Surrogacy's Emotional Challenges: A Mother's Story

Being a surrogate mother is a complex and demanding process that can be emotionally challenging. Surrogates must grapple with the psychological aspects of carrying a child that is not genetically related to them, navigating legal contracts, and forming relationships with the intended parents. While some surrogates embrace the role with joy, others may struggle with the emotional toll of surrogacy.

The surrogacy process involves extensive screening, medical procedures, and legal contracts. Surrogates must undergo physical and mental health evaluations, fertility treatments, and regular appointments to ensure a healthy pregnancy. They also need to establish clear expectations and boundaries with the intended parents, which can be emotionally taxing.

While some surrogates find fulfillment in helping others achieve their dream of parenthood, others may experience confusion, guilt, or anger. The emotional impact of surrogacy can be profound, and professional counselling is often recommended to help surrogates process their feelings.

Additionally, surrogates must consider the potential impact on their own families and support systems. Spousal support is crucial, as surrogacy can affect marital relationships and intimate connections. Navigating social perceptions and explaining surrogacy to children can also be challenging.

Overall, the emotional complexities of surrogacy cannot be understated. While it can be a rewarding experience, it is essential for prospective surrogates to carefully evaluate their readiness and seek professional guidance throughout the entire process.

Emotional attachment to the baby

At first glance, it may seem obvious that a surrogate mother would get attached to the child. After all, she carries the baby for months and gives birth, which is an incredibly emotional process. However, surrogate mothers choose to become surrogates not to have a baby of their own, but to help others build a family. Overall, gestational carriers become surrogates to help intended parents, not to be attached to the baby.

Most surrogate mothers report that they do not experience the same feelings of attachment as they did with their own children. Many surrogates say they feel more connected with the intended parents than they do with the baby, and they cannot wait to watch the intended parents meet their child for the first time. Surrogates often view what they are doing as "babysitting" for nine months.

However, surrogacy can be a high-risk emotional experience, and many surrogate mothers may face negative experiences. It is recommended that surrogates receive professional counselling before, during, and after pregnancy. The American Society for Reproductive Medicine (ASRM) strongly recommends that gestational carriers receive psychological evaluation and counselling. A full mental health evaluation and thorough psychological testing can help ensure that each surrogate is committed to the journey.

Some surrogates may struggle emotionally after giving birth, largely due to pregnancy hormones. However, if the surrogate has a solid relationship with the intended parents and has prepared for this time of transition, they should readjust to everyday life relatively quickly. There is no shame in reaching out for help from a support team, surrogacy professional, or the intended parents, if appropriate.

Every surrogate's feelings are different, and a surrogacy specialist can help a surrogate understand and process their feelings throughout pregnancy and following delivery.

Navigating the emotions of the intended parents

Before the pregnancy

Before committing to surrogacy, it is important to ask yourself some hard questions to determine whether you are ready to embark on this journey. Ask yourself: "Can I be pregnant with someone else's child for nine months?", "Am I willing to commit to a healthy pregnancy even though it's not my baby?", and "Am I ready to commit to a year or longer of intense fertility treatments, a potentially difficult pregnancy, and a close relationship with the intended parents?".

During the pregnancy

It is recommended that intended parents remain as involved as possible throughout the surrogate's pregnancy. This can include attending doctor's appointments, decorating the nursery, and having a baby shower. By taking an active role in the pregnancy and going through all of these normal stages, you will develop a sense of connection and attachment with your baby.

It is also important to address any unresolved grief or loss before the baby is born. If you have chosen surrogacy due to infertility, it is healthy to move through the grieving process beforehand. This will allow you to focus on your child's needs and your excitement to become a parent.

After the birth

The transfer of the baby from the surrogate to the intended parents is a huge milestone and marks the beginning of a new life chapter. To ensure a smooth transition, it is important that the baby's senses are confirmed by allowing them to be in contact with the surrogate immediately following delivery. This can be done by placing the baby on the surrogate's chest or through some other form of physical touch, such as holding their hands and feet.

The surrogate should then physically transfer the baby to the intended parents, symbolising the handing over of attachment. Skin-to-skin contact between the parents and child is crucial following the transfer to allow the baby to become familiar with their smell, sound, and touch.

To further support the emotional transfer, it is recommended that the intended parents make an effort to see the surrogate family again within a couple of weeks of the baby's birth. This provides reassurance to the child that they haven't lost anyone and helps to reinforce that the surrogacy process was successful.

The physical toll of pregnancy and birth

Pregnancy and birth can take a significant physical toll on the body, and this is no different for surrogate mothers. Surrogates must undergo a thorough screening process to ensure they are physically and emotionally ready for the process. This includes a review of medical and birth records, an in-home assessment, a psychosocial evaluation, and background checks.

