Sunday, May 16, 2010
4:50 AM | Edit Post
This is my 2nd interview with a surrogate mother. The first was with Alison, a traditional surrogate (you can read it here). This time we're talking with Veronica, a gestational surrogate. Please feel free to share your thoughts and ask additional questions in the comments section.
My name is Veronica Lacquement and I’m 29 years old, a doula and on a self-education course towards becoming a midwife. I’m a second time gestational surrogate for the same family I helped the first time. I myself have a with four children, two who are my husband’s from a previous marriage and two that are ours together. Ever since the birth of my son I’ve realized that I had something I could give to others. Many of my friends have struggled with infertility and my own pregnancies were very easy and I honestly get the biggest high off of labor and birth. So the fact that I love helping people sort of made it all fit together for me. It comes down to I get to help people who can’t have babies on their own because I have good, healthy, full term pregnancies and enjoy the process a lot.
Veronica and her surrogate daughter, E
What things did you consider while making your decision final?
It depends on which decision you are referring too. When choosing to become a surrogate probably the most important one is whether to be a Traditional Surrogate (TS) or a Gestational Surrogate (GS). Both of these are very different as a TS uses her own eggs which are fertilized usually through artificial insemination. A GS has no genetic relationship and is just an oven with a bun or two...or god forbid three+.
For myself I originally was going to be a TS first for friends. But my friend’s health declined and at the time I had become friends with another couple who were facing the challenge of finding a surrogate. Due to their health circumstances they required a GS. The most important factor for me was being comfortable and confident with the Intended Parents (IPs) and having a sense of trust. There is one thing that you cannot afford to not have in a surrogacy relationship and that is trust. If you have even the slightest bit of doubt it should be clarified well before anything other than a verbal agreement between two parties is made.
How did you explain things to your children, family, and friends? How did they react?
My kids met the IPs when they came out to visit before we fully agreed to work together. I explained they couldn’t have a baby themselves, but I could have one for them. They honestly didn’t care. The rest of my family was very supportive, but I come from a rather unique background. My mother was a lesbian who wanted a child and my fathers were gay men who did as well. All three of them were friends and decided to co-parent a child, me. So while co-parenting is different, it has some similar roots to surrogacy. As for my friends I, again, have a very eclectic mix of friends. None of them reacted negatively, at least to my face, and all of them were supportive. Most everyone asked if my health was at risk and that was their greatest concern.
How did you and the intended parents find one another?
For me it’s a convoluted store. Most intended parents and surrogates are matched through agencies that specialize in surrogacy. Others are matched through online message boards that have classifieds for this purpose. Then there are those who are family or friends who offer to do it for each other. I fall between the 2nd and the 3rd of these.
I met my IPs through a message board that was geared at support. It didn’t have a classified section and was all about helping others going through the process, whether IPs or Surrogate. I had joined because I was going to be a surro for a friend. They had joined because they were starting their journey into Surrogacy and looking for one. I emailed them because we had a lot in common and I just wanted to offer my own individual experience with what they were going through. For about 8 months we talked via email or instant messenger and I cheered them on as they met or talked to first one surrogate or another, but none of them came through.
One day I was talking to my friend, the one who I had been planning to be a surrogate for, about their lack of ability to find a surrogate. At this point her health had declined drastically and she told me that I needed to be their surrogate. It came completely out of left field but it felt ‘right’ to me at the same time. We spent some time talking to make sure she felt confident of this fact, and she indeed was. That very day I emailed them and told them what my friend had said. They had known all along in our friendship that I was already committed to doing this other surrogacy. Within a month they had a plane trip booked out and they came to visit for a face to face. We talked a LOT about our expectations and beliefs. For me it was making sure they understood my belief that pregnancy and birth was not a disease or medical problem and making sure they would support a natural birth. When we parted ways they had a
LOT of book reading to do, but we
had agreed to work together and we got the ball rolling.
What kinds of things did you and the intended parents talk about in order to determine compatibility?
For me the biggest thing was that my pregnancy and birth not be considered a disaster waiting to happen. I went into great depth explaining a lot about natural birth, telling them about resources so they could look it up for themselves, and talking about my own birth experiences.
