In your life, even after becoming a birth worker, there will be hills, speed bumps, pot holes, and road blocks along the way. While we’re going through it, and it feels like we will never come out of it, or understand why it is happening to us, we can envision what this will do for our future, and as the light at the end of the tunnel starts to become brighter, perhaps we can turn the struggles into our advantages, if we choose to visualize our journey that way.
Allow me to preface by saying I do not ever intend to belittle or invalidate someones current feelings or situation. You have every right to feel those negative feelings and be upset that the world is not spinning in your favor, at this time. Instead, I would like this post to be encouraging and uplifting, rather than be perceived as toxic positivity.
My mindset will be more easily explained by sharing how my own struggles have helped me, personally, improve as a birth worker.
In 2015, I was intending a home water birth. Instead, my midwife abandoned me, I had a hospital birth that was not even remotely close to my birth plan, and it resulted in a fair amount of trauma. At this time, my career was a police dispatcher and my goals were to go to the police academy and become an officer. My birth plans drastically changing made me realize I needed to serve my community in birth work rather than in uniform. In 2016, I began that journey to be a birth worker.
In 2018, I was a surrogate to twins and it went horribly, but I learned SO MUCH about multiples pregnancy, surrogacy, IVF, and the interventions involved in a multiples birth, as well as primal trauma, and how it feels to be absolutely used. This granted me so much patience, taught me more about informed consent, showed me what a “high-risk pregnancy” looks like from the patient’s perspective, and I was able to carry this knowledge into my birth work to serve such a broader range of clients.
In 2019, I suffered multiple miscarriages, my son was diagnosed with leukemia, and then he was taken away from us because we delayed treatment to seek a second opinion on his chemotherapy protocol. The losses helped me connect further with the bereavement side of my birth work. My son’s diagnosis taught me how to grasp more medical terms, read lab work more effectively, and communicate with doctors in a different way. Having Noah taken away has taught me a lot about how CPS, dependency case law and court, works, which can help a lot of families in the birth world, surprisingly, especially those that choose home births.
Turning Trauma into Healing
That being said, if you feel like something in your life is hindering you, a past trauma, or a struggle you are currently going through, I offer you a challenge that may help.
Take a moment this week to write down your struggles individually, and for each struggle, I challenge you to find how that struggle can bring you a new gift and new experience for your career. If you feel ready, offer that as something you have experience in on your website, it may help a family that has been or is going through something similar, connect with you better. It is way okay to be open about our struggles, previous or current, as they are not just struggles, they are LIFE EXPERIENCES.
A few examples of experiences, which may seem un-favorable and potentially even morbid, to discuss on a professional website might be:
Domestic Violence (1/4 women experience this.. if you get more than 4 women to view your website, one of them is likely a fellow victim that appreciates that you understand her prior or current journey)
Loss & Fertility Struggles (Loss statistics are at about 1/4.. Infertility is about 1/8.. This applies to so many)
What else can you think of, or may want to share from your own personal experience, that could actually do you or others a service in regards to birth work?
I always love to be able to turn something hard, into something positive and something to look forward to and utilize, and I hope to share and help others do the same.
Surrogacy has really taken off recently. In the most popular surrogacy group on Facebook, there are over 13,000 members eagerly asking questions, commenting and either completing or beginning their surrogacy journey as an intended parent or as a surrogate, gestational or traditional. It seems more and more I see my timeline popping up with friends going through surrogacy, that I really never expected to.
I have people reach out to me daily asking about my surrogacy experience and honestly, answering is becoming exhausting, time consuming and draining, so I will put it here for the world to see and it will find the people it’s meant to find and if you’re looking for answers and perspectives, here they are. Please read in full before reaching out to me with questions. It’s long but it’s necessary if you feel you are wanting to make an informed decision on whether surrogacy is right for you. If you are contemplating egg donation, please see our egg donation article for my perspective on that here.
