Surrogacy is not on the government's agenda and there is no electoral mandate to legislate for it, but Labour MP Romilda Zarb says the subject should still be discussed openly, arguing that somebody has to start the conversation.

In an interview with The Malta Independent on Sunday, Zarb stressed that she was not announcing a bill or a change of policy. As a backbencher, she said, she does not implement changes, and the government remains bound by the mandate it received at the ballot box. What she is asking for, she said, is that the subject be heard.

"I said let's not sweep this subject under the carpet, let's listen," she said, referring to her contribution on surrogacy in Parliament. "It doesn't mean we will agree on everything, and it doesn't mean we will get to the point of implementing it. But somebody has to start the discussion."

Zarb added that the debate need not be confined to the Chamber. It could take place among stakeholders, non-governmental organisations, medical and ethics professionals, and through newspapers and public opinion, she said, so that no sector with a view to offer is left out. Lobbies had already made their comments, she noted, which meant the discussion did not have to happen in Parliament, and she said she was not looking to frighten anyone on the issue.

She described surrogacy as a controversial subject and one that demands care. Any framework, she said, would have to safeguard the rights and welfare of the child being carried, protect the woman carrying the pregnancy, and ensure that she is not exploited.

Zarb distinguished between voluntary surrogacy, an arrangement in which a woman carries a pregnancy for intended parents without financial compensation or profit, and the commercial kind. The voluntary model was the one she had addressed in Parliament. She said she personally did not feel inclined towards the commercial model, but added that several people who had approached her had expressed that wish, and had asked whether she expected them to go abroad.

That question, she suggested, is already being asked in practice. In the last legislature, she said, the government recognised that some people were travelling abroad for surrogacy, and noticed an anomaly: a second parent was entitled to paternity leave, but a mother who had not carried the pregnancy was not entitled to maternity leave. Legislative changes were made so that she could benefit from maternity leave.

The concept of surrogacy itself, however, had not entered the agenda. "Every time we hold back, I believe that out there people are waiting on surrogacy and we are turning them away," she said.

Zarb drew a parallel with how IVF reached the statute book. Even when the concept was first pushed, some people disagreed with it, she recalled, and others did not agree with the government when it amended the law to allow pre-implantation genetic testing for monogenic disorders (PGT-M). Surrogacy was now at a comparable stage, she said, which called for discussion first and caution throughout. Before any conversation begins, she said, there has to be careful listening and analysis to make sure no sector is left out.

The comments came as Zarb defended the government's record on in vitro fertilisation (IVF), an issue she has pressed repeatedly through parliamentary questions to the Health Minister. She said it was the numbers emerging from those questions that kept drawing her back, because they showed the opportunity being given to Maltese families.

The Health Minister has told her that the take-home baby rate rose from 18% in 2013 to 45% in 2025, while the number of annual users climbed from 100 to 774. Zarb explained that the take-home baby rate measures how many IVF procedures actually end with parents bringing a baby home, and she acknowledged that some people who go through the procedures have not yet managed to become parents.

She said that since 2013 some 4,757 prospective parents had come forward and that more than 1,100 babies had been born, among them some through PGT-M, a procedure used alongside IVF to check embryos for specific inherited genetic conditions before transfer to the uterus. State investment had grown from €75,000 in 2013 to €6.7 million this year, she said. IVF is provided free in Malta, and the refund of IVF medicines amounts to around €4.6 million, with almost every application benefiting by around €2,000.

The age limits have also been widened, she said. Egg retrieval is now possible up to the age of 45, while an already fertilised embryo can be implanted before the woman turns 48.

On the cap on funded cycles, Zarb said the definition of a cycle changed in 2022. Previously each embryo implantation counted as a cycle. Now a cycle is a full round of IVF, from which the fertilised eggs yield a number of embryos. The limit was set at three cycles in 2022 and later raised to five, after the Prime Minister was approached during the election campaign earlier this year by a woman who had exhausted three cycles without becoming a parent.

Asked whether five remains the right number, Zarb did not say whether it still applied. She said, however, that she would not rule out a need to increase it in future, describing it as "living politics" to keep listening to people. Discussions on IVF in Parliament are continuing, she said, and the question is whether access can be widened further.

She rejected the idea that IVF still carries a stigma that deters couples. She acknowledged that the procedure was once seen by some in a Christian country as not "natural", and said some people still keep it hidden, but she did not think anyone dreaming of becoming a parent would see that as a limiting factor. Reluctance to speak about it, she said, usually comes from people not wanting to reopen a wound.

The process is physically and mentally demanding, she said, pointing to women who have to inject themselves daily and to the wait of several days after implantation before a pregnancy test can be taken. She did not believe people abuse the system.

The expansion of PGT-M to 17 additional conditions has drawn criticism from the Malta Federation of Organisations of Persons with Disability, which warned it risks sending the message that some lives are more valuable than others. Zarb said she did not see the two positions as different. PGT-M, she said, is offered only to couples going through IVF who have serious hereditary conditions, and was not about "perfect babies" but about giving those parents an opportunity they were previously denied. She said she respected the federation's views and that the decision would always rest with the parents.