Not all couples have the option to conceive, carry and give birth to their biological child. This can happen for a variety of reasons — which we’ll get into later — but, whatever the reason, if you’re reading this, then you are most likely considering using a gestational surrogate mother to build your family.
What is a gestational surrogate mother?
A gestational surrogate mother — also known as a gestational carrier — is a woman who carries another couple’s biological child. In the past, the term “gestational carrier” was used separately from “surrogate” because a surrogate contributed her own eggs to the process, while a gestational carrier did not. These days, surrogates do not typically contribute their own eggs to the process, so we tend to use the terms “gestational carrier” and “surrogate” interchangeably.
When a couple is considering a gestational carrier, it means they plan to use their own eggs and sperm — or those that have been donated — to create an embryo that is then implanted into a surrogate via in vitro fertilization. The surrogate then goes through 40 weeks of pregnancy and gives birth to the baby on behalf of its biological parents.
Surrogacy has not always been the most common route to starting a family. In the past, it’s had a reputation as an option only available to the rich and famous. But things are changing. Between 1999 and 2013, surrogates in the United States gave birth to 18,400 infants.
If you’re considering becoming one of the many families whose lives have changed through the surrogacy experience, congratulations! We know you are excited, but you likely also have a lot of questions.
To understand the process, as well as what makes a good surrogate, it’s important to know how it works and what to expect if you choose to build your family via a surrogate. The more you know from the beginning, the better equipped you will be to handle the twists and turns you’ll encounter along the journey to bring your child into the world.
Who Needs a Gestational Carrier?
While some people can work with a friend or family member they know well, most of the time couples select a gestational carrier they have never met. Yes, this does involve relying on a total stranger to nurture and protect the most precious thing in your world — your child. It can be a huge leap of faith, but one that has a beautiful outcome.
There can be many reasons to select a gestational carrier. In general, prime candidates for this process include:
- Same-sex couples
- Single adults who want to build a family
- Couples considered too old to adopt
- Couples struggling with infertility
Gestational surrogacy may be an especially viable option for couples struggling with infertility due to:
- Repeated miscarriages
- An abnormal uterine cavity
- Medical issues that make pregnancy risky
- Failure to get pregnant using IVF
Characteristics of an Optimal Gestational Carrier
Selecting a gestational carrier for this process can be overwhelming for some prospective parents. After all, you are selecting the person who will care for your child during nine months of pregnancy. At Western Fertility Institute, we are committed to working closely with each family to choose the surrogate who will be best for them and their child. We want you to be comfortable with the woman who you choose to carry your child and bring them into the world.
The screening process for a gestational surrogate mother is designed to determine a potential carrier’s ability to get pregnant and carry a baby to term successfully. While it may seem strange to spend so much time digging into a stranger’s background and health, it’s an important part of the process that can’t be rushed.
The multi-step screening process will include a variety of exams, meetings and questionnaires. While each clinic has its own variation on this process, in general, you can expect to find that a potential gestational carrier will be evaluated on these primary characteristics.
1. Age
A potential carrier should be within her childbearing years, although this range may vary slightly between different agencies. Western Fertility Institute requires that gestational carriers be between 21 and 44 years of age. This range in ages is selected for two reasons. First, a potential carrier should be old enough — and mature enough — that she can handle the demands that the surrogacy process places on her, including demands on her body, her health and her time. On the other hand, a carrier must be young enough that her body is physically up to the challenge of pregnancy, which can become difficult as women get older.
2. Previous Successful Pregnancy
A potential gestational carrier should have already had at least one successful pregnancy and delivery of her own within the last five years. While this doesn’t completely guarantee that there will be no complications down the road, it provides some reassurance that her body can physically handle pregnancy. Any miscarriages or abortions must also be disclosed.
While a previous C-section won’t necessarily disqualify a potential surrogate, a woman with multiple C-sections in her medical history may not be a viable candidate for gestational surrogacy. There is some debate about how many C-sections a woman can have. However, doctors do agree that repeat C-sections increase a woman’s risk of serious health complications during and after pregnancy, including increased risk of heavy bleeding after delivery and injuries to the bladder and bowels. A woman who has had multiple C-sections also has a higher risk of developing placenta previa or placenta accreta, potentially serious complications that can impact both her and the baby.
3. No Significant Illnesses
Before beginning the process of being a gestational carrier, a woman is required to undergo a detailed physical evaluation to make sure she does not have any health conditions that may complicate a pregnancy. During the health screening, she will also be evaluated for an overall healthy lifestyle, which can provide a healthy start for any potential pregnancy. Surrogates are screened for sexually transmitted diseases, as well as immunity to certain diseases, including chicken pox, measles and rubella.
In addition to screening for any significant illnesses, a potential gestational carrier will be evaluated on her body mass index — Western Fertility Institute requires a BMI of 33 or below — as well as blood pressure and other health conditions. While some conditions do not disqualify a woman from the surrogate process, others may put her at too great a risk, such as diabetes or high blood pressure. A thorough look into her medical history, as well as current health conditions, can protect a potential surrogate from putting herself at risk, as well as your baby.
4. Psychiatric Background
In addition to a complete physical, a potential gestational carrier will be evaluated on her mental health. This evaluation is used to determine whether a woman has any history of substance abuse or mental illness that might compromise her ability to be a successful gestational carrier. She will also be evaluated on her current mental health to make sure she can handle the emotional toll that third-party reproduction can take.
