Traditional Surrogacy: An Ancient Practice with Modern Relevance & Something to think about

By: Dr. Mary Nochimson

Surrogacy often feels like a modern medical innovation — something made possible by advanced fertility science and reproductive technology. Yet the concept of one woman carrying a child for another is far older than many realize.

Traditional surrogacy — where the surrogate uses her own egg and becomes pregnant for intended parents — has roots that reach back thousands of years. In fact, it appears multiple times in biblical narratives, reflecting how deeply human the desire to grow a family has always been.

Let’s explore traditional surrogacy from historical, biological, and practical perspectives — including its presence in scripture, potential health considerations for surrogates, genetic awareness for families, and the biological differences between sperm and egg contribution.

Traditional Surrogacy in the Bible: 4 Historical Examples

In ancient times, when infertility prevented a couple from conceiving, a culturally accepted solution in some communities was for another woman — often a servant — to bear a child on their behalf. The child was then considered part of the intended family.

Four well-known biblical examples reflect this practice:

1. Sarah and Hagar (Genesis 16)

Sarah, unable to conceive with Abraham, gave her servant Hagar to Abraham.
Hagar bore Ishmael, who was raised within Abraham’s family.

2. Rachel and Bilhah (Genesis 30:1–8)

Rachel struggled with infertility and asked her maid Bilhah to conceive with Jacob.
Bilhah gave birth to Dan and Naphtali, considered Rachel’s children.

3. Leah and Zilpah (Genesis 30:9–13)

Leah later followed the same custom, offering her maid Zilpah to Jacob.
Zilpah bore Gad and Asher, counted among Jacob’s sons.

4. The Continuing Lineage Through These Arrangements

The children born through these surrogate arrangements became part of the tribal foundations of Israel. These births were not treated as marginal — they shaped lineage, inheritance, and identity.

This demonstrates that surrogate childbearing was not viewed as unusual in that cultural context, but rather as a meaningful path to family continuity.

Genetic Insight: A Major Advantage of Traditional Surrogacy

One unique aspect of traditional surrogacy is genetic transparency.

Because the surrogate provides the egg, her family medical history is directly relevant to the child’s biology. When the surrogate is known or well-screened, this can provide valuable health insight.

Benefits of known genetic lineage may include:

Early Awareness of Heritable Conditions

Families can understand predispositions to:

Cardiovascular disease
Metabolic conditions
Neurological disorders
Autoimmune patterns

This knowledge allows:

Early screening
Preventive lifestyle planning
Proactive pediatric care

Key Benefits of IUI in a Traditional Surrogacy

1. More Natural Fertilization Process

The egg and sperm meet inside the body, mimicking natural conception. Many families appreciate this physiologic approach because it supports the body’s own timing and environment.

2. Minimal Medical Intervention

No egg retrieval procedure
Usually no anesthesia
Often minimal or no hormone stimulation
IUI (Intra-Uterine Insemination) physically gentler for the surrogate.

3. Lower Cost

IUI is significantly less expensive than IVF. This makes surrogacy more financially accessible for many families.

4. Simpler and Less Invasive

The procedure itself takes only minutes and feels similar to a routine gynecological exam. Recovery time is essentially none.

5. Lower Medication Exposure

Some cycles use mild ovulation support, but many do not require intensive hormone regimens.

6. Supports Traditional Surrogacy Specifically

Because the surrogate provides the egg in traditional surrogacy, IUI is often the most straightforward method of conception.

The Gray Area with Traditional Surrogacy Using IUI

Traditional surrogacy with IUI is considered a legal gray area because the surrogate is both:

the woman who carries the pregnancy, and
the genetic (biological) mother of the baby.

When sperm is placed in her uterus during an IUI procedure and pregnancy occurs, many laws automatically recognize the woman who gives birth as the legal mother, regardless of any agreements made beforehand.

Because of this, lawyers and fertility clinics worry about situations where:

the surrogate changes her mind, or
the intended parents change their mind.

These situations can lead to complex custody disputes, which is why many professionals prefer gestational surrogacy through IVF, where the surrogate has no genetic connection to the baby.

——————————————-HOWEVER————————————————-

Where Genetics Can Change the Picture

Genetics makes the situation feel different from a biological perspective.

If the sperm used for the IUI comes from:

the intended mother’s husband, or
another close relative within the intended family,

then half of the child’s DNA still comes from the intended family line.

Biologically speaking, a child always receives:

50% of their DNA from the egg, and
50% from the sperm.

But it’s important to understand that genetic connection and legal parenthood are not always the same thing. Maybe they should be. Laws in many places still prioritize who gives birth, which is why professionals describe traditional IUI surrogacy as a gray area.

WHY can’t legal agreements be drawn AND laws created to support the intended parents in this process?

I leave you with that note.