In the U.S., surrogate parenting is widely accepted. Although no official figures exist, experts believe perhaps a thousand American children are born every year through surrogacy.

A patchwork of state-to-state regulations governs the practice. But the bottom line is if you're an American in the market for a surrogate — and you have money to spend — you can do it.

Things are very different in other parts of the world.

In Europe, for example, it's illegal in half a dozen countries, including France, Germany, Italy and Spain. It is permitted in a handful of other European nations — though there are major restrictions.

In the U.K., British couples hoping for a child cannot openly solicit a surrogate, and women cannot publicly offer to be surrogates.

Simon Clements and Steve Williams managed to successfully navigate the complicated process, and are now the proud dads of Sophie.

Their journey to become parents began, first, by dismissing any of their female friends' offers of help.

"We felt like the law wasn't completely clear on who the child would go to once he or she was born," says Williams.

An Israeli man carries his newborn baby, who was born to a surrogate mother in Nepal, as he arrives at Ben Gurion airport near Tel Aviv on April 28, after a massive earthquake hit the Himalayan nation. Israel was criticized for evacuating the babies and Israeli parents who had come to pick them up — but leaving the babies' mothers and other pregnant Nepali surrogates behind.

An Israeli man carries his newborn baby, who was born to a surrogate mother in Nepal, as he arrives at Ben Gurion airport near Tel Aviv on April 28, after a massive earthquake hit the Himalayan nation. Israel was criticized for evacuating the babies and Israeli parents who had come to pick them up — but leaving the babies' mothers and other pregnant Nepali surrogates behind.

Jack Guez/AFP/Getty Images

In July 2012, they joined a support organization called Surrogacy UK and attended socials organized by the group. The gatherings, which often take place in pubs, are opportunities for would-be parents to meet potential surrogates.

But the situation is tricky, since the law doesn't allow them to discuss surrogacy.

"We talked about everything else, we talked about our jobs, we talked about our social lives, we talked about our interests," Williams recalls.

Clements and Williams went to 12 socials — one a month, for a year. They also had a profile on the website. And once again, they were able to say anything they wanted about themselves — except that they were hoping to have a baby through surrogacy.

Eventually, in October 2013, they met Lauren, the woman who would end up bearing their child, using a donor egg.

"She read our profile and really liked us as a couple and liked the sound of our interests," Williams says.

In December last year, more than two years after the process began, Clements and Williams welcomed Sophie into their lives.

Now, they say, they expect Lauren to remain in their family's life.

"We've seen it happen with other intended parents, when they have their children, they introduce the children back to the surrogate, saying 'Here's your tummy mommy,'" Williams says.

Looking Abroad For A Surrogate

Clements and Williams were lucky. Some couples in England spend years unsuccessfully looking for someone to carry a child for them.

Many parents in Europe and the U.S. turn to other countries, such as Thailand and Nepal, where high-profile cases involving surrogacy have been in the news recently.

And in India, surrogate parenting is a virtual industry.

"There are many agencies who are offering women who will be able to rent their womb," says Ranjana Kumari, director of the Centre for Social Research in New Delhi.

Kumari has studied surrogate pregnancies in India and is an advocate for Indian surrogates, who are usually very poor women.

As in cases of organ sales, Kumari says, the women are willing to go through the procedure because of the money-making opportunity.

No one knows how many surrogate children are born in India. Kumari's best guess is that the figure is around 40,000 a year — more than half of them to international parents.

In India, the process can cost $60,000, while in the U.S., estimates range to upwards of $150,000.

A surrogate mother in India may receive as little as one-tenth of the total amount. But even that sum allows some women to support themselves.

Kumari says India has few laws regulating surrogacy, which can leave the mothers vulnerable.

"These women are identified by the doctor. There is a middleman who would then benefit by this whole effort of getting this woman to the doctor," Kumari says. "These women who are being hired, most of them are illiterate so they don't know what they have been promised. Even the money promised doesn't go to them because all the food they eat, all the care that is provided, is all deducted from her [payment]."

This is a global industry, without global regulations. From the United States to Europe to India, families are sometimes making decisions in the dark about the most personal issues that any human can face.

Without a doubt, Williams and Clements are ecstatic to be dads to Sophie.

"She does complete our life," Clements says.

The two men say they would like a second child someday.

But given the effort it took to conceive Sophie, they're content for the time being to nurture their family of three.

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

RENEE MONTAGNE, HOST:

There are many ways families are formed today that would've been unheard of just a couple of generations ago. One is surrogate parenting. We're exploring it this morning as part of our occasional look at the modern family. Surrogacy is widely accepted in the United States, but it's rare in many parts of the world.

ARI SHAPIRO, HOST:

Even in the U.S., nobody is tracking exact numbers. Experts believe perhaps a thousand American children are born every year through surrogacy. The country is a patchwork of regulations from state to state. But the bottom line is if you're in the market for a surrogate and you have money to spend, you can do it.

