New restrictions and bans on abortion may do more than affect women facing unplanned pregnancies — they could soon have a drastic effect on intended parents using gestational surrogacy to add to their families.
While American Surrogacy won’t dive into the ethics and morality of abortion as an unplanned pregnancy option, we see it as our duty to keep intended parents and gestational carriers informed of all aspects of the medical surrogacy process. And, in some situations, selective reduction and termination (another name for abortion) are integral parts of a safe surrogacy journey.
If you’re unsure how new abortion bills may affect your ability to pursue surrogacy, we encourage you to contact our surrogacy specialists or speak with your personal reproductive endocrinologist. In the meantime, read below to learn more about this important new development in gestational surrogacy.
Why is Selective Reduction and Termination Used in Surrogacy?
Before we get into the details of new abortion laws across the country, you must first understand why they might even apply to surrogacy in the first place.
Selective reduction and termination are relatively common in the medical process of surrogacy, although these procedures are used less frequently thanks to advances in pre-genetic screening. Intended parents and gestational carriers only want to proceed with pregnancies that have the best chances of success, and that all starts with the embryo transfer process.
During in vitro fertilization, it’s common for intended parents to create several embryos. Their reproductive endocrinologist screens these embryos to determine which are the most viable, with the highest chances of success. The doctor will then transfer those embryos to the surrogate’s uterus.
Sometimes, however, a doctor will transfer more than one embryo to a surrogate. This may be done when several embryos are of lower quality; the more that are transferred, the increased likelihood that one or more may implant. But, when two or more do implant, intended parents are left with a choice: to continue with the increased risks of a multiples pregnancy or reduce to a singleton pregnancy.
If they choose a singleton pregnancy, the doctor will inject any extra implanted embryo with medication to stop its heart. That way, a surrogate can continue to carry one embryo, without the added risks of carrying twins or triplets.
In other situations, an embryo may start developing abnormally once it has implanted in the surrogate’s uterus. It may develop genetic or chromosomal abnormalities undetectable in prior genetic screening. Intended parents may make the heartbreaking decision to end this pregnancy before it gets further along, especially if the fetus is not expected to survive outside of the womb. To save themselves and their surrogate from the stress and emotional turmoil of that later on, they may choose to terminate.
Keep in mind: The decision to use selective reduction or termination is not one made lightly. Both intended parents and their gestational carrier will agree on the situations in which each of these is used before they even begin the medical process. The surrogacy contract will always detail the situations in which these procedures are (and are not) acceptable.
While no intended parent or gestational carrier wants to experience a selective reduction or termination, these procedures are still important parts of the surrogacy medical process — but may be put in jeopardy with new abortion restrictions and bans across the country.
How Could Abortion Bans Affect the Surrogacy Process?
New legal challenges to abortion have popped up over the last few years — the most noticeable being “heartbeat” and “personhood” bills, which prevent abortions after the sixth week of pregnancy and assign human rights to embryos, respectively. While pregnant women considering abortion are undoubtedly the targets of these bills, they can also have a dire effect on those using assisted reproductive technology.
First, let’s tackle the so-called “heartbeat” bills:
A reproductive endocrinologist is involved throughout the beginning of the surrogacy process. This doctor will monitor the embryo transfer and the surrogate’s early pregnancy, confirming the success of the transfer and completing the first ultrasound. If an abnormality occurs in the fetus, they will be the first to know — and often the professional to recommend selective reduction or termination.
They will typically also complete the six-week ultrasound, which will check for a heartbeat. If a heartbeat is not heard, the doctor will usually induce a miscarriage.
But, in a state where abortions after six weeks of pregnancy are banned, this might not always be possible. Perhaps a heartbeat was heard at the six-week appointment but not at the 12-week appointment. Maybe the heartbeat stops a day after the six-week appointment. What would usually be the normal course of action — termination — would be impossible, forcing intended parents and gestational carriers to wait for nature to take its course, however stressful and emotional that would be. It could be medically risky, as well.
Surrogates in states such as Alabama and Louisiana may find themselves unable to match with intended parents or even complete the surrogacy process at all. Many intended parents may not wish to start the process with a surrogate who cannot terminate or selectively reduce in the future, just in case. And, for surrogates in Alabama, traveling to another state for a pregnancy termination won’t be possible; a surrogate, her doctor and her intended parents will be criminally liable.
In effect, these “heartbeat” bills will make gestational surrogacy in these states all but impossible. For many, the risks of the process won’t be worth it — and they’ll choose another state to pursue their family-building journey.
On the other hand, intended parents may not even get so far as the gestational surrogacy process. New “personhood” bills may make it difficult for them to even complete in vitro fertilization in certain states.
In essence, “personhood” bills assign all the rights of a living human to an embryo. This means that hopeful parents would be unable to donate extra embryos to research or discard of them. They would be forced to store them indefinitely or donate them to another couple, which is an extremely personal decision to make.
An intended parent should have the right to choose what they wish to do with extra embryos, but “personhood” bills could effectively take that right away from them — if IVF is even an option. As infertility psychologist Angela Lawson theorizes:
“In short, as legislation regarding at what week of pregnancy an abortion can be performed potentially changes, such laws affect IVF. The assignment of personhood to embryos will mean that IVF clinics will no longer be able to create, freeze, or dispose of them. It would also prevent the retrieval of eggs for fertility preservation because those eggs would be used in the future to create embryos, thus creating ‘life’ in the lab.”
Intended parents who live in states with these laws would be forced to go out of state to complete their fertility treatments — adding more costs to an already expensive process.
Here at American Surrogacy, we advocate for every intended parent’s right to choose the path that’s best for them. We also believe in defending the right to gestational surrogacy across the country, even when new laws and regulations make that difficult.
That’s why, when you work with us, we will work for your interests every step of the way. That means matching you with a surrogacy partner in a surrogacy-friendly state and helping you find the medical professionals you need to complete your journey. For more information on surrogacy with our program, please contact our specialists online or call them at 1-800-875-BABY(2229).