Surrogacy Medication: Advice from a Former Surrogate

Every gestational surrogate’s medications and timeline will vary somewhat, depending on what a fertility clinic prescribes. Still, most women who are thinking about becoming surrogates want to know what that medical process is like — including side effects from medications, the types of medications they might have to take, and more.

Here, Chelsea, a former American Surrogacy surrogate, explains the surrogacy medications she took, some tricks she found helpful, and more:

Chelsea’s Medication Experience

The first medication that the clinics will generally put you on is birth control pills. Even people who have their tubes tied are required to use this. This helps the clinic manipulate your cycle to line up with your transfer date. They’re very precise and tell you when to begin the pills and when to discontinue them.

Next, I was on Lupron. The needle size didn’t faze me at all. It was an easy shot to take, and one or two equated to the feeling of a bee sting. I was on this for 26 days. The Lupron did give me some killer headaches. I wanted to stay in a dark room, and I was very sensitive to sounds. Drinking a lot of water helps.

After 12 days, I began taking estrogen, as well. I took estrogen in the form of Estrace pills (two pills, twice a day) and an estrogen patch called a Vivelle Dot. I switched this patch every Monday, Wednesday and Friday. They leave behind a lot of sticky residue that is impossible to clean off. I had sticky marks until I was done with my meds at 14 weeks. The estrogen caused a lot of discharge. I had even emailed the clinic about it at one point to make sure it was normal.

My clinic was stricter about monitoring so, on day 22, I was required to have my ultrasound and blood work done at the clinic. This was the only ultrasound and blood work I had during the cycle. They checked my ovaries to make sure they were “quiet” and checked my uterine lining. I was good to go at 8mm. Then, they checked my blood estrogen level.

I began taking progesterone five days before transfer. This lines up with the age of the embryo(s). The needle is quite large: 22-gauge. This is due to the fact that it’s an intramuscular injection. You really only feel that initial poke; the length of the needle isn’t felt. The size of the hole of the needle is because the medication is in oil (sesame, olive, ethyl oleate). I actually had to switch from sesame to ethyl oleate after weeks on the injections because you can develop a delayed allergic reaction, which was a large rash in my case.

Some tips for this medication:

  • Warm the vial in your bra, on a heating pad or in your hands prior to injection. The oil is thick, so warming it helps inject easier.
  • Rub the area after injection thoroughly. The oil needs to be dispersed. I was on 2cc of PIO (progesterone-in-oil) so it was quite a large amount to put into the muscle daily.
  • You will develop lumps so massage, massage, massage. (Yes, rub your butt!)

I used a cheap Walmart drawer container to store my medications. I’m very type A, and it helped organize things. I was constantly getting new shipments and refilling it. I also downloaded blank calendar pages to fill in what medications I took each day. I marked them off as I took them. It was taped to my bathroom mirror.

All of these medications need to be taken at the same time every day. So, if you have a job, plan to take them when you know you will be home!

We’re so grateful to Chelsea for sharing her experiences and advice with future surrogates and for being such a great ambassador for American Surrogacy! If you’d like to talk to Chelsea about what it’s like to be a surrogate with American Surrogacy, contact us now at 1-800-875-BABY(2229).

How Skin-to-Skin Contact Works in Surrogacy

Parents of a baby born via surrogacy don’t have the opportunity to carry their baby in utero, which is how many parents emotionally and physically bond with their baby before he or she is born. But this certainly doesn’t mean that you’ll have a weaker bond with your child if they are born via surrogacy. It simply means that you might need to play catch-up and bond a little differently.

Like in any new relationship, you and your baby might need to spend some time working on your physical and emotional bond. Remember that families who come together through surrogacy love each other no more or less than any other family, and they’ll tell you that. It might be disappointing if you don’t feel that magical instant bond with your child right now, but don’t worry — it’ll happen!

This is where these surrogacy-specific bonding tactics come in.

The Benefits of Skin-to-Skin Contact

There have been many studies on the physical, emotional and mental benefits of skin-to-skin contact for babies and their parents. Here are some of the findings:

  • Healthy infants were shown to have reduced responses to painful stimuli like vaccinations, blood sampling, or cord cutting during skin-to-skin contact.
  • Babies cried less, were calmer and went to sleep more quickly when on their parents’ chests.
  • Newborns that had immediate skin-to-skin contact experienced physiological benefits that included improved thermoregulation, cardiopulmonary stabilization, blood glucose levels, enhanced oxygen saturation levels, breathing and sleep patterns.
  • For preterm infants who spend time in the NICU, skin-to-skin contact is even more important for brain development.
  • Skin-to-skin contact has been linked to decreased separation anxiety.
  • Reduced risks of hospital-acquired infection were shown in babies who received skin-to-skin contact, as they acclimated to the surrogate’s and intended parents’ bacteria and received the protective benefits of that bacteria.
  • The salivary cortisol levels (a biochemical marker for stress) were significantly decreased in all babies when the length of skin-to-skin increased beyond an hour. The levels continued to decrease with longer contact periods.

You can learn more about the research on skin-to-skin contact through these sources:

How to Do Skin-to-Skin Contact with Your Baby

Skin-to-skin contact is simple. When the baby is born, parents often like to place the naked baby on their bare chests as quickly as possible, for as long as possible, sometimes even while the baby is being cleaned and the cord is being cut. This is recommended for a minimum of an hour, if possible. You may have also heard this method called “Kangaroo Care.” Some parents will delay routine medical steps until after this bonding time if their baby is healthy and stable.

If you’re unable to have skin-to-skin contact with your child moments after he or she is born, don’t worry. Bonding through physical touch with your child is something that will continue to be beneficial to both of you as they grow up. Physical contact between a parent and their child is a good way to strengthen bonds, no matter when it starts.

