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tel aviv  |  While Israel was mobilizing to aid victims of Nepal’s earthquake and locate its citizens this week, the Jewish state’s attention was turned to the safety of 26 Israeli babies recently born to surrogate mothers in Nepal.

Parent with his baby born to a surrogate in Nepal arrives at Sde Dov Airport in Tel Aviv on April 27. photo/jta-flash90-tomer neuberg

Hundreds of Israelis every year choose surrogate pregnancy, in which an embryo with genetic material from at least one parent is implanted in a surrogate, who carries the pregnancy to term. Here’s why Israelis opt for surrogate pregnancies, and why so many — primarily same-sex couples and single parents, for whom surrogacy in Israel is not legal — choose surrogate mothers in places like Nepal.

Why would heterosexual Israelis choose surrogacy?

Israel encourages couples to have children in a variety of ways. Aside from maternity-leave policies that are far more generous than in the United States, the state heavily subsidizes in-vitro fertilization for women who are unable to conceive naturally and preimplantation genetic diagnosis for those who qualify.

Since 1996, surrogacy also has been legal in Israel, but only for heterosexual couples. They typically choose surrogacy when the woman cannot carry the baby to term or the pregnancy poses a significant health risk. There are numerous restrictions on who can serve as surrogates.

“People don’t choose this saying ‘How fun, I won’t have to be pregnant,’ ” said Mina Ulzary, co-founder of the Center for Surrogacy–Israel. “They choose it after difficult vacillations, both emotional and medical.”

How does surrogacy differ for heterosexual couples, same-sex couples and single parents?

About 270 Israelis choose surrogate pregnancies every year, according to Ulzary. Approximately two-thirds choose foreign surrogates because the process is cheaper and surrogate mothers are easier to find. Georgia, Ukraine and India are among the more popular countries. Surrogacy in Israel costs approximately $64,000; surrogacy abroad can cost $40,000.

Heterosexual Israeli parents who choose surrogate pregnancy can find either an Israeli woman to act as a surrogate or a woman from overseas.

Same-sex couples, however, must go abroad for surrogacy. Although a bill to allow same-sex couples to have surrogate pregnancies in Israel passed an initial vote in the Knesset in June 2014, it has yet to become law. Currently, same-sex Israeli couples are limited to three countries if they wish to pursue surrogacy: the United States, Mexico or Nepal, according to the Times of Israel. (Single parents must also go abroad for surrogacy.)

Merav Levy, director of Israeli Surrogate Motherhood, which encourages surrogacy within Israel, says the Israeli process is safer and more convenient for a couple than traveling to a Third World country to retrieve their baby. To bring a baby to Israel from abroad, the mother and father must prove that their DNA matches the baby’s and endure a bureaucratic process that can keep them from returning home for up to three weeks after the birth.

Same-sex couples who are limited to the three countries listed above for surrogacy typically use donor eggs from European and South African women, according to the Times of Israel, and pay their South Asian surrogates up to $10,000.

Why do some Israelis choose surrogacy in Nepal?

Though the quality of health care in Nepal is seen as second rate, Nepali surrogacy has become a popular choice for Israeli same-sex couples who are barred by local laws from surrogacy in countries with better medical care, such as India, Georgia and Thailand, Ulzary says. Israeli couples began seeking surrogates in Nepal in 2012, according to Ulzary, who estimates that some 100 couples find surrogate mothers there every year.

What does Jewish law say about surrogacy?

Halachah, or Jewish law, allows surrogacy, and a rabbi is part of the Israeli Health Ministry committee that approves women for surrogate pregnancies. Babies born of surrogacy abroad must undergo a brief conversion process upon arriving in Israel, including immersion in a mikvah, according to Ulzary.