How Philippine clinics illegally facilitate surrogacy

READ: Part 1 | Inside the Philippines’ booming underground surrogacy industry 

The last time Maria* gave birth, she said it felt different from the previous times she birthed her two children.

It was, after all, just a job.

“I didn’t feel any attachment at all,” she said. “I feel like I just shared my blood. I really didn’t feel like it was mine.” 

Maria had agreed to help an infertile Filipino couple achieve their ultimate dream of having a child, serving as their gestational surrogate in 2015. In exchange, she earned half a million pesos ($10,000), a huge sum of money in the Philippines, which she then used to renovate her house and invest in property. 

She is part of a secretive womb-for-hire industry in a predominantly Catholic country, where surrogacy is not regulated at all.

The industry is so clandestine that there is no single record or document saying Maria gave birth. The only evidence that she did, is because she says so.

Maria said her name never appeared on any medical records when she carried the baby for her commissioning couple. From her very first pregnancy scan, she had used the name of the intended mother — so there was no trace of Maria in any paperwork. 

It was the doctor who falsified the records for the couple.

“All of the medical records, everything was named after them,” she said. “They knew the doctor, and that was the doctor from the start, all the way to the delivery.”

She said the intended mother even went so far as to pretend she was pregnant around her family and friends.

“She bought the fake pregnancy bump, the things that actresses use on TV…so that her family would think that she was pregnant and was the one who gave birth to the baby to avoid any questions,” Maria said.

This falsification of birth certificates is illegal in the Philippines, and includes a penalty of imprisonment of up to eight years.

While surrogacy itself is a legal gray area in the country, many clinics and agencies commit this crime, in the process of transferring the child to commissioning parents.

Faking birth records

In the Philippines, the woman who gives birth to a child is presumed to be the legal mother. This complicates surrogacy arrangements in the country, where the only valid way for parentage to be transferred is for the commissioning parents to adopt the child from the surrogate, a time-consuming process with no guarantee of success. 

This also means that if a surrogate changes her mind and decides to keep the baby, the law will likely side with her and commissioning parents face the possibility of losing their child.

To avoid this, some agencies and clinics in the Philippines falsify birth records, illegally listing the commissioning mother on the child’s birth certificate as the legal mother. This reporter was shown a birth record where the surrogate’s name was replaced with the name of a different woman, allegedly by the clinic that employed her.

Interview requests to the surrogacy clinic went unanswered, so this reporter visited the clinic in late August 2024 and posed as an interested client to see if they would offer to falsify a birth record.

Inside, the co-owner discussed their surrogacy program.

“Surrogacy is $54,000 (P3 million). That includes the matching of the surrogate, the onboarding, the testing of the surrogate, the stimulation (of the surrogate’s endometrium for the embryo transfer),” she said. 

She added that surrogates usually earn P350,000 ($6,000) to P460,000 ($8,000), in addition to receiving free accommodation and allowances during their pregnancies. The fee did not yet include the cost of other in vitro fertilization (IVF) procedures related to the practice.

Without prodding, the co-owner also said the clinic could assist in registering the commissioning mother as the birth mother on the official birth record.

“We’re going to be putting your name as if you’re the one who gave birth to the baby,” she said.

She admitted that the practice wasn’t legal, but that it was a quicker alternative to going through an adoption process.

The falsification of birth records, however, is just one of the crimes linked to the industry.

The co-owner of the clinic also admitted to partnering with Chinese hospitals before the pandemic, and sending about a hundred Filipino women to become surrogates in China where the practice is prohibited. She said Filipinos were a cheaper alternative to Chinese surrogates, and that at one point, they were being asked to send up to 40 Filipino surrogates a week, a demand she couldn’t meet. 

She said she also sent surrogates to Thailand and Cambodia — all under the guise of traveling as tourists.

“It’s so hard right now because immigration’s very, very strict with Filipinos leaving the country,” she said, adding that she has stopped flying them abroad since the pandemic.

Recently, Philippine authorities have detained women heading overseas as surrogates and filed trafficking charges against their recruiters. Just last October, Cambodia announced that 13 pregnant Filipinas who were found working as local surrogates could face jail terms after giving birth. 

The Bureau of Immigration has condemned surrogacy as a practice that “exploits the vulnerability of our women, who out of poverty and desperation agree to such arrangements,” while the country’s justice department has said that surrogacy “is a form of trafficking that’s punishable under our current laws.” 

But some agencies remain undeterred. This reporter identified at least one Chinese-run agency recruiting Filipinas online, promising to help them illegally apply for student visas to China so they can stay there over the course of their pregnancy. 

Exploitation of women

Professor and human rights lawyer Elizabeth Aguiling-Pangalanan, who researches issues surrounding surrogacy, said that such arrangements worry her.

“My concern here as an advocate for children’s rights is, what happens to the child. The status of the child. The identity of the child is at risk,” she said. “The greater problems would be the possibility of trafficking of the child. Aside from the problems of the woman herself, who may be trafficked.”

The fact that surrogates are nearly always less wealthy than the intended parents further opens the door to exploitation.

