New Study Reveals Mental Health Risks for Surrogates in Pregnancy

A recent study published in the JAMA Network Open has unveiled significant mental health risks associated with surrogacy, highlighting that gestational carriers face higher incidences of mental health disorders during and after pregnancy compared to women who conceive naturally or through in vitro fertilization (IVF). Conducted by researchers at McGill University and the Institute for Clinical Evaluative Sciences (ICES) in Canada, the study examined a comprehensive dataset encompassing 767,406 pregnancies in Ontario between 2012 and 2021.

According to the findings, surrogates are particularly susceptible to new-onset mental health issues, with diagnosed conditions ranging from mood and anxiety disorders to more severe complications like psychosis and self-harm. Dr. Sumina Reddy, a fertility consultant and director at Fertilica IVF & Women Care in Hyderabad, emphasizes the emotional complexities involved in surrogacy: "Pregnancy is not just a biological process; it’s deeply emotional. Surrogates undergo all the hormonal, physical, and emotional changes associated with pregnancy, irrespective of their genetic connection to the baby."

The study revealed that many surrogates had their mental health issues diagnosed in emergency or inpatient settings, indicating a troubling delay in support and intervention. Dr. Sarada Vani N, a senior consultant in Obstetrics and Gynaecology at Yashoda Hospitals, noted that the median time from conception to diagnosis of these conditions was approximately two and a half years, suggesting that some issues manifest long after childbirth. Furthermore, the study found that nearly one in five surrogates had a history of mental health issues, raising concerns about the adequacy of psychological evaluations in surrogacy practices.

In India, the Surrogacy (Regulation) Act of 2021 mandates psychological and medical evaluations for surrogates, but Dr. Reddy argues that implementation of these guidelines remains inconsistent. "This study should serve as a wake-up call. Are we truly evaluating these women across all centers?" she questioned. At Fertilica, Dr. Reddy's practice includes postnatal mental health check-ins as a standard part of surrogate care. She insists that this approach should not be the exception but rather the norm across all medical facilities.

While the research underscores the necessity of comprehensive mental health support for surrogates, it does not detract from the value of surrogacy as a reproductive option. "Surrogacy is a courageous and generous act," Dr. Reddy stated, emphasizing the need for societal support that extends beyond physical care to include emotional well-being before, during, and long after the birth of the child.

Despite its significant findings, the study has limitations, including a sample size of only 758 surrogates and reliance on administrative health data, which may not capture subtler emotional challenges. Nevertheless, the statistical significance of the results calls for urgent attention to the mental health needs of surrogates, advocating for enhanced safeguards and support systems. As public awareness of surrogacy grows, addressing the mental health implications for gestational carriers becomes increasingly imperative in shaping policies and practices that honor their contributions.