Crossing Borders for Babies

Ukraine is the number one surrogacy spot in the world for Americans, Europeans, and Canadians. Ukrainian surrogacy clinics continue to grow rapidly due to their easy access, cheap prices, and the benefits of Ukrainian legislation in comparison to other countries.   

Bianca Smith has had a long and tiring journey trying to get pregnant. In 2004, she stopped taking the contraceptive pill, and from then until 2016 she and her husband had several tests, injected hormones, tried using Bianca’s eggs, tried using donor eggs and attempted in vitro fertilization (IVF) many times. Being born in South Africa, married in Britain and currently living in Florida, Bianca has seen her fair share of the world, but she never imagined she would end up in Ukraine at the end of 2016 for her first consultation regarding surrogacy.

“Before this, I had never even considered Ukraine, not for tourism, not for surrogacy, not for any destination. Ukraine had never entered my mind,” says Bianca Smith, author of My Ukrainian Surrogacy Story: a personal account of my mission to motherhood in Kiev and now proud mother of twin boys.

Bianca and her husband headed to Ukraine at the end of 2016, after three years of failed IVF attempts and an estimate of €225,000 spent (you can read a detailed outline of their journey here). The Smiths ended up in Ukraine after researching and considering both Britain and the US, who were either too expensive or had questionable legislation.

“In the US the starting price was about €120,000 and nobody has that kind of money laying around. While it was cheaper in Britain the laws do not protect the intended parents and from any moment between contraception and six weeks after the birth, the surrogate can decide to keep the baby, and we couldn’t live with that after all the failures we’ve had, so that wasn’t an option for us either.”

After the endless amount of resources and money put into trying to conceive, Bianca’s husband gave her an ultimatum: either remain childless or go somewhere with a money-back guarantee – they couldn’t deal with any more failures emotionally or financially.

Bianca came back with one better after she found the Biotex clinic in Kiev, where you can choose from one of three packages on offer and receive a 100% guarantee that you will leave the clinic with a baby (if you fulfill all of the necessary requirements). The Smiths decided on the top tier VIP package for €50,000, the top package on offer in Ukraine and incomparable to even the starting prices in both the US and UK.

This package included: unlimited number of attempts, all relevant medical examinations, medications and medical expenses, legal services (regarding passports and citizenship, lawyers if necessary), accommodation, meals and transportation.

Biotex is the most popular clinic in Kiev, with some months seeing more than 100 babies born. Biotex also offers some of the cheapest options. For just €9,900 you can get a surrogate mother and unlimited attempts at conception, guaranteeing you a baby.

10 week old photoshoot of Bianca, her husband, and the twins while the family were still in Ukraine. After the birth of the baby, to organise passports and birth certificates, the family were required to remain in Ukraine for four months.  Source: Bianca Smith

According to Sam Everingham, of Families Through Surrogacy, demand for surrogacy in Ukraine has jumped by 1000% since 2015. This is because the country has found itself as one of the only being able to offer surrogacy tourism. As well as this, Ukraine has liberal laws which attract people from all over the world. The legislation in Ukraine recognises the intended parents as the biological parents from the moment of conception and demands no set price on how much surrogates are paid. This creates an open, and sometimes unfair, market for surrogate mothers. These women, according to Olga Bogomolets, doctor and MP on the parliamentary health committee, only turn to surrogacy “as a result of the rapid fall of living standards in the country.”

While the Ukrainian laws focus on protecting the intended parents, it’s not all straight forward. Many western couples are unhappy with the process in Ukrainian surrogacy clinics as it is not up to the high standards they are used to in the western world, nor does it meet their expectations for the price they are paying. On top of this Ukraine can be a bureaucratic nightmare, with some couples needing to stay there isolated for months to finalise passports and birth certificates.

Despite these worrying aspects of surrogacy in Ukraine, it remains unbelievably popular. According to Anastasia Aleksandrova, the senior manager of the English Department in the Kiev-based Biotex clinic, the reasons for the growth in surrogacy in Ukraine are quite clear.

