Non-governmental organisations have called for clearer and tighter provisions on surrogacy in Rwanda’s bill on health services, raising concerns that unclear provisions could put surrogate mothers at risk.

The concerns were presented on Tuesday, May 20, during a consultative meeting organized by Réseau des Femmes Oeuvrant pour le Développement Rural, a women-led NGO, which brought together representatives of civil society in Kigali to discuss the bill and prepare their recommendations to the Parliament, which is still reviewing the draft law.

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They stressed the need for more robust regulation of surrogacy, one of the assisted reproductive health services proposed in the draft law.

Xaverine Uwimana, the coordinator of Réseau des Femmes, stressed the importance of protecting surrogate mothers with enforceable regulations.

"We need clear protections, especially in cases of medical complications or responsibilities after birth. It should not be left to informal contracts,” Uwimana said.

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While the draft law allows surrogacy through private contracts, members of the civil society say it does not go far enough in outlining the rights and responsibilities of all parties involved, particularly surrogate mothers.

"The suggestion is to clearly define the rights and responsibilities of both the person receiving the surrogacy service and the one providing it. These should be clarified further than they currently are in the bill,” said Rose Mukantabana, a lawyer.

She argues that the draft law mentions that surrogacy should be based on a contract between the parties involved, but this arrangement alone is not sufficient.

"Detailed guidelines from the Ministry of Health should be introduced to protect all parties, especially surrogate mothers, in the event of medical complications or disputes,” Mukantabana said.

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Hallelujah Mahoro, an advisor on sexual and reproductive health and rights at HDI Rwanda, questioned the requirement that surrogate mothers must have previously conceived and given birth without complications.

"When it comes to complications, no one can determine them definitively,” said Mahoro. "A doctor can conduct tests to assess risks even in someone who has never been pregnant.”

Mahoro also raised questions about the cost of surrogacy services, noting that the draft law does not make it clear whether they will be covered by insurance companies or if individuals will be expected to pay out-of-pocket.

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Uwimana raised a separate concern about the lack of regulation on gamete donation in the draft law. She warned that without safeguards, one donor might biologically parent multiple children across the country, increasing the risk of biological siblings unknowingly entering romantic relationships.

"There must be clear laws regulating this service to ensure it is controlled in a way that prevents negative consequences in the years to come," she said.