Surrogacy 101

#SurrogacyMyth: You can't become a Gestational Surrogate if your tubes are tied

Many women have said “I would love to be a surrogate but I have had my tubes tied.” They are very surprised to learn that, indeed, a tubal ligation will not prevent them from helping a couple become a family!

A tubal ligation is a permanent form of birth control, true.  After this procedure has been performed, an egg cannot move from the ovary through the tubes (a woman has two Fallopian tubes), and eventually to the uterus. Also, sperm cannot reach the egg in the Fallopian tube after ovulation (release of an egg from the ovary.) To become a Gestational Carrier, where you are not using your own eggs or tubes and therefore a woman can become a surrogate even if her tubes have been tied. (You cannot become a traditional surrogate where you would be using your own eggs.)

If this is the only thing holding you back from becoming a surrogate, I suggest that you find an agency and see what else you need to do to qualify as a gestational carrier. You will be glad you did!

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#SurrogacyMyth: You can be a surrogate even if you have never been pregnant

I have heard women say “Since I don’t want children of my own, I would be the perfect surrogate” or "I don’t want my own baby but I do want to experience pregnancy” or “I know I want children later but I want to be a surrogate now”. To all these women, if I feel they would be qualified, I say “What about egg donation because you are not qualified to be a surrogate”. Many sighs of disappointment and questions of “why not”? (Are you digging the quotes?)

Here are the main reasons that someone who has never had a baby should not be a surrogate:

*There is no previous experience with pregnancy and birth. No one knows what complications this body may have.

*Not sure if there would be any fertility issues

*No personal knowledge of the discomforts of pregnancy

*No personal knowledge of the pain of the birthing process

*Possible emotional issues through out

I have heard of surrogates without previous pregnancy experience be successful but that is almost always for a family member. Some clinics or doctors will make an exception in these cases. Again I remind my readers that the surrogacy process is costly with the Intended Parents investing thousands and thousands of dollars and having someone that has proven that she can carry and give birth to at least one healthy baby is an important part of the process.

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#SurrogacyMyth: If a woman has been pregnant in the past year or so, she shouldn't need a maternity clothing allowance

Ahhhh the Maternity Clothing Allowance, a topic of many a conversation. Most surrogacy arrangements have an amount of $750-$1000.00 earmarked for maternity clothing. In the case of twins, a surrogate may use that money around the 10^th week of pregnancy and for a singleton she may use it at around 12-14 weeks. Nothing stops anyone from buying clothing earlier from what the agreement states but the surrogate will not be reimbursed until the time agreed.

Some intended parents might ask a surrogate why she would need new maternity clothing especially if she had a baby within the past 2 years. Here are just a few reasons:

*She gave all of her maternity clothing away not thinking that she might need them again

*She had her last baby in the winter and will need a wardrobe for an entirely different season(s)

*She has a “professional” career and needs to update her wardrobe

*She has a job that requires a uniform and she needs to buy maternity sizes in order to continue working

*She tossed all of her old maternity undergarments and will need to buy new (comfortable bras and underwear often need replacing)

*She has an event that she will attend during her pregnancy and will need to buy appropriate clothing 

*She needs clothes for all reasons: Sleeping, playing, swimming, working, lounging, going out and staying in.

If your wife or significant other were carrying this baby, would you not expect her to buy clothing that was stylish and actually fit for her growing body? Case closed.

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#SurrogacyMyth: Criminal Background checks on both Intended Parents and Surrogates & their partners is a waste of money and time

Most Surrogacy Agencies hire a company to run background checks on their clients (IPs) and surrogate candidates, including husbands/partners. This is not because everyone is under suspicion. It just makes all parties more comfortable. You want to believe that people would be honest upfront but what is important for you to know may not be what they want to share. Now if you are working with someone that you know well; a family member or a close friend, you really don’t need to have a background check. But if you are working with someone you hardly know, maybe you met on the internet or by classified ad or it’s a friend of a friend of a friend, a background check is a good idea, for all parties. What are you looking for? DUI’s, drug conviction, child abuse, criminal charges and so forth. Anything that will give you pause about working together. It’s better to find things out before the contracts are signed then after. **NOTE Background checks for all involved (up to 4 people) should cost under $400.00. Not a bad price for a piece of mind!

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#SurrogacyMyth: Any attorney can draw up a surrogacy contract so don't waste time vetting reproductive lawyers

Would you have a mail man sell your home for you just because he sees a lot of houses during his mail delivery route? NO? Well then don’t expect a family law attorney or a divorce lawyer to have the knowledge to draw up a surrogacy contract. It’s tempting to want to cut corners and save money but skimping on the contract phase is not the place to do that!

