Rwanda’s Healthcare Services Law of 2025 has, for the first time, legalized and regulated surrogacy, marking a major shift in the country’s reproductive health landscape.
Under the law, surrogacy is categorized as part of assisted reproductive technologies (ART), allowing couples or individuals with medically proven infertility to have children through a surrogate mother.
State Minister for Health Dr. Yvan Butera told Parliament that infertility in Rwanda affects couples in different ways: 30% due to male factors, 30% due to female factors, another 30% from combined issues, and 10% unexplained.
The law permits surrogacy strictly for medical necessity and requires a notarized agreement. Both intended parents and surrogate mothers must meet eligibility criteria. Surrogacy is altruistic, meaning surrogate mothers can only be reimbursed for pregnancy-related expenses such as medical care and nutrition. The law also grants immediate legal parentage to intended parents at birth.
“In my view, this is a positive step for couples struggling with infertility. One challenge, however, is the lack of an official fee for surrogate mothers. There should be a set reward for anyone willing to help,” said Cassien Sibomana, a parent from Ngoma District.
Despite these reforms, practical challenges remain. Before the law, surrogacy operated in a legal gray area, causing inconsistent court decisions. Today, access to ART services is limited and expensive, making surrogacy inaccessible to many families. Critics note that the ban on commercial surrogacy protects women but limits the number of potential surrogates.
Cultural debates continue, with some questioning the practice of third-party reproduction and the rights of children born through surrogacy. The law currently allows surrogacy only for married heterosexual couples, leaving others excluded.
“I worry about the child’s rights, as the baby will not be raised by its biological mother. True maternal love may be affected, but since this is the only option for some couples, society may have to accept it,” said Olive Nyirantezimana, a mother and healthcare worker in Ngoma District.
As the Ministry of Health prepares implementation guidelines, Rwanda moves into a new era of reproductive health, offering hope for many families while facing ongoing social, economic, and ethical challenges.
