Friday, June 20, 2008

how surrogacy works

the primary reason that i started this blog was to get some information out there about surrogacy, from the viewpoint of an intended mother. in reading my posts, i realize that i have not done a very good job at meeting this objective. this process is very emotional and brings up issues that you never even thought existed. this post though is going to be about the process. so

fasten your seat belts, this is going to be a bumpy ride:

first, you have to become infertile, this can be voluntary or involuntary, and for the purposes of this discussion, it does not matter. in my situation it was being born with a bleeding disorder (von williband's disease) combined with polycystic ovarian syndrome.

this will give you the magic combination for marathon periods. at the age of 12, was hospitalized because my blood pressure was 60/40, i had my first blood transfusion and my first d&c at this time. i was put on 3 birth control pills a day, which after a couple of months quit working. lucky me got to graduate to estrogen and progesterone. by the time, i was 13 i was on the highest dose of estrogen made. i will not bore you with how terribly awful this is for a child, or anymore boring details. this whole process was repeated over and over, until i had had ENOUGH. i finally got to the point where i had no quality of life. therefore, at the age of 31 i had an endometrial ablation because i could not take another 3-6 month period and the hormones were making me so sick. this was the hardest and best decision i have ever made. this is not to say that there have not been moments when i worried that i had made a mistake. once i came back to reality though, i knew that there was no other option, and my quality of life has greatly improved.

once you have determined that you are unable to carry a child and are prepared to turn this over to someone else, you need to find people to help you navigate this minefield. this is a lot easier said than done, in my experience there is not a ton of information floating around. i am one of those people who trusts about 5 people on the whole planet and none of them could carry a baby for us. we have all heard the horror stories about surrogacy, and there is an element of risk inherent in this process just as there is in any endeavor. i hire people to do my taxes and take care of my lawn, so why would i not hire someone to guide us through this?

we had a false start with our first attempt to find an agency, but that is what happens when you are finding out how this works. the best advise i can give here is to do what feels right to you. emotions have to stay out of this, which i know is much easier said than actually done, but you have to try if you do not want to risk much worse emotional harm later. i would do anything to be a mother, except risking all that i own, or compromise my integrity.

remember you have never done this before so there is going to be a big learning curve. interview people, ask a ton of questions, and wait until you find someone who makes you feel comfortable. these people are going to make your pure will into a baby.

at the agency interview, you will be given a ton of information. i probably only remember about 5% of what we were told in this 4 hour meeting. nervous does not even come close to what i was feeling. take notes, and remember that you can always ask questions later, when you are not scared to death. most of what they go over is procedure, agency history, and a general overview of the process. then there are the questions that none of us really want to answer.

do you want to do amniocentesis?
if the results of the amniocentesis are not good, what actions will be taken?
in the case of high order multiples would you want selective reduction?
for me at this point i wanted to crawl under the table, who wants to think about these issues?

this is the point where you need to put on your big girl panties and be brutally honest. we all want to think that these issues will not affect us, but they do happen. in the perfect world, we would be immune from this and could deal with them only if they arise. here in the real world you are asked these questions so that you are matched with someone who has the same views as you. you should not feel judged by the answers you give. better to get over this part now than when it happens and you find out that you and the surrogate have different feelings.

next, there are all kinds of fertility tests, psychological evaluations, drug tests, and paperwork. the most difficult part of the paperwork for me has been putting together a profile. this is what prospective surrogates first see about you and your partner. i guess it is like putting together something for a dating service. personally, i have never used one of these services, but i imagine that is what it would be like, only about you as a couple. this part of the process is a lot like being in jr. high and liking a boy/girl. you pass notes through your friends (the agency) and a lot of worrying if they (the surrogate) are going to like you back.
this is as far as we have gotten, so the rest of this is what i have been told.

next, it is the big meeting. we will go with our agency representative to meet the surrogate and her partner in person. this is after we have all approved each other’s profiles. at our agency, this woman and her family will have been approved before we meet them. from what i have heard, this is not always the case. if we all agree to working with each other then we start drawing up the contracts. you learn fast that there are soooo many lawyers in this process, which is good b/c everyone needs to be protected as much as possible. there are so many pitfalls that spelling it all out is important.