Preparing for Surrogacy
You must know that the process going into surrogacy is a hurry up and wait game. Whether you go through an agency or independent, you can expect to be waiting at minimum 6 months before even starting to get pregnant; some women wait much longer – even years. So do not go into this expecting to get pregnant or get a paycheck quickly, by any means.
Before you even get into the nitty gritty, check if your state even allows surrogacy. The ability to be a surrogate depends on the state YOU live in, not the parents. For example, in New York, surrogacy is not permissible or legal. There are ways to get around it, but it’s a gamble for you and the parents legally. For a state by state guide, learn more here.
Types of Surrogacy
There are different types of surrogacy, so you must decide which route you will take.
Traditional surrogacy involves using your own egg, so you would be biologically related to any baby you carry. This may involve home insemination, in clinic insemination, IUI or the full IVF process, extracting your eggs, creating an embryo or multiple embryos, and transferring the embryo(s) into your uterus.
A gestational carrier is just that – a carrier. You are simply hosting the embryo(s) and they are not directly biologically related to you, though, if you are carrying for a cousin, sister, daughter or any other relative, they will be distantly related to you, of course. This involves the second half of IVF and we will go in depth with that explanation in a bit.
The Legal Side
Once you’ve decided whether you want to be a gestational carrier or a traditional surrogate, you will pursue an agency. Typically agencies do not aide traditional surrogates as they are legally more complex and involved. There are TONS of agencies to choose from; vet them wisely. Ask questions about how they support you through the process, what process steps they handle prior to you getting matched with parents, if they can match you with parents that fit your values and birth plan, how compensation is handled, and if you are 10-99d for the compensation you receive (if so you must save at least 15% of your compensation for the following tax year, or you will be investigated by the IRS).
Some values that are important to consider in surrogacy are:
Compensation: What is the compensation amount to make it worth it for you to dedicate your body for a minimum of 10 months, sometimes over a year if transfers fail, you have to do mock cycles, you have an early loss, etc? What about lost wages if you have to miss work for appointments, or quit your job all together? What will be your transfer fee? What about if you have to have a hysterectomy from birth complications?
Embryo Transfer: This is one that really stirs the surrogacy community up, but let me make it clear that transferring multiple embryos to increase likelihood of pregnancy is no longer evidence based. It sounds like it makes sense at first, but it is not backed by science. It just increases your risk of multiples, and there are some theories that transferring a lower grade embryo with a higher grade embryo makes a pregnancy LESS likely to occur or sustain. Multiples occurred through IVF increase the interventions pushed in pregnancy and birth and enhances your risks for pre-term labor, placental complications, pain, rupture and more. If your Reproductive Endocrinologist recommends transferring two or more, run away. You should always transfer ONE for yours and baby’s safety. Transferring two or more, to “save money”, is NOT worth it.Also, how many separate transfers are you willing to do before you have the option to drop the contract? The standard is three, but it’s absolutely your choice. It can be very taxing on your body and may require out of state travel and lots of time away from your own family.
Termination: Under what circumstances are you willing to terminate? None? Any? Parents choice? Specific birth defects? Multiples? You absolutely must know what your stance is on this and put it in the contract.
Parental Involvement and Contact: How involved do you want the parents to be? Would you like someone local that can attend every appointment? Or do you prefer someone to give you space through the pregnancy and update them via text or call after each appointment? Can you tolerate communicating via translator if your parental match is foreign? Are you comfortable with them being present through the entire birth, or are you more private?
Birth plan: Do you want someone that is okay with a natural birth? Home birth? Birth center? Hospital? Who will your provider be? Are you okay with being induced if requested? Would you agree to a scheduled cesarean? What are your limitations on intervention? At what stage of labor do you plan to go to the hospital? Who will be present in the room if you need a cesarean and only one person can go with you? What happens if the parents don’t make it to the birth? Who will cut the cord? Who do the baby/babies go to immediately? Would you like a doula present? A birth photographer? If so, who covers those costs? Will you share a room after birth? Who gets the placenta(s)?
Providing Breast Milk: Are you willing and able to provide breastmilk?What will be your charge per oz? Will you do it for free? How long are you willing to provide for?