If you do plan on trying to initiate skin-to-skin bonding with your baby at his or her birth, here are a few tips:

  • When packing to meet your baby at the hospital for the first time, include shirts that can be unbuttoned to allow quick access for skin-to-skin contact with your baby on your bare skin while preserving your modesty and comfort.
  • You and your surrogate will need to talk to your hospital nursing staff in advance about your wishes for skin-to-skin contact, and explain that you’re the intended parents in this birth plan. You’ll likely need to remind the hospital staff of these details in the busy aftermath of birth, but this way they’ll know not to swaddle the baby immediately, to avoid placing the baby into an incubator right away, or to hold off on some of the routine medical procedures like weighing your baby until after you’ve had time to hold him or her.
  • There are some studies that show that having skin-to-skin contact with the surrogate first may be beneficial for the baby, as a newborn is able to colonize her bacteria (maternal flora vs hospital flora) faster. This may reduce the chances of your child forming allergies and getting an infection. If everyone is comfortable with this, your baby’s health can benefit from this step, and then you would be able to have skin-to-skin contact with him or her next. This is another transitional step for your baby; remember that they’ve become attached to your surrogate in the previous nine months of development.

Remember to follow the advice of the hospital staff at your baby’s birth! Sometimes even carefully planned births don’t go exactly as we envisioned, so you may not be able to have that early skin-to-skin contact with your baby for whatever reason. Again, don’t worry. You’ll have plenty of opportunities to bond with your child soon.

Other Ways to Bond with Your Baby

Bonding with a baby born through surrogacy doesn’t start and end at birth or is achieved solely through skin-to-skin contact. Here are a few ways you can bond with your baby before he or she is even born:

  • Talk to your baby in your surrogate’s womb. Try giving your surrogate a recording of your voice reading books to play to your baby through headphones on her belly so your child can hear your voice.
  • Give your surrogate a “transitional item.” This could be a teddy bear that your surrogate sleeps with that will later go home with you after the baby is born, so that your baby has the familiar scent of your surrogate to help her or him transition. This can help with “emotional transference.”
  • Stay active in the pregnancy process as much as your surrogate feels comfortable with. This is more for your sake than for your baby’s, but participating in your surrogate’s pregnancy and staying in touch with her can help you feel more like your baby is “yours” and facilitate your own emotional attachment.
  • If you want and are able to, you can try to breastfeed your baby. This is not a necessity for bonding with your child, but it can be a wonderful experience for both of you. Breastfeeding is possible for many intended parents with preparation.

On the other hand, there are some ways you can bond with your child after he or she is born. These are applicable not just to parents of children born via surrogacy but also for families who come together through adoption, “traditional” methods or any other way. Try these bonding tactics:

  • Give lots of gentle touch and physical affection. Hugs, baths, play time, holding hands, brushing hair, carrying your baby in a sling or just holding and cuddling your child is important for newborns as well as for young children.
  • Talk to your child. Studies have shown that talking to your children at any age vastly improves their language skills in addition to promoting bonding. Tell them the story of how they were born, sing to them, read them lots of books, give them verbal praise and affection or even just tell them again how much you love them.
  • Prioritize routines. Getting into a regular feeding and sleeping schedule can sometimes be tricky, particularly with newborns. However, the ritual of those routines will not only make your life a little easier, but your child may also benefit from the bonding time during those daily rituals. Bath times, getting dressed, feeding times, reading a book together in your arms before their nap, singing the bedtime song — whatever you do for your daily routines, try to use it as an opportunity to spend some quality time together and focus solely on your child.

With time, you’ll likely find ways of bonding that work best for you and your baby, because every family is different. In the meantime, don’t stress too much. The parent-child bond may or may not be immediate for you, but it’ll happen, and when it does, it’ll be just as strong as it is with any parent and child.

You can always contact an American Surrogacy specialist at 1-800-875-BABY (2229) if you need additional post-surrogacy resources.

What to Expect at the First OB Visit in Your Surrogacy

Prior to your surrogate’s first visit with her obstetrician (OB), she and you will have primarily worked with your fertility clinic, which will be very familiar with the surrogacy process. But your surrogate’s OB may have never experienced a surrogate pregnancy before and may not know what to expect. You and your surrogate may not know what to expect, either!

We know how confusing this time can be, which is why we’ve answered some of your biggest questions about prenatal appointments in gestational surrogacy journeys below.

What the Average OB Experience Is Like

The first OB visit generally occurs between 8 and 12 weeks of pregnancy. The surrogacy process won’t affect this first OB visit much, although the doctor may ask a few questions about gamete donors, if applicable.

If you’ve never experienced one before, a prenatal visit can be a little scary. Here’s what happens in the standard first trip to an OB for surrogates, depending on the week of pregnancy and the doctor’s recommendations:

  • The surrogate’s health and vitals will be checked, and she’ll be asked a lot of questions to make sure her first trimester is going well so far.
  • Your surrogate may receive a full physical, so you’ll need to step out and give her some privacy.
  • Your surrogate will have her blood drawn to test for fetal abnormalities.
  • There may also be a urine test, a pap smear, or other tests to check fetal and maternal health.
  • A transvaginal ultrasound may be performed to evaluate early development.
  • You may be able to hear the baby’s heartbeat.
  • The doctor will review the next steps and schedule the next routine appointment.
  • You and your surrogate will sign a lot of paperwork, usually HIPPA consent forms to release medical information. Most of this paperwork will be completed by your gestational carrier.

The first visit to the OB consists mostly of the doctor asking questions, some of which may be rendered inapplicable as a result of the surrogacy process. This is usually an exciting time for surrogates and intended parents alike, so enjoy the moment together!

