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By Robin von Halle
More and more Americans are choosing overseas gestational surrogates, particularly poor, uneducated Indians. It raises troubling issues that intended parents and the fertility industry need to consider.
The New York Times and The Wall Street Journal recently reported that India’s surrogacy industry has grown by $500 million since the process was legalized in 2002. Supporters claim the process is far cheaper than stateside surrogacies, but after factoring in plane tickets, the exhausting legal hurdles, and travel within India, the cost difference is negligible.
More importantly, as the number of clinics in India multiplies, few seem to have seriously wrestled with the moral consequences of these “baby factories.”
Proponents of Indian surrogacy cite the wages most surrogates earn in their nine months: between $2,000 and $10,000. This is an enormous sum for these women, equivalent to one or even two year’s salary, but how do we feel about paying them far, far less than we would pay a fellow American who experiences the same pains and challenges? What does it say about us when we choose a service where the women are often confined in a clinic for the duration of their pregnancy, where we never see her face or know her name? What does it say about us when the only way we know the human being who we’ve chosen to carry our child is by the thumbprint on her contract—proof of her illiteracy and perhaps her desperation?
All these questions underscore the huge differences between gestational surrogacy as it’s undertaken through the services of a reputable agency in the U.S. and in a country where fail-safes are not necessarily factored into the process.
Our surrogates typically undergo rigorous psychological screening to ensure they can handle the idea of carrying someone else’s child and giving it up to the biological parents at the end of nine months. They must have borne at least one child. They must have a strong family network in place, like husbands or partners, who support their decision to be surrogates. Typically, there is ongoing interaction throughout the pregnancy between the surrogate and parents. And finally, what comes out of the psychological testing, time after time, is this huge differentiator: The money is not the primary motivator. The ability to help others create families is.
Many of us know the feeling, the ache, of wanting a child, and the conviction that we would do anything to hold one of our own. But how far are we willing to go? In a country where colonialism is a not so distant memory, we have to ask. Are the women behind the boom in Indian surrogacies being given a hand up? Or are they being exploited?
By Robin von Halle
You may have heard it on the news: “Octomom” Nadya Suleman’s doctor has been expelled from the American Society for Reproductive Medicine (ASRM) for transferring six embryos into the 33-year old woman, which resulted in the much-discussed birth of eight babies (after two of the embryos split).
Good move.
We have been working with the fertility industry for more than 15 years. As the industry grows, it’s up to us—the professionals—to make sure we’re meeting the highest standards of practices and behaviors, and follow those guidelines established by ASRM and the American Fertility Association.
The Octomom and her doctor took a tremendous risk by implanting such a large number of embryos. She is extraordinarily lucky that the babies are all healthy. Doctors say giving birth to extreme multiples comes with exceedingly significant risks for the mother and the babies.
ASRM suggests that reproductive endocrinologists transfer two to three embryos for women between the ages of 35 and 37. The transfer of three to four embryos for women 38 to 40 is also noted with these guidelines. However, transfer of a single embryo is the recommendation for women under 35 who have a good chance of achieving a pregnancy. She had already given birth to six other children, so Suleman clearly was physically able to become pregnant and give birth.
The fertility industry needs to work as a team to try and create families with as little risk as possible for the mother and her baby. Women have to remember there are limits to what their bodies can do. Suleman’s experience of healthy octuplets may be more the exception, not the rule. One Minnesota couple that gave birth to sextuplets in 2007, for example, lost five of them after only a 22-week gestation. Risks for multiples include bleeding in the brain, intestinal problems, developmental delays and lifelong learning disabilities.
We at ARR felt it was important to adopt a code of ethics and to promote that code on behalf of our industry, egg donation and surrogacy. It calls for compensating egg donors and gestational surrogates solely for their time, effort and inconvenience, and complies with all ASRM guidelines.
ASRM has guidelines for a reason and it’s up to us to respect and follow them.
By Robin von Halle
The television show, “It’s Always Sunny in Philadelphia,” had its fall premier a few weeks ago with its lead female character, Sweet Dee, wanting to be a surrogate.
“Baby Mama” created the perception that all surrogates are uneducated and desperate. This show took it all to a whole new level.
The plot has Sweet Dee answering an ad published by a couple looking to have a baby. (I am not going to get into why finding a surrogate on your own is not the wisest choice, but, if you want to learn more check out: Do-It-Yourself Surrogacies – Step Carefully.) Her motivation: compensation and what the intended parents could do for her.
When she first met with the intended parents she called them “rich yuppies” and asked if they would be willing to “double down” on the price if she would commit to having twins. She also played on the couple’s emotions to get what she wanted. By the end of the show Dee’s brothers came by the couple’s house to start a bidding war for her womb.
This is wrong in so many ways.
First of all, surrogacy is not a “rich person’s” game. In fact, in the nine years that we’ve been matching intended parents with surrogates, few have pursued it without making significant financial and personal sacrifices.
Secondly, in our experience, the women who decide to become surrogates are smart, mature, well-rounded individuals who just want to help someone create a family. Compensation is secondary, and is intended to reflect the time and medical procedures the process entails. Frankly, someone like Sweet Dee, who is clearly desperate for money, wouldn’t pass the battery of psychological tests that is part of the surrogacy vetting process.
Surrogacy is a legitimate and valuable option for family building in our society today. It’s too bad that a stereotype that adds sunshine to Philadelphia casts unnecessary clouds on the process.
By Mary Ellen McLaughlin
My, how times have changed, especially when it comes to health insurance and surrogacy. Nine years ago, when ARR started its surrogacy services, the majority of the surrogate’s health insurance plans covered the pregnancy.
Today, over 90 percent of our surrogates pregnancies are not covered by their own health plans as insurers devise new ways to limit their exposure.
ARR asks all prospective surrogates to bring their policies to us. We, along with a lawyer, carefully read through the insurance plans and identify any questionable exclusions (look for a section called reproduction or maternity). We then bring them to the attention of the potential surrogate. Being prepared on this front will help the surrogate feel more comfortable with the entire process.
For intended parents, finding a surrogate who already carries health insurance that does not exclude surrogacy is ideal. But this is the exception, not the rule. Today, specialized maternity insurance for can cost intended parents as much as $35,000 for a multiple pregnancy.
It’s also important to understand that certain procedures are not paid for by the surrogate’s health insurance plan, for which intended parents are responsible. These include IVF treatments, any medication included with those treatments, and fertility testing.
Unfortunately, insurance companies are always coming up with new ways to save a dime. As much as we dislike these surrogacy clauses, they are now becoming standard within the industry.
By Robin von Halle
It’s a fact, as USA Today recently reported: more women are waiting to start families. And it’s also a fact that the longer a woman waits, the harder it becomes to get pregnant.
That’s the bad news. The good news is that in today’s world, alternative methods to procreation like egg donation and surrogacy make starting a family a lot easier, whatever your age.
Most women who come to Alternative Reproductive Resources for help are between 30 and 50 years old.
Typically, however, age is not the reason women come to us for surrogacy services. Most are in their 30s and suffer from medical issues, such as cancer, endometriosis, polycystic ovarian syndrome or unexplained fertility issues. Those who seek our egg donation services tend to be in their 40s, when eggs become less viable and help may be needed in order to get pregnant.
Trying to have a baby today is much different then 30 years ago. Our mothers were all married in their 20s and started having children soon thereafter. Today, many 20-somethings don’t even think about having children. They are focusing on their education and careers and want to make sure they are financially stable before creating a family.
Count your blessings, whether you wait or not to start trying, that your options today are so abundant!
