Did you enjoy your pregnancy? Do you want to help someone build a family that otherwise may not be able to build one? These are some questions that may pop into your mind when considering whether you want to act as a gestational surrogate. But how do you become a surrogate? If you are considering becoming a surrogate, where do you start? It can seem like an overwhelming endeavor to figure out the best place to be matched with the perfect intended parent(s). Below are some of the considerations and methods that a woman will take when endeavoring to become a gestational surrogate:
Can I Be A Gestational Surrogate?The first consideration you have to analyze is whether you live in a state that is surrogacy friendly. Every state has different laws regarding surrogacy and since the birth will likely occur where you live, it is important to know whether you live in a state that is conducive to the surrogacy process. Some states have additional requirement to act as a surrogate, such as age like the requirement under Florida law, so a consultation with an experienced reproductive attorney in your home state will be imperative to determine the legal status for the surrogacy process and if you are legally fit to act as a surrogate. For a summary on Florida surrogacy law's, visit my prior blog article titled, "Summary of Florida Surrogacy Laws" Eventually if you embark upon the surrogacy process, you will be analyzed by a fertility doctor and licensed mental health professional to determine if you are medically and psychologically fit to act as a gestational surrogate. Prior to getting that far into the process, you have to consider your prior pregnancy history and whether another pregnancy will be right for you. While it is a medical opinion as to whether or not you will be fit to act as a surrogate, some considerations the clinic’s look at is whether your prior deliveries were uncomplicated, with limited C-Sections, that your weight is at a healthy level, and whether your lifestyle provides the proper support to help you during a pregnancy (i.e. home/work balance and surrounding family and friends support). Another consideration is what type of health insurance do you have, if any, and if you have health insurance, does it cover or exclude a surrogacy pregnancy? This issue of whether a surrogate has health insurance that covers the surrogacy pregnancy will need to be analyzed by a health insurance expert as ultimately, the intended parents are responsible for medical bills relating to the surrogacy process and they will need to make sure you have adequate health insurance.
How Does A Surrogate Get Matched with Intended Parents?The three main ways that a surrogate can match with intended parents include: (i) using a surrogacy agency; (ii) asking family or friends to be a surrogate; or (iii) self match using the internet/social media, craigslist, fertility clinic, etc...
Use a Surrogacy Matching AgencyUsing a reputable surrogacy agency is a wonderful way to be matched with intended parents. The surrogacy agency typically has a database of intended parents who meet the legal requirements in order to work with a surrogate, along with the financial means in order to pay for the entire surrogacy process. Some benefits of working with a surrogacy agency as opposed to self-matching is the surrogacy agency establishes the financial arrangements between the surrogate and the intended parents so the parties do not need to discuss money amongst themselves. The payments to the surrogate with an agency will be in accordance with industry standards and being a surrogate, you want to make sure you are protected that you are being reimbursed for what you are going to experience accordingly. Additionally, the surrogacy agency assists with coordinating the logistics of the entire process from coordinating appointments with the fertility clinic, the OB, making travel arrangements, and assisting in formulating a birth plan with the hospital. A good surrogacy agency is generally the perfect intermediary and coordinator of the process from A to Z and can make the matching process smooth for a surrogate. Regarding the surrogacy matching process, according to the book I co-authored title, The ABA Guide to Assisted Reproduction: Technology, Legal Issues, and Pathways to Success (“ABA Guide”),
Each agency works differently, but generally, in order for a surrogate to be properly screened by an agency, the surrogate starts by completing an application with the agency. The surrogate must provide all of her prior medical records relating to her previous pregnancies. Also, if a surrogate has acted as a surrogate before, she should provide her prior IVF cycle records and information on the previous delivery. The potential surrogate should also provide her Pap smear, current within the past twelve months. The surrogacy agency will initially review these medical records, at times with an on-staff medical professional. A surrogate should also provide the surrogacy agency with a copy of her medical insurance benefits (if she has health insurance coverage), along with copies of her most recent paystubs. This will allow the agency to make a cursory review of the medical insurance to determine if she has medical coverage for surrogacy and to determine how much income the surrogate makes so that when it is time to match her with the intended parents, the intended parents will know how much they will need to pay in lost wages if the surrogate misses work due to an issue with the pregnancy. Once a surrogate joins an agency’s program, she then gets matched with the intended parents. Typically the first step is to share the surrogate’s profile with the intended parents to make an initial determination if the surrogate is a good fit. The surrogacy agency requests that any potential intended parent complete a profile revealing their background information so they are properly matched. If the intended parents like the profile, the parties may have a telephone call or video conference to become acquainted with one another. If that meeting is successful, the parties will arrange to meet in person. A representative from the agency attends and facilitates the conversation at these meetings, as it may be an awkward situation for these strangers to meet to discuss such an important journey. While the issue of selective reduction and termination is further discussed during the psychological review and with the attorneys, the agency’s representative guides the parties to discuss the topic of whether or not the parties are on the same page in this realm, in the event something is wrong with the fetus or if there are more than two embryos that implant in the surrogate’s uterus
Asking Family or Friends to be a SurrogateSome matches are made directly between known friends and family. When matching with a known intended parent, make sure you fully consider this decision. According to the ABA Guide:
Pregnancy can be a dangerous prospect. A woman can lose her reproductive organs rendering her unable to have more children and it may even result in death. While these situations are unlikely, you have to consider . . . how would you feel if your sister was your surrogate and something horrible happened to her? There are additional factors you have to take into account when asking someone you know well to act as your surrogate. While there may be some obvious advantages to having friends or family act as a surrogate, including a higher level of trust and possibly saving on expenses, such benefits do not come without additional risks and unique considerations. Questions raised by the ASRM as it relates to first-degree family members acting as surrogates include: “Can a donor or surrogate closely tied to and perhaps dependent on the recipient couple make a free and fully informed decision? What are the consequences of the unusual resulting relationships on the donor or surrogate, donor-conceived persons, and rest of the family? Additional concerns raised by the ASRM include, What if the IVF is not successful, how will this impact the parties’ relationship? What if the child is born with a genetic or birth defect, how will that impact the parties’ relationship? Will the surrogate have problems detaching herself from the child since the child will be in her life more than may be with an unfamiliar surrogate? Many of these questions are answered in a different way depending on the physical and emotional closeness of the parties, the maturity of the families involved, and other factors such as financial dependency. Whenever considering using a family member or friend as a surrogate, it is crucial that all parties discuss the following: (i) emotional implications involved with a licensed mental health professional (this therapy should include the intended parents, the surrogate and her spouse/partner, and possibly other immediate family members and the future children when they are older); (ii) physical implications involved with a licensed medical professional to address the medical risks involved, including the medications used with ART and risks of ART and pregnancy; and (iii) legal implications involved with an ART attorney in the applicable state to ensure that the parties legal parenting rights are protected and properly explained.