There are a limited number of issues in modern bioethics that strike such a raw nerve in Pakistan as surrogacy. In its most basic form, surrogacy is a medical arrangement in which a woman carries a child for someone who cannot conceive naturally.
All over the world, this practice has brought a great amount of relief to childless couples. In places such as the United States, India, and even Iran, surrogacy has become an established though carefully regulated pathway to parenthood. In Pakistan, however, the very word “surrogacy” is whispered with suspicion, tangled in taboos of faith, morality, and family honour.
Surrogacy comes in two distinct forms. In traditional surrogacy, the surrogate uses her own egg, which makes her both the biological and birth mother, a scenario that does not align with Islamic principles. In gestational surrogacy, however, the surrogate is only a carrier; the embryo comes from the intending married couple, meaning no third party has a biological connection to the child. This is the method that raises most of the ethical and legal debate.
To make it more understandable, consider a situation in which there is a woman who can produce an egg but cannot carry a pregnancy due to medical reasons, perhaps she was born without a uterus or has experienced repeated miscarriages. A gestational surrogate can carry the embryo safely to term, giving the couple a child genetically theirs while the surrogate plays only a supportive, gestational role. Here, the surrogate is simply for development, nurturing the child during pregnancy with no genetic contribution of her own.
Modern medical science offers analogies that help put surrogacy in perspective. Organ donations, blood transfusions, and bone marrow transplants rely on people, at times unknown, giving part of themselves to save or improve another life, often described as miracles. Surrogacy, when in a carefully regulated and controlled framework, can be seen in a similar light, a medical intervention that allows families to flourish without compromising ethics, provided the surrogate participates both voluntarily and knowingly.
Beyond its medical promise, surrogacy touches a wound that runs far deeper, which is the stigma of childlessness. In Pakistan, to be without children is to live under a cloud of pity, whispers, and quiet exclusion. It is not just a private grief but a public verdict, stamped most heavily on women, who are often blamed, mocked, or left isolated. For them, surrogacy represents more than science; it represents a lifeline, a chance to reclaim dignity from a society that equates motherhood with worth.
Between absolute ban and unchecked market lies a space still uncharted, and perhaps it is there that Pakistan’s conversation must finally begin
Statistics tell part of the story: a 21–22% infertility rate, or about 4 million couples across the country. A 2011 study found that nearly 8 in 10 women had never even heard of IVF. Misconceptions, from fears of “unnatural babies” to rumours of religious sin, remain entrenched.
In 2017, the Federal Shariat Court (FSC) delivered a landmark ruling: third-party surrogacy was declared invalid and un-Islamic. Only IVF between a married couple, with the wife herself carrying the pregnancy, was considered permissible. All other arrangements were deemed contrary to Islamic injunctions, exploitative of women, and disruptive of family lineage.
And yet, a blanket ban does not erase demand. They simply go underground, into dangerous, unregulated, and often exploitative arrangements, or they cross borders to countries more permissive.
Islam places sacred weight on nasab (lineage), and many scholars equate introducing a third party into reproduction with zina. However, it can be said that this comparison is completely misplaced because in gestational surrogacy, there is no sexual relationship outside marriage, as the surrogate’s role is purely gestational, carrying an embryo created from the intending parents’ gametes. To liken this to zina ignores the fundamental difference between sexual impropriety and medical assistance in family creation.
Moreover, surrogacy, the judges feared, would create a “womb-for-hire” market, preying on poor women. What if the surrogate refuses to hand over the baby? What if parents reject a disabled child? Who inherits what when lineage is muddled? This fear is also not completely without basis, as exploitation can occur if vulnerable women are pressured into surrogacy for financial gain, or if legal protections are absent. Only women who fully understand and willingly participate should be involved, ensuring that their rights are respected and that they are not unfairly advantaged or coerced.
Critics expressed concern that children of surrogacy might be stigmatised or shunned, and the parents may end up living a life full of questions and remarks. But here lies the paradox: those who cannot have children already endure the same fate, silenced, pitied, or abandoned. If the aim is to protect dignity, does denying surrogacy truly achieve it? Or does it merely leave couples trapped in the very shame society already heaps upon them?
Islamic thought, however, has also proven adaptable in the face of new challenges. Iran, another Islamic republic, chose a different path. By grounding their approach in the principles of compassion, justice, and the protection of family, Iranian scholars and lawmakers endorsed gestational surrogacy under tight regulation. As a result, it is now both legally recognised and socially accepted there.
Even within Islamic tradition, non-biological bonds have long been recognised. The concept of raḍāʿa (foster mothers) allowed a woman who breastfed a child to establish a lasting familial bond, creating recognised kinship without any genetic connection. This historical precedent shows that family ties in Islam are not always limited to biology. If nourishing a child through milk could create legitimate relationships centuries ago, some argue that carrying a child gestationally, without contributing genetically, could be seen in a similar spirit, highlighting the possibility of compassion and care shaping family beyond mere genetics.
Still, raḍāʿa is not a perfect analogy as it is a bond rooted in nourishment after birth, not in conception or pregnancy, and classical scholars have drawn clear lines around lineage and inheritance. Yet its existence shows that Islamic law has, at times, embraced broader understandings of kinship.
None of this denies the risks of surrogacy. Exploitation is real. Commercialisation is dangerous. But is prohibition the only answer? The answers will not be simple, but neither is the pain of those who live without children. Between absolute ban and unchecked market lies a space still uncharted, and perhaps it is there that Pakistan’s conversation must finally begin.