As with any scientific report, it’s essential to bear in mind the limitations of this research, some of which are mentioned in the paper itself. Although the overall sample size was large, the subgroup of gestational carriers was small, and that may affect the results.

It’s important to be cautious before drawing general conclusions, particularly since we know that many women who have been gestational carriers or surrogates, have had healthy babies and gone through pregnancy with no health issues themselves.

Nevertheless, what this paper does highlight is that we actually know relatively little about the particular risks of harm to the woman who acts as surrogate, or the baby, in surrogacy. As the authors point out, while a gestational carrier should ideally be healthy and at low risk of complications, this is not always what happens in practice.

This raises some ethical questions, first of all about the potential exploitation of women who act as gestational carriers and who effectively bear the risks of pregnancy on behalf of someone else.

Second, the scarcity of accurate data on the risks and outcomes of surrogate pregnancies must really make us ask how seriously the health of women, as opposed to the health of the foetus or baby, is taken.

The neglect of women’s health in the history of medicine is well recognised, and may be exacerbated in the situation of surrogacy, where the gestational carrier’s role is socially obscured.