Impact of the war in Ukraine and the COVID-19 pandemic on transnational surrogacy- a qualitative study of Danish infertile couples' experiences of being in 'exile'

Research question: How did Danish permanently infertile couples experience surrogacy when going abroad and what impact did the war in Ukraine and the COVID-19 pandemic have on this? Design: A qualitative study was performed between May and September 2022. The in-depth semi-structured interviews were conducted with 14 permanently infertile couples across Denmark who were in different stages of using surrogacy. The interviews were transcribed and analysed using systematic text condensation. Results: All except one couple went abroad, mainly to Ukraine, to have an enforceable transparent contract, professionals to advise them and the possibility of using the eggs of the intended mother. They did not feel that this was a choice but rather the only option they had to have the longed-for child. According to current Danish legislation, the intended mother could not obtain legal motherhood over the child, not even through stepchild adoption, and this increased the feeling of not being a worthy mother. This study expanded on the term reproductive exile by identifying four different forms of exile: the exiled Danish couple, the gestational carrier in exile, exile at home and, finally, the reproductive body in exile. Conclusions: Understanding infertile couples experiences when crossing borders is important for several reasons. It may, among others, assist politicians and authorities in developing a sound Danish legal policy on surrogacy to address the current issues of legal parenthood and avoid missing reproductive opportunities for permanently infertile couples.

Automated summary

This study examines the experiences of Danish permanently infertile couples when undergoing surrogacy abroad and the impact of the Ukraine war and COVID-19 pandemic. The findings reveal that most couples went to Ukraine due to the availability of enforceable contracts, professional advice, and the option to use the eggs of the intended mother. Current Danish legislation prevents the intended mother from obtaining legal motherhood, leading to feelings of inadequacy. The study highlights the importance of understanding cross-border experiences to inform legal policies and ensure reproductive opportunities for permanently infertile couples are not missed.