What Makes a Good Gestational Carrier?
A good gestational carrier is more than a healthy young woman with a desire to help. The healthiest, kindest woman in the world may not have the right motivations for the task she will face. Or, she may not be in a place in her life where she can handle the demands surrogacy will place on her. And, perhaps most importantly of all, she should be someone who you — the potential parent — feel comfortable with. In addition to her health history, as you are choosing a surrogate, it’s important to consider:
1. Location
There is no hard and fast rule about choosing a gestational carrier who lives near you. In fact, many people work with carriers who live in other cities or even states. However, it’s important to ask yourself a few questions before selecting one halfway across the country:
- Do I want to be present at the doctor’s appointments and ultrasounds?
- Do I want my child to hear my voice? If so, do I want that in person or am I willing to send audio recordings or Skype with my surrogate?
- Can I afford the travel costs associated with being present for important moments?
A gestational carrier isn’t required to live near the clinic. In fact, many of our surrogates complete their initial health screenings via phone and then travel to the clinic for the transfer appointment — the appointment when the embryo is implanted into your uterus. While they are required to return to the clinic to confirm the pregnancy, once they approach the end of their first trimester, they can stay home and work with the OBGYN of their choice.
2. Marital Status and Support System
There is no requirement that a gestational surrogate be married, but it is important that she has a stable home life. That means that she is not in the middle of a divorce or anticipating a change in her relationship status during the surrogacy process. It means that she has the support of her spouse or significant other to undertake the surrogacy process.
Why is support from a partner significant? Once a gestational carrier becomes pregnant, the pregnancy is just like any other normal pregnancy. She may experience morning sickness or extreme fatigue. She may not be able to carry around a toddler if she has one in the home. She may not be able to clean or cook meals like she usually would. Having the help and support of a spouse or partner sets the gestational carrier up for success from the beginning.
If a potential carrier is not married, it is recommended that she have the support of family and friends who live close by.
3. Motivation
Unless a friend or family member has volunteered out of the goodness of her heart, it is expected that gestational carriers will be compensated for carrying a child. In addition to paying for the medical expenses, travel expenses and any other expenses they incur during the surrogacy journey, gestational carriers are paid a sum of money for their role in helping you grow your family. This fee is agreed upon up front with the rest of the legal terms.
Because money is involved, it’s important to make sure that a potential gestational carrier isn’t doing it only for the money. While this may certainly be one legitimate motivating factor, it should not be her only reason for undergoing the process. An ideal gestational carrier should also have a sense of calling or purpose when it comes to the surrogacy process. She should firmly believe that she is undergoing this process because she wants to help another couple experience the joy of a child.
4. Background Check
Any potential gestational carrier will be subject to a background check before being accepted. A background check reveals any past criminal activity — if it exists — as well as potential financial problems, substance abuse, domestic abuse or disturbances, or even a series of reckless driving tickets. All of this can be important in determining whether or not a potential carrier can provide a safe, stable environment for a successful pregnancy.
5. Stay-at-Home vs. Working Surrogates
When it comes to a potential carrier’s employment status, there are pros and cons to either scenario. Choosing a carrier who works full-time means selecting a woman who probably has her own health insurance, whose children already have a secondary caregiver when she can’t be there and, perhaps most importantly, she has a good work ethic and understands what it means to be committed to something she agrees to do.
On the other hand, some couples prefer working with a stay-at-home mom because she has more availability to potential parents. This is especially important if they plan to join her for appointments or visit her during the pregnancy. If a stay-at-home mom is put on bedrest at any point during the pregnancy, the potential parents are not required to compensate her for lost wages, which is sometimes the case with working surrogates. However, they may end up paying more for her childcare costs since she will likely have to hire a backup caretaker to be with her children during appointments or when she needs to rest.
Western Fertility Institute
Selecting a gestational surrogate to carry your child can be a beautiful but challenging process. At times it may seem like it’s taking forever, and you may wonder if it’s worth it. But when you hold your child in your arms for the first time and experience parenthood, all of the waiting and all of the wondering will simply be replaced with an overwhelming love for the child you’ve waited so long to meet.
At Western Fertility Institute, our goal is to ease the burden on potential parents by walking with you throughout the entire surrogacy process. From the first time you inquire about surrogacy, through all of the screenings and walking through legal, all the way to your child’s birth, we are here to answer questions and direct you. We work to ensure the highest quality in reproductive care and offer our patients the greatest chance at conception that we can. To date, our surrogacy success rate is 86 percent.
If you are considering growing your family through surrogacy, we invite you to learn more about the process. Contact us today.
Sources:
https://www.cdc.gov/art/key-findings/gestational-carriers.html
https://www.snyderlawfirm.com/Articles/Characteristics-Of-A-Good-Surrogate.shtml
https://www.buildingfamiliesinc.com/en/2011/02/what-qualities-make-a-good-surrogate-mother-february-1-2011/
https://www.prnewswire.com/news-releases/whats-the-difference-between-a-gestational-carrier-and-a-surrogate-150487325.html
https://www.pacificfertilitycenter.com/blog/what-are-some-characteristics-look-gestational-carrier
https://www.webmd.com/infertility-and-reproduction/qa/how-can-i-choose-a-surrogate-mother
https://www.webmd.com/infertility-and-reproduction/guide/using-surrogate-mother#1
https://www.mayoclinic.org/tests-procedures/c-section/expert-answers/c-sections/faq-20058380a