In addition we talked about legal worries such as multiple gestations, abortion for severe abnormalities, and of course money. We agreed on everything and so were settled on going forward to working on finding a clinic and getting lawyers and a contract drawn up. EVERY surrogacy should have a contract and not just a spoken agreement. A contract will go over their rights, your rights, what you agree to, what limits (if any) there are for both of you, payments and fees, etc. It can take some time to hash these out, but it is well worth it so that both parties feel comfortable. For example the original contract their lawyer drew up only stated Obstetrician as the care provider for a pregnancy. I insisted that midwife be put in there because I wasn’t going to an
OB unless something occurred
that would require me to.
How much "control" did they have over your pregnancy and birth? Did you compromise on anything for them, or did you do things your way?
This is where contracts come in. I was very firm on many things in my contract like making sure Midwives were named as a care provider and not just OBs. There is a section of contracts for things that are called Invasive Procedures. Things in this are: CVS, Amniocentesis, D&C, Selective Reduction, Cerclage, etc. I asked that episiotomy be put in there. Their lawyer tried to tell them that was a silly thing to include so they called me and asked me what it was. After I finished describing the procedure they told their lawyer that Episiotomy BETTER be put in under Invasive Procedures as they wouldn’t want their genitals being cut wide open either! We did compromise a little bit in terms of we both would have to agree on a care provider. This didn’t honestly become an issue at all, but it could for some people. This is why I firmly believe it is important to become friends for at least 6 months before doing ANY sort of real work on a surrogacy together.
Let's talk worst case scenarios: What happens if something unexpected comes up? A birth defect, multiple babies, etc. What kinds of agreements did you have in place in case of anything like that?
These are again covered in the contract. Each surro and IP pair usually discuss this before even agreeing to work together. It’s a little silly to go through the testing for the surrogate only to find out that she won’t abort, due to whatever reason, for severe defects incompatible with life. Or won’t abort for down’s syndrome even. The same thing goes for multiple babies, especially in the case of GS’. Mostly this has to deal with selective reduction when parents REALLY don’t want twins and want to selectively reduce a pregnancy. Again, this SHOULD be fully covered in contracts ahead of time, but there have been a few cases where a surrogate or IPs find themselves realizing they can’t do what they agreed to in a contract. This is, again, where it becomes so important to have a good, solid, and trusting relationship before hand on which you build the surrogacy.
Is it legal for an intended family to change their mind and not take the baby? What would you do if that ever happened?
It is legal for them to do so and usually the baby winds up being put up for adoption. This really varies from state to state. There are some states where even if the surrogate has no genetic relationship to the baby, she is still considered the legal mother. So she can pick and choose who to adopt the baby to...or she can choose to keep the child. I personally have only heard of this happening once in a case where the IPs had boy/girl twins and they only wanted the girl. It was a very sad situation. I don’t recall the ending clearly, but I believe the boy child was put up for adoption.
As for what I would do in a situation like that? I am honestly not sure. With the couple I am currently carrying for I believe our relationship to be good enough to not have to worry about this. However if it were to come up I could not make the decision without my husband and family. It may very well turn out we would keep the baby, but then I know many people who still have empty arms who have much more means than I to care and love for a child. So in all honesty I would likely choose friends who have been trying for some time to either adopt or go through surrogacy without success to adopt the baby too.
Is it legal for a surrogate mother to change her mind and keep the baby? Could anything ever happen that would make you do that?
Yes it is. And usually the courts will uphold that surrogate as the child’s mother. This is why it is so important to have trust. Contracts will very often not protect IPs in this case, which is why everyone takes a risk. The IPs may not get a baby, the surrogate may not get paid or worse be rejected and ridiculed after handing the baby over.
For myself I do not see this happening. Not unless both parents wound up perishing or some such. But even then they have family that would take on their daughter and, likely, would want her siblings as well. I do not want more children. I am done with my family. The only thing that might change my mind is if one of the parents came up being a child molester and the other parents strived to protect their partner. That is the ONLY circumstance I can even fathom.
How do you prepare yourself mentally and emotionally for birthing a baby and then being separated? How did it feel once you were living it?
I am done having my own family and so I went into this fully accepting the fact that I would get to enjoy a pregnancy, labor, and birth but not have to deal (too much) with night time wakings, dirty diapers, and fretting over every small sniffle. For me I came at it from the point of the babysitter. I just had to work a little bit harder at the very end to make sure baby arrived safe and sound back to their parents.
