How is being a surrogate different than carrying your own baby?
For a lot of women when they want to conceive a baby, they do not need the medical assistance of a fertility specialist. These women usually conceive, celebrate and prepare for the growth of their family! These women who have a wonderful experience conceiving could potentially make wonderful surrogates.
When someone decides to become a surrogate the journey is different than when carrying a baby for yourself, but exactly what does that look like? How will you know this is going to feel different and in the end, ultimately feel ok with relinquishing the baby to its parents? Let’s take a look at the break down of how the journey typically unfolds as there are several basic requirements, and steps that take place in order to achieve the end goal of having a baby.
First, one must consider who is a surrogate?
A surrogate is a woman who carries a baby for another hopeful parent who is otherwise unable to carry a baby on their own. For instance, some women have various medical conditions that prevent them from holding a pregnancy and experience multiple miscarriages or some women are without a uterus altogether.
There are many medical reasons why an individual is unable to conceive and carry their own baby, and they ultimately have a choice to make.
- Live without having a child of their own
- Use a surrogate.
Who can be a surrogate?
As an initial screening process, a woman interested in becoming a surrogate must fit a few basic requirements in order to proceed with the application and screening process. Each surrogate must be from a surrogate-friendly state, and unfortunately, women are unable to become a surrogate if they are from Louisiana, New York, and Michigan.
A woman must have a Body Mass Index of 30 or below. A woman with a BMI over 30 is generally not an ideal candidate because this could be an indicator to the health and success of a pregnancy. A woman who is interested in becoming a surrogate must meet the basic age requirements of 23-38 years of age.
Although many women have successful pregnancies into their 40s, the likelihood of success decreases. She must have had a minimum of one uncomplicated, full-term pregnancy, be financially sound and not on any state or federal financial assistance, non-smoker and not exposed to second-hand smoke, and have no criminal history. Once she passes the initial screening criteria she is free to begin the application process.
Application and Screening Process to become a surrogate
Once we have covered the basics, the surrogate must provide more detailed information in her surrogate application about her background, relationships, employment, pregnancy history, and motivations for becoming a surrogate. She is required to provide her pregnancy and delivery medical records and clearance letter from her OBGYN.
As the coordinating agency, we thoroughly review the medical records to look for any complications and foreseeable issues that we are able to address prior to a surrogacy pregnancy.
These records are also provided to the overseeing fertility clinic and they make the ultimate decision if the surrogate’s medical history is acceptable. At this stage, we also run a thorough criminal history background check and drug screening. An ideal candidate will have a proven history of health, and making responsible choices.
Match Making with Hopeful Parents
Once we have approved a potential surrogate, we begin to create a profile and begin honing in on who she would make a great match with! We aim for the best quality match in order to have the best possible outcome. We strive to find like-minded people with wishes, morals, and beliefs. As the coordinating agency, we introduce our surrogate and hopeful parents prior to assigning them as a match.
They have the opportunity to get to know one another and see If they feel comfortable with the individuals they could be working with. At the end of the day, both the surrogate and the hopeful parents must be comfortable with the match prior to moving forward.
Medical Evaluation and Psychological Evaluation
After we have an agreed match, the surrogate and her spouse will move forward with the medical evaluation and psychological evaluation. The surrogate will travel to the fertility clinic and will be fully evaluated with blood work and a physical exam. If the surrogate has a spouse or intimate partner, the partner will also need to be willing to submit to bloodwork. The fertility clinic has the authority to determine if she is a viable candidate to carry the pregnancy.
The surrogate and her spouse will also complete a psychological evaluation. During this time, the Psychologist is measuring their stability, motivations, and preparedness for the journey ahead. They aim to ensure that everyone, including the hopeful parents, are emotionally prepared to handle a pregnancy through gestational surrogacy. After the surrogate and her spouse pass both the medical and psychological evaluations, they are free to move into the legal contract phase.
