayer.
It can be an act of love. When a sister, cousin or close friend carries a child for a couple, it can be a beautiful sacrifice. Many surrogates speak of the joy of helping another family. Their generosity reflects the spirit of Galatians 6:2: “Bear ye one another’s burdens.”
It can ease the pain of childlessness. In our African setting, childlessness carries a heavy social burden, and too often the woman is blamed even when the problem lies elsewhere. Some marriages collapse; some husbands are pressured to take another wife. Where surrogacy is handled honestly and lawfully, it can protect a marriage from such pressure.
It has medical support. The science behind gestational surrogacy builds on IVF, pioneered by Robert Edwards and Patrick Steptoe, whose work led to the birth of Louise Brown in 1978. Edwards later received the Nobel Prize for it. Today, millions of children worldwide have been born through IVF, and surrogacy is one of its applications.
The bad
Emotional attachment. Nine months is a long time. A surrogate feels every kick and carries the child close to her heart. Some find it painful to hand the baby over. In traditional surrogacy, where the child is genetically hers, the pain can be deeper still.
The famous “Baby M” case in the United States (1986–88) shows this clearly. Mary Beth Whitehead agreed to carry a child for William and Elizabeth Stern, but after the birth she refused to give the baby up. The courts eventually gave custody to the Sterns, while recognising Whitehead as the legal mother with visiting rights. The case opened the world’s eyes to how messy surrogacy can become when hearts are involved.
Family confusion. Who is the mother: the woman whose egg was used, the woman who carried the baby, or the woman who raises the child? Children born through surrogacy may later ask hard questions about their origins. When the surrogate is a relative, family relationships can become strained, especially if the arrangement is kept secret.
Medical risks. Pregnancy is never without risk. Surrogates face the same dangers as any pregnant woman: high blood pressure, diabetes in pregnancy, bleeding, caesarean section and, in rare cases, death. IVF also raises the chance of twins or triplets, which brings additional risks.
Legal uncertainty. Laws differ widely. Some countries ban surrogacy entirely; others allow only the altruistic type; a few allow commercial arrangements. In Ghana, there is still no comprehensive law dedicated to surrogacy, so couples rely on private agreements that may not hold up well if a dispute arises. Without clear law, questions about parental rights, birth certificates and inheritance can become a nightmare.
The cost. Surrogacy is expensive. IVF, medical care, legal fees and the surrogate’s expenses can run into large sums. Some couples sink into debt chasing a result that is never guaranteed.
The ugly
Exploitation of poor women. This is the darkest side. In some places, poor women are recruited to carry babies for wealthy foreigners. They may live in crowded “surrogacy hostels,” have little say over their medical care, and receive only a small fraction of what the clients pay. India and Thailand once had booming commercial surrogacy industries, and both tightened their laws after cases of abuse drew public outrage. The Swedish writer Kajsa Ekis Ekman, in her book Being and Being Bought, argues that commercial surrogacy turns a woman’s body into a rented space and a child into a product.
Children treated as goods. In 2014, the case of Baby Gammy shocked the world. A Thai surrogate gave birth to twins for an Australian couple. One twin, a boy with Down syndrome, remained with the surrogate in Thailand while his healthy sister went to Australia. Whatever the full facts, the case raised a painful question: what happens when the “product” is not what the buyer ordered?
Disputes and abandonment. Some intended parents divorce during the pregnancy and no longer want the child. Some surrogates demand more money at the last minute. In a few sad cases, babies have been left stateless in foreign countries because no nation would recognise them as citizens.
Fraud and trafficking. Where there is money and no regulation, criminals follow. There have been reports of fake clinics, false promises and even baby-selling disguised as surrogacy.
These abuses have led many voices to call for limits. Pope Francis, in January 2024, called for a universal ban on surrogacy, describing it as a violation of the dignity of both the woman and the child. Italy later made seeking surrogacy abroad a crime for its citizens. On the other side, many feminist and human rights thinkers argue that a woman should be free to decide what to do with her own body, and that good regulation is better than a ban that pushes the practice underground.
A pastor’s counsel
As a pastor and counsellor, I do not believe the Christian answer is a quick “yes” or a quick “no.” Christians of good faith disagree. Some churches reject all forms of surrogacy; others accept gestational surrogacy within marriage, using the couple’s own egg and sperm, as a medical treatment. What matters is that every decision is taken prayerfully, honestly and with full knowledge. Here is my practical counsel:
- Pray together first. Do not let pressure from family or friends drive your decision. Seek God’s peace as husband and wife (Philippians 4:6–7).
- Keep it within marriage. Any arrangement that brings a third person’s egg or sperm into the marriage raises serious moral questions. Discuss these openly with your pastor.
- Get proper medical advice. Visit a recognised fertility specialist. Understand the risks to the surrogate and the child, and the realistic chances of success.
- Get proper legal advice. Have a written agreement drawn up by a qualified lawyer. Make sure it covers parental rights, medical decisions, expenses and what happens if something goes wrong.
- Protect the surrogate. Never exploit a poor or vulnerable woman. Treat her with dignity, pay her medical needs fully, and ensure she has given free and informed consent.
- Plan to be honest with the child. Secrets have a way of coming out. At the right age, tell your child the story of how he or she came into the world, and tell it with love.
- Consider adoption too. Many children in our orphanages and children’s homes are waiting for loving parents. Adoption is a deeply biblical picture: God Himself adopted us as His children (Ephesians 1:5).
- Remember that a childless marriage is still a complete marriage. Your worth, and your wife’s worth, is not measured by the number of children you have. Hannah was deeply loved by Elkanah even before Samuel came (1 Samuel 1:8).
- Churches should put in place doctrinally sound regulatory policies: Churches should be abreast with any scientific knowledge breakthroughs and review them in the light of the word of God. To be able to handle such dicey issues, churches should put in place policies which are regularly updated to address such issues so that when people confront leaders with such scientifically complicated matters, their doctrinal stance can be unambiguous in handling such matters.
Conclusion
Surrogacy is like a sharp knife. In the hands of a careful surgeon, it can save a life; in the wrong hands, it can wound. The good is real: hope, healing and new life for couples who have wept for years. The bad is real: emotional pain, family confusion, medical risk and legal gaps. The ugly is real: exploitation, the buying and selling of children, and fraud.
The Church must neither condemn every childless couple who considers surrogacy nor bless every arrangement without question. Our task is to walk with such couples in love, give them the truth, and help them make choices that honour God, protect the vulnerable woman and respect the dignity of the child. Above all, we must remind them that children are a heritage from the Lord (Psalm 127:3), and that His grace is sufficient, whether the cradle is full or empty.
Written by Pastor William Boachie-Ansah (Atomic Hills District)