The gestational surrogacy contract, as well as the contracts for traditional surrogacy, are lengthy and complicated. The wording is very important and there are several sections outlining who is responsible for what and what happens under certain circumstances. It covers issues like what constitutes a breach of contract, who will be named guardian if something happened to the Intended Parents, what happens to the baby if it’s born with a deformity, and who is holding escrow and when are payments made? (Among many other things)

Make the investment and hire an attorney who knows the ins and outs of reproductive law. Not adoption law, not family law, but REPRODUCTIVE LAW. This lawyer can also handle the parentage actions needed to ensure that the Intended Parents names are on the birth certificate. If something should go wrong or there is a misunderstanding, the contract may hold the solutions.

The contract doesn’t promise that the humans who signed it will behave or that everything will go smoothly but it does make sure they everyone is following the “rules” and fulfilling expectations. A good surrogacy contract lends everyone a piece of mind during what can be a long and sometimes complicated process. Protect yourself and insist on the best lawyer for the job. (*NOTE: Both the IPs and the GC need their own attorneys, one lawyer to draw to up the contract and one to review the contract on behalf of the surrogate.)

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#SurrogacyMyth: Surrogates are in the business of selling babies

Can we all say the word ILLEGAL all together? Surrogacy does not equate the selling of babies. No matter what some say, any money a surrogate may make is nothing compared to a full-time job. What payments a surrogate does receive is to either assist her in taking care of herself or taking care of the unborn baby she carries OR reimbursements for co-pays or incidentals needed to follow her contract throughout the surrogacy process.

A first-time surrogate receives between $28-$34 thousand. That may look like a lot but the average surrogacy journey lasts for at least 15-18 months. At the high end, that’s $1888 per month (for those that hate math). I wonder how much day care costs per week these days? And that would be 5 days a week for 9-10 hours. If it were 24/7 I would hazard a bet that it would be more then 2k per month. There is a benefit package that often accompanies the base fee which includes reimbursements for things like lost wages, child care, housekeeping, and maternity clothing, to name a few. There is also compensation for invasive procedures like amniocentesis, C-sections or D&C’s.

In Gestational Surrogacy, women are volunteering to carry a baby for another person or couple. Yes, there is money involved. Payments are also made to the clinic, the egg donor, the RE, the attorney, the mental health professionals, the pharmacy, the OBGYN, and the hospital. This list doesn’t include any specialist that might be involved with the pregnancy/birth. Surrogacy is an expensive process no matter how you look at it.

The thing to remember is surrogacy is an unselfish feeling that has to start in the heart. Of course there are other reasons and rewards that women may want to be a surrogate but the main point is helping others have the children they need to make them parents. It’s simple really. People helping people, families helping families. What could be wrong with that?

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#SurrogacyMyth: As long as you are of legal age (18) & have had a baby, you can become a surrogate

Sorry but NO. Has it never happened before, an 18-year-old becoming a surrogate? I am sure it has in the past but there are many reasons that it is rare, especially in the USA. Here is my take on why it is best to wait until a woman is at least 21 to become a surrogate.

First, an 18-year-old with a baby, because she has to have had an uncomplicated pregnancy and birth AND parenting her own child as per most requirements, will have her hands full just parenting! Secondly, although she is of legal age to sign a contract, it could be challenged in court depending on the circumstances. Third, the rest of a woman’s fertile life has to be considered. There is a chance that she might lose her fertility due to a complication within the surrogacy pregnancy/birth. Although this is the same for older women it can be even more devastating for those under 21.

Very few 18-20 year old’s will pass the psychological evaluation due to maturity. Responsible and mature women with life experience make the better surrogate/carrier (one would hope). I know that statement will not be a popular one among those younger women but the truth is the surrogacy process is very expensive for Intended Parents. Upwards toward $125,000.00 and that means that the majority of the responsibility rests on the shoulders of the surrogate. She needs to take her part very seriously. A surrogate needs to follow all of the doctor’s orders. She needs to take all of her shots, pills, patches etc. at the right times. She needs to have reliable transportation to attend each and every appointment. She needs to take care of herself even if it means putting her own family on the back burner. If she is put on bedrest that means staying on bedrest, if she is told no sexual activities with her partner then that means NONE. If she is told she can’t lift more than 10 lbs. that means no picking up her 30-pound toddler. She needs to keep track of every receipt, bill, statement and parking permit throughout the process.

Needless to say, for those of you who are under 21 and dream about becoming a surrogate, just wait. Do all of your research, read the qualifications and requirements and be ready when the time comes to fill out that application. Your heart is in the right place and that is the first step!

