Doctor Answers Surrogate Pregnancy Questions | Tech Support | WIRED

[00:00] and surrogacy expert, Senior Partner at Growing Generations. This is "Surrogacy Support". [energetic music]

[00:14] to want a surrogate even though I'm capable It depends on what your reasoning is, that actually you have a lot of anxiety about being pregnant

[00:30] that happened in your past or someone you know There actually could be many reasons underlying your wish So we would explore that of course.

[00:44] of gray areas, your career is taking off and your career is one where if you took the time off Here's where I land and it is a little controversial.

[00:58] of reproductive freedom, not just for you, The carrier should be fully informed. why they're coming to surrogacy, what their needs are,

[01:13] and she can choose. or wrong, but I can tell you truthfully, anecdotally, They believe in surrogacy as a way to create families

[01:31] I know a lot of people are curious about celebrities There is a lot that goes on So it may look like a celebrity's just choosing a surrogate

[01:46] It isn't always the case. Often, those celebrities have a reason to use a surrogate, It's a lot of money.

[01:58] and that's why you need really good experts and help to make this the most ethical process possible.

[02:10] "Surrogacy, exploitive or empowering?" When it is done right, absolutely empowering. her home life, her financial status, her background,

[02:25] I wanna give the gift of motherhood to somebody else. I am actually partnering with these intended parents

[02:37] How amazing am I? for the surrogate is the look on the parents' faces That is an incredibly empowering moment.

[02:52] You know, this is a delicate process to be doing this the most ethically that it can be done. that everybody is communicating, that there's transparency,

[03:07] authenticity, honesty, expectations are set correctly, that there are legal contracts in place, that there are all that are readily available.

[03:19] and empowering experience. they're fully informed and consented. The screening process is multi-layered and several months

[03:33] One of the tells for me is that a lot of women after the surrogacy to do something in their lives They really see the act of giving birth

[03:50] and seeing the joy, that accomplishment empowers them that are an expression of self-actualization. In vitro fertilization?"

[04:06] Surrogacy is essentially third party-assisted reproduction the intended parents become parents, and the surrogate is the person who carries that baby.

[04:20] That is how embryos are made outside of the woman's body, and that is where the egg is retrieved from the intended mom and then tested and then that becomes the embryos.

[04:36] Probably the number one reason of a medical reason that they cannot carry their own child. of a gestational carrier, which is the kind of technical way

[04:52] So really, anytime the parents need help, this is when a gestational carrier can step in and help. A Quora user asks, "How realistic is the scenario in Friends

[05:06] If the sister qualifies medically, The one issue that we really wanna safeguard when surrogacy

[05:18] or friends, is that no one is being exploited. or no to your infertile sister. as much as it is gentle unconscious coercion

[05:34] But it does happen and it can happen beautifully. to be involved even more so. Jimmy Johnny23, "What happens if a surrogate mother decides

[05:48] That is the number one fear of people but it isn't actually a real thing. In years of me doing this, I have never had a surrogate want

[06:00] to be talked out of keeping a baby. She does not feel like the baby's parent. She is crystal clear

[06:13] Now, having said all of that, She does not have a legal right to the baby as long in a state where surrogacy is safe and legal

[06:28] it's really important that the agreement is legally binding. she has no legal standing even if she wanted to.

[06:42] and regretting this decision. I'll say most agencies have is what ends up having in 30 years never having had

[06:58] a surrogate even question whose baby it is and who takes Broccoli Custard asks, "What's the difference Gestational surrogacy is what most people are doing.

[07:13] is not genetically related to the embryo. that embryo is transferred into the surrogate's uterus and that surrogate is on hormones to support the pregnancy.

[07:27] Traditional surrogacy is where the surrogate's egg is used or a sperm donor sperm for the intended parents to the surrogate.

[07:40] "If a surrogate aborts, her body, her choice." of what the parents' preferences would be if something but ultimately it is the surrogate's choice,

[07:56] This surrogate is asked multiple times about this And no one wants to have an abortion.