How to Prepare for Your Surrogate’s First OB Appointment

These five steps may help you navigate your first visit together at the OB:

Step 1: Jointly Decide How Much You’ll Participate in Your Surrogate’s Pregnancy

You’ve probably already talked about this when you created your surrogacy contract together, but you’ll need to have an honest conversation with your surrogate about how much of your involvement she feels comfortable with during the pregnancy and about how much you’d like to participate, if possible.

Not all intended parents accompany their surrogate to her first OB visit — maybe they’re unable to due to distance, or maybe the surrogate feels more comfortable going to this appointment without them. Regardless, you’ll have the rest of your child’s life to participate in important milestones, so missing the first OB visit certainly isn’t the end of the world.

Step 2: Talk to the OB Before the Visit

This may require leaving multiple messages, talking to several nurses and playing phone tag, but it’s important that everyone involved (especially the doctor who’ll be overseeing the surrogate’s care) knows about your surrogacy partnership, and is aware of everyone that will be attending the appointment. The OB may need to talk to the patient (your surrogate), as well as you, prior to this visit.

If they’re prepared for intended parents and the surrogate, plus her spouse (or whoever might be attending the doctor’s visit), then they’ll be better prepared to do their own job of walking you through what comes next in your surrogate’s pregnancy.

Step 3: Be Prepared for Some Insensitivity

Not everyone at the OB’s office will be aware of your surrogacy partnership. Even those who are aware may slip up and say things that are insensitive. Try to be patient and understand that out of the many pregnancies this office sees daily, surrogate pregnancies are rare.

Remember that you’re in this together with your surrogate. People may congratulate her on “her” baby or ask her unwelcome questions about surrogacy. Remember that both of you will likely be subject to uncomfortable moments, but that you’ll get through those moments together.

Step 4: Remember that Conflicting Feelings Aren’t Unusual for IPs

It’s not uncommon for intended parents to have complicated feelings throughout a surrogate pregnancy, and these feelings may be especially heightened at your first OB visit. You may:

  • Feel jealous that your surrogate is the one experiencing this visit with the doctor.
  • Grieve that you’re unable to carry your baby.
  • Be hurt or feel awkward when office staff ask questions or make assumptions about the baby’s genetic background.
  • Feel frustrated that you’re not in control of the pregnancy and your baby’s health and protection.
  • Be scared that you’ll lose the baby, especially if you have experienced previous pregnancy loss.

These types of emotions are usually coupled with the excitement, joy and nervousness that is typical of parents in an OB’s office. If you need to talk to someone, remember that you can always turn to your American Surrogacy specialist for support.

Step 5: Your Surrogate May Look to You

Surrogates have their own emotional support systems, but they’re doing this to complete your family. They want to make sure that you enjoy this appointment at the OB, too.

This appointment is a good opportunity for you to grow closer together and to remind your surrogate of how much you appreciate her and how much you’re looking forward to meeting your baby. Some ways to affirm your excitement to your surrogate can include:

  • Going out to lunch before or after your appointment together
  • Bringing her a little gift, like a card or a pregnancy pampering kit you put together
  • Giving her a hug
  • Taking a photo together to mark the occasion
  • Showing her something you plan to give to the baby, or telling her about name options
  • Or simply telling her how excited you are and how happy you are to have her in your life.

Seeing that you’re excited is what makes surrogacy worthwhile to surrogates!

Remember that if you have any questions about the medical processes of surrogacy, including the upcoming OB appointments, you can always call American Surrogacy at 1-800-875-BABY(2229).

How Strict Are Surrogacy BMI Requirements?

The Body Mass Index (BMI) is a measurement of body fat based on your height and weight, taking into account whether the two are proportional. In surrogacy, almost all professionals will require that you fall within a certain BMI range in order to become a surrogate. This may seem like an insensitive requirement, but, like most rules, they’re there for an important reason.

Here’s what you should know about the BMI requirements for surrogates:

Why is a Surrogate’s BMI Important?

There are a number of reasons why a woman’s BMI is important to her eligibility as a surrogate.

  • A higher BMI has been associated with preeclampsia, gestational diabetes, pregnancy hypertension, an increased rate of cesarean section, postpartum hemorrhage and other pregnancy complications.
  • A higher BMI has been linked to complications with the baby after the birth.
  • A too-low BMI has been associated with an increased risk for preterm delivery and small-for-gestational-age (SGA) babies.
  • A too-high or too-low BMI takes longer for you to become pregnant — about twice as long if you have a higher BMI versus a healthy BMI. With surrogacy, time is literally money for the intended parents, because it means more embryo transfers.

These requirements can be frustrating for healthy women who don’t seem themselves as “malnourished” or “obese,” as the BMI index may label them, or who fall outside the required range for surrogates.

However, your BMI when you’re trying to become pregnant can directly affect your health and safety, the baby’s safety and the legal safety of the intended parents you’re hoping to help. By applying to become a surrogate, it can be assumed that you’re an incredibly loving and generous person who wants to help others. If you don’t meet the health requirements, you could put yourself and others at physical, emotional, financial or legal risk. So, to minimize the possibility of these risks as much as they can, surrogacy professionals establish rigorous health requirements for surrogates, like BMI.

What is the Typical BMI Requirement that a Surrogate Must Meet?

These can vary slightly from one surrogacy professional to the next. At American Surrogacy, we work with women who have a BMI of 19 to 32, based on the fertility clinic’s recommendations. This is what health professionals have determined to be a healthy BMI range for adults, so most surrogacy professionals stay within that range fairly closely.

Remember that the BMI requirement is just one of many requirements that prospective surrogates must meet. There are also emotional, legal and other health requirements that you’ll need to complete, which can vary slightly depending on the state you live in and the surrogacy professional you work with.

If you’re not sure if you meet the BMI requirements to become a surrogate, ask your surrogacy professional.

