It is impossible to say certainly where surrogacy was first used in history, mentions of it are found in many sources from different countries of the ancient world which make it clear that this practice has existed for several thousand years. Given that, not all sources carry the exact date, in some cases we can only draw conclusions based on the prescription of the culture in these countries. What is obvious and what unites all these stories is the natural desire of people to reproduce and fight for the opportunity to feel the happiness of becoming parents.
The first mother in the world
If we rely on the first known date in history, then it can be argued that it was Hagar.
The book of Genesis 16 (1-3) of the Old Testament of the Bible tells the story of Abraham and his barren wife Sarah, who, wanting to give an heir to her husband, turned to the help of her Egyptian maid Hagar, who gave birth to 86-year-old Abraham's son Ishmael. According to the main sacred book of Jews, Christians and Mohammedans, Ismail was born in 1910 BC. in the land of Canaan near Hebron. All Arabs descended from Ismail, therefore they are traditionally called either Ismailis or Hagarians in honor of Ismail Agari's surrogate mother, emphasizing to us the most important role that this woman played in the history of a whole nation. As for Abraham's wife Sarah, she was still able to give her husband a son 14 years after the birth of Ismail. In 1897 BC. they had Isaac. An interesting historical fact is that in the same year Sodom and Gomorrah were destroyed.
Second and third known history
Further in Genesis 30 (1-8), the story of Rachel and Jacob is described, in which the barren Rachel, the second and beloved wife of Jacob, who was the grandson of Abraham, asked her husband to "live" with his slave Valla and that "she gave birth to a child on her lap" and that at least through her, Rachel would have children. Valla gave birth to Rachel and the 85-year-old Jacob a son Dan, and then another son Naphtali. Later, Rachel will be able to get pregnant on her own and will give birth to Jacob's son Joseph, who will become not less known biblical character.
Rachel's sister Leah, who is also another wife of Jacob, having ceased to bear children for Jacob, also resorted to the help of her servant Zillah, who gave birth to Jacob the sons of Gad and then Asher (Genesis 30 (9-13). Leah turned to the help of a surrogate mother, despite the fact that she herself had already given birth to Jacob four sons before, but being an unloved wife, Leah tried in every possible way to surpass Jacob's beloved wife, her sister Rachel, and therefore was ready to resort to this method. Issachar, Zebulun and Dinu.
Of course, given that the fertilization process took place in those days in an exclusively natural way, in addition, given the fact of the genetic relationship of the surrogate mother with the child, as well as the hopelessness of her position and the lack of any rights as a slave, the events were dramatic for all participants. A woman who gave birth to her own genetic child, despite her complete disagreement, was forced to transfer the child to another person. At the same time, the sterile wife, realizing the need and desire of her husband in the formation of the family, had to put up with the "betrayal" of her husband and live with it. Thus, against the background of the presence of multiple moral problems, various tragic stories developed, such as the expulsion of Hagar and her son Ishmael.
Legal practice of Surrogacy in Mesopatamia
In Mesopotamia in the middle of the 18th century BC. surrogacy was generally accepted and enshrined in the codex of law created by King Hammurabi in 1780 BC. practice. Its historical value also lies in the consolidation of the presumption of innocence for the first time. In his Code, the King of Babylon established that a barren wife must give her husband a slave in order to continue the family line. A man was forbidden to have additional concubines for himself, he could do this only if his son was never born, and at the same time the concubine should not be equal to the barren wife. The law protected slaves who became surrogate mothers, which, in fact, kind of changed their status and put them in a more advantageous position. Interpreting in a modern manner, we can say that certain social guarantees were provided for surrogate mothers who successfully gave birth to a son. The law said that they could not be sold, even if they dared to equate themselves with the mistress. The punishment for them, in this case, could be the imposition of a slave sign and being considered a slave.
Surrogacy in Ancient Egypt
In ancient Egypt, surrogacy was also a common practice. With the objective of procreation, the pharaohs used the services of concubines. But it is worth mentioning that children born of concubines could claim the throne only if there were no children born from a wife of "solar" blood. The Egyptians believed that the ancient rulers of Egypt in a straight line descended from the sun god - Ra. In order for the "sun" blood not to mix with the blood of ordinary people, the pharaohs resorted to the help of concubines in matters of childbearing only as a last resort, and for the same reason the pharaohs even took their own sister as wives, despite the influence of this fact on the health of the offspring.
Indian Legends about Surrogacy
Surrogacy is described in the Indian legend of the birth “Mahvir” in 599 BC. Mahavira is the founder of Jainism and Jain philosophy, a preacher who, according to the legend of the Jains, became a holy sage and the 24th Tirthankar - the last Jain Buddha. Translated from Sanskrit, his name means Great Hero. Mahavira was conceived in the womb of the goddess of knowledge and learning Sarasvati - the wife of the god of creation in Hinduism Brahma. Then, according to the legend, Mahavira was transferred by the gods into the womb of Queen Trishala so that thus a child was born in the family of the aristocratic class of Kshatriya warriors.