There are certainly other factors to consider as well that your lawyer will discuss with you in building contracts, but those are the main, important factors.
The Evaluation Stage
Now, let’s move on to the evaluation stage! In this stage you will be required to attend several appointments, gas and time coming from your own pocket. This involves a medical evaluation of your reproductive organs and general health at a Reproductive clinic, an approval from your OBGYN for clearance of pregnancy, a psychological evaluation for you and your partner, a background check, and a blood draw to screen for diseases, drugs, hormones and nutrient levels.
You will need to get a hysteroscopy during the medical evaluation, in which they insert a catheter into your uterus and fill a balloon with saline to examine you for cysts, endometrial tissue abnormalities, and uterine shape to check for optimal conception and pregnancy chances. It’s not really painful but definitely feels odd and you may experience period like cramps and bloating after. You will need a recent healthy, normal Pap smear and pelvic examination from your OBGYN for pregnancy clearance. If you are not immune to specific “preventable diseases” some reproductive clinics may require you to be immunized before proceeding. If you have any drugs in your system, you will be denied point blank, for obvious reasons.
During the psychological evaluation you will need to take a test that’s about 300 questions long, it tests for psychotic and sociopathic tendencies and how risky of a person you are. It’s all multiple choice and true or false, and based on your own opinions, so don’t worry, you don’t need to study. Then you will meet with the psychologist where she or he will chat with you about your surrogacy motives, family psychological well-being, how safe your home is, how your birth and previous pregnancy experience was, how you feel about different surrogacy scenarios and what you would do in those situations, and they will gauge your partner’s well-being and how supportive they are of the surrogacy. Your partner must be completely on board. If you don’t have a partner, you must have great support, such as your parents, reliable childcare or someone else that can be there when you call, as needed.
You also must be at least 21 years old, not be on any type of government financial assistance (food stamps, WIC, or any variety of that), have had at least one healthy, complication-free and term pregnancy and be raising said child. People who have had gestational diabetes, pre-eclampsia, antenatal depression, pre-term delivery, hyperemesis gravidarum, placenta accreta, or any other complication may not qualify.
Once you have gotten through all that, now it is time to start contracts. Contracts can take several months for some matches, and as little as a couple weeks for others. Have your lawyer go over EVERY SINGLE DETAIL and ASK QUESTIONS. ADVOCATE for yourself, or you may regret it. Remember all those values we mentioned before and include them ALL. It doesn’t matter if you are “being complicated,” the lawyers are making thousands off this contract and it’s so worth it to protect yourself. Take your time, don’t feel rushed by this part. You will need to have your contract notarized and if you are married, your spouse will need to sign as well, in most states.
Now, we move forward into the process of getting pregnant! Are you exhausted yet?? LOL
You may have a mock cycle to see how your body responds to medications, or may be put on birth control to syncopate your cycle with the Intended Mother’s if doing a fresh transfer. The medication protocol is different per every clinic, and sometimes different per each individual, so it’s truly hard to gauge what your specific cycle will look like. It is EXTREMELY rare that a clinic allows a natural cycle so do not hang on those hopes going into it.
The medications you may be put on include:
Birth Control (this may be the mini pill or something stronger)
Lupron (this is an ovulation suppressor and is self-injected into your abdomen)
Estrogen (this may be oral or self-injected)
Progesterone (there are many forms, PIO, or progesterone in oil is the most common and effective, and is injected into your upper buttocks or your thigh, you may be on this for 2 months or more once transfer occurs. There is also oral progesterone and vaginal suppositories and those may be used in combination with progesterone in oil or solitary.)
PLEASE research the side effects of these medications before proceeding, they can have life long effects and include but are not limited to, dizziness, fainting, vaginal bleeding, painful and sore knots at injection site, allergic reaction, nausea, vomiting, migraines, sore breasts, infertility and cancer of the breasts, cervix and ovaries. Progesterone supplementation can lead to placental complications and those complications are common in the surrogacy world.