When I finally gave birth to a beautiful little girl it was amazing. I was happy and high from the birth hormones, but I did not feel attached to the child. In fact I was in awe and adoring the new family I was watching be formed in front of my eyes. This little girl didn’t look at me once while she floated in the water, but instead stared at her daddies who were in the tub and tubside. It was amazing.
Were the intended parents present for the birth?
See above, but yes. They flew out when I was 38 weeks pregnant and stayed for 10 days after the birth. Sometimes it happens that parents don’t get there in time, but that is how birth is! Most IPs try to make sure they’ll be there for the birth.
What was it like immediately after you had the baby and in the few days afterward? Was baby immediately handed to the intended parents or did you spend some time together?
I described the immediate afterwards a little bit above, but I’ll happily give more details! She was born in water at a freestanding birth center. One dad was in the tub with me, the other was right beside the tub. All three of us had our hands on her from the moment she surfaced. Mine was mostly to make sure she didn’t go too far from me because of the cord. We were waiting till it stopped pulsing to cut it. When it was time her daddies did something I didn’t expect and that was ask ME to cut the cord. It was a beautiful symbolism of letting go completely.
They got out of the tub while I washed. I had actually managed to pump about an ounce of colostrum before her birth, which they fed to her while holding her skin to skin. For the next several days I was pumping every two hours to get my supply up. While we were at the birthing center I nursed her in the evening so they could get some sleep. Then afterwards I would nurse her on and off as I visited them, bringing milk every day that I pumped. It felt so natural and perfect. When they left we all were weepy because while it was the ending of one thing, it was the beginning of their life on their own as parents.
Did you have an arrangement to breastfeed or pump for the baby?
Yes we did. At first they were unsure if they wanted me to actually breastfeed. They feared I would become attached. But she proved to be a ‘sucker’ and that first night they finally decided (After hours of sore fingers) to ask me if I would nurse her. I had told them all along I was fine with nursing her and that I didn’t think there would be any attachment problems. I was right too, but I also respected their concern.
As for pumping I pumped for five months and produced enough milk for her to be exclusively breastfed for her first year of life. I made up my own pumping schedule, took a galactagogue for three days to increase my supply, and at the end of 6 weeks I was pumping 80 ounces on average per day.
What were the agreements made about contact afterwards? Have they been upheld?
In my situation there were no hard and fast agreements about contact afterwards. However we also had been friends prior to working together and so it was sort of the assumption we would stay in contact. I understood they would be distant afterwards and raising their baby. However I did and do get pictures fairly regularly, we talk a lot via instant messenger, and this past year we have been using Skype to video chat and my surro-daughter has been present and able to see and hear me.
What kinds of feelings do you have towards the child now?
She is my friend’s very adorable and sweet little girl. I’m excited I got to help her out the way I did and love seeing them together as a family. I love her the way I would love any dear friend’s child who I have seen grow from a newborn on up.
How do you feel about it all now? Was it better or worse than you imagined it would be? Any regrets or things you would change?
The experience was beyond what I imagined it would be. I am an optimist so I thought it would be a good experience, I never expected it to be so awe inspiring and amazing. Even to this day I look back over the year or so we spent working on getting pregnant and then having the baby. It is probably one of the best things I have ever done. As for changing anything? No, I don’t think I would change a thing!
Do you plan to be a surrogate again? Why or why not? If so, have you thought about how many more times you might do it?
I am currently pregnant with twins for the same couple! They wanted their daughter to have a sibling (or two) and came to me after the wonderful experience we had together. I do think I would like to do it for another couple after these babies are born. However having gone through the IVF rigamaroll several times, and the medications, I think I want to go back to my original plan of being a TS. The couple would have to have a VERY special need for me to consider being a GS again. The strain of a pregnancy is nothing compared to that of the medications for me.
I have to admit that it is addicting. I do want to do it again. But it isn’t just the part of helping someone achieve a dream that drives me. I absolutely love the high of labor and birth. My son was an orgasmic birth, my daughter was intense and an amazingly fast one, the surro-babes was unique and eye opening, and I’m very excited and looking forward to laboring and birthing twins! That drives me as much as the chance to help someone, since my own family is complete. Getting to go through labor and birth without having to worry about the poopy diapers is a plus for me.
How do things like insurance coverage work? Are you responsible for any costs, or do the intended parents cover it all?
