Why Americans come for treatment in a warzone
Lucy couldn’t afford treatment in the U.S., so she flew halfway around the world to a country at war, all so she could finally have children of her own.
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“We always wanted a child, but first we had one miscarriage, then another. We spent a lot of money on treatment and IVF, but nothing worked out,” shared Lucy*.
Lucy and Brad lived in Colorado. They had been dreaming of having a child ever since they met 14 years ago, but when they finally decided to try for a baby, they discovered that the journey was much more difficult and longer than they had imagined.
After four years of infertility treatment and three unsuccessful IVF (in vitro fertilization) attempts, they decided to explore surrogacy; however, upon learning the cost of the process in the United States, they had to consider more affordable international options. So, they chose Ukraine.
Even before the war, Ukraine was one of Europe’s leading destinations for medical tourism - primarily for dentistry, fertility treatments, and plastic surgery, these figures dropped significantly since the start of the full-scale invasion (the World Health Organization has documented at least 2,881 attacks on Ukraine’s healthcare system as of February 2026) but the healthcare sector is adapting and continues to treat patients. Clinics are purchasing generators, setting up shelters, and providing services though risking disruption.
These risks remain a daily reality. In late March, Russian strikes damaged a maternity hospital in western Ukraine, forcing patients and doctors to evacuate to shelters while they were providing medical care. A father and his daughter, who were visiting the maternity hospital in Ivano-Frankivsk to see the mother after the birth of a baby brother, were killed.
And perhaps the most famous image of the war is from in 2022, when the Russians bombed a maternity ward in Mariupol.
For Americans, the biggest reason for medical tourism is the U.S. healthcare system itself: according to surveys by Peterson-KFF, a partnership that monitors American healthcare performance, about 41 percent of respondents carry medical debt, which can run up to hundreds of thousands or even millions of dollars due to medical emergencies. About 36 percent of American adults say they have foregone necessary medical care in the past 12 months because of the cost.
The Ukrainian healthcare system is also known for its large number of high-quality private facilities that provide IVF or dental services. Many Ukrainian refugees travel home specifically to get dental treatment, even if they have insurance in the host country.
Before the full-scale invasion, Ukraine was one of the world’s leading centers for surrogacy after Thailand, India, and Nepal banned the practice, following reports of the exploitation of women. Surrogacy in Ukraine is so popular, in particular because of the Family Code of Ukraine, which leaves the surrogate mother with no possibility of claiming rights to the newborn, and the child belongs entirely to the intended parents from the moment of conception.
This differs, for example, from the United States, where in most states parents must go through a pre-birth order or adoption process even after undergoing IVF themselves.
Lucy and Brad met in 2012 while hanging out with friends.
“I remember really liking his smile, and I thought how I’d love for my children to have a smile like that,” Lucy said. “He kept telling me that he fell in love with me because of the way I played with his brothers. He said it would be great to someday find a woman who would treat his own children the same way. And here I am.”
For six years after their wedding, the couple didn’t even bring up having kids. Lucy worked as an elderly care provider, and Brad was in real estate. They both wanted to secure a stable income for their family first, and only then think about having children.
“Back in 2019 or 2020, we didn’t know much about [difficulties with] getting pregnant… I knew there were people out there dealing with infertility, but I never thought it would happen to me,” Lucy said.
Approximately one in six people worldwide experiences infertility or difficulty conceiving at some point in their lives; some of these people are candidates for IVF or other assisted reproductive technologies.
When the doctor told Lucy the problem was with her, she felt deeply alone. She blamed herself for not being able to give Brad a child, especially since he already had a son, and even thought about leaving him so he could build a family with someone else.
“All the people around me who were getting pregnant annoyed me to death. I hated them, I hated myself, and I hated Brad for choosing me,” Lucy said.
But despite all difficulties, the couple stayed together and even underwent three rounds of IVF in an effort to have a child of their own.
IVF involves collecting eggs and sperm, combining them under a microscope in the lab, and then placing them in an incubator to allow the embryo to develop. If everything is successful, the embryo is transferred to the woman’s uterus, where the baby grows just as in a normal pregnancy. More than half of IVF cycles are unsuccessful. Most often, this happens because the embryos stop developing either before or after being transferred into the woman’s body. That’s what happened three times in a row with Lucy.