(SOUNDBITE OF AD)

UNIDENTIFIED WOMAN: The best reward about being a mother is being able to watch your child grow into a beautiful individual. We provide the full-service, hands-on gestational surrogacy and egg donation program.

SHAPIRO: That's an ad for one of many companies that offer surrogacy services in the United States. Things are very different on the other side of the Atlantic Ocean. Surrogacy is illegal in half a dozen European countries. It is permitted in a handful of others where there are major restrictions, like England. On a recent sunny day, I met two dads in London with their new baby.

STEVE WILLIAMS: I'm Steve Williams.

SIMON CLEMONS: I'm Simon Clemons.

WILLIAMS: And we have our daughter here, Sophie Williams, as well.

SHAPIRO: Hi, Sophie.

SOPHIE WILLIAMS: (Squealing).

WILLIAMS: Yeah, thank you.

(LAUGHTER)

SHAPIRO: British couples hoping for a child cannot openly solicit a surrogate. Women cannot publicly offer to be surrogates. It's a complicated situation for anyone to navigate. Simon and Steve eventually found a woman named Lauren to bear their child using a donor egg.

WILLIAMS: We joined a support organization called Surrogacy UK.

CLEMONS: I suppose what we could just say is before we did that, we dismissed any of our friends offering to help us.

SHAPIRO: You considered asking female friends if they would help you?

WILLIAMS: Yes, but we felt like the law wasn't completely clear on who the child would go to once she was - he or she was born.

CLEMONS: Which is why we then - it started with a Google search, didn't it? We...

(LAUGHTER)

SHAPIRO: What terms did you put into a Google search?

WILLIAMS: UK and surrogacy, I think.

CLEMONS: Surrogacy UK came up. Surrogacy UK provides socials - they're often held in pubs - where intended parents can meet surrogates.

SHAPIRO: But describe for me a social setting where there are clearly these women of childbearing age; there are clearly parents who are not able to have children on their own. And yet, neither is able to say to the other, here's what we're doing here.

WILLIAMS: We talked about everything else. We talked about our jobs. We talked about social lives. We talked about our interests.

CLEMONS: We spent a year going to socials. It was about one a month. So in our first year, we went to 12 socials. But apart from the socials, we also have a profile.

SHAPIRO: And that's on a website where you're allowed to say everything about yourselves except for the fact that you are hoping to have a baby through surrogacy?

WILLIAMS: Yes.

SHAPIRO: So how did you meet Lauren?

WILLIAMS: She read our profile and really liked us as a couple and liked the sound of our interests.

SHAPIRO: And you expect that Lauren will remain a part of your life and a part of Sophie's life.

WILLIAMS: Yeah. We've seen it happen with other intended parents. When they have their children, they introduce the children back to the surrogate, saying, here's your tummy mommy.

SOPHIE: (Squealing).

WILLIAMS: Yes.

(LAUGHTER)

SHAPIRO: Many hopeful parents in Britain are not so lucky. Some couples in England spend years unsuccessfully looking for someone to carry a child for them. So many parents - in Europe and the U.S. - turn to other countries. In India, surrogate parenting is a virtual industry.

RANJANA KUMARI: There are many agencies who are offering women who will be able to rent her womb.

SHAPIRO: That's Ranjana Kumari. She's director of the Centre for Social Research in New Delhi. She has studied surrogate pregnancies in India, and she advocates for Indian women who become surrogates.

KUMARI: They are, by and large, very, very poor women. They need money. Just like organ sale, they are willing to go through operation to get the child out because there's a cost to this child. And anything may go wrong in the process because there's a huge money transaction that takes place between the commissioning parents and the doctor.

SHAPIRO: No one knows how many surrogate children are born in India. Her best guess is that the figure is around 40,000 a year, more than half of them to international parents. In India, the process can cost $60,000, a fraction of what it would in the U.S. A surrogate mother may receive as little as one-tenth of that money. But even that small sum allows some women to support themselves. Kumari says India has few laws regulating surrogacy, and that can leave the mothers vulnerable.

KUMARI: These women are identified by the doctor. There's a middleman who would then benefit by this whole effort of getting this woman to the doctor. These women who are being hired, most of them are illiterate, so they don't know what they have been promised. Even the money promised doesn't go to them because all the food they eat, all the, you know, care is provided is all deducted from her cost.

SHAPIRO: This is a global industry without global regulations. From the United States to Europe to India, families are sometimes making decisions in the dark about the most personal issues that any human can face. You can hear the emotion in the voices of Steve Williams and Simon Clemons, the new dads in England.

CLEMONS: She does complete our life.

WILLIAMS: I was going to say, it was a totally new experience to call myself a dad for the very first few days she was born. And I was saying dad to her, and that felt absolutely amazing.

CLEMONS: Yeah, we couldn't be happier.

SHAPIRO: They say they would like a second child someday. But given the effort it took to conceive Sophie, they are content for the time being to nurture their family of three. Transcript provided by NPR, Copyright NPR.

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