This varies from surrogate to surrogate. If the surrogate doesn’t have a policy that will cover a surrogate birth, then the IPs will get her one that will. ALL medical expenses related to a surrogacy are supposed to be covered by the intended parents. Now there have been IPs who have dropped the ball on Surrogates before, and it can cause a huge mess. Thankfully this is one area where contracts can and do help to protect the surrogate.
In addition some things that may not be considered necessary are sometimes covered by the IPs. Things like chiropractic care, prenatal massage, acupuncture, etc. Most of the time these things are not needed for the continuation of a healthy pregnancy, but can be negotiated on to be included. I negotiated to have chiropractic care covered from 32 weeks of pregnancy onward.
How much do you get paid, and how do you come to that agreement?
I am personally on the very low end of the scale. I didn’t get into this for the money and almost every surrogate out there doesn’t. For me I wanted to make sure I could help the people who didn’t have super deep pockets.
A first time gestational surrogate is compensated between 20k and 22k. A ‘proven’ gestational surrogate can make anywhere from 25k on upwards of 35k (This is usually someone who has done it 4 or more times with little to no complications).
Traditional surrogacy seems to have a much broader monetary range than gestational. Usually it is between 18k and 22k for a first timer. I think some of it depends on specific genetic traits that are desirable. Yes, IPs do shop around for desirable physical traits. Usually they are looking for someone who has very similar traits to the intended mother and/or father. IPs do the same thing when they are looking for an egg donor (ED) only with a Traditional surrogate you are getting your surro and ED all in one.
In coming to an agreement on compensation most IPs have an idea of what they are willing to pay. Most surrogates know what they and their family is willing to accept. A surrogate doesn’t usually make the decision of what her compensation will be without at least thinking of her family, if not talking to her husband. There may be some negotiation of compensation and this depends on the surrogates experience, the IPs pocketbook, and a few other factors.
If strangers comment on your pregnancy, do you mention anything about being a surrogate? What kinds of reactions have you gotten?
It really depends. Most of the time I don’t comment on my pregnancy being a surrogacy I just smile and nod. These are folks I won’t be seeing again more than likely, so I don’t need to witness their possibly negative reaction by mentioning it. When I have mentioned it, usually to the regular check-out person at the store or some such, it’s an offhand comment. “Yeah, the baby’s parents are really excited.” Most of the time the people don’t catch it until I’ve left. Now and again I’ll get the, “Oh, so you’re a surrogate?” response to which I confirm. The only experiences I’ve had are people saying, “That is cool.” Or, “That is really great of you to do that! I couldn’t do it.”
What goes into the "process" that most people might not realize?
Hehehehehe. Oh man…a
there is finding the right match. Not everyone has a situation like mine where
we were friends and it just happened to work out that we could suddenly work
together. Most IPs and Surrogates use either agencies that specialize in
surrogacy, or classifieds on surrogacy community boards and sometimes they do
both. A surro/IP will generally write a brief Bio about why they are looking
for a surrogate, their most pressing concerns and needs, and possibly what they
are looking for in terms of payment. Then the opposite party will scan these
classifieds and reply to the ones that seem to match their needs.
Things that are often discussed in classified ads are controversial subjects like selective reduction, abortion, willingness to undergo genetic screening, no previous cesareans, etc. Those looking for a traditional surrogate will post basic physical traits and education that they are seeking; blond hair, brown eyes, around 5’7” and graduated college as an example.
From there either party will respond to the replies they get and slowly a narrowing down process occurs. Email is the usual form for awhile discussing more pressing details and talking more about who they are and their beliefs. Then things will generally move on to phone calls. If those go well then a physical meeting is established and this is usually where the decision to work together is made, though it may not be stated until after the meeting.
With an agency they do a lot of this work. They have profiles of all of their surrogates and make profiles of the IPs that sign up with them. The IPs have their criteria and the agency shows the IPs various profiles that match. From these the IPs choose and the agency will then send the IPs profile to the surrogate, who gets to say ‘yay’ or ‘nay’ based on what they read. Or they may want to know more. The agency acts as a go-between. Some people feel this is safer as the surrogates often already have been medically and psychologically screened before hand, but it also subtracts a lot of the closeness that surrogacy sometimes requires. After both parties think they’d like to know more about the other a three way call is set up for surro and IPs to talk, with someone from the agency listening in. After this a face to face may be arranged, but usually the surro/IPs agree or disagree to work together.