I also strongly encourage you to look into birth trauma and primal memories of infants, but that’s a subject for a different day. Surrogacy is not victimless and not solely a positive gift, no matter the relationship between the surrogate and parents. Moving forward…
My Surrogacy Story
This is my personal story and perspective of my surrogacy, after sharing that informational bit. Take it and do with it as you will!
I had always envisioned myself one day carrying a child for someone that couldn’t, I was not actively pursuing, it wasn’t something I was necessarily looking to do right away at the time, but I was open to it and researching it and did talk to a couple women that were connected to me by a friend that had her babies via surrogate. Between these first conversations I realized what was important to me.
I met a woman that was the sweetest soul, her story touched my heart. I spoke with her about my intentions and knowledge for the pregnancy and birth, and she communicated that there was trust and free reign, that she agreed with how I felt about interventions, that it was my body to make informed and safe choices with, that she believed in the natural lifestyle, she was raised naturally and her business seemed to jive with exactly what she was saying. I thought we connected very well, that I had found my soul sister. We talked for months and months, and I even drastically lowered my compensation to almost nothing because I truly thought this was a lifelong bond and connection, as it should be, and as it was portrayed from her that it would be. The monthly compensation wouldn’t even pay my rent by itself, if that gives you any idea of how low it was. But I was okay with it because I felt that she truly respected and appreciated me, and that’s all I wanted, to bless a loving pair of souls with a beautiful little baby, it was never about money for me. I bring up the low compensation because when you’re a surrogate, at least in my experience, apparently it’s justifiable that the parents treat you however they want because they pay you so well. I beg to differ.
I went through every check of the process with flying colors. I responded to the medications with ease, was injecting myself daily but pushing through.
We transferred two embryos and both of them implanted, that evening I felt the actual implantation and remember pointing out the exact spots of the implantation to the mother, it was pretty cool to be so in tune to my body at that time. We got a positive pregnancy test just 3 days later. I flew home the day after.
Then, just 6dpt…
About 5 weeks go by and my pregnancy tests have just been getting darker and darker and my HCG is through the roof. A little nausea and sickness has started to show itself, but I didn’t think much of it. I went to my first ultrasound of the pregnancy and I remember the tech asking me how many embryos I had transferred as she turned the screen to me to show me two distinct sacs with little beans growing in them.
As the days passed after this appointment and my HCG kept spiking, my little bit of nausea turned into violent all day sickness, barely keeping water down, fainting spells, and basically bed ridden. Turns out, the medications used for surrogacy and IVF can stimulate H Pylori overgrowth and cause Hyperemesis Gravidarum.
And then things got worse again… Had my first and only ER trip at 14 weeks because I started to faint again, and felt like I was dying this time. My body was so depleted. My BP was very low and my heart rate was 150 resting, obviously my body was in dehydration survival mode. My husband quickly whisked me to the hospital and they were able to replenish my fluids and check on the babies but they also found placenta previa. Handling my sickness was a challenge between the parents and I because they weren’t comfortable with CBD oil, or prescription meds. I was at a loss.
There were also payment complications with bills. Somehow my moms FSA account got charged from that hospital bill, payment plans in my name were discussed, but in the end it all got paid, after a very stressful few days for everyone. So be aware this can happen! This is why it’s important to have an escrow account.
Finally, around 17 weeks, I came out of the horrible sickness I was experiencing. Around 20 weeks the placenta previa cleared on its own.
At 24 weeks the parents came down again, this time for a little bit longer, and I was forced into a high risk MFM appointment, for absolutely no reason, where they did almost a two hour long ultrasound that was very painful. If anything, those high risk appointments are WHY women lose babies because of how stressful they are. The doctor there put it in the mother’s head that an induction must be done at 38 weeks for twins or else they could die. Couldn’t give any statistical or scientific back up for this, she said it just is what it is. On our two hour car ride trip back to my house, I explained how inaccurate that is and even found studies that negated what the doctor said.