“Surrogacy is growing because Ukraine has become more promoted, a lot of countries have closed their doors (India, Cambodia and Taiwan), the US is too expensive, in Britain there’s no laws protecting intended parents and in Ukraine the level of medical services has greatly improved meaning you’ll get the same service for much cheaper and much quicker.”

Why Ukraine?

There are several key characteristics that make Ukraine the most popular destination for surrogacy, with the most obvious being the affordable price, the Ukrainian legislation is also a factor.

In Ukraine, commercial surrogacy refers to a surrogacy agreement in which the surrogate mother is compensated for her services beyond the reimbursement of all medical services.

There is much debate surrounding the ethics of commercial surrogacy. The most popular arguments are that it takes advantage of vulnerable women, exploits the system and commodifies human life. Arguments on the other side say it is fairer for surrogates to receive money for their services than to be simply an altruistic participant and commercial surrogacy is better regulated, transparent and open.

Bianca Smith agrees with the latter. “These women are not getting exploited if they’re going to reputable agencies. Of course, bad things do happen. This is apparent in every industry. But, because the living standards are so low in Ukraine most of them are doing it for their children’s welfare, or college funds or bigger homes or to open their own business. These are the reasons these poor countries are advocating surrogacy.”

Anastasia Aleksandrova also agrees. “I won’t say all women want to become surrogate mothers for money reasons because that’s a lie, but they deserve to be rewarded for their work. The political climate has just made surrogacy more popular for these Ukrainian women as they’re going to earn so much more for this than anything else. We look after our women, and while the western world sometimes can’t understand because our processes are so cheap for them. It’s just because the entire medical part is cheaper here because we pay a lot less, even for food and maintaining maternity houses, or even donors and surrogate mother compensation is less.”

While it was easy to find those, who have benefitted from the surrogacy process in Ukraine and for their success stories to be heard, after many attempts I was unsuccessful in getting in touch with a surrogate mother. Many of them keep their identities private or are just not interested in being interviewed. Despite this, I have tried to gather as much information about the experience, ethics and process as possible.

Another factor that makes Ukraine so popular is the fact that the rights of the intended parents are put first. From contraception, the intended parents are known as the biological parents. As soon as the child is born the intended parents’ names are on the birth certificate, and it is up to the intended parents to decide how big of a role the surrogate has in the baby’s life.

Through Biotex, it is expected that the intended parents be in contact with the surrogate during the process. It’s an emotional experience for all parties involved and often the surrogate mothers have doubts and worries about what is going to happen to their child. These meetings aim to put the surrogate mothers at ease.

“At Biotex we make it compulsory at the 12-week mark for the parents to meet the surrogate. We ask intended parents to be completely involved and to show their love for their future baby, it helps the surrogate. Emotionally when a surrogate mother doesn’t feel involvement of the parents she is afraid for the future of the baby. We are also afraid in these situations,” says Anastasia Aleksandrova.

While many people believe Ukrainian legislation to be relaxed compared to other countries, this is not necessarily the case. It’s just very different. Medical tourism is a huge business in Ukraine and plays a major role in lifting the Ukrainian economy. Surrogacy clinics Biotex and the Successful Parents Agency both stressed how often checks by authorities occur.

“Authorities come very often to check how things are going because you know it’s such a delicate topic. All clinics are privately owned so there’s no funding, they are just carefully checked. The area is very close to child trafficking, so we agree it should be carefully checked,” says Olga Tsisarenko, chief patients coordinator of Successful Parents Agency.

Aleksandrova agrees. “Sometimes negative feedback is common – clients post on our Facebook page about how we turned them down, but it is because they didn’t provide the necessary documents and I couldn’t accept that and risk our entire program. Some people are obviously disappointed, but we need a solid legal base because we are very thoroughly checked. This is a very right thing, we don’t want any bad things to happen to anybody involved. We want transparency.”