Establishing the Legal Contract for the Surrogacy Arrangement
The surrogate and the intended parents will be given the opportunity to select who they wish to represent them through this journey. It is recommended that each individual chooses an attorney who specializes in assisted reproductive law. it is very important to establish a contract between both the surrogate and the hopeful parents.
This sets a clear expectation of compensation, acceptable and unacceptable behaviors, where the child is to be born, travel limitations, and who is to assume parentage. Difficult topics such as termination of the pregnancy, or death are discussed and handled so that everyone is on the same page with what to expect during the process if these circumstances should arise. Towards the end of the pregnancy, the attorneys will begin the process to establish parental rights.
Fertility Medication and Embryo Transfer
Once we have finalized both the screening process and established a legal contract, the surrogate is free to begin the fertility clinic’s protocol in efforts to begin prepping her body to receive the embryo. The fertility clinic will establish a specific schedule for daily medications that the surrogate is responsible to take. Some medications are injected, taken orally, or as a suppository. It is very important that the surrogate follow the protocol, both before and after the embryo transfer as prescribed by the treating Fertility Doctor. These medications help her uterine lining to be optimal for receiving the baby, and they also help her hormones adjust.
After the surrogate’s body is prepared and ready she will travel to the fertility clinic to receive the embryo. This is a major milestone everyone is eagerly awaiting and the procedure is quick and painless. Once the transfer is complete, typically the surrogate is required to be on bedrest for a couple days. Then we wait till we have a positive pregnancy test with a fetal heartbeat!
Pregnancy, level monitoring and transitioning to an OBGYN
“Congratulations you are pregnant!” The results we have all been waiting for! With much anticipation and preparation, we are finally at one of the most exciting stages of the journey. As the surrogate, it is very important to continue taking the medications as prescribed by the treating fertility clinic in order for her body to have the best chances of holding onto the pregnancy.
The surrogate will be required to attend weekly appointments to monitor her levels and progress of the pregnancy. When the clinic feels she has reached a point where she can begin to wean her body off the medications and be released from their care, she will graduate and transition to the care of her OBGYN. This is typically done somewhere around 10-12 weeks gestation.
When the surrogate graduates from the fertility clinic’s care, she will assume care under an OBGYN. At this stage, if everything presumes to be normal the surrogate will follow the routine lab work and appointments associated with any pregnancy.
Delivering the baby and relinquishing the baby to its parents
There are many milestones we eagerly await during this entire process, but the one we look forward to the most is the birth of this miraculous child(ren). Everyone involved in the surrogacy arrangement will agree where the surrogate will deliver the baby and a birth plan that everyone is comfortable with.
The surrogate will deliver in a hospital or birth center located near her home, however, it is agreed upon earlier in the pregnancy if the surrogate is comfortable with the intended parents being present in the delivery room, or if she will nurse and provide breastmilk. After the child is born, the intended parents will assume the responsibility of the child and the surrogate will be given the opportunity to focus on her postpartum rest and recovery.
Compensation and Commitment
A surrogacy pregnancy is greatly different than a natural pregnancy intended for herself. A surrogate must commit to following through with her contractual agreements whether that be taking the fertility medication on a daily basis, respecting travel limitations, attending several medical appointments, or following a specific diet. At the end of the day, the surrogate must be emotionally prepared to relinquish the child to their parents.
Many would describe being a surrogate as a way to help people fulfill a joy they have and wish to provide to others, or as the ultimate babysitting job. The journey requires commitment, but the surrogate is compensated for her time, discomfort, and the risk she is willing to undergo for helping complete another family.
Although the surrogate is not preparing to bring home this new life by decorating a nursery and stocking up on diapers; becoming a surrogate can be greatly rewarding, surpassing any of the financial benefits. It provides an opportunity for a family to exist and to mend a parent’s once broken heart and fill the childless void. It is life-changing and creates a unique bond between two families that otherwise may not have been there!