During the process, surrogates must take fertility medications and commit to a year or more of intense fertility treatments. These treatments can be uncomfortable and require daily fertility shots. The surrogacy process can also be demanding, requiring attention to detail and organisation.

Pregnancy itself brings a host of potential physical complications. Some common complications include:

• Gestational diabetes: hormonal changes can cause the body to not produce enough insulin, leading to high blood sugar.
• High blood pressure: this can restrict blood flow to the placenta, slowing fetal growth and increasing the risk of preterm labour and preeclampsia.
• Infections: these can cause pregnancy loss, preterm labour, congenital anomalies, and stillbirth.
• Iron-deficiency anemia: pregnant women need more iron, and a deficiency can lead to fatigue, shortness of breath, and pale skin.
• Hyperemesis gravidarum: severe nausea and vomiting that can require hospitalisation.
• Placental abruption: the placenta separates from the uterine wall, causing bleeding, cramping, and uterine tenderness. If severe, it can be life-threatening for the fetus.
• Preeclampsia: a sudden increase in blood pressure after the 20th week of pregnancy, which can lead to seizures (eclampsia) and requires delivery of the baby.

These physical complications can have serious consequences and require careful monitoring and treatment by healthcare professionals.

The legal process and contracts

The Surrogacy Contract

The surrogacy contract is a comprehensive and collaborative document that outlines the rights, roles, and responsibilities of both the surrogate and the intended parents before, during, and after the pregnancy. It is recommended that each party has their own attorney to contribute to the terms and ensure their interests are represented. The contract typically covers the following elements:

• Finances: This includes the surrogate's base compensation, additional payments for items like maternity clothes, and added compensation for complications or special circumstances.
• Social Requirements: The contract outlines the surrogate's responsibilities during the pregnancy, such as abstaining from substances, and social agreements like who will be present at key appointments.
• Medical Instructions: The surrogate agrees to reasonable restrictions and instructions to ensure a healthy pregnancy and cooperates with medical providers.
• Resolution of Parental Rights: The contract establishes how parentage will be addressed, relieving the surrogate and her spouse of any legal rights and responsibilities and establishing the intended parents as the legal parents.
• Custody: The contract ensures that the intended parents have immediate custody of the child upon birth.
• Death or Disability: The contract should include a plan outlining the surrogate's responsibilities if the intended parents die or become disabled during the agreement.
• Confidentiality and Continued Contact: The contract should address the level of confidentiality and continued contact during and after the pregnancy, including social media posts and what the intended parents disclose to the child.

Other Legal Processes

In addition to the surrogacy contract, there are other legal processes that may be required, depending on the state and the specifics of the surrogacy arrangement:

• Pre-Birth Order: In surrogacy-friendly states, a pre-birth order can expedite the post-birth legal process, allowing the intended parents to be recognised legally and take the baby home from the hospital.
• Adoption and Post-Birth Legal Processes: If one or both intended parents are not genetically related to the baby, additional legal steps may be necessary, such as stepparent adoption or full adoption.
• Establishing Parentage: Working with a surrogacy professional and a local attorney experienced in assisted reproduction can help guide the intended parents through the legal process of establishing parentage.

The financial implications

Surrogate Compensation

UK law prohibits any payment to the surrogate during or after a surrogacy agreement. However, the surrogate must not be left out of pocket, and it is perfectly legal for the intended parents (IPs) to pay for all reasonable expenses incurred by the surrogate. These "reasonable expenses" can include the surrogate's travel costs, loss of earnings, maternity clothing, childcare, physical or psychological therapy, and more. The intended parents should also consider all possible expenses that could be claimed by the surrogate as related to her pregnancy. Recent court cases have approved “expense payments” of up to £25,000.

Clinic and Legal Fees

The fees for clinics vary depending on the clinic and location. London surrogacy clinics are more expensive, with fees around £25,000. That would include egg and sperm donation, fertilization, and the embryo transfer. Prenatal care and the delivery of the baby may be extra. Some clinical fees may be covered by the National Health Service, but the bulk of surrogacy expenses are not.

Legal fees can vary greatly depending on the lawyer. Some lawyers charge as much as £50,000, while most reasonable legal fees would total below £12,000. The court fee for a parental order application is currently £215, and you may also need to budget for legal advice and/or legal representation.

Total Cost

The total cost of surrogacy in the UK can surpass £50,000, depending on the clinic and surrogate. Surrogacy in the USA for UK parents, for example, costs £250,000 to £320,000+.

Frequently asked questions