What Happens if a Surrogate Doesn’t Quite Meet the BMI Requirement?

While most of the health requirements are pretty strict for a very good reason, the BMI requirements may be a little more flexible, depending on the clinic you’re working with and your individual situation.

Many surrogacy agencies are adamant about their BMI requirements, but if you’re close to the target range, we tend to evaluate things on a case-by-case basis and will simply prioritize overall health.

American Surrogacy may work with women who have a BMI as high as 35, as long as the surrogate is in good health, meets the other requirements and her fertility clinic approves her. If her BMI is high, we usually ask that the surrogate start working to safely bring down her weight before she becomes pregnant, so that we can minimize health risks wherever possible.

So, if you’re close to the required BMI range for surrogacy but aren’t quite in the target range, don’t panic. Talk to an American Surrogacy specialist at 1-800-875-2229 to see if you’d still qualify to become a surrogate, and talk to your doctor about creating a health plan to help get you closer to the ideal BMI range.

How DNA Sites are Changing Gamete Donation

Not all gestational surrogacies use embryos made from the gametes of two intended parents. In many cases, a donated sperm or egg cell is needed to create a healthy embryo for transfer. Whether it’s because an intended parent has low-quality sperm or eggs, or because an intended parent is pursuing surrogacy as a single parent, using gamete donations is more common than you might think.

Like many different aspects of assisted reproductive technology, the use of donated gametes can be a complicated one — as it has advanced rapidly within the law few decades. But, there is one modern aspect of using donor gametes to really pay attention to: the rise of DNA- and genetic-testing sites.

Today, anyone can send off their information to a DNA or ancestry site and find previously unknown genetic details. They may even locate biological relatives they had no idea existed.

This is a mind-blowing advancement for modern society but especially so for those using gamete donations in their assisted reproductive technology, including surrogacy. In fact, it’s changing the field in a way never anticipated.

The Move From Anonymous to Identified

Years ago, anonymous sperm and egg donors were common and accepted. Intended parents choosing to have a donor-conceived child received only a small amount of non-identifying medical information to share with their child as they grew up — if they even shared that their child was born via a donor gamete in the first place. Previously, information about donors was kept anonymous and sealed for years, and questions from parents and children went unanswered.

For many reasons, this left a negative impact on children. Their medical history always had the potential to change without them knowing the most recent information. They could never get answers to questions about who they looked like, where their traits came from, and why their biological parent had donated their gametes. Many children suffered identity issues from these situations.

Donor banks have started to recognize these disadvantages. The Sperm Bank of California recently updated its policies to require all sperm donors to participate in a known-donation program, phasing out anonymous sperm donors in 2016. It makes clear that donors are not expected to have a parent-child relationship with someone conceived through their donation — just updated medical and contact information upon the child’s 18th birthday.

American Surrogacy stands with those donor banks in recommending identified donations for all intended parents needing them in gestational surrogacy. Our specialists are always happy to talk with you in more detail about identified and anonymous gamete donation, as well as provide references to trusted identified gamete banks. To learn more, call our surrogacy specialists at 1-800-875-2229(BABY) today.

The Unrealistic Expectations of Being an “Anonymous” Donor

These new advances should be considered by every person thinking about becoming a sperm or egg donor. Whether you are considering this path to help someone else become a parent or to earn a little extra money, you need to think about the long-term effects of this decision.

If you are interested in becoming an anonymous donor, your gamete bank will likely do all it can to protect your information from being released — through its program. They have no control over DNA websites designed to connect biological family, such as 23andme.com or ancestry.com.

Sperm and egg donors promised anonymity decades ago are now being tracked down and contacted by their biological children without their consent. Because of the way these websites are set up, a donor doesn’t even have to personally take the test to be located; if one of a donor’s relatives does, the donor can often be found by their biological child.

Before you decide to become a sperm or egg donor, think hard about the decision you are making. It may seem like a short-term choice to help someone have a baby, but that baby won’t stay young forever. They will grow up and, like anyone else, they will have questions about their history and genetics. The odds are heavily in their favor that they will eventually find you, their biological parent. Are you ready for that?

The Donor Sibling Registry: Your Responsibility as a Parent

If you are an intended parent using a donor gamete to conceive your child via surrogacy, it’s important that you think hard in advance about the kind of information you will give your child as they grow up. Some parents of donor-conceived children keep this a secret until they believe their child is “old enough” to get it — but when a child grows up believing one thing to have their whole worldview shifted in one conversation, it can have drastic effects.

When you have a child via gamete donation, it is your responsibility to educate your child about their history and celebrate their personal story. You will also want to take steps to help connect your child with their biological relatives. You can use an identified gamete donor to start, but you can also register your child on the Donor Sibling Registry as soon as they are born. This registry will help your child find their biological relatives as they grow up.

If you choose not to take this step, remember that your child will be able to find their biological relatives another way. By using a DNA or ancestry website, they can quickly learn about their genetic history and true biological relatives — regardless of what you try to “protect them” from or keep them from knowing. Openness and honesty is always the best policy, especially in the rapidly changing world of gamete donation.

Before you engage in gamete donation, either as an intended parent or donor, make sure to do your research about this assisted reproductive technology. American Surrogacy specialists are always here to answer any questions you have about donor gametes in surrogacy and connect you to more professionals, should you desire more information.

Traveling to the Hospital on Short Notice: What to Expect

Witnessing the birth of your baby is an incredibly special moment, and many parents having a child through surrogacy are able to share in this experience alongside their surrogate. As you know, babies don’t always arrive at the most convenient times or precisely on cue. This means that many intended parents like to be ready to be by their surrogate’s side as she nears her due date so they don’t miss the big moment.

