In what’s used to be a well-kept secret, some women have used surrogates for more social reasons, not for reasons relating to infertility.

*“I call these cases designer surrogacy,” says Lori Arnold, MD, a northern San Diego fertility doctor. She says that she’s worked with a socialite “who didn’t want to get fat,” a runner who had an upcoming marathon, and a fellow MD who Arnold says, “couldn’t really afford to be pregnant—some women work right up to the moment they deliver, but others can be bedridden for several months.”

Woman who choose surrogacy for purposes other than infertility, may indeed, be judged. Many believe pregnancy should not be treated as an inconvenience. Many celebrities have been criticized for using a surrogate to prevent stretch marks or interrupting film schedules.

The first United States surrogacy contract written in 1976, caused speculation that we’d become a divided nation of breeders and then the wealthy who exploit them. There are some states, such as Texas and California that allow it, while others ban it altogether. In 2012, guidelines issued by the American Society for Reproductive Medicine (ASRM), state that surrogacy should only be used “when a true medical condition precludes the intended parent from carrying a pregnancy or would pose a significant risk of death or harm to the woman or the fetus. The indication must be clearly documented in the patient’s medical records.” In Texas, there has to be a medical necessity for someone to do surrogacy.

David Smotrich, MD, a San Diego fertility specialist who’s widely regarded as the world leader in the field, even offers a scientific rationale for social surrogacy, “If you take the same embryo, there’s a medical benefit to putting it in a woman who’s been pregnant before; we have proof that her uterus works,” he says, estimating that using a tried-and-true womb can boost IVF success rates by up to 20 percent.

But what is the definition of “medical need?” Paula Amato, MD, associate professor of obstetrics and gynecology at Oregon Health & Science University in Portland, who helped write the ASRM’s strict ethics guidelines, said it would be appropriate for doctors to offer the option to patients who suffer from severe anxiety or post-traumatic stress disorder. “We give a lot of leeway to doctors to make those decisions,” she says.

There are other potential candidates and situations that parents who want a family face. For example: an intended mother at risk for postpartum depression or one who has had a difficult first pregnancy.

As for Shared Conception (a Texas-based surrogacy agency), we have never agreed to work with clients interested in designer surrogacy. We have, however, seen cases where there is a mental reason, such as the intended mother being on anxiety medications or where the intended mother had a high-risk pregnancy the first time and has anxiety over having another high-risk pregnancy. These scenarios do exist and Shared Conception understands and is happy to assist.

Shared Conception wants you to share your thoughts with us- do you believe in designer surrogacy?

 *some content from Sarah Elizabeth Richards