[08:08] But if a surrogate says something like this won't happen we're just gonna have questions about whether not because we believe in abortion or against abortion,

[08:23] but because we want her to be safe and happy at the end, So most of the time, the surrogate's position but of course I would have one if the parents wanted me to.

[08:38] Now, I will also say embryos are typically being tested We've only had one case of a fetal abnormality and in that case the parents did choose

[08:50] when that happens. but it is ultimately the surrogate's choice, how she would feel about it.

[09:03] to have an abortion, yes, she can have an abortion. of a surrogate needing to abort

[09:15] to do it if it happened, an an abortion just because. but in terms of her body,

[09:28] Organic Mother. Yes. to the number of overall pregnancies

[09:40] After six pregnancies with the risks surrogacy is optional for the surrogate. of our ability do no harm to her.

[09:55] she could be a surrogate twice. Many of those will be a sibling journey for the same family. Many surrogates are very happy to have done one and done.

[10:10] It's something they feel really good A Quora user ask, "What happens legally Most of the time if a surrogate miscarries,

[10:24] the very first trimester. The miscarriage will be completed, then typically speaking, the doctor will wait one or two cycles and then step in

[10:37] the doctor will want the parents to match is a high risk for future miscarriages.

[10:49] and the surrogate will be terminated amicably So you may be wondering about the compensation When the surrogate goes for that first embryo transfer,

[11:04] because it is inconvenient Then once she's pregnant, her compensation is paid monthly throughout the pregnancy

[11:16] So if she has a miscarriage, the compensation will stop for the time that she was pregnant. "Do surrogate mothers have the same job protection

[11:29] Legally, they are still a pregnant person Having said that, it does happen and they need some extra help

[11:44] Fantastic Fortune 716, "Surrogacy, where to begin?" you have been having some difficulty having

[11:56] Surrogacy is not plan A. after all other things have been exhausted. of normal healthy grieving.

[12:13] or if you need to use outside help, All of these are not the way we grow up thinking So there is some natural grieving that has to happen

[12:28] because surrogacy is very successful if that is your path. to new perspective intended parents of go on for them that they have had trouble, problems,

[12:46] challenges, setbacks, disappointment, frustration, tragedy, So if you're the intended parents, I wanna have a baby through a surrogate,

[13:00] and then you will do your due diligence, meet with some agencies, meet with some doctors, get information, Third party reproduction is a village experience.

[13:12] and you wanna pick the team that really has your back So that's how where to start as an intended parent. this is typically someone who has given birth.

[13:27] uneventful pregnancies and deliveries. And sidebar, I know a lot of people cannot believe that, but there are a lot of women who really love being pregnant.

[13:39] is being a mom and they realize that they could give where to start isn't all that different.

[13:52] You're gonna find lots of resources. or three, figure out how they do things, see meet the actual people involved in the agencies.

[14:04] One of my favorites is familyequality.org, which has a lot Resolve.org, that's another one. Both organizations focus on advocacy, education

[14:20] There are referrals there. There are doctors that you can find through those two sites. Blew Hour Echo writes,

[14:36] Back home and getting judged. There's so many different ways I can answer this question 'cause you're gay dads.

[14:50] and you are gonna be your son's best advocate. We always wanted to be dads I mean, this is why I wrote a children's book,

[15:04] We always knew you were meant to be ours, and here you are If you're getting hassled

[15:16] grownups, you know, can be really judgy. but you know why you had a baby through surrogacy If the judgment is because you went to Mexico,

[15:30] that's just silly because you went the path that allowed you Now, I don't wanna pry and assume, is because there's an idea

[15:45] that surrogates in developing nations are being exploited. as they are in the US, of the experience you had.

[15:57] and you had a great experience, We Will Mock You asks, "What happens if the intended parents The only way they can relinquish

[16:11] they would relinquish a naturally born baby. they cannot change their mind. In order to use a surrogate, you have to name two sets

[16:24] who would take the baby in case you die So if you abandon the baby, one of those sets and be the legal guardian of that baby.