Here’s what you need to know about being ready to get to the hospital for your baby’s birth as an intended parent via surrogacy:

How Most Intended Parents Handle Travel

People who have become parents through American Surrogacy have traveled to their surrogate’s location up to two weeks before the baby’s birth, staying in hotel rooms to wait for that call saying that it was time to go to the hospital.

While you don’t have to settle in that early to wait for your surrogate’s due date, some intended parents simply feel more comfortable being nearby. That’s entirely up to you and your surrogate.

Most intended parent-surrogate matches are long-distance, so it’s very common for intended parents to travel across several states to get to their surrogate’s hospital. You can jump in the car or on the plane in anticipation of her due date, or when you get the call that she’s going into labor. Again, that depends on what you and your surrogate are most comfortable with.

This will typically be something that you’ll discuss with your surrogate in advance, often when you’re creating your surrogacy contract together. Having an established plan can make everyone feel more confident and relaxed, so that as the big day draws near you’ll at least have a rough idea of what to expect.

What Happens If Your Surrogate Goes Into Labor Early

The thought of missing their child’s birth keeps some intended parents up at night. True, some women do go into labor and give birth weeks before their due date. However, should this happen, that doesn’t necessarily mean you won’t see your baby’s arrival.

If you get a call saying that your surrogate is in labor and you need to travel to meet your baby as soon as possible, here’s what you’ll need to do:

  • Stay calm
  • Check in with your surrogacy specialist, if you haven’t already
  • Try to get on the first available flight or start driving

A few things to remember:

  • Everyone, especially your surrogate, wants you to be able to share in this moment, so be understanding
  • Your surrogate’s health and your baby’s health take priority above all else
  • If you get that call and need to start traveling, grab your paperwork but don’t worry too much about packing more than the absolute essentials — most things for you and baby can be bought or borrowed when you arrive
  • If you don’t make it in time for your baby’s birth, remember that you’ll have the rest of your life together, and that’s much more important

A few general tips to help you stay prepared for short-notice travel:

  • Have your hospital bags packed and ready a few weeks before your surrogate’s due date, including the essential newborn supplies you plan to take
  • Notify your work, family and close friends that you might need to leave quickly and that you could be gone for a while
  • Make arrangements for pets or children, so you can call someone quickly to care for them while you’re gone
  • Have a rough plan for how you plan on getting there and back, but stay flexible
  • Have a rough plan for accommodations, but stay flexible
  • Keep your phones charged and on you at all times

It can be tempting to want to plan out as much as possible, especially when it feels like so much is out of your control. But your baby will be born on his or her own schedule and sometimes, there’s just no planning for that. In the meantime, try to relax and be ready to roll with whatever surprises parenthood brings.

If you have any questions about what to expect when it’s time for delivery, or if you’re ready to start your surrogacy process, contact American Surrogacy now at 1-800-875-BABY (1-800-875-2229).

What to Expect from Your Surrogacy Mental Health Screening

We know there can seem like an endless amount of hoops to jump through before you can begin your surrogacy process — and we know a lot of them will be new to intended parents and gestational carriers. Perhaps one of the biggest surprises that our clients have is learning they will have to undergo a mental health screening before they can be approved for their surrogacy journey.

They often ask us, “But I’ve researched and I understand everything I need to about surrogacy. Why do I have to talk to a mental health professional about the process? Isn’t my surrogacy specialist enough?”

Actually, no — all intended parents and gestational carriers are required to complete a separate psychological evaluation by a licensed mental health professional before they can move forward. In fact, it’s even a legal requirement in certain states. While our surrogacy specialists can answer all of your practical questions, just as you will need a lawyer to answer your legal questions, you’ll need a mental health professional to ensure you are 100 percent emotionally prepared for this upcoming journey.

Many of our clients have never undergone a psychological screening before. Usually, these screenings take about one 60- to 90-minute session, but the process is unique for every intended parent and gestational carrier. It’s totally normal to be nervous — which is why we’ve broken down what you can expect from this visit below.

More questions about the surrogacy process? Don’t be afraid to contact our surrogacy specialists at any time.

Intended Parents

If you are an intended parent, you may deal with a lot of emotions during your surrogacy journey — anxiety over your lack of control, jealousy over someone else carrying your child, and excitement over your upcoming arrival. It’s normal to feel overwhelmed before and during the surrogacy process, which is why a mental health screening can be so important.

When you meet with a mental health professional, they will sit down with you and your spouse (if applicable) and discuss topics such as:

  • Your infertility history: It’s important that you have grieved all of your infertility losses prior to beginning the surrogacy process. You will need to be fully committed to the surrogacy journey, which means you must have accepted your losses and be looking forward to the positives of gestational surrogacy.
  • Your emotions regarding surrogacy: Surrogacy can be harder for some intended parents than others, especially those who are used to having a great degree of control or intended mothers who are grieving their loss of the pregnancy experience. Your psychologist will ask you questions about these feelings and help you work through them before you begin.
  • Your plans for parenting your child: Your child will be born through a unique manner, and it will affect how you parent them in the future. The psychologist will discuss with you your plans to tell your child(ren) about their surrogacy story, any gamete donors and other issues specific to raising a child born of assisted reproduction.

Gestational Carriers

If you are considering becoming a gestational carrier, you are making a life-changing decision to help another person become a parent. This is a beautiful, selfless choice — but not one that should be made without great forethought and consideration.