The birth of Mahavira in the Kshatriya family was predetermined by the Gods, but Mahavira wanted to rewrite his fate in order to be born in the caste of priests and priests of the Brahmins. For this, Mahavira changed his karma in the life preceding his new birth and incarnated in the fetus with which the brahmin Devananda became pregnant. Despite his efforts, Mahavira did not manage to change the course of events, as the gods became aware of his intentions, and on the same day, Trishala, a princess from the royal Licchavi Empire and the wife of the Jain monarch Siddhartha of Kundagram, modern Bihar, became pregnant. On the eighty-second day after conception, when both the women of Devananda and Trishala were in the arms of their husbands, the gods took both fruits from them and changed their places. So Mahvira had no choice but to reconcile, because he could not change anything else, and he was forced to be born in the family provided for him by the Gods. And Trishala and Devananda, who gave birth on the same day, became surrogate mothers, because women carried other people's children.
Surrogacy in the Ancient Lands of Little Asia as described in the works of the Plutarkh
In his essay "The valiancy of Women", Plutarch tells about Deiotare reigning about 120 BC, the king of Galatia and his barren wife Stratonica, who realizing the need to have legitimate children for the inheritance of the royal power, persuaded him to conceive a child with another woman. Deyotard agreed and was delighted with his wife's selflessness and gave her free rein. Stratonica brought a beautiful girl named Electra with her husband, whom she had chosen from among the prisoners. She asked Deiotar to allow her to accept and raise the born child as her own, which Stratonica did with love and magnificent generosity.
The practice of severe motherhood in Ancient Greece and Ancient Rome
In Ancient Greece and Ancient Rome, according to the available evidence, in order to acquire an heir and if the wife was infertile, it was considered possible to seek help from another woman who could become pregnant and give birth to a child. The child was the legal child of an infertile married couple.
Application of Surrogacy in Asia
Such a different cultural and religious traditions of China, Japan and Korea in the Middle Ages also have references to surrogacy. One of these historical facts was even put into the plot of a film based on real events. A talented film by the famous Korean director Im Kwon-taek, which tells the story of a young peasant girl - a concubine who has not yet reached adulthood, who gave birth to an heir for the noble family Lee, who was forced to use her help due to his wife's infertility. The picture is called “Surrogate Mother”. This story has a tragic end, because the girl had to give up the child who was biologically related to her. In those days, there were completely different foundations, which often gave rise to such severe moral upheavals.
The method, which implied the presence of a genetic link between a surrogate mother and the child born to her, as well as in which conception took place by means of sexual intercourse, in our opinion, can be called surrogate motherhood only conditionally, although it really is the source of traditional surrogacy.
The World's First Agency of Surrogacy Motherhood
In this form, the method of traditional surrogacy existed until the second half of the last century. The world's first surrogacy agency was opened by an American lawyer from Michigan, Noel Keane, in 1976. For a long time, his agency has been practicing services with the use of in vivo fertilization, while it should be noted that this did not meet any obstacles on the part of the authorities. By 1988, 302 babies were born thanks to the agency's activity.
Invention of Exracorporal Fertilization
Using the method of fertilization, we are used to, surrogacy began to be used only at the end of the 20th century, when in vitro fertilization was invented. The history of the discovery of the IVF method (We give a link to our article on IVF) dates back to 1944, when the American doctor John Rock and the American scientist Miriam Menkin first carried out the fertilization of human eggs "in vitro". Even so, given that these were only the first steps in this area, the fertilization efficiency was low, presumably due to the misconception of pathological separation of oocytes for successful fertilization. This was followed by developments in this group by doctors and scientists in different countries of the world. So in 1951 Min Chueh Chang Chinese-American reproductive biologist began to study the environment and conditions for the cultivation of gametes and embryos in vitro. In 1954, Grigory Petrov, a Ukrainian embryologist and candidate of medical sciences, described in detail all stages of fertilization and cleavage of a female egg. Then in 1966, Robert Jeffrey Edwards, a British physiologist and Nobel Prize winner in physiology and medicine, established that in vitro maturation of female eggs occurs within 36-37 hours after the peak of luteinizing hormone. In 1973, Australian gynecologist Carl Wood, along with a group of doctors and scientists at Monash University, achieved the world's first "biochemical pregnancy" in humans using IVF. So, a few days after the introduction of a fertilized egg into the uterus, the concentration of chorionic gonadotropin in the woman's blood increased, which confirmed the onset of pregnancy, but, unfortunately, this pregnancy did not find its development. Years later, in 1983, the same group of doctors were able to achieve the world's first pregnancy after the introduction of an embryo that had previously undergone a freezing procedure into the uterus, but this pregnancy was also unsuccessful, since a miscarriage occurred due to infection of the placenta.
