In the fast-growing industry of international surrogacy, destinations for low-cost options are constantly shifting. India used to be the top choice for Western couples looking for value for money: until recently, a surrogate baby from India cost as little as $15,000, a quarter of what it usually costs in America. After a series of scandals around the ethics of outsourcing pregnancy to disadvantaged women led India to ban surrogacy for foreign couples, Thailand, Mexico and Nepal took their turns at the top of the list. But over the past few years, each of those countries has banned or severely restricted foreign surrogacy.

Now Cambodia has stepped in to fill the gap, quickly forming a foreign surrogacy market that, according to officials, is fueled in part by Thai brokers who moved their operations, and many of their surrogates, to the country. The government has suggested it will bring in laws to regulate the practice or even ban it by making it a trafficking offence, but nothing has yet been put in place. In the absence of any clear legal framework, scores of surrogacy agencies have sprung up offering Cambodia packages for around $30,000 per baby.

“There is no doubt that Cambodia’s surrogacy industry has been hurriedly assembled,” says Sam Everingham, director of the Australian advocacy organization Families Through Surrogacy. Everingham visited Cambodia a year ago to witness the surrogacy scene for himself. He says the facilities he visited were impressive, with Western doctors employed to do the embryology.

However, he says, when an industry grows so quickly, there is the risk that proper procedure gets overlooked, and women could be harmed. “Intended parents should be concerned about the risks of surrogates not being adequately screened or counseled in such an environment,” says Everingham.

One of the biggest concerns anti-surrogacy campaigners have about the industry is that women are persuaded to undertake a surrogate pregnancy for money without proper recognition or understanding of the health risks involved. In India, it was found that women were being forced into surrogacy by their husbands or fathers. Women were also reportedly being implanted with up to four embryos and then told to undergo selective abortions if that led to a multiple pregnancy.

In Cambodia there is so little information about the industry, which has shrouded itself in secrecy for fear of being shut down, the risks are even higher, say campaigners.

Women & Girls Hub contacted three surrogate agencies offering services in Cambodia to ask for details on their surrogates and information on the services they offer. All of them declined to comment.

Even parents who have used a surrogate in Cambodia appear reluctant to talk about the experience. In June, the online magazine Gay With Kids announced Greg, a British man, and his Polish boyfriend were the proud new fathers of Mickey, one of the first babies born through surrogacy in Cambodia. He was delivered on Valentine’s Day 2016.

When Greg was contacted by Cambodia’s English-language newspaper the Phnom Penh Post, he declined an interview. However, he reportedly sent the newspaper a message saying: “The more publicity about surrogacy … the quicker it will close down … [I’m] afraid the media has been no friend at all to the world of surrogacy.”

Donna Dickenson, emeritus professor of medical ethics and humanities at the University of London and author of the book Me Medicine vs. We Medicine, says the fact that some surrogacy clients would prefer governments stay out of the industry shows a concerning attitude. “Many countries feel [foreign parents] simply take the ‘Third World’ for granted,” she says.

In the developing world, governments are taking a firm stand on foreign surrogacy, in part because they see the industry as a Western import. And that, Dickenson says, is good news. “’First World’ agencies present [surrogacy] as a win-win situation for everyone. The Western parents get a baby, and the women in the ‘Third World’ get money,” she says.

But she says the argument doesn’t withstand scrutiny. The very fact the Indian government decided to ban an industry valued at $400 million a year shows it had decided the ethical concerns outweighed the economic benefits.

While there is a risk clamping down on surrogacy in Cambodia will drive the industry underground, Dickenson says clear and strict legislation with penalties would deter parents from trying to break the law.

But Everingham says parents should not be punished for wanting to have children. “Bad practices tend to be the result of a lack of regulation and irresponsible operators,” he says.

Noting that surrogacy in developing nations provides many parents who cannot afford the process in Canada or the U.S. with their only viable option, Everingham says what Cambodia’s surrogacy industry needs are well-considered laws that respect the rights of surrogates and the unborn child, while underlining the responsibilities of parents and agencies to act ethically.