A Retrospective Comparison of American Women’s Spontaneous Conceptions and Gestational Surrogate Pregnancies

Abstract Purpose: To evaluate the retrospective pregnancy experiences of American women by comparing spontaneous pregnancies with gestational surrogate pregnancies. Methods: Data were collected via structured interviews following an approved survey tool utilizing an online video platform. In total, 97 interviews were conducted. Results: Demographic data was collected on age, ethnicity, primary language, country of birth, education, and income level. Data revealed that a woman was more likely to have a pregnancy that was high-risk during a surrogate pregnancy than a non-surrogate pregnancy, independent of maternal age or gravidity (OR 7.22, p<0.001). A surrogate pregnancy had 4 times higher odds of resulting in a c-section (p<0.001) as well as delivering at an earlier gestational age (p<0.001). Further, women were more likely to experience adverse effects, including postpartum depression, following delivery of a surrogate child than their own biological child (p<0.001). Finally, the rate of new post-surrogacy chronic health issues for non-Caucasian women was significantly higher than for Caucasians (p<0.001). Women reported using the payment they received for their surrogacy for basic needs. Almost half of the women reported using the money to pay bills or get out of debt.Conclusions: These results are among the first of their kind. This study reveals that surrogate health disparities exist and that there may be long-term complications after a surrogate pregnancy. This raises important social, economic, and ethical issues related to surrogacy which must be further explored. Future work will build on this study and help elucidate the circumstances and consequences surrounding this complex issue.