For the remainder of my pregnancy, this would be an issue that continuously came up – the doctors wanting to schedule an induction. At this point, I felt I was the only one truly advocating for the health of the babies, and that no one understood how dangerous this was and started to shut down emotionally. After all, lung development continues well up to 40 weeks and beyond, why would we want to risk them having poor breathing and spending time in the NICU?
For the rest of the pregnancy it was almost nothing but a hassle, and dealing with people watching me in surrogate groups on social media. Anything I would post in private surrogate only groups were immediately sent to the parents, so I didn’t even have a safe place to express my feelings anymore. Things were taken out of context and made the parents feel concerned with my emotional well-being and state of mind. Even someone I thought was a good friend sent screenshots of text messages of me venting, which caused a major wedge in the surrogate-intended parent relationship that never needed to be there.
As “induction day” drew nearer, tensions were high, speaking terms were non-existent, and I was gathering the necessary tools and speaking with legal people in preparation for a court battle, if need be. I cancelled the induction appt.
At the same time, the OBs office was also giving me a hard time, refusing to even see me if I wasn’t going to be induced, which is completely unethical and from what I read up on, actually illegal. I forced my way into the office and demanded an on the spot appointment because I wasn’t about to be accused of breaching contract just because I didn’t have my weekly appointment. I allowed the weekly NST, as usual, and the chart immediately picked up back to back contractions, and a hard time picking up baby A (the boys) heart rate. The OB asked me to just do an hour of monitoring in the hospital to be safe.
Monitoring at the hospital still showed contractions back to back, though I wasn’t feeling a thing so I assumed it was at best early labor, I could see them and they were nice and strong and steady. But I wanted to go home.
About mid point of monitoring, I got up and had to go to the restroom pretty badly. I felt a lot of pressure. My water gushed out with a pop and was a heavy flow, there was no mistaking, but I was still doing great. They came back in to hook me up and I let them know my water had broken and she asked to check me to see where I was at and I agreed to one check, I was 7cm. Well, guess go time is soon then, I thought. The OB came in quickly and announced that I needed an epidural, and with a calm and collected face (still having no contractions), I told her absolutely not and signed a non consent for pain medication form. My beautiful doula friend came to support me at this point. I asked them to call the mother and when she got there, things got really obnoxious with them trying to force the epidural.
Basically telling me I either get it or I’m having a c section right now. I asked the doctor to place it without running it, so if there was an emergency, it was quick easy access. I thought this was a good compromise that I could live with.
While they were preparing the anesthesiologist, I entered transition and was in my zone. On the floor, on all fours, full on growling though contractions in a true animalistic state. It was the most powerful feeling that I will never forget. Toe curling, full body coursing, back to back intense pressure. Like a hug from a large person that’s just way too tight, but is warm and familiar.
Now let me tell you, trying to sit still through transition with nurses holding you down while they place a needle in your spine is outrageous and gross. A needle that I didn’t even want. A needle that served me no purpose. I was at the finish line, let Birth happen for goodness sake.
And, wouldn’t you know it, they ran the damn medication anyways without permission. My body instantly reacted very badly. At first I started to go numb, then I felt my body go weak, tingly, my vision went blurry, now black and in and out of consciousness. I was shaking profusely. All I could think in my head was don’t pass out or they will cut you, don’t die for this, you have your own baby at home. My BP tanked to 70/30.
Tons of nurses rushed in to try to stabilize me. All of this for a medication that I was refusing. I should have kicked them in the face. I should have been stronger. In this test, I surely failed. The strength that I am for other women, I couldn’t even be for myself. I was ashamed.
They pulled the epidural and I regained myself and started to regain feeling and immediately went straight to the best part, when the babies came from womb to earth. I didn’t have all my feeling back for when the boy came, I was still a bit limp in my legs so I gave a little effort of push for him. With the girl I had my body back and FER completely took over when she was ready! She took her sweet time, coming 45 minutes after the baby boy, descending and my body taking a nice little break in between them, but she flew on out when she was ready with minimal efforts on my part!
