Surrogacy is the practice where a woman carries and gives birth to a child for another person or couple, known as the intended parents. It exists in two primary forms: traditional and gestational. Traditional surrogacy involves the surrogate providing her own egg, making her the biological mother. Gestational surrogacy utilizes in vitro fertilization (IVF) to implant an embryo created from the intended parents’ or donors’ gametes, meaning the surrogate has no genetic link to the child. While the underlying social arrangement is ancient, the medical technology defining its modern form is a product of the late 20th century.
Surrogacy in Ancient History and Tradition
The concept of one woman bearing a child for another originated from societal and legal necessity, particularly concerning lineage and inheritance, rather than medical science. These early arrangements, which align with traditional surrogacy, relied on natural conception and are documented in texts dating back thousands of years.
One of the earliest examples appears in the biblical Book of Genesis, involving Abraham, his wife Sarah, and her maid Hagar. Sarah, being infertile, offered Hagar to Abraham to bear a child on her behalf, securing an heir for the family line. The story of Rachel and her servant Bilhah illustrates a comparable strategy for overcoming infertility within the family structure. This historical context shows that the fundamental societal function of surrogacy has existed for millennia.
Ancient Babylonian law also contained provisions that addressed this type of arrangement, specifically permitting a wife to provide a servant to her husband to bear children. Utilizing a surrogate in this manner could prevent the husband from divorcing his wife due to her inability to produce an heir. These traditions highlight that the practice was acknowledged and sometimes codified within the legal and social framework of early civilizations. The children born from these unions were generally considered the offspring of the intended parents.
Technological Foundations for Modern Surrogacy
The shift from traditional, naturally conceived surrogacy to the modern, medically controlled process began with breakthroughs in reproductive science. The initial steps toward medicalizing the process started in the late 18th century with the pioneering of artificial insemination (AI). Scottish surgeon John Hunter performed one of the earliest recorded successful instances of AI in humans around 1790.
This technique was refined in the 19th and early 20th centuries, becoming a method for traditional surrogacy by using the intended father’s sperm to inseminate the surrogate. The true technological foundation for modern surrogacy was laid in 1944 when Harvard professor John Rock and his team successfully fertilized a human egg outside of the body for the first time. This achievement proved that conception could be initiated in a laboratory setting, a prerequisite for in vitro fertilization (IVF).
The development of IVF technology culminated in the birth of Louise Brown in England in 1978, the first baby conceived through this method. This monumental event demonstrated that a fertilized embryo could be created in a dish and successfully implanted back into a woman’s uterus. Following this, the first successful pregnancy using a donated egg occurred in 1983, which was an important precursor to gestational surrogacy. These advancements provided the medical community with the tools to create an embryo entirely separate from the woman carrying it, enabling the non-biological nature of gestational surrogacy.
Defining Milestones of the Late 20th Century
The technological possibility created by IVF quickly translated into the practical reality of modern surrogacy through specific legal and medical milestones. The first formalized agreement in the modern era occurred in 1976 when Michigan lawyer Noel Keane drafted the first legal surrogacy contract, though the surrogate was not compensated for her services. In 1980, the first compensated traditional surrogacy arrangement was brokered in the United States.
The invention of modern surrogacy, specifically the gestational form, is marked by the first successful birth using an embryo genetically unrelated to the surrogate in 1985. A woman carried a pregnancy for a couple using an embryo created from the intended mother’s egg and the intended father’s sperm. This gestational method immediately reduced the legal and emotional complexities of traditional surrogacy by eliminating the surrogate’s genetic claim to the child.
This new medical pathway gained traction following high-profile legal battles over traditional surrogacy, such as the famous “Baby M” case, which began in 1986. This custody dispute highlighted the risks inherent in traditional arrangements where the surrogate was the biological mother. Consequently, gestational surrogacy became the preferred and more legally sound option, quickly becoming the standard practice for intended parents worldwide.