|Increasing numbers of infertile women are travelling to Ukraine because of its relaxed laws on commercial surrogacy[GALLO/GETTY]
"No drinking, no smoking, no taking drugs and eat healthily." As she lists the rules she wants her future surrogate mother to abide by, the voice of Rumyana Nencheva, 34, a dentist from Varna, Bulgaria, gets thinner and quieter.
Nencheva has come to Ukraine, seeking a surrogate mother. Diagnosed with uterine cancer in June 2008, she cannot bear a child of her own.
According to the European Society of Human Reproduction and Embryology, ESHRE, in 2010, one in six couples in the world suffers from infertility.
In up to 35 per cent of cases, ESHRE says, this is down to physiological reasons in the woman. An average of nine out of 100 women aged 20 to 44 cannot have a child.
"Infertility is turning into an epidemic whose peak we have yet to see," says Georgi Stamenov, the head of Nadezhda (Hope), one of the main centres for reproductive health in Sofia.
She is a part of a growing phenomenon of women who are unable to get pregnant - and facing a ban on surrogate pregnancy at home - travel thousands of miles to Ukraine to rent another woman's womb.
Victims of society's stigma against childless women, especially in the Balkans, they also confront the hostility of the law in most countries to paid-for surrogacy.
They are drawn to Ukraine by the former Soviet republic's relaxed laws on commercial surrogacy, its relatively developed medical infrastructure - and the price.
Most women heading for Ukraine come from western Europe and the Americas - only they can usually afford the fees. But a growing number, like Nencheva, are middle-class professionals from the Balkans for whom the cost is still a huge sacrifice.
The staff at the International Surrogate Motherhood Center (ISMC), in Kharkov, Ukraine, tell Nencheva that she is not the only woman with that name from Bulgaria to have travelled more than 2,000km to Kharkov.
"We have many patients from the Balkans," the woman at the centre confides. While there, Nencheva spots another Balkan traveller, Snezhana, a rotund Macedonian in her forties.
For women who want to escape the taboo on childlessness, and who do not want to adopt, the only solution is to find a surrogate mother who will carry their egg to maturity.
For most governments, however, surrogacy raises serious ethical dilemmas, mainly concerning women being paid to carry children for someone else.
That is why no European Union country allows commercial surrogacy, and why women seeking to rent a womb have to head east to Ukraine, Russia, Georgia, Kazakhstan, or even further afield to India.
In the EU, Austria, Germany, Sweden, France, Hungary and Italy prohibit all forms of surrogacy, paid-for or not. Britain, the Netherlands, Belgium, Denmark and Greece allow surrogacy, as long as no commercial element is involved.
Ukrainian law, by contrast, is the most surrogacy-friendly in Europe. Article 123.2 of Ukraine's Family Code stipulates that women may receive financial compensation to carry someone else's child, and the law places no limits on the amount that can be paid.
The law also guarantees the biological mother's legal rights to the child or children born in the surrogate mother's womb. No adoption process or court order of any kind is required. The entire process is regulated by a contract signed between the agency or clinic, the biological mother and the surrogate mother.
By this, the surrogate mother surrenders all rights to the child carried in her womb. Only the names of the biological parents are entered on the birth certificate.
Valery Zukin, the vice-president of the Ukrainian Association of Reproductive Medicine (UARM), says 150 to 200 paid-for surrogate motherhood cycles take place in the country each year.
About half of the women renting these Ukrainian women's wombs are foreigners, usually from the US, Britain, France, Sweden and Italy, but also from Balkan countries.
Cheaper in Kiev
In Balkan societies the taboo against childlessness is especially strong. Here "the inability to conceive a child, and carry it to maturity, is regarded as abnormal," says Bulgarian psychologist Yana Pacholova.
"If people learn about it, the woman experiences shame, reproachful glances, negative attitudes, whispers behind her back, isolation and being pointed out by society," she adds.
Fear of barren women in Bulgaria is handed down the generations. Folklore teaches that childlessness is a curse and a disease.
In some parts of the Balkans, the families of a childless woman give her the child of a relative to bring up as her own, according to Violeta Stan, a child psychiatrist in Timisoara, western Romania.
But, among the Roma, the inability of a woman to conceive can lead to the annulment of the marriage. Among the Kardash community in Bulgaria, meanwhile, a mother-in-law can even chase away an infertile daughter-in-law.
The law is not the only reason why women seeking wombs to rent come to Ukraine.
"The main reason ... is the price," claims Marina Vasilieva, a patients' coordinator at New Life, a surrogacy centre that opened a permanent office in Kiev in March this year.
The ISMC in Kharkov initially quoted Rumyana Nencheva around 21,760 euros [about $29,000] for its services. Prices depend on the state of the biological mother's ovaries and on whether she requires donor sperm or not.
New Life in Kiev charges in American dollars. Its price is higher, at about $35,000, [26,000 euros], including an egg donation.
This is still only about one-third of the price charged in those US states, such as Florida, Nevada, New Hampshire, Virginia and California, that permit commercial surrogacy.
For renting out their wombs, the agencies in Ukraine pay surrogate mothers from $7,000 [5,080 euros] in Kharkov to $12,000 [around 8,700 euros] in Kiev.
Beside that, would-be parents are expected to pay the women about $290 per month in support fees, or a total of about $2,610 for the whole pregnancy.
"They also pay for medical expenses during the pregnancy and for monitoring," Vassilieva explains.
"The terms for our surrogate mothers are quite good, for Ukraine," she says but stresses that being a surrogate mother is not an instant passport to wealth.
A single-bedroom apartment in the capital, Kiev, costs around $80,000 [about 58,000 euros]. Vassilieva notes that is at least six times the average fee a surrogate mother earns.
However, Ukrainian law does not limit the number of surrogate pregnancies a woman may carry.
Too pricey for the Balkans
While prices in Ukraine are far lower than in the US, they are well above what most people in Balkan countries can afford. It is far too costly for Ani Dimova, a frail-looking young woman from Asenovgrad in Bulgaria.
She still remembers her deep shock on discovering in her teens that she would never conceive. "At first, my parents tried to hide it from me," she says.
"I was 14 and had just had my first check-up in hospital. I went outside and waited for them in the car. When my mum came out, she was crying."
Though naturally smiley, Dimova says few days go by when she is not reminded that she cannot have her own child. "I've thought about going somewhere where surrogacy is possible but the prices are very high," she says.
"They're not for the likes of us. In Ukraine, you'd need about 50,000 Bulgarian leva [around $34,000] saved up."
According to Bulgarian social anthropologist Haralan Alexandrov, today's more conservative climate on surrogacy - and the silence surrounding the issue - reflects the strength of patriarchal values in the region.
"Suffering is not to be talked about," he says. "There's no evil intent here, it's just how our culture operates."
In Varna, following weeks of online communication with the clinic in Ukraine, Rumyana Nencheva is back to square one.
Doctors at the Kharkov clinic have concluded that while her ovaries are not exhausted, they are almost so. Unsure whether she has a usable egg, the clinic has decided not to take her on. She finds it hard to decide on her next move.
Ani Dimova is considering moving to a country where surrogacy is permitted. Of Bulgaria's current ban, she says: "I don't want to think it will stay forbidden forever."
Doroteya Nicolova is a Varna-based journalist and editor. This article was produced as part of the Balkan Fellowship for Journalistic Excellence, an initiative of the Robert Bosch Stiftung and ERSTE Foundation, in cooperation with the Balkan Investigative Reporting Network.
Source: Al Jazeera and the Balkan Fellowship for Journalistic Excellence