A recent Canadian study[1] found a higher rate of new-onset mental illness for gestational surrogates after comparing non-gestational and gestational carriers. The cohort-based study found that, out of 767,406 pregnancies, “...the incidence rate per 100 person-years of new-onset mental illness was 5.2 among non-gestational carriers with unassisted conception, 5.0 among non-gestational carriers who conceived by in vitro fertilization, and 6.9 among gestational carriers.” These illnesses included anxiety and mood disorders, substance abuse issues, self-harm events, and other mental health disorders.

 

Surrogates already undergo mental health screenings and counseling before beginning the process, and agencies strongly recommend that potential carriers have solid support networks before pursuing surrogacy, so what could be causing this increased rate of mental illness?

 

 

Dissociation

Surrogacy exploits women’s miraculous ability to be co-creators with God in making new human beings, as a surrogate’s main objective is to grow a healthy baby and deliver the child back to the consumers who have rented her entire body for their means. Surrogacy asks women to intentionally be mothers, and then denies that they are, in fact, mothers. Both of the women involved, the intended mother and the surrogate, are intentionally separated from their children, intentionally separated from their bodies through dissociation, or the separation of mind from body, and no one can say, plainly and unambiguously, who the true mother is. These women dissociate because neither of them is entirely connected to their bodies–one woman is only expecting a baby mentally, and the other has convinced herself that she’s only expecting a baby physically, even though she’s the one forming the child’s being within her, because she won’t be raising the baby.

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As Anthropologist and Yale professor Kalindi Vora writes: “Through counseling and conversations with doctors, a surrogate is encouraged to think of her womb as a space she can rent out; the analogy many surrogates spoke of is that the womb is like a spare room in a home, where someone else's baby will stay and grow.”[2] Feeling natural attachment towards the child you’re carrying, of course, does nothing to benefit the 14-billion-dollar industry.[3]

 

This unnatural process requires a separation of mind and body of the surrogates–the process of dissociation. This dissociation is similar to prostitution, in that, as a coping mechanism, prostitutes shut out feelings that are emotionally unpleasant or traumatic, and split their awareness between their minds and their bodies in order to protect their innermost selves from being affected by the abuse their bodies are experiencing.[4] After the abuse, it’s often difficult for these women to re-establish a proper and healthy interrelation of their minds and bodies.[5]

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The reality of dissociation takes place when the surrogate makes a part of herself (her uterus) into an object that belongs to someone else. Prostitutes and surrogates both claim that parts of their bodies are not themselves in order to distance themselves from their experiences. A prostitute will claim “my body is not myself,” and a surrogate will claim “the child is not mine,” and this process is exactly what makes surrogacy work best.[6]

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Surrogacy asks of a woman the same split awareness of mind and body, as a surrogate is asked to view her body as an incubator and herself as simply a “babysitter,” even though she is the one responsible for forming the very being of the child and for giving birth to the child, all while enduring the separation of the child her body naturally knows as her child, a child who has also formed a bond with her, from her body. Surrogates are told that nutrients, including calcium from her very bones that are feeding the growing child, and that the cells that are swapped between mother and child and remain in the mother, have absolutely nothing to do with her because the child doesn’t have her genetics or isn’t being made “for her.”[7]

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This dissociation is more difficult in surrogacy than in prostitution, however, as surrogates do not have the opportunity for escapist activities that prostitutes can use as coping mechanisms to deal with the reality of selling themselves. Surrogates are not able to simply take time out and “stop being pregnant,” and they can’t escape by using alcohol or drugs, as they must think of the children’s well-being in every aspect of their daily lives, while simultaneously distancing themselves from their bodies and the children they are carrying. Surrogates can’t simply shut themselves off with escape mechanisms to numb the reality that their bodies are being rented, as they must distance themselves from a part of themselves while being required to care about a part of themselves.[8]

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When pregnancy is no longer the act that makes one a mother, but an act where a woman can outsource her body and intentionally deny bonding with the child growing inside her, there’s an unnatural severing of mother and child that could contribute to mental health concerns.

 

 

Wired to care for their children

Pregnant women also undergo changes in their brains to better respond to the cues and needs of their infants.[9] For example, there is a reduction in gray matter[10] in the brain that helps women become more attuned to responding to the needs of their babies.[11] This change in gray matter is called “synaptic pruning,” and “helps streamline neural pathways that may aid mothers in recognizing and responding to their baby’s needs. This transformation is thought to improve emotional regulation, social interactions and attachment — essential skills for nurturing a newborn.”[12]

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Along with changes in the brain, the increase in the hormones oxytocin and prolactin help mothers to recognize infants’ emotional cues, facial expressions, distinguish their cries,[13] and influence maternal bonding and attachment behaviors.[14]

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How incredibly difficult it must be psychologically for a woman, whose brain and hormones have changed to care for the baby her body biologically knows as her child, to have to sever that connection. Even if the woman has convincingly told herself that she has no attachment to the child she has carried, her body still naturally longs for this child.

