Surrogacy and the Moral Significance of Gestation: Reassessing Procreative Responsibilities

Journal
Bioethics
Publisher
Wiley
Date Issued
2026-07-06
Author(s)
Pietrini‐Sanchez, Maria‐Jose
Type
Article
DOI
URL
Abstract
Practices involving assisted reproductive technologies (ARTs) presuppose the allocation of procreative responsibilities of various types and degrees among clinical embryologists, fertility doctors, and nonmedical individuals such as gamete bank staff and attorneys, while typically exempting them from parental rights and obligations. These individuals are appropriately regarded as third-party participants in assisted reproductive technology (ART) procedures. Surrogates, however, engage in gestational labour which implies a sustained, embodied, and relational form of care fundamentally distinct from the technical or procedural contributions of other third-party participants. This distinction calls into question the adequacy of classifying surrogates as mere third-party contributors. This article rejects that classification and argues that the procreative responsibilities of surrogates are better understood as proto-parental responsibilities grounded on the normative significance of gestation. These responsibilities constitute a prior stage of parenthood, providing the moral basis for subsequent parental rights and obligations. In advancing this view, this article critically engages with the professional model proposed by Ruth Walker and Liezl van Zyl, according to which surrogates' procreative responsibilities should be understood in professional terms. I argue that the professional model undermines the surrogate's reproductive autonomy, trivialises the moral significance of gestation, and obscures the moral importance of the connection between gestation and parenthood. By contrast, the account developed here argues that proto-parental responsibilities arise from gestational proximity and the pregnant woman's capacity to cultivate relationship goods foundational to the parent–child relationship. © 2026 John Wiley & Sons Ltd.