The parents and I shared a room the first night and the babies were discharged before I was. I was able to make it home just in time for my baby boy’s third birthday party on the 7th! My son’s birthday is July 3rd and the twins is July 5th.
Because of misunderstandings, the parents and I didn’t talk from about 3 weeks postpartum to about 4-5 months postpartum, in which we fought about bills and all the complicated crap that happened in the surrogacy. It all surrounded expectations that weren’t met and hurt feelings.
If you ask me if I would ever do surrogacy again, the answer is no. I wouldn’t even go back and re-do the surrogacy I had. I would have never chosen to pursue it, knowing what I know, now. I think it is one of the least natural and most emotionally complex things you can do. I would only ever do it for my siblings, if needed. It aged me immensely, caused an array of health issues that who knows when I will fully recover from and has a lasting emotional impact. Not because of the bonding with the babies, I didn’t feel sadness when they were given to their parents, but the sadness that the surrogacy was everything I didn’t want. The birth wasn’t even breezy, though short, it too, was stressful. There are some that have beautiful, heart warming stories about their surrogacy and go on to have many journeys, and I wish I did too, but alas, there are two sides to surrogacy, and I’m here to share that it isn’t all rainbows and butterflies.
It has been a year since I had the twins, and my, oh my, how things have changed. I have not spoken to the mother in several months, even prior to my son’s cancer diagnosis in April. Needless to say I am so disappointed that she did not even care enough to reach out when my son was diagnosed, when mine or his birthday came around, or even at all on the twins’ birthday. It is such a shame to give someone so much love and happiness into their world without any gratitude. But I am generally at peace with it, I cannot make other people be good people out of pure desire, they have to choose to do so on their own.
Thanks for reading. Feel free to reach out with anything I did not answer here..
This article is inspired by Tampa Bay Birth Network! You can find more information about the organization at their website: Tampa Bay Birth Network
Some people view not being able to get pregnant while in an LGBT relationship as a positive thing. Natural birth control right?! We must reconsider our words, as some LGBT couples really struggle through the fact that they cannot accidentally conceive or easily begin to try doing so, like a lot of heterosexual couples can. But, there ARE options!!
Choices Beyond Adoption
LGBT couples are four times more likely than heterosexual couples to adopt, likely many due to this challenge or by preferred choice, but what if your family simply does not want to adopt, but wants to have biological children? Your feelings are valid and there are choices beyond adoption!
First, it is very important to make a game plan when trying to conceive as an LGBT couple. What are the realistic options? What are the most cost-effective options? If the cost-effective options do not work, what will be the next step, and can you afford the more expensive treatments? How much money do you need to start saving for the treatments? Set goals for when you or your partner would ideally like to be pregnant! Start eating healthy, whether you are the partner contributing sperm to a carrier, you are the partner getting pregnant, or you just want to be extra healthy for that brand new baby that is going to be coming into your life.
If you will be using a sperm bank, there are a lot of different options, and a plethora of things to be looking for. Check the pricing! Is it affordable? What does the initial fee cover? What extra fees are there to view potential donors and once you have decided on one, what are the legal fees involved? What are the sperm shipping costs? How is their matching process? Do they have facial matching options? (This is where you can put a picture of anyone you want, including your spouse, and get matched up with donors that look like that person). Do you want the donor to be completely anonymous, have their contact information released when the child turns 18 (known as an Open-Identity Donor), semi-involved (in their life, but not as a parental figure), or do you want to co-parent with the donor? Do you know someone who will be a donor for you PERSONALLY? Most sperm banks have very strict qualifications as far as medical history, including relatives, luckily! Not all sperm banks are LGBT friendly though. Biogenetics, California Cryobank, Cryobiology, Idant Laboratories, Pacific Reproductive Services, Rainbow Flag Health Services and Fairfax Cryobank are known to be LGBTQ friendly.
Fun fact, there are also such things as Donor Sibling matching sites, where families that used the same donor, can talk about their kids and meet, if they would like to!