Before you can become a surrogate, your psychologist will discuss with you some important aspects of your surrogacy decision. This conversation will help you ensure you are making the right choice for not only you but also your spouse and your children. Some of these important topics will include:

  • Your reasons for being a surrogate: Not all women are eligible to be a gestational carrier, and their motivations can sometimes play a role in whether they are approved. Your psychologist will ask you about your reasoning for taking this path. Be honest; they can tell if you are simply interested in surrogacy for financial reasons instead of selfless, generous reasons.
  • Your feelings about pregnancy: It’s important that all gestational carriers are excited for their upcoming pregnancy experience. After all, you will have to accept the risks and side effects of pregnancy for a selfless reason; there will be no child of your own to take home after nine months. For this reason, your psychologist will ask you about your experiences with your prior pregnancies and what you are expecting from this one.
  • Your preparation for family expectations: Surrogacy won’t just impact you; it will impact your family, as well. For this reason, your spouse will need to complete a psychological screening, too. Your psychologist will talk with you both about your expectations for your family during your pregnancy to ensure you are ready for changing dynamics and the sacrifices you will all need to make.
  • Your understanding of the risks of being a carrier: Becoming a carrier means accepting certain risks and repercussions — some of which are more extreme than others. It’s important that you understand these risks before deciding to be a gestational carrier. Your psychologist will talk to you about these topics to make sure you are 100 percent comfortable with the path ahead of you.

Whether you are an intended parent or prospective carrier, your psychological screening is a big part of your pre-surrogacy process. Your surrogacy specialist will always help you prepare for this conversation and connect you with a trusted local professional for your screening. Still nervous? Think about the questions you may be asked and try to come up with some thoughtful answers ahead of time. Don’t be afraid to come into this screening with questions of your own; it shows you are mature and recognize the complexities of the topics you will be discussing.

For more information about psychological screening and other surrogacy requirements, please call our agency today at 1-800-875-2229(BABY).

National Birth Defects Prevention Month

January is National Birth Defects Prevention Month. This month focuses on raising awareness of birth defects, how they’re caused, the affect they have and how some can be prevented. Through National Birth Defects Prevention Month, the hope is that those who are affected by birth defects can live healthier, longer lives, and that those who are growing their families remain unaffected by birth defects.

What Is a Birth Defect?

There are many kinds of birth defects, and they can affect people in many different ways. Here are some important facts that everyone should know about birth defects:

  • Any complication that is presented at birth that alters the body’s appearance, function, or both is considered a birth defect.
  • One in 33 babies is born in the United States with a birth defect.
  • The severity of birth defects can range from moderate to critical, even causing death.
  • Birth defects are a leading cause of infant mortality.
  • Most birth defects occur during the first trimester.
  • Although some defects are detectable during gestation or at birth, some defects may not be identified until later in the person’s life, especially if the defect hadn’t caused noticeable health problems for the person.

How Preimplantation Genetic Screening (PGS) is Helping to Decrease Birth Defects in Surrogacy

In gestational surrogacy, preimplantation genetic screening (PGS) is routinely conducted to help prevent birth defects. PGS checks the embryos used in surrogacy for potential genetic diseases or disorders that could result in a birth defect before they’re transferred to a surrogate to carry. Here’s how PGS works:

  • A few cells are microsurgically removed from the embryos being tested after they’ve been developing for about five days, at which point the embryos are frozen.
  • The DNA of those cells is examined to see if certain genes which could cause harmful defects are visible. This stage takes a minimum of one week.
  • If the embryos have no concerning genetic issues, an embryo (or multiple embryos) will be transferred to the gestational surrogate in the hopes of a successful implantation.

In addition to PGS, prenatal screening is also routinely done later in the gestational surrogate’s pregnancy to catch any other potential health concerns. The health and safety of gestational surrogates as well as the baby are the two primary goals in surrogacy, so PGS and prenatal screening are both important to achieving that.

What You Can Do

Many of the causes behind birth defects are unknown, but there are always efforts being made to better understand and prevent birth defects whenever possible. Here’s what you can do:

As a Surrogate…

Gestational surrogates must meet a fairly strict list of physical requirements. This is designed to limit the risk of health problems for the surrogate as well as the baby. Surrogates must be generally healthy, have already given birth with no pregnancy complications, have a healthy BMI, be free of STDs, be smoke- and drug-free, be financially stable, meet age requirements and meet other important health criteria.

These health requirements may make it less likely for birth defects to occur, but even the healthiest gestational surrogate can’t guarantee that a child she carries won’t develop a birth defect, as much as she’d like to protect the baby from health issues. If you’re a surrogate, most of the strategies for preventing birth defects are the basics of maintaining a healthy pregnancy. This includes:

  • Seeing your OBGYN for regular prenatal checkups. Some defects can be caught early and treated or prevented before birth.
  • Staying healthy by eating right, drinking lots of water, exercising regularly (light to moderate), getting plenty of sleep and of course avoiding smoke, drugs, alcohol and other unhealthy habits.
  • Taking your prenatal vitamins, especially daily iron, which can reduce the risk of anemia, as well as daily folic acid, which has been shown to reduce the occurrence of birth defects in the baby’s spine and brain.
  • Reducing your stress. Stress hormones can be transferred to the baby through amniotic fluid and can negatively affect development, so rest, meditate and try to stay relaxed.

Remember that you can do everything right and a child may still be born with a birth defect. Although this is a frightening thought for surrogates who feel responsible for the safety and health of the intended parents’ child, understand that most of the time, these things are out of anyone’s control. Keeping yourself healthy is the best thing you can do for the intended parents’ baby!

As an Intended Parent…

Again, there is no 100 percent guarantee that a child will be free of birth defects. However, there are a few things that you can do as an intended parent to reduce the risk of birth defects when you’re having a child via surrogacy, including:

  • Using donor gametes if you or your spouse has a genetic disorder that you’re worried about passing on.
  • Obtaining a detailed family health history on both sides whenever possible.
  • Having PGS completed on your embryos prior to embryo transfer with your gestational surrogate to ensure your embryo(s) are healthy and free of potential defects.

An important thing to consider as an intended parent: what would you want to do if one or more of your embryos had a genetic disorder that would lead to a birth defect? This possibility can be difficult to think about, but it is something you’ll need to consider before you complete PGS.

