A pregnant woman. PHOTO/COURTESY
For nearly a decade, Madina and her husband Abdul have shared a loving marriage, but one thing continues to cast a shadow over their union: they have no children. The emotional weight of infertility has led them to consider surrogacy; a path filled with hope and hard questions. As they wrestle with ethical dilemma, they wonder is seeking a surrogate the right choice?
Surrogacy is a form of assisted reproduction in which a woman, known as a surrogate mother, agrees to carry and deliver a child on behalf of another person or couple, who become the child’s legal parents after birth.
What surrogacy involves
There are two main types of surrogacy, each defined by whether or not the surrogate has a biological connection to the child. In traditional surrogacy, the surrogate is genetically related to the baby, her egg is fertilised with the sperm of the intended father (or a donor), usually through artificial insemination. In contrast, gestational surrogacy involves no genetic link between the surrogate and the child. An embryo created through in vitro fertilisation (IVF), using the egg and sperm of the intended parents (or donors) is implanted into the surrogate’s uterus.
Surrogacy is often considered by individuals or couples who are unable to conceive or carry a pregnancy due to infertility, uterine complications, or health risks that could endanger the woman’s life. For them, surrogacy offers a lifeline to parenthood.
The process involves complex medical procedures such as IVF and requires carefully drafted legal agreements to outline the responsibilities and rights of everyone involved. Ethical questions, especially those around compensation, consent, and the emotional well-being of the surrogate also come into play.
In Uganda, surrogacy exists in a legal grey area. Although there is no law explicitly permitting or banning the practice, it has quietly taken root through informal arrangements. However, this could soon change. In 2023, Parliament introduced the Human Assisted Reproductive Technology Bill, which aims to regulate practices such as IVF and surrogacy under a clear legal framework.
According to the Bill, only individuals or couples facing verified medical infertility or health conditions that prevent natural reproduction would be eligible to pursue surrogacy. This means those seeking surrogacy for non-medical or lifestyle reasons would not qualify. The Bill also outlines age requirements for surrogate mothers, setting the minimum age at 18. However, the Uganda Human Rights Commission has recommended increasing this to 21 years, arguing that the emotional and psychological demands of surrogacy require greater maturity.
Importantly, the Bill states that surrogate mothers will not hold any parental rights over the children they carry. Legal responsibility and parenthood will be transferred to the intended parents after birth. To ensure ethical standards and medical safety, fertility centres offering assisted reproductive services would need to be accredited annually by the Ministry of Health, based on recommendations from the medical and dental practitioners’ council.
The Bill also proposes strict penalties for violations. Medical practitioners found using unauthorised gametes or embryos, or engaging in any activity outside the law—could face substantial fines and even imprisonment. These measures aim to protect all parties involved and ensure that surrogacy in Uganda is carried out safely, ethically, and transparently.
Status of surrogacy in Uganda
As of May 2025, the Human Assisted Reproductive Technology Bill remains under consideration in Parliament.
The government has requested additional time to harmonise the Bill’s provisions before it can be passed into law. Until that happens, surrogacy in Uganda continues to operate in a legal vacuum. While it is increasingly accepted as a way to help couples facing infertility or serious health challenges to have children, it remains unregulated.
This leaves intended parents and service providers vulnerable. Without statutory protections, all surrogacy arrangements are based on private contracts that lack enforceable safeguards. This heightens the risk of legal disputes, emotional distress, and ethical complications. Surrogacy in Uganda, like in other parts of the world, raises a host of ethical concerns. Here are some major issues surrounding the practice.
Lack of legal framework
Uganda does not yet have a specific law governing assisted reproductive technologies (ART). Although the Constitution offers broad rights that could be interpreted to support ART, the legal ambiguity around parentage, custody, and the welfare of children born via surrogacy remains a major concern.
Risk of exploitation
In the absence of regulation, surrogate mothers often from financially vulnerable backgrounds can be exploited by commissioning parents or agencies. There are fears that some women are not giving fully informed or voluntary consent.
Also, many women agree to become surrogates primarily due to economic hardship. This raises ethical questions about whether their decision is autonomous or driven by desperation.
Commercialisation of the body
Turning surrogacy into a transactional arrangement risks commodifying both women’s bodies and the children born through the process, sparking deep discomfort among critics.
Cultural and religious objections
In many Ugandan communities, childbearing is closely tied to lineage, identity, and tradition. Surrogacy can be viewed as alien or even shameful. Additionally, some Christian and Muslim groups oppose surrogacy on religious grounds, arguing that it disrupts natural conception, marital intimacy, and divine will.
Profit vs patient welfare
There are concerns that some fertility clinics may prioritise financial gain over the health and rights of surrogate mothers, especially in an unregulated environment.
Recommendations
Tracy Ritah Achola, a lawyer, recommends that Parliament should fast-track the review of the Assisted Reproductive Technologies (ART) Bill 2021 before it is passed into law, to make it non-discriminatory and applicable to all persons of reproductive age, as this will respond to many existing gaps in access to ART treatment and services for people with infertility issues.
The Bill seeks to offer protection to persons seeking the assisted reproductive technology services and providers of the services, and in all this, must exhibit principles of equality and non-discrimination as provided for in the Constitution of the Republic of Uganda 1995.
Parliament should fast track the development, passing and operationalisation of the Regulations on Assisted Reproductive Technology (ART) for purposes of regulating costs and setting financial thresholds on ART treatment and services, to avoid financial exploitation of people seeking and receiving ART treatment.
Benchmark on the provisions in laws and policies on Assisted Reproductive Technology in countries such as Kenya and South Africa, which have proved to be positive on high-technology scientific procedures, for example, ART, and have passed progressive laws on the same.
Recognise the right to benefit from scientific innovations and technologies such as ART, for all persons in need of such as per the international laws and treaties that Uganda is a party to.
The need to create options for surrogacy and ART within the law, beyond infertility issues. Inability to give birth is not limited to fertility issues, it could also be mental health issues (even though fertile), preference or lifestyle.
Bottomline
Surrogacy offers a pathway to parenthood for many who would otherwise have no chance of having biological children. In Uganda, it is quietly becoming a reality for more couples, but without clear laws, the journey remains fraught with uncertainty.
The proposed Human Assisted Reproductive Technology Bill is a step in the right direction.