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#SurrogacyMyth: DNA testing is not needed in the cases of Traditional Surrogacy arrangements

There was a recent surrogacy news article about a Dutch gay couple and their surrogate. She gave birth and the couple was very happy…until the DNA test came back and the baby was actually the Traditional Surrogate’s and her husband’s baby girl. How did this happen? Apparently, the surrogate and her husband had intercourse instead of abstaining when she should have. Needless to say, the gay couple had to give the baby back. You can read all about this case here: http://www.dutchnews.nl/news/archives/2017/05/gay-couple-told-to-hand-back-baby-to-surrogate-after-dna-tests/ ‘As gay parents, you actually have no rights,’ Janssen told the AD. ‘Everything depends on the mother’s willingness and good faith. Apart from an internet checklist, we had nothing on paper.’ It seems that they skipped may steps including drawing up a contract!

This is just one of many examples as to why hiring professionals to assist you during the surrogacy process is so important. DNA testing, especially within a traditional arrangement, can be so important. Don't skimp on surrounding yourself with knowledgeable and competent professionals.  

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#SurrogacyMyth: In the USA, Surrogacy arrangements are valid in all 50 states.

Unfortunately, not all US states have jumped on the surrogacy band wagon! These 5 states are not surrogacy friendly at all (meaning that women from these states should not give birth to a surrogate baby within state lines) Louisiana has very limited laws and I suggest that you talk to a reproductive attorney before you even consider LA. Michigan is a very emphatic NO along with New Jersey and New York. A surrogate could be criminally charged. Washington state allows “compassionate, non-compensated” surrogacy arrangements but all other paid arrangements are considered criminal.

Heterosexual Intended Parents from the above states can work with a surrogate in any of the surrogate friendly states. Gay or single intended parents also have to be aware of the laws in certain states. Here is a great website to learn about each states surrogacy laws from Family Connections GESTATIONAL SURROGACY LAW ACROSS THE UNITED STATES.

Remember that these laws often change and contacting a local reproductive attorney BEFORE you get started in a state you are unsure of is the best advice I can give you.

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#SurrogacyMyth: IVF will work the first time with a qualified surrogate!

In Vitro Fertilization is a true miracle to those needing extra help conceiving a child. Sometimes IVF alone is not the answer, especially for gay couples or women with medical conditions like cancer. When another woman is needed, a gestational carrier, IVF breathes new hope into a once seemingly hopeless situation.

No fertility clinic that I know will guarantee a pregnancy on the first attempt of IVF (or on the 4^th attempt for that matter) The intended parents are the people who usually choose the RE/clinic so we all hope that they have done their homework regarding live birth statistics. All involved also hope that any embryos that are made and transferred are of great quality. They hope that the eggs and sperm are from the most perfect source. There is a LOT of hope involved in IVF BUT, surprise surprise, even if everything is deemed A+, Grade 1, “Excellent”, and the carrier has the “best lining I have ever seen” the IVF process can still fail! And because of this fact, the surrogacy agreement often will state that it will cover the time frame of up to 3 IVF attempts.

My best advice beyond “expect the worst but hope for the best” is for intended parents to do their research and find the best clinic they can afford. Secondly, be prepared for an IVF cycle not to work for no good reason. Everyone is doing their job and it will still fail because we are human and nothing is perfect. Keep the hope, follow doctor’s orders, know that you are not alone but be realistic.  Everyone wants the same thing. A healthy pregnancy and birth.

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#SurrogacyMyth: All health insurance policies cover surrogacy pregnancy and delivery!

Don’t we all wish this were true! But over the past decade or so most insurance companies have revised their policies to exclude surrogacy arrangements. Some policies are vague and read as if there is some wiggle room but a surrogate candidate must be very careful as she reviews her policy. If bills pertaining to a surrogacy pregnancy and birth are submitted to an insurance company that decides that payment is not their responsibility, several things can happen. First, remember all surrogacy contracts state that the Intended Parents are responsible for all medical bills in relation to the surrogacy arrangement. Most, if not all, medical bills are in the name of the surrogate so as she receives these bills she is expected to arrange payment. If these bills are submitted in a timely manner then the IPs may pay them as soon as possible, perhaps money from the escrow account would be used or maybe they will arrange payments with the OBGYN or hospital. If the insurance company takes it’s time with the decision, the escrow account could be emptied and closed as well as the Intended Parents leave the state or the country (If they are International) and these bills could be left for the surrogate to be responsible for. 

This has happened several times. What can be done to make sure that an insurance policy will be held up and make the payments expected? First, have a professional review the entire insurance policy. If there is any question then the Intended Parents need to invest in a backup plan or full surrogacy insurance coverage backed by a Lloyds of London policy. No one wants to be left with bills after giving an amazing gift of life and family, just as no intended parent wants to be stuck with unexpected medical debt.

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Surrogacy Myth’s BUSTED

On Twitter and Facebook I have started the #SurrogacyMyth which is a way to not only dispel current myth’s about the surrogacy process but a discussion starter for those who need or want more information. I also have invited anyone who has a #SurrogacyMyth to share in the comments section of this blog! My next few blog posts will start to bust these myths!

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