Ghanaian women’s motivations for becoming surrogate mothers

Abstract

This study explores the motivations behind Ghanaian women’s decisions to engage in surrogacy, a growing practice within the country’s assisted reproductive technology landscape. Using a phenomenological qualitative approach, 21 surrogates from three privately owned agencies in Accra were interviewed to uncover the underlying factors influencing their choices. Thematic analysis, guided by Braun and Clarke’s framework, revealed three primary motivators: socio-economic factors, altruism, and religious beliefs. Financial incentives emerged as a significant driver, with participants citing surrogacy as a means to alleviate economic hardship, fund education, or support family needs. However, altruistic motivations were also prevalent, as some women expressed a deep empathy for childless couples and a desire to provide them with a sense of familial completeness. Religious motivations, rooted in Christian doctrines of love and service, further shaped the decisions of a subset of participants, who perceived surrogacy as a moral duty aligned with their faith. The findings underscore the complex interplay between economic vulnerability, cultural norms surrounding motherhood, and ethical considerations in shaping surrogacy decisions. The study situates these motivations within Ghana’s socio-economic context, highlighting how financial necessity intertwines with seemingly altruistic and religious frameworks. It concludes that while altruism and spirituality often surface as explicit motivations, economic realities play a critical underlying role, reflecting broader dynamics of commodification in global reproductive markets. This research contributes to a nuanced understanding of surrogacy in Ghana, providing insights into the ethical and socio-economic dimensions of this reproductive practice.

Background

Surrogacy, a growing form of assisted reproduction, has been subject to ethical, legal, and social scrutiny worldwide, especially in the context of low- and middle-income countries [1–4]. Surrogacy is an advanced assisted reproductive technology that creates pathways to parenthood for various individuals facing reproductive challenges. This includes women with uterine abnormalities, those without a uterus, or those with medical conditions that prevent them from safely carrying a pregnancy. Additionally, it offers a solution for women who have experienced recurrent miscarriages or have undergone unsuccessful fertility treatments. In recent years, surrogacy has also enabled male couples and single individuals to conceive children who are genetically related to them by involving a surrogate who carries the pregnancy. This option represents a significant development in reproductive medicine, allowing individuals and couples, regardless of gender or partnership status, to fulfill their desires for biological parenthood [1].

The duty of procreation to populate the world for the continuity of the human race is not something that societies and individuals take with levity, especially, in Africa [5]. In Ghana, for instance, motherhood is deeply intertwined with cultural identity, and women who struggle with infertility often face considerable social stigma [6,7]. Surrogacy, therefore, becomes not only a medical solution but a social intervention [8], offering hope to childless couples. This is because it affords them the opportunity to have a child (ren) and thus avoid the stigma associated with childlessness.