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(Reuters Health) – A decade after giving birth, surrogate mothers don’t appear to suffer lasting mental health difficulties as a result of giving away the babies they delivered, a small study suggests.

While previous research has found that depression and other psychological problems can surface in the first weeks and months after birth, less is known about the long-term impact of surrogacy.

A research team surveyed 20 surrogate mothers approximately one year after birth and again 10 years later to assess how their mental health changed over time.

“Findings from the current study suggest that in the longer term surrogates do not experience psychological problems as a result of being a surrogate,” said Dr. Vasanti Jadva, the study’s lead author and a senior research associate at Center for Family Research at the University of Cambridge in the U.K.

“Given that the majority of surrogates still felt very positive about the surrogacy it is not surprising that they were not found to be experiencing psychological problems,” she said.

There are few statistics on the number of babies born through surrogacy. Due to ethical concerns, the practice is illegal in many countries around the world as well as in some U.S. states. But interest in this option continues to grow as more women opt to postpone pregnancy until later in life when fertility wanes, and as more same-sex couples look for ways to start families when they can’t conceive on their own.

Jadva and colleagues originally surveyed a sample of 34 surrogate mothers in 2003 to see how the women felt about the experience roughly one year after giving birth. A decade later, 20 of the women participated in a follow-up study.

As reported in Human Reproduction, the surrogates were interviewed at home and asked in detail about their relationship with the surrogacy parents and child and their psychological well-being. They also completed questionnaires to assess mental health.

The group included nine genetic surrogacies, which uses the surrogate mother’s egg. The rest were gestational surrogacies, which use implanted embryos.

After a decade, all of the surrogates in the follow-up study had normal or above-average self-esteem, the follow-up study found. None had signs of depression. Three surrogates had been prescribed stimulants or sedatives at some point since the 2003 evaluation. Two of these women were on medication at the time of the follow-up interview.

The majority of the surrogates maintained contact with the surrogacy child as well as with the mother and father raising the child, the follow-up study found.

Of the 15 surrogates who remained in contact with the child, 14 reported that the relationship was positive. Gestational surrogates were more likely than genetic surrogates to feel a special bond to the child.

Due to the small study size, as well as the loss of some surrogates from the original study, the researchers said it’s unclear to what extent the findings would be relevant to other surrogacy arrangements currently being carried out.

It is also possible that the findings might not be applicable outside the U.K., where surrogacy is legally permitted, particularly in places where the practice isn’t legal, the researchers write.

Even though surrogacy looks very different in the U.S. today than it did when this research began years ago in the U.K., the findings still resonate with what many American surrogates may experience, said Dr. Andrea Braverman, an associate professor of obstetrics and gynecology at Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia.

“This study shows that surrogacy can work well, and it can work well over the long term, but it doesn’t tell us what conditions made this possible,” said Braverman, who wasn’t involved in the new study.

“Personally, when I talk to surrogates after they deliver, they don’t look at it as giving up their baby, because it was never theirs to begin with. It is an amazing, personal life experience that people go through together and the fact that they come out of it feeling positive doesn’t surprise me.”

SOURCE: http://bit.ly/1ACFRnQ Human Reproduction, online December 19, 2014.