Surrogacy is increasingly becoming a medical solution for women unable to carry pregnancies due to infertility or life-threatening health conditions, according to Kenya Obstetrical Gynaecological Society President Dr. Kireki Omanwa, who says the practice should be viewed as part of reproductive healthcare rather than a social controversy.
Speaking during a Radio Generation interview on Friday, Dr. Omanwa explained that surrogacy is not a modern concept and has existed for generations as families struggled with infertility challenges.
“Surrogacy, in the simplest form, is basically where a lady is not able to carry a baby, and so this lady designates somebody else to carry this baby for her or for them,” he said.
The obstetrician and gynaecologist noted that surrogacy is only considered after doctors establish that carrying a pregnancy would be medically impossible or unsafe for the intended mother.
“Most of the time, the reasons are medical, not even most of the time, 100% of the time the reasons are medical,” he stressed.
According to Dr. Omanwa, infertility remains a major challenge across the world, with African countries recording some of the highest rates despite the continent’s high birth rates.
“The incidence of infertility is about 10% in the developed world, but when it comes to our countries, it’s a lot higher,” he stated. “Our infertility rates range anywhere between 10 up to 30% of the adult population.”
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The discussion comes at a time when African countries continue to record some of the world’s highest fertility rates while also facing rising infertility cases and growing demand for assisted reproductive services.
Studies on reproductive health in sub-Saharan Africa show that while many countries continue to experience high birth rates driven by early marriages, poverty, limited access to contraceptives, and cultural pressure to have large families, many couples are still unable to conceive naturally.
Research has also shown that secondary infertility remains common in the region due to untreated sexually transmitted infections, unsafe abortions, complications during childbirth and poor access to reproductive healthcare services.
According to the World Health Organization, about 17.5% of adults globally experience infertility, with prevalence standing at 16.5% in low- and middle-income countries compared to 17.8% in high-income nations.
Dr. Omanwa outlined several medical conditions that may prevent women from safely carrying pregnancies, including severe fibroids, repeated miscarriages, congenital absence of the womb, and cases where the uterus is too small to sustain pregnancy.
“There are some ladies who are born without a womb, while others are born with a tiny womb that cannot carry a baby,” he stated.
He further explained that women who have undergone major surgeries involving the brain or heart may also be advised against pregnancy because of the physical strain pregnancy places on the body.
“A baby reorganizes the lady’s organism and puts a lot of pressure in the body,” he highlighted.
The doctor added that repeated pregnancy loss can also push doctors to recommend surrogacy as a safer option for affected women.
During the interview, Dr. Omanwa argued that infertility and surrogacy are not new issues, citing biblical accounts involving Abraham, Sarah, Rachel and Jacob.
He pointed to the story where Rachel asked Jacob to have children through her maid after struggling to conceive, describing it as an early form of surrogacy.
The KOGS President also challenged the long-held belief that infertility mainly affects women, saying men equally face reproductive health complications.
“Most people don’t consider infertility as a medical problem, they consider it more of a social problem,” he noted.
To explain the issue further, he shared the case of a man who sought fertility testing despite already having children, only for repeated medical examinations to confirm he was not producing sperm.
According to Dr. Omanwa, male infertility can result from infections, injuries and medical conditions affecting sperm production. He said illnesses such as mumps, especially when contracted in adulthood, can damage the testes and interfere with fertility.
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“When it affects us as gentlemen, it goes down because it’s spreading through the whole body,” he said while explaining how mumps can affect adult men.
He maintained that infertility should be treated as a medical condition rather than a source of blame or stigma within families and relationships.
“World Health Organization has actually designated infertility as the fifth highest disability,” he expressed, affirming how infertility is a global disability.
As infertility cases continue rising, demand for fertility treatment and surrogacy services is also growing in countries including Kenya, Nigeria and South Africa.
However, experts say access to advanced fertility treatment remains low across sub-Saharan Africa because of high costs and limited medical infrastructure, with studies indicating that fewer than two percent of infertile couples can access advanced reproductive care.
Dr. Omanwa concluded by emphasizing that surrogacy is only recommended after doctors determine that pregnancy would pose serious medical risks or cannot be carried safely by the intended mother.