The last eighteen months have been tough for international surrogacy facilitators and agents. In the wake of several high profile cases, India has continued to tighten its restrictions on surrogacy. Thailand closed its doors in 2014 although the case of Baby Carmen continues to highlight the danger of surrogacy in a place where the legal framework is evolving. An earthquake in Nepal didn't slow them down, but the Supreme Court in Nepal has put a moratorium on surrogacy. The news from Mexico has not been encouraging.
Of all the possible locations on the planet to descend upon for surrogacy, where are the international facilitators and agencies going now?
As a wise man once said, I'm not making this up.
Let's see what the US State Department (link) has to say about traveling to Cambodia.
"Cambodia has a high crime rate, including street crime. Military weapons
and explosives are readily available to criminals despite authorities’
efforts to collect and destroy such weapons. Armed robberies occur
frequently, and foreign residents and visitors, including U.S. citizens,
are among the victims. The Embassy has also received reports that hotel
rooms of U.S. citizen visitors in Phnom Penh were burglarized while the
occupants were asleep."
"Local police rarely investigate reports of crime against tourists, and
travelers should not expect to recover stolen items. It has also been
reported that some police stations charge foreigners between $20 and
$100 to file a police report."
The concept of someone breaking into my hotel room while I'm sleeping is creepy to say the least, the idea of this happening in a room where my newborn infant is sleeping is horrifying. That's saying nothing about the military-grade weapons that are easily accessible.
On LGBT Rights:
"While there are no legal restrictions on same-sex sexual relations or
the organization of LGBT events in Cambodia, public attitudes remain
negative towards LBGT individuals, and same sex marriage is generally
not permitted. There have been no reports of arrests or violence related
to LBGT travelers."
The fact that there have not been reports of arrests or violence related to LGBT travelers may seem encouraging, however the cultural climate of negativity towards the LGBT community is concerning. What is more concerning is that despite several cases of LGBT parents experiencing legal issues in non tolerant countries, that facilitators and agencies continue to bring their clients to places where their rights are not recognized and protected.
Most importantly, this is what the US State Department says on on Health:
"Medical facilities and services in Cambodia do not meet international
standards. Both Phnom Penh and Siem Reap have a limited number of
internationally-run clinics and hospitals that can provide basic medical
care and stabilization. Medical care outside of these two cities is
almost non-existent. Local pharmacies provide a limited supply of
prescription and over-the-counter medications, but because the quality
of locally obtained medications can vary greatly, make sure to bring a
supply of your medications that is adequate for the duration of your
stay in Cambodia. You should be wary of purchasing local medication.
Counterfeit medication is readily available, often indiscernible from
authentic medication, and potentially lethal."
Even if we were to ignore everything else, what about the above paragraph indicates that Cambodia is a safe and appropriate place to conduct a surrogacy? By definition, surrogate pregnancies are considered high risk. The increased risk of multiple pregnancy and prematurity make access to high quality health care critical for the safety and wellbeing of babies.
Likely, if you point this out to one of the facilitators or agents currently touting Cambodia as the next great option for international surrogacy they will tell you that "their" doctors and clinics are state of the art. Given that they make thousands of dollars from IPs with absolutely zero accountability for outcomes, I suppose it's not surprising that they would minimize the risk. Disappointing, but not surprising. I mean really.... who cares what the State Department has to say as long as the facilitators "feel" good about it.
Families through Surrogacy's website has the following to say about surrogacy in Cambodia:
Note: The Cambodian surrogate retains parental rights under the law. While facilitators may feel comfortable minimizing the risk that this poses to intended parents, one only has to look at the current Baby Carmen case to see just how dangerous ignoring the legal rights of the surrogate is.
As always, we urge all hopeful IPs to consider the risks to everyone involved when it comes to weighing your options, no matter how desperate you may feel. As has been said here before, where your baby will be born is the first decision you will make that could have serious and/or long-lasting repercussions on your baby's health. As the first anniversary of my twins' birth and my son's death quickly approaches, I remember how we were reassured repeatedly that our surrogate was receiving the absolute best care possible, and that my twins would have access to the same level of healthcare as they would in a regional medical center in the United States. My wife and I believed what we had been told repeatedly by our facilitator, and it wasn't until we received conflicting information in the wake of the premature birth that our facilitator admitted that she wasn't a medical professional.
As a matter of fact, none of them are.
None of them are legal experts in any of the numerous countries they have churned through over the last almost two years, either. There is no possible way any of them could become legal experts on surrogacy in country after country after country.
None of them are fluent in the local language, and I find it implausible that any of them could have become experts in the local customs and cultural practices in the very limited amount of time that they spend there before declaring a program "open for business."
Yet they routinely present themselves to desperate intended parents as being experts who are able to determine whether a hospital, clinic, or even an entire country is an appropriate and safe place to bring a newborn into the world.