27 December 2012

Uganda: Born of a Surrogate Mother

Christmas is here and we are celebrating the birth of Jesus Christ. Like Mary the mother of Jesus conceived a baby by the Holy Spirit, Ugandan women are also having 'miracle' babies, writes Carol Natukunda

In 2005, a 29-year-old mother was paid sh4.5m to carry a pregnancy for another woman. She delivered healthy twins and immediately handed them over to the woman who had hired her to carry the babies. She was not allowed to see the babies even for a minute. This woman (names withheld) became the fi rst surrogate mother in Uganda.

A surrogate mother is a woman who agrees, usually by contract and for a fee, to bear a child for a couple who are childless because the wife is infertile or physically incapable of carrying a pregnancy. Usually, she has no gene attachment as only a fertilised egg is put in her womb.

In a telephone interview with Sunday Vision on July 29, 2006, the surrogate mother, who preferred anonymity, was

excited about her experience. "I did it for money, but now I am very proud to have rendered such a service to a mother who lost her womb to cancer at the age of 22," she said.

"I was not allowed to see the babies after birth, but I do not mind. They have already paid me sh4.5m as agreed and I am home recovering. I am very relaxed, especially since my husband had consented to the arrangement," she added.

The surrogate mother said she had to take her children to a boarding school when she was fi ve months pregnant, so

that they would not ask about the babies. She also had to leave her home to avoid the neighbours' enquiries after giving birth. The surrogate mother was also mentally and psychologically prepared to give birth to another woman's children.

Now Common

Six years later, many Ugandan women are embracing the technology. Over 50 Ugandan women have since rented their

wombs, according to Dr. Tamale Ssali, the director of Women's International Hospital in Kampala.

This means that there are over 50 Ugandan children who have been born through surrogacy, since some of them might be twins. Ssali says the surrogacy programme gives one an opportunity to make dreams come true for those who cannot have their own children.

While not biologically related to the baby, surrogates play the most critical role in the process - carrying and delivering the baby created through eggs donated by the mother and sperm from a sperm donor or father.

Ssali is reluctant to discuss how much each of these 50 women earns at the end of the whole process. "It is not about money. It is often a mutual agreement. In fact, there are those who have done it free of charge," says Ssali.

However, a source at the centre says surrogates are paid between sh4m and sh10m. But sometimes, the source adds, because of the emotions and excitement involved, the "hiring" parents even triple the fee. "That is usually on a private arrangement. We do not intervene," the source said.

According to Ssali, both parties are often advised to sign a contract in order not to have any misunderstandings during the process.

The procedure

Dr. Ssali, who handled the first surrogate mother, says the procedure costs about sh13m. The costs include sh5m for gynaecological tests and sh3m for antenatal care and medicines.

The programme also involves counselling and psychological support to guide one through the entire journey. The surrogate mother is also provided with as much information as possible; spelling out their expectations in the surrogacy process.

"We thoughtfully match you with ntended parents, who desire the same experiences you do," says a doctor who prefers anonymity. "We look at this as a miracle. You are providing something that no one else can."

The doctor was, however, hesitant to comment on whether this is a form of making quick money, especially for women who are disadvantaged. "It is a selfless service. No amount of money can reward anyone. It is only a token of appreciation," he says.

Sources further reveal that on average, they receive about five inquiries every week on surrogacy. While the hospital may help couples fi nd a surrogate mother in some cases, some come with their friends or relatives, who offer to do it voluntarily.

Why Surrogacy

Efforts to talk to some of the women who have gone through the surrogacy experience were futile. The hospital says it is unethical to reveal identities of these women.

Besides, the phenomenon is relatively new in Uganda and has a lot of stigma surrounding it.

But like the fi rst 29-year-old surrogate mother confessed to doing it for a mother who had lost her womb, a lot of couples choose surrogacy because of many problems. Ssali observes that some women may have overgrown fi broids in the uterus, which cannot allow them to conceive.

Others may have lost their uterus as a result of excessive bleeding during previous childbirth or a serious infection, which may have caused the uterus to rapture. Another common illness is endometriosis, a condition in which the uterus gets inflamed.


It is not easy being a surrogate mother, or the receiving parent. One nurse tells of a surrogate mother whom she had to relocate to another district altogether because she could not fi t in the community. With the money she got, she was able to start a business and start life all over again.

"It is complicated. What do you tell your neighbours who have seen you pregnant? Even if you are on the receiving end, how do you break the news that you have a baby when they have never seen you pregnant?" says a nurse.

In developed countries like the US, there are stories of surrogate mothers developing a close bond with the unborn baby and feeling devastated when they have to surrender the child at birth.

Because of the laws in many countries, surrogacy is similar to adoption, in that the surrogate mother is often recognised as the birth mother and can still change her mind about handing over the child to the birth parents.

If she decides to keep the baby, the parents will also lose any money they have invested into care for the surrogate mother. Even though the adoptive mother did not give birth, she still will experience a myriad of feelings that come along with being a new mother.

In Uganda, no cases of disgruntled surrogates have been reported. "The practice goes on undercover, so probably even if there is a problem, someone fears to report it," observes Sarah Opendi, the primary healthcare state minister.

Surrogate offspring

There are concerns that the rising numbers of children born through assisted reproduction may suffer lower self-esteem or be treated less positively by parents, siblings and schoolmates.

However, several studies show that children born to a surrogate mother or conceived through donated sperm or a donated egg do just as well psychologically as their counterparts who are naturally conceived.

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