Lucy and Brad didn’t consider surrogacy; they didn’t have that kind of money at the time. In 2026, the cost of surrogacy in the United States ranges from $150,000 to $220,000. Additionally, $25,000 to $45,000 may be required for donor eggs or sperm.
In 2023, Lucy came across an ad from a Ukrainian surrogacy agency offering prices that were half as much. She initially rejected the idea of surrogacy in Ukraine, but she became interested in international surrogacy. After considering other foreign countries, they decided to explore Ukraine again.
“Ukraine seemed like the least suitable choice — especially with the war and everything,” Lucy said. “I can’t pinpoint a specific reason — it just all seemed weird and unfamiliar. In Cyprus and Greece, we just didn’t find anything that felt right.”
Lucy was worried about the safety of the surrogate mother and the doctors, about keeping the embryos at the right temperature, and about her future child.
“I was concerned because I’d heard the approximate costs of surrogacy in the U.S…I was really worried that these women were being exploited. The price seemed very suspicious,” said Lucy.
The couple already had embryos that were created and frozen during previous IVF cycles. After signing the contract, they had them shipped to Ukraine via special delivery. The clinic assured her that the embryos would be safe in its laboratory with its own generator-powered independent power supply.
“It was like a fresh start for my husband and me. It was as if we were planning our wedding again, but this time for the baby,” Lucy shared.
Despite their own elation and joy, the couple couldn’t share their decision with their families for a long time. They feared misunderstanding and judgment, and Lucy still felt guilty about not being able to carry the child herself.
“I breathed a sigh of relief once we told them. It was incredibly hard to carry that burden alone, especially with the surrogate mother in Ukraine and all the heavy shelling going on there,” Lucy said.
They went above and beyond what was required by the contract to help the surrogate mother, and they grew very close during the nine months she spent carrying the baby. Lucy was even present at the birth.
“I was afraid to go to Ukraine. The news makes it all seem so unbelievable, but we got lucky and didn’t encounter any explosions,” Lucy said.
She and Brad spent about three weeks in western Ukraine before, during, and after the birth. While they were waiting for their daughter to be born, they even managed to get their teeth fixed - taking further advantage of Ukraine’s high standard of healthcare and lower costs for elective procedures not covered by their American insurance.
Just two months after their daughter was born, missile debris struck one of the offices at the clinic where they underwent treatment. Seven people were killed in the missile strike: two patients and five staff members.
“I saw it on the news; it was awful. When it’s something you know, it’s just awful to watch,” Lucy said.
Lucy knew little about Ukraine before her own journey to motherhood, which was far from easy. She risked her safety and traveled halfway around the world to make her dream come true.
“It’s not an easy journey, it’s very difficult, and I’m not sure I’d recommend it to anyone. But personally, I don’t regret a thing. Our daughter is almost 3 years old now. We’re still in touch with our surrogate mother and sometimes help her out,” Lucy said.
They haven’t told their child that she was born via a surrogate mother, but they have no intention of hiding the truth if she ever asks. They’ve already bought several books that explain complex processes like surrogacy in simple terms.
*Names have been changed due to the sensitivity of the topic. The couple has moved to New York, where international surrogacy is prohibited by law. To protect them from potential legal consequences, their names have been changed.
Editor’s Note:
After a very difficult winter, our team is gradually returning to its usual rhythm of life and work.
April is just around the corner, which means The Counteroffensive will soon celebrate its third anniversary.
Thank you for staying with us all this time. Subscribe to our publication so you don’t miss important stories from Ukraine.
NEWS OF THE DAY:
Good morning to readers; Kyiv remains in Ukrainian hands.
By Oksana Stepura
RUSSIA SENDS UPGRADED DRONES TO IRAN: Russia is reportedly sending upgraded drones to Iran. They are based on Iranian Shahed models that Russia has refined during the war against Ukraine, adding improved navigation, anti-jamming systems, and AI capabilities, the Associated Press reported. These more advanced drones could pose a greater challenge for the U.S. and its allies, particularly jet-propelled models, which are significantly faster and harder to intercept.