 

It’s already known that children separated from their mothers at birth can experience a life-long primal wound [15], so it shouldn’t be surprising that this severing can also lead to an increase in mental health issues for surrogates since mother and child are a dyad.[16] In order to preserve the dignity and worth of women and children as made in the image of God, we must strive to follow Christ’s ideals for marriage, family, and motherhood, and heed the teachings of the church on surrogate motherhood as written in “Donum Vitae”: “Surrogate motherhood represents an objective failure to meet the obligations of maternal love, of conjugal fidelity and of responsible motherhood; it offends the dignity and the right of the child to be conceived, carried in the womb, brought into the world and brought up by his own parents; it sets up, to the detriment of families, a division between the physical, psychological and moral elements which constitute those families.”[17]

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[1] Velez, Maria P, Natalie Dayan, Simone N Vigod, William Buckett, Sydney Flatt, Jonas Shellenberger, and Joel G Ray. 2025. “New-Onset Mental Illness among Gestational Carriers.” PubMed 8 (7): e2523428–28. https://doi.org/10.1001/jamanetworkopen.2025.23428.

[2] “Kalindi Vora | S&F Online | Critical Conceptions: Technology, Justice, and the Global Reproductive Market.” 2025. Barnard.edu. https://sfonline.barnard.edu/reprotech/vora_03.htm.

[3] Burke, Samuel. 2024. “Shadowy Baby Factories—the $14 Billion Surrogacy Industry with Hidden Links to Eastern Europe.” Fortune Europe. https://fortune.com/europe/2024/08/16/shadowy-baby-factories-the-14-billion-surrogacy-industry-with-hidden-links-to-eastern-europe-canada/.

[4] “Surrogacy - OBJECT NOW.” 2021. June 5, 2021. https://objectnow.org/surrogacy/.

[5]Kajsa Ekis Ekman. 2014. Being and Being Bought : Prostitution, Surrogacy and the Split Self. North Melbourne, Victoria Spinifex Press, 99

[6]Kajsa Ekis Ekman. 2014. Being and Being Bought : Prostitution, Surrogacy and the Split Self. North Melbourne, Victoria Spinifex Press, 172-173.

[7] “Amazon.com: Surrogacy: A Human Rights Violation (Spinifex Shorts) EBook : Klein, Renate: Kindle Store.” 2025. Amazon.com. 2025. https://www.amazon.com/Surrogacy-Rights-Violation-Spinifex-Shorts-ebook/dp/B0758L6CV4/.

[8] Kajsa Ekis Ekman. 2014. Being and Being Bought : Prostitution, Surrogacy and the Split Self. North Melbourne, Victoria Spinifex Press.

[9] Oatridge, Angela, Anita Holdcroft, Nadeem Saeed, Joseph V Hajnal, Basant K Puri, Luca Fusi, and Graeme M Bydder. 2002. “Change in Brain Size during and after Pregnancy: Study in Healthy Women and Women with Preeclampsia.” AJNR: American Journal of Neuroradiology 23 (1): 19. https://pmc.ncbi.nlm.nih.gov/articles/PMC7975506/.

[10] Lanese, Nicoletta. 2024. “Pregnancy Shrinks Parts of the Brain, Leaving ‘Permanent Etchings’ Postpartum.” Live Science. September 16, 2024. https://www.livescience.com/health/neuroscience/striking-brain-scans-reveal-how-one-mom-s-brain-changed-during-pregnancy.

[11] Caruso, Catherine. 2016. “Pregnancy Causes Lasting Changes in a Woman’s Brain.” Scientific American. December 19, 2016. https://www.scientificamerican.com/article/pregnancy-causes-lasting-changes-in-a-womans-brain/.

[12] “How Pregnancy Rewires Your Brain for Motherhood.” 2024. Nuvancehealth.org. 2024. https://www.nuvancehealth.org/health-tips-and-news/how-pregnancy-rewires-your-brain-for-motherhood.

[13] “How Pregnancy Rewires Your Brain for Motherhood.” 2024. Nuvancehealth.org. 2024. https://www.nuvancehealth.org/health-tips-and-news/how-pregnancy-rewires-your-brain-for-motherhood.

[14] Feldman, Ruth, Aron Weller, Orna Zagoory-Sharon, and Ari Levine. 2007. “Evidence for a Neuroendocrinological Foundation of Human Affiliation.” Psychological Science 18 (11): 965–70. https://doi.org/10.1111/j.1467-9280.2007.02010.x.

[15] Verrier, Nancy. n.d. “Adoption: The Primal Wound Effects of Separation from the Birthmother on Adopted Children.” https://adopta.hr/images/pdf/the_primal_wound.pdf.

[16] Tsang, Li Ping Marianne, David Chee Chin Ng, Yoke Hwee Chan, and Helen Yu Chen. 2019. “Caring for the Mother-Child Dyad as a Family Physician.” Singapore Medical Journal 60 (10): 497–501. https://doi.org/10.11622/smedj.2019128.

[17] Congregation for the Doctrine of the Faith. 1987. “Instruction on Respect for Human Life.” Www.vatican.va. February 22, 1987. https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html.

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