As a Person Who Cares…

If you’ve been affected by birth defects, know someone with a birth defect, or you simply want to help raise awareness and offer support, everyone can step up during National Birth Defects Prevention Month. Here are a few simple ways you can join the cause:

  • Join the #Prevent2Protect Thunderclap to raise awareness of National Birth Defects Prevention Month and to sign up to share a unified, simultaneous message of support across social media.
  • Share your story with the hashtag #1in33 This is Me if you or someone you love has been affected by a birth defect, and help others to feel supported and understood.
  • Share factual information about health, and how steps can be taken to prevent some birth defects by using the hashtag #Prevent2Protect when you share that information.

How will you participate during National Birth Defects Prevention Month? Let us know in the comments.

7 Questions You Have About Your Surrogate’s Delivery

It’s finally here, the thing you’ve been waiting your entire family-building process for — your gestational carrier’s delivery. As much that goes into the initial stages of the surrogacy process, you may not have thought about what would happen when your gestational carrier reaches the end of her pregnancy. What can you expect from your upcoming hospital stay?

This is a new experience for many intended parents, and it’s perfectly normal to have lots of questions about this part of the journey. Your upcoming hospital stay can be nerve-wracking and exciting at the same time. The good news is that the more prepared you are for this experience, the more successful it will be.

Understanding what to expect from this part of the surrogacy journey is a big part of preparing for the unknowns ahead of you. When you work with American Surrogacy, your surrogacy specialist will always help you prepare for this exciting time. He or she will answer all of your questions and help you feel comfortable with what is to come.

You can always talk to your specialist by calling 1-800-875-2229(BABY). In the meantime, you can find answers to some of the most commonly asked questions about a gestational pregnancy hospital stay below:

1. Will we be present during childbirth?

Yes! Your surrogacy specialist and your gestational carrier will do everything possible to ensure that you make it to the hospital in time for your carrier’s delivery. You will be in close communication with your carrier and receive all the updates she gets from her obstetrician, and you will be made aware of the hospital plan every step of the way. This way, you’ll know when your surrogate is due, and you can make the proper arrangements to be there during childbirth.

That said, babies come when they want to, so you may want to take precautions just in case she goes into labor earlier than expected.

As far as being in the room during the actual birth, that will depend upon the policies of the hospital where your gestational carrier is delivering. Some hospitals will only allow a certain number of people into a delivery room, and the rules could be even stricter when there’s a cesarean-section. In some cases, both intended parents are allowed to be in the room with the carrier and her spouse, but some situations allow for only one or two people to accompany the carrier into delivery.

As with every other part of the hospital plan, a plan for who will be present during delivery will be set before the carrier gets close to delivery. You and your surrogate will decide which preferences you are both comfortable with during that time.

2. Will we get our own room?

Again, the answer to this will depend upon hospital policies. Some hospitals treat surrogacy as similar to adoption; intended parents can stay in a hospital room near the carrier after the baby is born. This can be incredibly instrumental in the bonding time shortly following birth.

However, some hospitals do not provide extra rooms for intended parents. Therefore, some parents stay in the same room with their gestational carrier as she recovers, or they stay in a nearby hotel and visit the carrier and their baby as often as possible.

3. Will our baby get to stay with us?

Again, this will depend upon hospital policy. If you are staying in a hospital room, and the surrogacy situation has been explained to hospital staff in detail, it shouldn’t be a problem for your baby to stay in the room with you as your surrogate recovers and your baby waits for discharge.

However, there may be situations in which a baby cannot stay in the same room with either the intended parents or gestational carrier, most notably in cases of premature birth or other birth complications. Separation from a new baby can be stressful for any parent, let alone a parent who didn’t carry a child themselves. Remember that your baby’s doctor will do everything they can to move your child to your rom when they are medically ready. In the meantime, if you are staying at the hospital, you can always visit your child as often as allowed. You can invite your gestational carrier to accompany you, as well.

4. Will our names be placed on the baby’s birth certificate?

If your state laws allow for a pre-birth order, your names will be placed on your baby’s birth certificate when they are born. This can be a massive relief for intended parents, but remember that, even if you don’t have a pre-birth order, there will never be any confusion about who the baby really belongs to. Your surrogacy specialist will make sure the hospital is aware of your situation and understands the parental rights you have in this process.

Some states don’t allow for pre-birth orders, only post-birth parentage orders or adoption. If this is the situation with your surrogacy, your surrogacy attorney will explain the necessary legal process to you before your carrier gives birth. They will also work to ensure that an amended birth certificate is provided to you as quickly as your state processes allow for.

5. Can I breastfeed my baby in the hospital?

If you are an intended mother, you may be interested in breastfeeding your child born via surrogacy. Not only is this recommended by breastfeeding advocates, but it is entirely possible — and you can start breastfeeding once your child is born.

You’ll need to talk to your doctor ahead of your carrier’s delivery to ensure you induce lactation early enough for your baby’s delivery. If you have a separate room for you and your baby during the hospital stay, you may even have access to lactation specialists during this time. They can help you with any issues you have inducing lactation and adjusting to your new breastfeeding schedule.

6. Do we get a say in the hospital and delivery plans?

While your gestational carrier will be the one undergoing childbirth, you are still an active part in this surrogacy process. When your carrier creates her hospital plan, your surrogacy specialist will make sure to include you in this decision-making. If you have specific desires for your child’s birth — such as a natural delivery, delayed cord clamping or more — it’s important that you tell your carrier and surrogacy specialist as early on as possible.

Like the other aspects in surrogacy, a hospital plan may include compromises. Being honest about what you want early on will help ensure a surrogacy process you are comfortable with.