“In the first place, if they don’t have money for their basic needs, then they will agree to anything, and it will be the commissioning parents [who] can determine the amount of care, the amount of money that will be given,” she said.

Aguiling-Pangalanan added that it has become more crucial for the Philippines to pass a law on surrogacy for the benefit of all parties.

“We’re in fact allowing the same thing, but pretending that that problem doesn’t exist,” she said. “If they end up doing it here [in the country], then it’s a black market, under the table, which means that the women are not protected at all. So it has to be something above board that is within state regulation.” 

There are also no current regulations that require background checks of intended parents, who sign up to have babies through surrogacy.

Bianca*, an intended parent in the Philippines, said she was never screened by the clinic to determine how serious she was about having a child, nor vetted in any way. She was just asked to sign a contract agreeing to the payment and communication terms.

“I feel like because you’re spending that much, they probably already assume you’re serious,” she said.

The desire for children

Aside from protecting surrogates, a law would also aim to protect intended parents.

Bianca, 45, started IVF at 37. But after being diagnosed with a condition that would make it risky to carry her own child, she decided to hire a local surrogate. That surrogate is now more than halfway through her pregnancy and Bianca is grateful for the chance to finally have a baby via gestational surrogacy using a donor’s egg and her husband’s sperm.

But it has not been easy. She has gone through a clinic, but according to her contract, she cannot meet her surrogate and can only communicate via the handler, who has continuously demanded more money for the surrogate’s needs for things like an air conditioner. She has had no choice but to comply and keep dishing out money.

“We have already accepted that this is how it’s going to be until we have the baby,” she said. “For my peace of mind, I will just believe whatever she says as long as I can see the baby is well every few weeks from the clinic’s report.”

Bianca asked for anonymity for her family’s privacy and for fear of legal repercussions from her clinic.

She added: “How I wish it was like in the US, where you can have a relationship with your surrogate. Where you can bring her home, make sure she’s eating well and taken care of, without that fear of being taken advantage of.”

Indeed, the US has become an alternative option for hopeful Filipino parents.

Filipino Ninoy Roco and his partner Walter have always wanted children of their own. But even if it would have been much cheaper to do in the Philippines, they deemed the risk far too great so they opted to hire a surrogate in California, and work with an agency there, where commercial surrogacy is legal.

“There were no laws to protect us here, and I was scared because I’ve heard of people doing it under the table, under the radar. But I was scared because there were no contracts that would bind us and, and I felt it was not safe,” he said.

After spending about $180,000 (P10.5 million) — a discounted price since his husband’s insurance paid for the hospital expenses — they are now the proud parents to twins, a boy and a girl. 

Roco said surrogacy has enriched their lives, and made their dreams come true.

“It’s changed our lives completely because, for 43 years, I was only tending to myself. Now, you’re responsible for two lives. And, this path has so much happiness. Such a cliche but it brought purpose to our lives,” he said. 

But Roco also recognizes that it was a privilege for them to afford to do it in the US. 

He said that if surrogacy was regulated in the Philippines, he would have opted to do it locally, where he would have had much more support from friends and family.

Bianca too said a law would give her peace of mind. 

“With the legalization, I hope that the fear of the surrogate not handing over the child upon birth to their intended parent, maybe to ask for more money, or for whatever reason, may be lessened,” she said.

“I hope surrogacy can be legalized in the Philippines. It will give those suffering from infertility, just like me, another option to realize their dream of becoming mothers.”

Surrogacy law?

But a law appears to be a distant reality. 

In 2023, Zamboanga First District Congressman Khymer Adan Olaso filed a bill in the House of Representatives aiming to establish professional surrogacy standards and ethics, and regulate the industry. The bill, however, would only permit altruistic surrogacy — where surrogates would not be paid. 

Olaso, who is a faithful Catholic himself, said that if he were to push for commercial surrogacy, it would not have a chance of passing due to opposition from the Church.

“The fact that this thing [surrogacy] is happening already, then we will legalize it, but we will not do much more than that, because I know that I will also break our Catholic faith in God,” he said.

The Church has been vocal in its condemnation of surrogacy, with Pope Francis himself calling the practice “deplorable” and “a grave violation of the dignity of the woman and the child, based on the exploitation of situations of the mother’s material needs.”

“A child is always a gift and never the basis of a commercial contract. Consequently, I express my hope for an effort by the international community to prohibit this practice universally. At every moment of its existence, human life must be preserved and defended,” he said in a speech in January.

Aguiling-Pangalanan said it will take a lot of political will and grassroots efforts for such a bill to pass, but that it is not impossible. 

“There’s hope but it’s going to be a difficult battle, I think, with Catholic Church opposition to it,” she said. 

With or without a law, surrogates like Maria are not discouraged. She said she would do it again if given the opportunity.

“If someone offers me to be a surrogate again. I want to try it again,” she said. “I’m happy and thankful to be destined by God to help a family.” – with additional reporting by Aun Qi Koh/Rappler.com

*$1 = P58.6