UKRAINE AND UAE TO COOPERATE ON DEFENSE: Zelenskyy met with the UAE’s President, Sheikh Mohammed bin Zayed Al Nahyan, to discuss a forthcoming security and defense cooperation, Al Jazeera reported. The UAE expressed a growing need for advanced drone defense capabilities. Several years of defending against Russian drone attacks has positioned Ukraine to become one of the world’s leading producers of sophisticated drone interceptors. “We are open to joint work, which in a strategic perspective will definitely strengthen our people and the protection of life in our states,” Zelenskyy said.
FINLAND TO CHECK WEAPONS DELIVERIES TO UKRAINE: Finland’s defense minister announced that they will verify whether US weapons purchased by NATO members are reaching Ukraine, following reports that the Pentagon might redirect that equipment to the Middle East, Ukrainska Pravda reported. While Rubio denied any such relocation is currently happening, Trump acknowledged the US regularly relocates weapons across the world. Meanwhile, NATO secretary general Rutte assures that promised military aid will continue being supplied under PURL.
DOG OF WAR:
Nastia met this cute pup. His name is Lilu.
Stay safe out there!
Best,
Oleksandra
 | A guest post by
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Beautiful reporting on a deeply personal journey, and Lucy and Brad’s story deserves empathy…wanting a child, facing infertility, doing everything possible to build a family. That part is clear and human.
But there’s a structural question here that the piece touches but doesn’t fully explore: why is surrogacy illegal in most of the EU, and Switzerland?
There should not be a market for creating human beings.
Switzerland, Germany, France, and much of Northern Europe prohibit commercial surrogacy not because they’re anti-family or morally rigid, but because they’ve decided that treating gestation as a purchasable service crosses a line. The concern isn’t the intended parents’ motives (which are almost always genuine and loving). The concern is what happens when you create a market structure where women’s reproductive capacity becomes a commodity sold under conditions of economic desperation.
Ukraine now has a surrogacy market operating in a warzone. The economic logic is clear: families need income, the medical infrastructure exists, and there’s demand from wealthier countries. But the underlying dynamic is troubling, women in a country under bombardment, facing displacement and economic collapse, gestating children for foreign families because that’s one of the few ways to generate significant income.
Lucy worried “these women were being exploited” when she saw the price difference. That instinct was correct. The price is lower because Ukrainian women have fewer options, less bargaining power, and operate in a country where war has destroyed alternative economic opportunities.
The couple went “above and beyond” the contract and stayed close with their surrogate. That’s genuinely good. But the individual relationship doesn’t address the systemic problem: you’ve created a market incentive for women in desperate circumstances to lease their bodies for nine months.
And then there’s the child. Lucy and Brad have books ready to explain surrogacy “in simple terms” if their daughter asks. But what happens when she’s old enough to understand that her birth involved:
Her biological material shipped frozen across continents
A woman in a warzone carrying her for payment
A country where missile debris later killed seven people at the clinic where she was born
Legal frameworks in her home state (New York) that prohibit the very arrangement that brought her into existence
The reporting mentions “the Family Code of Ukraine leaves the surrogate mother with no possibility of claiming rights to the newborn.” That’s presented as an advantage for intended parents—-clean legal transfer, no custody complications.
But from the child’s perspective years later, it means the woman who carried her had zero legal recognition of that relationship from conception onward.
Switzerland and the EU didn’t ban this arbitrarily. They looked at the long-term ramifications…for surrogates, for children, for what it means to turn gestation into a purchasable service; and decided the ethical costs outweigh the benefits, even for loving families who desperately want children.
None of this is Lucy and Brad’s fault. The US healthcare system’s obscene costs pushed them to look internationally. Their love for their daughter is real. But we can acknowledge their joy while also recognizing that wartime surrogacy markets are a symptom of systems failing at multiple levels: healthcare inaccessibility in the US, economic desperation in Ukraine, and global inequality creating conditions where wombs become export commodities.
The fact that this all happens under the beautiful language of “helping families” and “making dreams come true” doesn’t change the underlying extraction mechanics.
As someone that has contemplated the impact of this, I really don’t know…
—Johan