This is a guest blog post written by Gennifer Rose, creator of the blog Surrogacy Mama.
When you look at the correlation between mental health and surrogacy, they are connected from the very beginning of the surrogacy journey. When a woman is considering becoming a gestational carrier, she needs to give significant thought to how she will feel being pregnant and delivering a baby for another family.
Some women have the ability to love and care for a baby, but still be able to keep a degree of separation and not consider herself to be the mother of the baby. Other women may feel like they cannot detach their feelings of motherhood with a baby they carry.
From a mental health standpoint, some women are better suited for gestational surrogacy because of their ability to compartmentalize their emotional connections. There’s no right or wrong way to love a child; we all just process our feelings differently.
Gennifer Rose’s first-hand experience with surrogacy
My name is Gennifer Rose and I am a mother of two kids, I have worked as a surrogacy professional for years, and I am the creator behind my Surrogacy Mama blog.
When I started working in surrogacy, I had no prior professional experience in the fertility world. With that being said, I personally knew women who had suffered from infertility and really struggled with getting pregnant. I knew how much I cherished being a mother, and the idea of helping others really intrigued me.
Fast forward a couple of years, and the idea of becoming a gestational surrogate myself started to grow on me. I had seen first-hand so many sweet connections between surrogates and the parents they helped. Many of them became lifelong friends, even considering them members of their family. Being a woman who is lucky enough to have high fertility and experienced healthy pregnancies, I was a great candidate to be a surrogate.
My surrogacy agency matched me with a single woman who could not get pregnant on her own. While I was open to helping anyone have a baby, I really liked the idea of one woman helping another woman become a mother. It’s a deep connection that really bonded us. Choosing the right intended parents or parent is an important consideration. Sienna* and I communicate almost daily and stay active in each other’s lives—we are a perfect match and have developed a wonderful relationship.
*The mother’s name has been changed for privacy reasons.
The process of becoming a surrogate
Definition of a surrogate
One point that is very important to mention: the modern day surrogate is medically known as a gestational carrier. These surrogates are not biologically related to the baby; the embryos are made with the egg of either the mother or an egg donor. So, while these surrogates are pregnant with the baby, they do not share any genetics with the baby. A cute way of saying it is: “I’m just the oven, and it’s totally their bun!”
Back in the olden days when in vitro fertilization medicine was less developed, traditional surrogacy was often practiced. In this scenario, the traditional surrogate is the biological mother because her own eggs are used to create the embryo. Because of the mental health implications of the surrogate being genetically related to the baby, traditional surrogacy is rarely ever practiced in IVF clinics these days.
Gestational surrogate requirements
The medical history and lifestyle requirements to be a surrogate are very strict, and sadly most women who submit a surrogate application will not be able to move forward. These standards are set very high to protect the health of both the surrogate and the baby. I’ve listed below the basic requirements that the fertility clinics require for surrogate applicants to pass the lifestyle and medical screening. Meeting these requirements is the first step in your initial application to a surrogacy program.
- Prospective surrogates must be mothers who delivered their own baby. This requirement exists so that these women fully understand what it’s like to be pregnant and deliver a baby. You wouldn’t want any surprises in a surrogacy pregnancy.
- The pregnancies of potential surrogates must have been healthy with a healthy baby and no medical complications.
- Most clinics require surrogates to be between the ages 21 – 42.
- Surrogates cannot be smokers or engage in any kind of drug-related activities.
- Their BMI must be under 35. This one requirement is a huge hot topic, with many believing it is unfair and discriminatory. That being said, it is currently a hard requirement for the fertility clinics who work with surrogates. The reasoning states that women over this BMI are statistically more likely to have medical complications during pregnancy.
- Surrogates cannot be convicted of a felony or live in a household with a convicted felon.
- Surrogates are IVF patients, which requires self-injecting medication before and during pregnancy. This can sometimes be a physical and mental hurdle for women who are not fond of needles, but most surrogates will tell you that you get used to it after a couple weeks.
- Surrogates must pass a psychological screening with a mental health professional who is a surrogacy specialist to make sure she fully understands the full scope of her commitment to this screening process.
- Surrogates must also meet with an ART attorney (Assisted Reproductive Technology) who is a surrogacy specialist to make sure to fully understand the legal process and implications of being a surrogate.
How much is a surrogate paid?
This is the big question everyone wants to know! The exact dollar amount of surrogate compensation varies slightly by agency and what the intended parents can afford, but in current times the typical range for base compensation is between $45,000 – $60,000 [USD] in cash payments. There are also additional financial benefits such as healthcare is paid for, along with perks such as housecleaning, child care, cash allowances, etc.