[16:37] that intended parents abandon their baby. and lawyers make things happen in a legal way, Niakatza, "How do surrogacy agencies recruit women?

[16:53] How much money is offered to them?" about who surrogates are and why they do it. young, opportunistic, in it for the money.

[17:06] Typically, surrogates are in their mid 20s Stable lives, stable relationships. They are coming to this process as a really kind

[17:22] to their already pretty beautiful, well-established lives. It's a similar mindset. We specifically do not recruit women to be surrogates.

[17:39] We want women who want to be surrogates to find us Socioeconomically, they have So they cannot be on food stamps or state aid.

[17:53] who are gonna be surrogates really need to be food stable, They cannot depend on the surrogacy compensation It does put exploitation on the table.

[18:07] for whom the surrogacy compensation is gravy. At Growing Generations, It is part of how we end up with only one to 2% of women

[18:22] We put them through a lot. and then of course all their expenses are also paid. and suffering, the inconvenience, the risk.

[18:34] From the time the surrogate applies Could be longer. for our friends without talking to me about it first.

[18:47] You are allowed to be as upset as you are Surrogacy is definitely a family affair It is not something to be taken lightly,

[19:00] whose husband is not fully on board. she is gonna need a doctor and a lawyer and all of the parts, and all of those experts will intervene

[19:13] to be fully informed and fully consenting. you get on board and maybe you don't. The most important thing is that you and your wife are safe

[19:28] Again, surrogacy is optional for the surrogate. So at the core, fundamentally, it cannot do any harm,

[19:41] that is not a good foundation for surrogacy. "My sister has been pushing me to be a surrogate. I agreed at first, but now I'm having major second thoughts.

[19:58] It is hard and there is a lot of pressure. of have fielded these situations. that are totally benign, something in your blood work,

[20:12] and a professional can help you get out of this. where the egg donor promises her brother

[20:24] and they can't wait and they get her in a room. I don't know how to get out of it. of it while saving face.

[20:36] and you definitely don't wanna do it A Quora user asks, "What are the risks involved in surrogacy So in terms of medically for the gestational carrier,

[20:49] and things put in place to ensure her safety. who apply because there's sometimes there's small things of foretell a risk, and the point of that is to protect her

[21:07] All surrogates undergo a psychological assessment. throughout the entire journey They have a support system if they need it.

[21:19] we thoroughly vet a surrogate support system. that's supporting her in this venture. The intended parents have a lawyer,

[21:32] This contract spells everything out for everybody. It is a very safe process from a legal perspective. Financially, the compensation, all of the expenses, all

[21:45] All of this is to say there's a lot of front end planning. We want surprises like it's you're pregnant, it's a boy,

[21:58] So we do a really good job of front ending the whole process Laputa9 asks, "Why is surrogacy illegal or limited

[22:10] So-called altruistic surrogacy is legal in many countries. That is considered illegal in many countries that the surrogate is being exploited.

[22:24] that whoever delivers the baby is the mother So if a surrogate delivers a baby, she's the legal mom.

[22:39] around surrogacy state that the intended parents are the parents who intended So even intended parents who have no genetic connection

[22:53] and a surrogate, they still have and that is the law in the US. So all surrogacy is altruistic.

[23:08] whether she is not, whether her expenses are being paid, ethical surrogacy is altruism. Surrogates are so generous.

[23:22] They are a special kind of generous. does not take away from that generosity. is very interesting because it doesn't really make sense.

[23:38] isn't that the more exploitative option? it's a two year commitment. It's, there's risk, there's time away from her family.

[23:52] It's only exploitive if she wouldn't make the choice If she is going against her own best judgment to meet a financial requirement.

[24:07] From WrecktheRIC, "Attachment issues from being removed This supposes that the surrogate is the mother. And there is a good body of research that babies born

[24:23] There are lots of ways in which the intended parents by participating in the OB care through the uterus, voice and music.