World's First Successful Case of IVF
For the first time, a group of specialists in Great Britain managed to successfully apply in vitro fertilization in 1977, as a result of their joint work in 1978, the world's first human "conceived in a test tube" was born, Louise Joy Brown, who is now raising two naturally born children.
The World's First Program of Surrogacy with the use of IVF
The world's first IVF procedure with a surrogate mother was carried out in 1986, also in the United States. Then the daughter named Melissa Stern, known as "Baby M" for a 37-year-old American woman who had a blocked fallopian tube, was carried by 22-year-old Mary Beth Whitehead. The woman responded to a newspaper advertisement posted by the Infertility Center of New York in the Asbury Park Press in search of surrogate mothers for infertile couples. By that time, she already had two of her children. Mary Beth Whitehead got pregnant on her first try. The relationship was secured by an agreement, according to which, using Mary Beth Whitehead's egg, she was artificially inseminated with the sperm of the husband of an infertile woman, and after giving birth to a surrogate mother, a monetary reward was paid. This IVF program, under the direction of Dr. Wolf Utian, was performed at the Mount Sinai Medical Center in Cleveland. The program was facilitated by Surrogate Parenting Associates, Inc., founded in Louisville in 1979 by Dr. Richard Levin, and it took about nine months to complete the legal process. This case was the first pre-planned and coordinated traditional surrogacy program in the world. Through Surrogate Parenting Associates, Inc. more than 500 babies were born, and in turn, Dr. Levin, like the lawyer Keane, became a famous person who forever took his place in the history of surrogate matrimony.
It is worth noting that the case was complicated by the fact that the surrogate and biological mother Mary Beth Whitehead refused to transfer custody of the child to the married couple with whom she had signed an agreement. Then the New Jersey courts recognized the surrogate mother Mary Beth Whitehead as the legal mother of the child, and also declared surrogacy contracts illegal and invalid. However, given that the most important in this dilemma was to protect the best interests of the child, the court even transferred custody of Melissa to the child's biological father William Stern and his wife Elizabeth Stern, thus creating the first precedent for securing rights to child for parents by intention.
The World's first Grandma to carry out her Grandchildren
Surrogacy began to be applied in different countries of the world. One of the most notorious in those days was the case when in 1987 in South Africa, 48-year-old Pat Anthony (Pat Anthony) successfully carried and gave birth to three grandchildren for her 25-year-old daughter Karen Ferreira-Jorge and her Alsino's 33-year-old husband. The couple had a son, but Karen's because of her uterus removed, after childbirth they didn’t have the opportunity to fulfill their dream of a big family. Having learned about surrogate motherhood, the spouses found a surrogate mother, but after thinking over the situation, they turned away from her services because of the fear that she might want to keep the children for herself. Then Karen's mother insisted on IVF. She received 4 embryos, of which 3 successfully engrafted. Moreover, for her surprise, the famous grandmother became rich with $ 500,000, which British journalists paid for the exclusive rights to report. They were allowed to film the birth, which took place by caesarean section. In accordance with the law in South Africa (Child Status Bill), Pat Anthony was considered the mother of triplets, so in order to secure parental rights for her daughter and her daughter's husband, she had to give up her parental rights in their favor, and they, in turn, were forced to adopt their own children.
Modern or "gestational surrogate motherhood" is based on significantly different principles and its most important condition is the inadmissibility of a surrogate mother to simultaneously donate an egg and bear a child therefore, the child carried by her has no genetic relationship with her.
Types of Surrogate Maternity
So, taking into account all historical experience from references in the Bible to the present day, surrogate motherhood is usually classified, guided by such basic principles as the presence of a child's genetic connection with a surrogate mother. To date, the doctrine and law does not have a fixed single identification of the types of surrogacy, but at the same time, most sources highlight:
Traditional surrogacy sui generis, which involves a genetic link between a surrogate mother and her child.
In our opinion, given that such a "tradition", when a surrogate mother had a genetic relationship with a child, ceased to exist in the modern world, it would be worth defining such a type of surrogacy as conditional surrogacy, such as which occurred during natural insemination, that is by means of sexual intercourse with a surrogate mother, used as a method in ancient times, or during insemination by the IVF method since his invention, but one way or another presupposes a genetic link between the surrogate mother and the child. Our proposed definition of "conditional" is explained precisely taking into account the inconsistency of the situation in which the surrogate mothers were at that time. Despite the lack of rights for surrogate mothers enshrined in the legislation, the possession of exclusive rights to the child by parents on purpose, despite the use of this practice in the status of surrogate mothers, one should not forget that, based on the direct relationship of the child with the surrogate mother, “ surrogate ” mother can be called so very relatively.
