Much has changed since Kim Cotton became the UK’s first surrogate 40 years ago, when she was forced to flee hospital on the floor of a car under a blanket, such was the level of media frenzy around her story.
She describes it as a harrowing experience and wishes much of that surrogacy journey had been done differently. “It wasn’t the right way to do surrogacy, but it was the only thing that was offered,” she says.
But it didn’t put her off surrogacy and instead helped her form a “profound passion” for empowering others to follow a similar path in a more supportive environment. She also went on to become a surrogate for twins born in 1991, which she describes as a beautiful experience.
She has spent decades running the surrogacy agency Cots (Childlessness Overcome Through Surrogacy), facilitating more than 1,000 pregnancies. But in September she is closing its doors as soaring demand and a lack of surrogates is making the job more stressful than ever before.
“The pressure I feel to try to find people surrogates now, it’s just overwhelming,” Cotton says. “I get phone calls every day from couples, often in tears. The desperation is just heartbreaking. It’s terrible.”
Kim Cotton, with the twins she carried. Photograph: PA Images/Alamy
There are now about 400 children a year born through surrogacy to UK parents, up from about 50 a year before 2008, and more than half are now born through international surrogacy arrangements.
Pro-surrogacy campaigners have blamed the stringent laws in the UK for pushing more people to seek surrogacy arrangements abroad, sometimes in countries with lax or nonexistent regulations. Waiting lists at many British surrogacy agencies are now years long.
“As soon as same-sex parents could go for a parental order, demand doubled, but supplies remained the same,” Cotton says. “There’s also just more infertility around. There’s so much cancer. And it’s affecting young women now, they’re having a hysterectomy in their 20s or 30s.
“It is very difficult. It is very frustrating. And it’s like trying to run an agency with your hands behind your back.”
The UK’s surrogacy laws have changed little since they were first introduced in 1985, when they were rushed through parliament as a direct response to Cotton’s pregnancy.
In 2023 the Law Commission published a report with suggested changes, including the creation of a national surrogacy register, and ensuring intended parents in domestic surrogacy arrangements can become parents from the child’s birth.
Under current laws, intended parents have to apply for a parental order after birth, which can take months and create issues over who makes decisions about the baby’s healthcare in the first weeks of life.
“In 1985 I said yes, I’m the birth mother, but my husband is not the father – he’s had a vasectomy. But I still have to put him down as the father on the birth certificate. Back then it was bad, and nothing has changed,” Cotton says.
“The laws are so antiquated, they’ve not changed since 1985 when I was a surrogate, but it was a kneejerk law that was passed. It’s fossilised. It’s a dinosaur. And it’s just on the back burner now. It’s a damn shame.”
Campaigners were hopeful the Law Commission report would lead to reform, but the change of government in 2024 has pushed surrogacy to the bottom of the agenda.
There is also strong opposition from those who are concerned that relaxing the laws could lead to people being coerced into surrogacy by financial need, or wealthy people outsourcing pregnancy because they have the resources to do so.
Cotton says: “We don’t want people doing it for the wrong reason. We don’t want anyone just thinking, oh, that might be a great way of earning money. There really needs to be altruism involved because it’s priceless what they do.
“I’m sure things will change in the future, but it’s politics. It’s too slow for me. And that’s why I have to back out, because I really thought we were going to get change with the Law Commission, and then suddenly the government changed and that was it, end of.”
As well as parental rights from birth, Cotton said she would like to see reform of the expenses system for surrogates. As commercial surrogacy is banned in Britain, advertising for surrogates is not permitted and only “reasonable expenses” are allowed to be paid.
Cotton says this seems to have been accepted as about £15,000-£20,000, although there is no official guidance around what is permitted.
“If the surrogate baby has been living with a couple since the baby was born, how are they going to say, well, no, actually I can’t give you a parental order because you paid a bit too much to the surrogate?” Cotton says. “So we need more clarity.”
Although she is closing down Cots, Cotton is reluctant to leave the world of surrogacy behind completely, and says she will continue to offer advice to people through a surrogacy advice line.
“I’m as passionate about surrogacy as I was 40 years ago. I think it’s the most amazing area to work in,” she says. “The couples are the most determined people I’ve ever come across in my life.
“And it’s an absolute honour to work with the surrogates. It really is. When I listen to them talk, I think: what a wonderful soul you are. Some of them express milk for six weeks, or three months sometimes, to help the baby get started. Isn’t that amazing?”