[24:38] The bonding and relationships are just as strong and the baby regardless of how the baby was born. and wanted by their parents,

[24:53] Wolede asks, "How much does surrogacy cost?" At the very lowest, about 150,000, 200,000, even $300,000.

[25:08] There's just a lot of parts and they all need to be paid. you've got the doctor's fee, the lawyer's fee,

[25:20] the medical insurance, the medical expense for the OB care. or a sperm donor. All of the surrogates travel, all of her lost wages,

[25:32] and the embryo transfer and then the pregnancy All of these expenses go into the process.

[25:44] by line budget so you know exactly how much it's predicted because actually it is very predictable.

[25:56] So no pregnancy ever assures a healthy baby. Pregnancy's risky, but with third party reproduction and guardrails in place that help

[26:12] Eggs and egg donors are scrutinized, sperm and sperm donors are scrutinized, the embryos are tested. The gestational carrier has lots of scrutiny

[26:26] So the odds are stacked in favor This is part science, part magic,

[26:39] So most of the time, surrogacy babies are perfectly healthy, There's just no way to completely reduce Next up from Goblin Mom,

[26:54] Talk to a couple of different agencies You'll get a feel for it. who interview women who wanna be surrogates

[27:08] be kind of your partner in this, tell you all about sort and really be there as a resource for you. because it's a very human process.

[27:22] Pleasant Choice 6130, Is it the same for intended parents?" to meet a certain baseline requirements.

[27:38] They have to live in a state where surrogacy is safe So they're financially stable. and friends, their boss, their kids if they're old enough.

[27:52] They have to be absent of any other medical issues. of criminal behavior, no arrests. to the point where they're medically screened,

[28:06] uterine ultrasound, kind of a head to toe, physical, to have a psychoeducational consult. They also have to have blood work and infectious disease

[28:20] to be impacting the surrogate. And then they will have a criminal background check. on the surrogate's mental health?"

[28:35] They will have a very comprehensive psychological assessment there's ongoing unlimited psychological support

[28:48] Pregnancy can be stressful and there are times and we do our best to mitigate that. and the intended parents start out with one type

[29:02] the relationship changes, the surrogate may be disappointed, but hopefully she's been so thoroughly screened because she knows in the process of screening

[29:19] One of the questions we ask the surrogate and at the end you never speak to them again, And if the surrogate says yes, then to be honest,

[29:32] Most people do stay in contact with their surrogate and with the intended parents, whether it be as little or being really actual friends, but not everybody.

[29:48] of being a surrogate shouldn't be to have If that happens, it's gravy, it's wonderful. should be helping someone become a parent.

[30:00] that we are only letting women go forward so that they're not hurt later. but because we wanna make sure

[30:14] We wanna make sure expectations are realistic. What is everybody's expectation for this journey together?

[30:26] and we wanna be friends for life, to understand as do the parents, and put in place to safeguard the surrogate's mental health.

[30:43] Her health in all ways, physical This is from the Futurology Subreddit. "Are we too close to making Gattaca a reality?"

[30:57] Look, science has taken us really far. the science around family planning, the science There are really clear ethics

[31:14] and there are very good ethics societies The American Society for Reproductive Medicine has papers There is a very robust ethical committee,

[31:29] and discusses all of these issues. the advances in science have been for the better. if they were conceived through surrogacy?"

[31:44] Kids wanna know where they came from, about where they came from or what it's supposed to be like. to be a mom, a dad,

[31:58] They know love, commitment. who's there to take care of them. some version of this, mommy and daddy, or mommy and mama,

[32:15] poppy and papa wanted a baby so much and we needed help. and we had this one And so a really nice lady helped us with this one

[32:27] And she helped us because we really wanted you. We thought about you and we prayed for you, And so she helped us and we were there when you were born

[32:41] and you wrapped your fingers around my finger, Babies, children wanna know, This is everything for today.

[32:55] I hope you learned something, and I am always here. I'm easy to find and I'm happy to be a resource. [bright music]