A MORE gut-wrenching depiction of vulnerability would be hard to find: a dozen premature babies, hastily evacuated from a neonatal ward in Ukraine, lying in an improvised bomb shelter. Medical staff are holding and rocking some of the babies. Others lie on makeshift beds, swaddled in blankets. It doesn’t look real.

Elsewhere in Ukraine, at least two babies have been born underground in recent days: one in a subway station in Kyiv, as her mother sheltered from Russian bombardment, and the other, a boy, in the basement of a hospital in the eastern region of Luhansk. No one reading about these women’s experiences could fail to feel extreme sympathy for their awful plight, and relief that they and their babies survived ... at least for now.

However, other recent births in Ukraine have been covered very differently in news reports. Since the Russian invasion, a wave of stories have focused on would-be parents from other countries who have paid women in Ukraine to carry babies for them via surrogacy. Some have found themselves stranded in Ukraine with newborns at the worst possible moment, unable to reach an embassy to collect emergency travel documents, while others face an agonising decision: they can follow government advice and refrain from travelling to the country – with unknown consequences for the babies – or defy that advice and go to Ukraine, not knowing how or when they will be able to return.

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Scant mention is made in those stories of the women who actually gave birth to those babies, and who are presumably also trapped in Ukraine given their physical condition and the fact they will have children of their own to look after (having already given birth to healthy offspring being a prerequisite for becoming a surrogate mother).

However, it is unsurprising that their circumstances are not reported, since the couples who enlisted their services via third parties likely never interacted with them directly, do not share a common language with them, and will probably never learn their fates.

Surrogate mothers are still given that title in Ukraine, which in the space of just two decades has become one of the world’s most popular destinations for seeking them. In the UK we tend to hear about “surrogates” – an adjective made into a noun – while in the US the even more dehumanising “gestational carrier” is increasingly used to indicate that the woman experiencing the pregnancy has no genetic relationship to the child; that she is not its mother.

The National: Oncology patients hold up sheets of paper with the words "Stop War" at a basement used as a bomb shelter at the Okhmadet children's hospital in central Kyiv, Ukraine, Monday, Feb. 28, 2022. (AP Photo/Emilio Morenatti)

Legal relationships are more complex, and one of the reasons Ukraine has become so popular for surrogacy is that the genetic or “intended” parents are also the legal parents from the moment of the birth. The other – related – reason for its popularity is the price. Clients can sign up for an all-inclusive deal, as if booking a package holiday. Websites make preposterous promises, such as offering a “guaranteed baby programme”. Surely only someone whose reasoning is clouded by desperation could avoid drawing grim conclusions about the standard of care that would be provided if a pregnancy didn’t go to plan.

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“The cheapest surrogacy in Europe is in Ukraine, the poorest European country. No wonder it involves numerous intermediaries and various misdemeanours, as well as any other business in Ukraine.” This quote isn’t from a politician, campaign group, or human rights organisation. Incredibly, it’s from the website of the BioTexCom Center for Human Reproduction, a major player in the surrogacy market in Ukraine. Its owner, Albert Totchilovski, is frank about the fact that he has been “accused of trafficking thousands of Ukrainian babies abroad”, and boasts that the sum paid to women from villages, whose salaries are a pittance and often have no men to support them, is “a huge amount of money for rural residents”.

In 2018, El Pais reported that Totchilovski claimed to control 70% of the market in Ukraine. The industry is unregulated and there are no official figures, but a report by Al Jazeera published in the same year, under the heading “Ukraine’s ‘baby factories’: The human cost of surrogacy”, cited a Kyiv-based lawyer who estimated there were 2000-2500 surrogate births in Ukraine every year, with almost half through BioTexCom. He also said that two-thirds of the industry operated illegally.

The report went on to allege poor housing and medical care of surrogate mothers, with one woman saying she was forced to share a small apartment with four other women 32 weeks into her pregnancy, even sharing a bed with one of them, then ended up in intensive care following poor standards of care in the hospital where she gave birth.

Spare a thought for these poor, desperate women in Ukraine, currently carrying babies who may never be collected, whose chances of decent postnatal care plummeted when the bombs began to fall, and whose nightmares may be only just beginning.