at some point, she will become pregnant. here there are all kinds of numbers and terms i cannot even begin to understand. at this point, i am not concerned with them. chances are though if you have made it this far you have been through the fertility ringer, so the majority of this will not be unfamiliar; you are just adding another person. the one major difference is that you are going to have to synchronize your cycles so you go on birth control at the same time.

once she is pregnant, you will go to various doctor's appointments together, or at least talk to each other and the ob/gyn if you live far away. in a perfect world she would live down the street, in reality for us at least she will most likely live very far away. thankfully, they can now e-mail you the heartbeat and the sonograms, is not technology nifty.

depending on the laws of the state in which she lives, not where you live, remember this. the custody thing will work one of two ways, with possible variations. if your husband's DNA has been used, he gets to go on the birth certificate automatically. the law has not gotten to the point where they recognize the DNA of the egg, so the mother is going to have to adopt the baby regardless of whose DNA was used. this is a stepparent adoption so it is not the grueling process of a stranger adoption. you are going to have a simple home study, they are much easier when you are married to the father, and the surrogate will sign away her rights. just like any other adoption, you will be the parent with all the rights and responsibilities. this is where the variation comes in, some states will let you do this in the second tri-mester, or you will do this after the birth. the only real difference here is the timing.

at the hospital you will have this all worked out before, but you can be there for the birth. now here is the tricky part, you know those plastic bracelets; well in they come in 3 packs for maternity, 1 for the baby, 1 for the woman giving birth, and 1 for the partner. due to the high security of maternity wards, you will only be able to get the baby from the nursery with the magic bracelet. some facilities will give you and your family their own room provided there is an empty one. they are not going to leave some poor woman out in the hall to give birth just so you can coo over your baby in your own room. in this case it will make it easy, if not though whoever has the bracelet is going to have to be there to get the baby, or the surrogate is going to have to get the baby. all this really means is there will be little rest for the person with the bracelet.
now here is the part that makes many people uncomfortable. this is my opinion only!!! the amazing woman who has just given you the greatest gift in the whole world needs some time to say good-bye to this parasite she has been hosting for nine months. i have read some very sad stories about surrogates who felt pushed aside once the baby was born. i figure i have waited years to take my baby home, another 30 minutes is not going to hurt. some people worry that doing this is going to make her want to keep the baby, and in some cases, it might, but these women go into this knowing they are helping you have a baby. this is not like an adoption; in most cases, she does not have any biological connection. so please give her those moments, it is the least you can do, because there will never be anyway that you can thank her for what she has given you.

most people work out the level of contact they want after the birth. there are some people who go home and send a few pictures and cards and never talk again, and then there are others who become family. this is up to you and your surrogate, and you will know what feels right. chances are though it will not be what you thought you were going to do in the beginning.

who are the amazing women that are willing to lone you their bodies for well over nine months? our agency requires that they have at least one child and encourages them to be finished having children for themselves. women sometimes loose the ability to have more children during the course of pregnancy. you will have to pay extra if she looses her uterus, but no amount of money can replace her ability to have more children for herself. personally, i could not live with myself knowing this had happened, so that i could be given this amazing gift. economically, they have to be sound. i am not going to pretend that the money is not a nice bonus for these women, but it is not the primary reason that they are doing this, fact is they are not being paid that much for what they are doing. from what i have read many of these women have some personal experience with infertility in their family, or are just love their children so much that they can not imagine not helping someone have the same joy they get everyday.

this is what i know for now. it is a lot to take in all at once. this whole process is a lot to digest. remember this is your labor process. the way i see it, i may not be carrying this child in my body, but i have willed him/her/them into being, by my desire to bring them into this world.


Bump Fairy said...

Are you using a Gestational Surrogate? If so your lawyer will arrange a Pre-Birth Order. You, as bio Mom, will be on babies birth certificate. You will also be the one with the bracelet. Surrogate gets one for herself, but not a second one matching the baby unless the intended parents request one for her. Surrogete is never mentioned on that childs legal documents. There is no step parent adoption, etc.
Unless you're using a traditional surrogate( or if the surrogate lives in a very surro-unfriendly state) then yes, you are correct!