Unconventional surrogate motherhood (gestational), which does not imply a genetic link between the surrogate mother and her child.
As for the definition of modern surrogate motherhood as gestational, in our opinion this definition is indeed the most accurate, given that it emphasizes the real function that the surrogate mother performs in this situation, and that is gestation and childbirth. It should be noted that the importance of achieving of modern science in the field of reproductive medicine consists not only in gaining an unhindered opportunity for infertile couples to become parents, but also in solving a severe moral problem that was present when using surrogacy in its outdated version. Thanks to this, a surrogate mother today is certainly still the same “angel” woman, a woman who rendered an invaluable service to the parents of the baby, but at the same time she has no relationship with the child, which does not create moral trauma for any of the participants in the process.
Concept of Surrogate Matter
The definition of surrogate material as a term, although it has the same essence, differs in the legislative acts of different countries. Somewhere this concept is revealed most widely, somewhere less but then, the basic principles are clarified in the following paragraphs of the law. Although there are countries where, despite the legalization of surrogate motherhood, there is no detailed regulation of the process, which can lead to collisions, provoking the emergence of different interpretations and as a result of controversial situations. Today Ukraine is one of the few countries where all positions and rights for all parts to the process are most clearly defined, and most importantly in the legislation of which guarantees of the rights to a child are provided exclusively for parents by intention.
As for the direct definition of the concept of surrogacy, taking into account modern practice we propose to formulate it as follows:
Surrogate motherhood is a contractual process of bearing a child for a third person with its subsequent transfer to parents by intent, accompanied by an act of medical intervention carried out by implanting foreign genetic material (embryo) into the body of a woman (surrogate mother), conceived as a result of the use of methods of assisted reproductive technologies when using genetic material from parents by intent or from a donor.
It is worth noting that this wording, as we mentioned earlier is the closest to the modern one, as well as to the one that is used in countries with legislative guarantees for parents by intention.
When is surrogacy permissible from the point of view of the current legislation of countries that consider it an assisted reproductive technology and permit its use? Surrogacy is used in cases where pregnancy and childbirth are undesirable or medically impossible, in cases where the risk of pregnancy is too dangerous for the intended mother, and also in cases where a single man or a married couple of two men want to have a child. As we can observe, these are all cases when another way to have children is either impossible or threatening the health of a woman or a child. For a woman who wants to use surrogacy, for the implementation of the reproductive process, the clinic must be provided with the appropriate supporting documents, that is, the doctor's conclusions about the presence of contraindications to pregnancy or confirmation of the unsuccessful passage of in vitro fertilization, as a rule, this is at least 4 such IVFs.
As for the definition of the concept of a surrogate mother, in the legislation of different efforts where surrogacy is allowed, this definition sounds different, although one way or another it has the same basis and meaning.
Summarizing the main positions that form the modern term "surrogate mother", we offer the following formulation.
A surrogate mother is a woman who, according to the contract, voluntarily, altruistically or for material compensation, bears and gives birth for parents at the intention of a child with whom she has no genetic connection, conceived and implanted by IVF using the genetic material of the parents by intention or donor.
The World Health Organization uses the term Gestational Courier to refer to a surrogate mother, defining her as a woman who has become pregnant as a result of fertilization using germ cells of both oocytes and spermatozoa belonging to a third person, and carrying a pregnancy, provided that either one or both of the people who provided the gametes for fertilization will become the parents of the child she has born.
I would also like to draw your attention to the wording of the term "parents by intention" as such, which is most often used today in all countries. Its use in such a formulation is associated not with the controversy of the rights to the child of his biological parents, but with the fact that from a legal point of view, they will become parents only after the fact of the birth of the child, and at the time of the immediate signing of the surrogacy agreement, they are exactly the ones with the intention of becoming parents. Calling parents by intention, genetic parents, will be actual only after the fact of the birth of a child and only if they both have a genetic relationship with the child, which does not always happen, given the need in frequent cases to use the material of a woman or man's donor or even use of full donation. So, parents by intention - those who intend to become the parents of a child whom, according to the contract, the surrogate mother bears and gives birth and with whom she has no genetic connection, conceived and implanted into the body of the surrogate mother through IVF using the genetic material of the parents by intention or donor.
After the fact of the birth of a child, these people can safely be called the actual parents or simply the parents of the child. Now they finally acquire such an important status, bringing the greatest sense of happiness in our life and a huge responsibility for a new life.