In this paper, we draw on three ethnographic studies of surrogacy we carried out separately in different contexts: the western US state of California, the south Indian state of Karnataka, and the western Russian metropolis of St Petersburg. In our interviews with surrogate mothers, intended parents, and surrogacy professionals, we traced the meanings and ideologies through which they understood the clinical labour of surrogacy. We found that in the US, interviewed surrogates, intended parents and professionals understood surrogacy as an exchange of both gifts and commodities, where gift-giving, reciprocity, and relatedness between surrogates and intended parents were the major tropes. In India, differing narratives of surrogacy were offered by its different parties: whilst professionals and intended parents framed it as a win-win exchange with an emphasis on the economic side, the interviewed surrogate mothers talked about surrogacy as creative labour of giving life. In Russia, approaches to surrogacy among the interviewed surrogate mothers, professionals and intended parents overlapped in framing it as work and a businesslike commodity exchange. We suggest these three different ways of ethical reasoning about the clinical labour of surrogacy, including justifications of women’s incorporation into this labour, were situated in local moral frameworks. We name them “repro-regional moral frameworks”, inspired by earlier work on moral frameworks as well as on reproductive nationalisms and transnational reproduction. Building on these findings, we argue that any international or global regulation of surrogacy, or indeed any moral stance on it, needs to take these local differences into account.

Purpose Loneliness is a phenomenon which affects people globally and constitutes a key social issue of our time. Yet few studies have considered the nature of loneliness and social support for older lesbian, gay and bisexual (LGB) people; this is of particular concern as they are among the social groups said to be at greater risk. The paper aims to discuss this issue. Design/methodology/approach Peer-reviewed literature was identified through a search of Scopus, PsycINFO and PubMed. A total of 2,277 papers were retrieved including qualitative and quantitative studies which were quality assessed using the Critical Appraisal Skills Programme. Findings In total, 11 papers were included in the review and findings were synthesised using thematic analysis. The studies were conducted in five countries worldwide with a combined sample size of 53,332 participants, of whom 4,288 were drawn from among LGB communities. The characteristics and circumstances associated with loneliness including living arrangements, housing tenure, minority stress and geographical proximity. Research limitations/implications The review suggests that among older LGB people, living alone, not being partnered and being childfree may increase the risk of loneliness. This cohort of older people may experience greater difficulties in building relationships of trust and openness. They may also have relied on sources of identity-based social support that are in steep decline. Future research should include implementation studies to evaluate effective strategies in reducing loneliness among older LGB people. Practical implications Reaching older LGB people who are vulnerable due to physical mobility or rural isolation and loneliness because of bereavement or being a carer is a concern. A range of interventions including individual (befriending), group-based (for social contact) in addition to potential benefits from the Internet of Things should be evaluated. Discussions with the VCS suggest that take up of existing provision is 85:15 GB men vs LB women. Social implications Formal social support structures which were provided by voluntary sector agencies have been disproportionately affected by recent austerity measures. Originality/value The authors sought to interrogate the tension between findings of lower levels of social support and discourses of resilient care offered by families of choice.

Information received by women regarding physical activity during and after pregnancy often lacks clarity and may be conflicting and confusing. Without clear, engaging, accessible guidance centred on the experiences of pregnancy and parenting, the benefits of physical activity can be lost. We describe a collaborative process to inform the design of evidence-based, user-centred physical activity resources which reflect diverse experiences of pregnancy and early parenthood. Two iterative, collaborative phases involving patient and public involvement (PPI) workshops, a scoping survey (n = 553) and stakeholder events engaged women and maternity, policy and physical activity stakeholders to inform pilot resource development. These activities shaped understanding of challenges experienced by maternity and physical activity service providers, pregnant women and new mothers in relation to supporting physical activity. Working collaboratively with women and stakeholders, we co-designed pilot resources and identified important considerations for future resource development. Outcomes and lessons learned from this process will inform further work to support physical activity during pregnancy and beyond, but also wider health research where such collaborative approaches are important. We hope that drawing on our experiences and sharing outcomes from this work provide useful information for researchers, healthcare professionals, policy makers and those involved in supporting physical activity behaviour.

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Egg donation is used in 7% of in vitro fertilisation cycles worldwide and increases annually (de Mouzon et al., 2020). It can be used to overcome a range of fertility issues, including age-related fertility decline or to avoid inheritance of X-linked conditions (i.e., genetic conditions that are located on the X-chromosome). There is no global consensus about whether egg donation should be permitted, and if it is, how and whether it should be regulated. In the UK, egg donation, along with other forms of fertility treatment, is regulated by the Human Fertilisation and Embryology Authority (HFEA), a body that ensures licensed fertility clinics adhere to the legal framework for assisted conception set out in the Human Fertilisation and Embryology Act (2008).As part of this regulatory framework, clinics are required to give donors specific information and to offer them (and their partner if they have one) formal counselling before they provide consent. However, there is no legal requirement in the UK for egg donors to take up the offer of counselling, though clinics can (and some do) make this mandatory.Professional guidelines for counsellors in the UK (BICA, 2019) suggest that counselling should ensure individuals reach an informed