7. How do we start planning our hospital stay?

When you work with American Surrogacy, your surrogacy specialist will ensure that your hospital plan is created in plenty of time to let you and your gestational carrier prepare for this experience. Typically, this plan is created during a carrier’s second or third trimester in a conversation between all parties involved.

While planning a hospital stay can be stressful in an independent surrogacy, when you work with American Surrogacy, your surrogacy specialist will handle all the necessary details. They will mediate the conversation between you and your gestational carrier, coordinate with the carrier’s insurance provider and medical professionals, and work with the hospital to ensure all professionals are prepared for the unique surrogacy situation ahead of them.

The birth of your baby can be an incredible experience. Let our specialists help you through every part of this process. To learn more about our agency’s services, please contact our specialists today.

Should You Consider Embryo Donation After Surrogacy?

When you’re an intended parent, you will put a lot of thought into the surrogacy process. But, you may not consider what will happen when your surrogacy is complete. If you’re like many intended parents, you will have remaining embryos after your gestational carrier gives birth — and you’ll need to decide what to do with them.

There are generally three options for leftover embryos: to dispose of them, donate them to science, or donate them to another intended parent. Many intended parents choose a fourth “option” — to keep them in long-term storage indefinitely — but, as an intended parent, you will need to decide what to do with your embryos at some point. At American Surrogacy, we encourage our clients to think about this earlier rather than later.

In this article, we’ll talk about one of the most selfless and beautiful choices for your leftover IVF embryos: donating them to another intended parent. Understandably, many people have reservations about this process, so having the right information can help you make the best decision for your family.

Whether you’re seriously considering embryo donation or simply want to learn more, here are some things you should know:

Signs Embryo Donation is Right for You

Donating leftover embryos is not right for everyone — and that’s okay! When you donate an embryo to another couple, you are often giving a very personal gift to a complete stranger. It can be nerve-wracking to consider.

However, there are a few signs that it may be the right choice for you:

1. You want to help someone else become parents.

As an intended parent, you understand the struggle that people like you go through to have a child. If you decide to donate your embryos, you can make someone else’s parenthood journey a little easier. Donated embryos can be used to help an intended mother experience pregnancy, reduce the costs of IVF for those looking into surrogacy, and even help LGBT couples who can’t conceive an embryo on their own.

When you donate your embryos, you give these intended parents a new chance at building their family. The people who choose this path empathize with those in that situation, and they make the selfless choice to give the possibility of a child to those who want it most.

2. You are uncomfortable disposing of your embryos or keeping them in long-term storage.

While frozen embryos are in no way considered viable, some intended parent feel uncomfortable disposing of the promise their embryos could have. Whether or not they view them as “children,” some people don’t believe that discarding their embryos (or donating them to science) is ethical.

On the other hand, keeping them in long-term storage is not a viable option either. Sure, it may delay the decision you have to make, and it can keep your options open if you wish to have more children, but you will eventually need to decide what you wish to do with your embryos. Otherwise, this will be a decision made by your family members when you die.

Donating your embryos can give you control over their use and a sense of purpose that you may not feel otherwise.

3. You are comfortable with being an identified donor.

There’s one thing that you should know before donating your embryos: You are not “giving up your children.” Instead, you are giving the possibility of a child to someone else. If that embryo successfully implants and develops into a fetus, there will be a child with your genetic material out in the world. That’s why embryo donation is also called “embryo adoption.”

For this reason, the people who donate embryos with their genetic material are highly recommended (sometimes even required) to do so on an identified basis. That means, when the child is old enough, the embryo donors can be contacted by their biological son or daughter (or his or her parents) for more information about genetic history, siblings, etc. You will not be responsible for your biological child’s well-being, and you will likely not feel the same connection that a birth parent feels to their child in an adoption situation. However, you will have the responsibility to give your biological child the information they need as they grow up.

Signs Embryo Donation is Not Right for You

If you’re unsure about donating your embryos to someone else, that’s completely normal. You may have a few concerns about the process, which is why learning as much as possible will help you make the best choice for your family.

There are generally a few signs that embryo donation may not be the best route for your family:

1. Your embryos are not high-quality.

This reason goes without saying. If you have struggled to conceive yourself, and you’ve turned to surrogacy and transferred the best quality embryo, your remaining embryos likely weren’t quality enough to be used for your own surrogacy. Therefore, they shouldn’t be donated to another couple if they have a high chance of failure.

If your reproductive endocrinologist determines that your leftover embryos are too low quality for donation to other intended parents, consider donating them to science instead. That way, experts can study your embryos to advance future assisted reproduction techniques.

2. You are uncomfortable with someone else raising a child who is biologically related to you.

If your embryos are created from you and your spouse’s gametes, it may make you uncomfortable to donate a potential biological child to someone else. Even if you choose identified donation, you will not be actively involved in your biological child’s life. For some intended parents, this can be a deal-breaker when it comes to donation. It takes a special kind of person to give a biological child to someone else; not everyone can be an embryo donor or birth parent.

Consider talking to an identified donor bank to learn more about this process to see if your concerns clear up with more information. If they don’t, that’s okay — consider donating your embryos to science, where they will never reach the point of viability.

3. You would rather dispose of your embryos.

Deciding what to do with your leftover embryos is a tough choice. You may not like the uncertainty of long-term storage, and you may be uncomfortable with donating your genetic material and the unknowns that come with doing so. In your case, discarding your embryos may be the best solution.

Remember, choosing to discard your embryos doesn’t mean that you are destroying “children.” It is always up to you to decide whether you are personally comfortable with discarding your embryos, but know that they are not viable and will not develop into fetuses unless implanted in a uterus.

If you are ever unsure as to what to do with your leftover embryos, we encourage you to speak in depth with your reproductive endocrinologist. This may not be a decision that you make overnight, but having the proper information and understanding all of your options will help you to choose the path that is best for your family.