From this stage any medical screenings that haven’t happened occur. These usually include an updated PAP, a reproductive endocrinologist (RE) taking a look at the surrogate’s uterus either through a hysteroscopy or a saline histogram. Also a psych screening occurs to determine if the surrogate really is capable of dealing with the emotional and mental rigors of a surrogacy…and if she isn’t just nucking futs as well.
Once the medical all clear is given contracts occur. The surrogate has her lawyer, paid for by the IPs, and the IPs have a separate one that they also are paying for. This is another place where things can be dissolved. Many surrogates and IPs have found that sometimes they just cannot agree on things that need to go into a contract that are very important. At that point some surrogacy pairs part ways, and it is usually amicably. This is probably one of the most important stages because the wording of a contract and what is included, or not, can make a huge difference on what/how a surrogate can do during the pregnancy. For example a surrogate who doesn’t think to have the care provider listing include midwives could find herself forced to see only OBs when she isn’t comfortable with that at all. Or she could find out that she can’t drink raw milk which she has been doing for years. So the negotiation of contracts and the back and forth and time put into these is very important. Rushing through them just so you can get started can lead to broken hearts and being put in a situation you may not really want, whether you are the IP or the surrogate.
After this comes the medical portion of things. Here the surro will either start tracking her cycles (If she is a GS) to determine the best date of ovulation, or she’ll go on a rigorous medical calendar to get her own ovaries to become quiet and on schedule for transferring the embryo(s). The thing that I think most people don’t realize about gestational is the amount of meds that go into your body before you are even pregnant. While you –can- do a natural cycle, most REs are not open to it as the success rate is lower…and most IPs are not willing to risk all the money that goes into IVF on something with a lower success rate.
The meds…Gestational surrogates start out on birth control pills to get a nice regular cycle and start getting their ovaries used to not ovulating. Then they are started on Lupron, which puts the body into a false menopause. Lupron can have a vast array of side effects and is probably the worst of the meds a GS will be put on. From there the BCPs are stopped and after a period the GS started on estrogen since the Lupron is keeping her body from producing it on its own. This is an intramuscular shot and the amount and frequency varies. There are also some REs who will do a shot plus suppositories/patches, and some who will just do suppositories/patches, so it varies from doctor to doctor. As you close in to a few days from transferring embryos you add in progesterone. This is still most frequently another intramuscular injection and it is done daily and is usually a shot that takes up to 5 minutes to fully inject. The progesterone and estrogen are suspended in a thick oil that takes awhile to inject into the muscle, all the while you have this needle sticking out your butt. It can get very tedious…and very sore. Some REs are switching to use suppositories after a confirmation of pregnancy now, which is a huge relief for some of us. Generally speaking you are on progesterone till 12-14 weeks of pregnancy and estrogen 8-12.
What kinds of misperceptions do you think people tend to have about surrogacy and/or you as a person for doing it, and what would you like to clear up?
The biggest misconception is that we are only in it for the money. That $$$ is our driving goal and we don’t really care about much else. This is the exact opposite from the truth in almost every single case. Most surrogates get into it to help someone. I went into it to help a friend not even realizing people get paid for this sort of thing. Then I was given the opportunity to move on to help someone else who not only offered me money, but insisted that I take it. That’s one thing I think people do not realize. The IPs almost always very much want to show their thanks to the surrogate beyond mere words and money has become the standard in how it is done. In some states where it is illegal to be compensated some IPs will buy a surrogate a car, or send them on dream vacations, or pay off a chunk of their house, etc. Granted after all the medications and doctors visits I’ve had to go through to become pregnant, I am glad that I am being paid something. This is hard work and there –is- pain involved (especially with GS and those dang shots!). Would you watch someone else’s kids day in and day out while they went to work without expecting to be paid? Especially if those kids are eating your food? Just some food for thought there.
I don’t do it for the money, but I also will not complain about getting compensated either…and neither does my husband who has to wait for 6 weeks while I go through IVF before we can be intimate again…or my kids who hold my hair back while I puke in the mornings and wonder why I am too tired to go outside and play with them. That money goes almost entirely to them and their enjoyment/health/benefit. My kids have NICE college funds started, we’ve been able to plan a huge
vacation that we’d very likely never be able to afford otherwise, and many
other things. It makes it worth it to my family who doesn’t get the ‘glow’ and
‘joy’ from being the one to carry and deliver into eagerly waiting arms.
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