The main entrance to the Biotex clinic. This is where the doctor’s offices, surrogate rooms, and medical rooms are located. Source: Sara Maryniak

Typical Ukrainian process

The typical process for the intended parents at the clinic ranges from 12 up to 18 months, depending on how organised all parties are. Each process starts with an initial email where all of the necessary information is shared. The intended parents inform the clinic of their situation, and the clinic responds with all of the requirements and prices.

In Ukraine, surrogacy is only an option with certain medical indications. This means you’re only allowed to be considered for surrogacy if you’ve had four failed IVF treatments. Surrogacy in Ukraine is also only available to straight, married couples.

“It’s not fair but it’s the way the legislation is. You have to be straight, you have to be married and you need to have failed IVF several times to even be considered. Many people get upset at this, and we have to turn many internationals away because of it. But our legislation is strict, and I’d never risk it,” says Aleksandrova.

“We have to be sure of everything. We communicate non-stop with both our surrogate mothers and intended parents, as we offer guaranteed programs we need everything to be right the first time around. We are responsible for everything – the baby, the intended parents, the surrogate mother…If something, anything happens we are responsible. The first visits and constant communication are so important,” she continues.

After a few emails the couples go to the clinics in Ukraine where tests are conducted. They sign a contract and start the program. Both Biotex and Successful Parent Agency said that communication is of major importance to all processes and they put it above all else. However, when talking to intended parents who’ve used these clinics, both complained about the lack of communication and went as far as saying they wouldn’t recommend the clinics because of it.

“What I will say is that I’m pleased with the surrogate we had. She was beautiful, healthy and very friendly, I wouldn’t have wanted anybody else. But, on the other hand, would I use Biotex again? Would I go to Ukraine again? No. We struggled with communication, they were slow, sometimes they never answered at all and there was no sense of VIP according to western standards,” said Bianca.

She and her husband were unhappy with the majority of the process. They had not only issues with communication but with the standards of the facility, the housemaids they were given, and the isolation they experienced. In saying this, they were only the second British couple to do surrogacy through Biotex, and the third VIP couple ever. They told me that things have changed since then as the number of people visiting the clinic has skyrocketed and people’s expectations have grown much higher.

Bianca finished her interview with one final statement about surrogacy in Ukraine. While she couldn’t be happier with the surrogate, and the two healthy boys that came from her, she made her stance very clear.

“I personally wouldn’t recommend them. What I will say, is that they are the best price wise. It’s why people are flocking to them, it’s why they are the most popular, it’s why they are the busiest. But other than that? There’s not really any reason to go there.”

The Smith family from a Christmas photo shoot in Kiev. Source: Bianca Smith

To go, or not to go?

While Ukraine is currently the world’s hottest destination for surrogacy there are always two sides to every story. On one hand, it’s easy to understand why people are flocking half way across the world for this: it’s cheap. But on the other hand, there are several ethical considerations to be had – whether it’s potential exploitation or the secrecy involving the treatment and process of surrogate mothers.

The families who have used clinics in Ukraine are always happy with the results –the dream family they’ve been trying for so long – but a majority of them haven’t been happy with the process and standards of the clinics.

On top of this, it is very hard to find any information or statistics regarding how much money is made in Ukraine from surrogacy, success rates or even how many surrogate mothers live in Ukraine. The silence surrounding surrogacy in this country makes it harder to form a solid opinion on it.

There doesn’t seem to be any upcoming changes for legislation or surrogacy in general in Ukraine. One of the most important factors that needs to be taken into consideration is the transparency regarding surrogate mothers. The process and treatment for them should be able to be more readily accessed as exploitation is a real fear in Ukraine.

More and more places around the world are closing their doors to commercial surrogacy for internationals. At this point in time, Ukraine will remain a popular destination for women like Bianca to get the children they’ve always wanted, and it is likely that popularity may even continue to rise in the years to come.