Ukraine’s ‘baby factories’: The human cost of surrogacy

Kiev, Ukraine – Throughout Ukraine, advertisements about becoming a surrogate mother are plastered on buses and throughout the metro.

They ask: “Аre you aged between 18 and 35? Do you have healthy children? Are you physically and psychologically fit? Are you law-abiding?”

Alina decided to become a surrogate mother in 2016 because she was struggling to make enough money as a hairdresser in her hometown of Donets, in Kharkiv.

“It’s hard to find a well-paid job in Ukraine,” she said. “I wanted to renovate the house and set aside money for my son’s university fees – they’re very expensive. My mother never had the means to support me in that way, but I want my son to get a good education.”

BioTexCom, Ukraine’s most popular surrogacy company, offered her $11,000 for one pregnancy and a $250 monthly stipend – a sum more than three times the average yearly salary in Ukraine of approximately $3,000.

“The company promised they would take really good care of me. It was an easy decision and my husband agreed immediately,” she said.

By March 2017, Alina became a surrogate mother for Anca, a 38-year-old from Romania, who is unable to carry a child due to multiple fibroids in her uterine wall.

“I had four failed IVF attempts. Surrogacy was my final option,” she told Al Jazeera.

Ukraine has become an increasingly popular destination for foreign couples seeking affordable surrogacy services since they became legal in 2002. The average package costs around $30,000, compared with prices between $80,00 and $120,000 in the United States.

Demand has surged since 2015 when Thailand, India and Nepal outlawed commercial surrogacy following reports of widespread exploitation of women.

The Ministry of Health was unable to provide data on the number of surrogate mothers in Ukraine.

According to Sergii Antonov, a Kiev-based lawyer specialising in the medical and reproductive field, between 2,000 and 2,500 children are born through surrogacy in Ukraine every year, with almost half through BioTexCom.

But as demand grows, Antonov says there are increasing reports of alleged exploitation of both surrogate mothers and intended parents. 

“Commercial surrogacy Ukraine is unregulated and two-thirds of the industry operates illegally,” he said.

We were treated like cattle and mocked by doctors.

by Alina, surrogate mother

Alina said the conditions for surrogate mothers are terrible.

She said BioTexCom put her up in a small apartment 32 weeks into her pregnancy with four other women, where she was forced to share a bed with another surrogate mother.

“We were all very stressed. Most of the women come from small villages and are in hopeless situations,” she said. “We spent the first week just lying around, crying. We couldn’t eat. This is a typical situation for surrogates.”

Alina said the supervisor visited the apartment most days to check on the women’s lifestyle.

“If we weren’t home after 4pm, we could be fined 100 euros. We were also threatened with a fine if any of us openly criticised the company, or directly communicated with the biological parents.”

Comments in online forums for surrogate mothers also document problems with BioTexCom. 

Alina and Anca frequently messaged each other using Google translate.

According to Alina and BioTexCom clients, surrogates were sent to give birth in a state hospital in Kiev where the level of care is reported to be poor.

“We were treated like cattle and mocked by doctors,” Alina said. “There was no hot water, we washed with plastic bottles over the toilet with water that was preheated in a kettle. I wanted to be transferred to a different hospital, but the staff threatened to not pay me at all if I complained to Anca.”

Contracts between surrogacy companies and intended parents basically state, 'You're on your own after the birth.'

by Sam Everingham, a director of the Australia-based Families through Surrogacy

Three days after giving birth Alina said she started bleeding heavily and was rushed to the intensive care unit, where doctors shouted at her: “We’re fed up with all your problems.” 

A piece of her placenta had remained in her womb after childbirth.

A “retained placenta” – placenta that remains in a woman more than an hour after birth – can be life-threatening as it can cause haemorrhaging and infection. Doctors removed the piece five days after the baby was born.

“I only found out Alina had given birth and was in intensive care because she texted me. BioTexCom didn’t tell us anything,” said Anca. “I was so afraid throughout the pregnancy it would go wrong.” 

In 2016, Anca’s first surrogate mother at BioTexCom miscarried her twins four months into the pregnancy. According to Anca, BioTexCom told her that the surrogate caught a fever and didn’t go to the doctor in time.

Hopeful parents often complain that Ukrainian clinics fail to properly monitor the health of surrogate mothers, said Anca.

A year prior to her pregnancy, Alina said she had undergone open heart surgery and that BioTexCom did not ask for her medical history.

“We’re so lucky everything turned out well. But Alina should not have been a candidate for surrogacy. There were too many risks,” said Anca.

A couple from Argentina said that BioTexCom allowed their surrogate mother to travel while six months pregnant with twins and unwell.

The surrogate went into labour during the trip and had no choice but to give birth in a small hospital which was ill-equipped to deal with the complexities of her labour. The premature babies were born in septic fluid.

At the time of writing, the babies are in intensive care at a hospital in the city of Dnipro. The couple said the company stopped responding to them after the birth.

BioTexCom responds

In an email seen by Al Jazeera from BioTexCom to an intended parent, it was clear that the company had not provided an explanation for a failed implementation.

Al Jazeera asked BioTexCom whether they conducted health checks on women applying to be surrogate mothers, if women were fined for being in contact with biological mothers, whether surrogates were forced to give birth in the low quality Kiev hospital and if the company provided reports to intended parents about failed implantations.

A spokesperson said the surrogate submits a “variety of tests” and meets with a psychologist and lawyer, but did not specify whether medical history was required.

Fines did not apply to surrogates for being in communication with mothers, but are issued for receiving money from the biological parents outside of the BioTexCom contract, the spokesperson said. 

All women give birth in state hospitals such as the one in Kiev, the spokesperson said, adding that if surrogates want to give birth in private hospitals, they could.

But the cost of a private hospital birth in Ukraine is several thousand dollars, which would leave the surrogate with little or no money left from the process.

I'm so happy that I helped to give a couple a beautiful baby boy, who's loved very much. But I would never be a surrogate mother again. It was a terrible experience.

by Alina, surrogate mother

Sam Everingham, a director of the Australia-based Families through Surrogacy, told Al Jazeera that some clinics in Ukraine are like “baby factories”.

“Contracts between surrogacy companies and intended parents basically state, ‘You’re on your own after the birth.’ There are some excellent clinics in Ukraine, but because they have smaller marketing departments to BioTexCom, it’s harder for foreign couples to learn about them.”

Everingham said couples often complain that clinics have “lost” their embryos or fail to explain the reasons behind a failed embryo implantation, forcing some to take legal action.

In other cases, he added, surrogates who miscarried or had a stillborn birth did not receive any payment.

“Some companies have it set up so that they can’t be held responsible for negative outcomes. It’s so important that people educate themselves about the risks.” 

Ukraine’s Ministry of Health and Ministry of Justice declined to comment.

Alina is now living in her newly renovated house with her husband and son. Next year, her son will go to university.

“I’m so happy that I helped to give a couple a beautiful baby boy, who’s loved very much,” she said. “But I would never be a surrogate mother again. It was a terrible experience.”