The reason the base compensation slightly varies is because not all women bring the same health status to the table. I am a surrogate myself and I will use my own scenario as an example. My compensation is $45,000 because at delivery date I will be 37 years old, which is considered a “geriatric pregnancy” and slightly higher risk for complications. My fertility could also be less strong than a woman in her twenties, which could possibly cause a failed embryo transfer.
Also, many intended parents are not wealthy people and they are scraping together all they have to attempt a surrogate pregnancy. Some women will take a slightly lower compensation to help out a sweet and loving couple.
Psychological screening for surrogates
After a prospective surrogate applicant’s medical records are reviewed and she’s determined to be in good health and able to physically move forward, she will be scheduled for a psychological evaluation with a licensed therapist who is a surrogacy specialist. It is really important that the agency connects the surrogate with someone who has extensive experience in the third party reproductive medicine industry. Surrogacy is incredibly specific and niche, and asking the right questions is really important.
From my own personal experience, the surrogate will fill out a long survey on her own before the appointment is scheduled. It asks questions along the lines of personal life experiences, trauma, the relationships in your life, criminal history, mental health and depression, finances, and character which includes disposition.
Once the therapist has reviewed the documents, the interview is scheduled for about an hour and a half of time. Together you will review your answers and talk about any areas where the therapist wants clarification or asks you to expand on your answer. Because surrogacy industry professionals are few and far between, these sessions are usually done virtually with HIPAA compliant software for virtual meetings (similar to Zoom and Skype, but specific to the medical industry).
The therapist will also ask questions about why you want to be a surrogate; they want to make sure the surrogate fully understands that they are in no way the mother. They will ask questions about how the surrogate feels about handing over the baby to the parents at delivery. If she shows hesitation or concern, then she will not be able to move forward. Also, financial gain cannot be the main reason why a woman wants to be a surrogate. While she is being paid, she has to express that she wants to help a family and her motivation goes beyond the compensation.
Finally, it is required that spouses or live-in significant others attend the therapy session. The therapist wants to make sure that the surrogate is in a supportive relationship and her partner fully understands what surrogacy entails. The partner must also acknowledge that they themselves have no parental connection to the surrogacy baby nor any parental rights.
Ongoing mental health care for surrogates
Ethical surrogacy agencies usually have an on-going mental health and wellness program for surrogates as they continue through the process. Having a professional therapist to speak with is very important, both during pregnancy and postpartum. The entire surrogacy process lasts about 18 months from beginning to end, and a lot can happen during this timeframe. Having an impartial party available to listen and voice concerns is a must for the mental health of surrogates (and the intended parents as well).
How to know if becoming a surrogate is right for you
Becoming a surrogate is no small decision. In order to assess whether becoming a surrogate is right for you, start by asking yourself the following questions:
Questions to ask yourself:
Why do I want to be a surrogate?
Think about what is motivating or drawing you into surrogacy. Do you have a genuine desire to help someone, or could you possibly be trying to fill a personal void in your life? Having a baby for someone else will not solve any of your own problems or fulfill your own desires for love and acceptance.
Does my current lifestyle and schedule allow for the commitments of surrogacy?
Surrogates are IVF patients, which requires a lot of weekly appointments and medical procedures. Surrogates also usually have to travel to different states for appointments at the assigned fertility clinic. Not only is surrogacy a commitment to be pregnant, it also involves a lot of your time and energy. Also, this often usually includes finding childcare for your children when you have to be at the doctors. While the intended parents do cover the cost of childcare, the surrogate needs to be the one to make the arrangements for babysitters.
Is my partner completely onboard with my decision to be a surrogate?
Surrogacy is a big commitment—not only for the surrogate herself, but also for her partner. All the appointments, stress of being pregnant and added communication with the agency and intended parents can possibly cause a rift between a surrogate and her partner. Make sure you fully communicate the extent of time and efforts involved in surrogacy with your partner before you begin the process.
Available Resources for Those Interested in Surrogacy
The best way to source real-life information about surrogacy is to ask experienced surrogates directly. There are many surrogacy-related Facebook groups open to the public. Their main purpose is to educate and connect people interested in learning more. You will find that the surrogacy community is especially close and connected. Because very little is known about surrogacy by the general public, we rely on each other for information and support.
Mental health is key when becoming a surrogate
In conclusion, mental health is a significant factor that influences the decision on whether to apply to be a surrogate. For surrogates, the process of carrying a child for someone else can be emotionally complex; it takes a special type of loving personality to be able to take on this responsibility. It is crucial to provide surrogates with comprehensive mental health support, including counseling and regular check-ins, to ensure their well-being throughout the entire journey.
Recognizing the importance of mental health in the surrogacy journey allows for a holistic approach that ensures the well-being of both surrogates and intended parents, ultimately contributing to a more fulfilling and positive surrogacy experience.