Types of Insemination
IVI – This is intravaginal insemination, meaning that donor sperm is placed in the vagina, as close to the cervix as possible, to travel up through the cervix, into the uterus, to meet an egg! This can be done at home with the right equipment, or in-clinic. A midwife, if they are willing, may also assist you, if you feel you want a professional alongside you, depending on state laws. IVI typically has a 10-30% success rate, depending on whether the sperm is washed or not (washed sperm increases chances, but this will have to be done in-clinic and can be more costly).
ICI– Intracervical insemination. This involves the use of a speculum, catheter and syringe to place sperm into the cervix, and then placing a sponge under the cervix to prevent mucus and sperm from leaking out, then is removed a couple hours later. ICI has a 5-30% success rate.
IUI– An intrauterine insemination also consists of a speculum, catheter and syringe, but the catheter will go a bit further, into the uterus for the best chance at sperm meeting an egg, and a sponge is again placed, and later removed. IUI success rates range from 2-40%.
IVF – In-vitro Fertilization is a bit more complex than any of the above listed methods. It requires eggs to be extracted from a donor or the intended carrier, whichever is best for your family, then matching those eggs with sperm from a donor or from one, or both, fathers! Embryos will develop to approximately 3-7 days old, and then be transferred into the carrier’s uterus. This is relatively the same process as surrogacy and involves a protocol of medications and lots of monitoring. It is certainly the most expensive but is sometimes the only option. IVF typically has a 40% success rate, but it truly varies per clinic and their different protocols.
If you are considering surrogacy to grow your family, here are the things you should be considering!
Traditional Surrogate VS Gestational Carrier
Traditional Surrogacy involves using the carrier’s egg, so she would be biologically related to the baby. This may involve home insemination, in clinic insemination, IUI, or the full IVF process (extracting her eggs, creating an embryo or multiple embryos, and transferring the embryo(s) into her uterus).
A gestational carrier is simply hosting the embryo(s) and they are not directly biologically related to her; though if it is a a cousin, sister, daughter or any other relative, they will be distantly related. This involves basically the second half of IVF where ovulation is suppressed, lining is thickened, and embryo(s) are transferred. Progesterone and estrogen are supplemented to sustain pregnancy.
Review the laws of surrogacy in the SURROGATE’S home state, as those will be the laws that apply, not your home state. Read laws state by state here.
The process leading up to becoming an intended parent are as follows:
Decide on an Agency or Choose to go Independent (aka “INDY”)
Match With Your Surrogate of Choice & Pay for her to go through her process
Build up an escrow account for surrogate compensation, medical expenses and a little extra to cover bases
Decide on a lawyer to do your contracts
Provide sperm and/or eggs to clinic of choice to make into embryos to freeze or use fresh
You might be wondering, what is the process that the surrogate goes through?
Requirements: Must be between 21 and 50 (generally), not be on any type of government financial assistance (food stamps, WIC, or any variety of that), have had at least one healthy, complication-free and term pregnancy and be raising said child. People who have had gestational diabetes, pre-eclampsia, antenatal depression, pre-term delivery, hyperemesis gravidarum, placenta accreta, or any other complication may not qualify.
Medical Evaluation (includes hysteroscopy, pap smear, pelvic exam, blood work)
Follow all steps necessary to complete all necessary evaluations, contracts and follow RE protocol to raise chance of pregnancy
Contracts are so very important, so be sure to discuss these and more, in-depth, when considering matching with a surrogate.
Place of Birth (Hospital, birth center, home?)
Compensation (plus lost wages, gas, transfer fee, complication fees, any other fees that may need to be considered.. How will it be broken up, monthly, bimonthly, lump sum, etc?)
SET or DET (This is how many embryos you will transfer)
What circumstances is termination requested?
Involvement & Contact
Surrogate Providing Breastmilk
Ask questions if you are confused, make sure you and the surrogate are in AGREEMENT before either of you sign, or this may cause future conflict. Do not rush!
Contracts must be notarized
Once the surrogate gives birth, you will work out any final payments or paperwork that needs to be done, and you will take home your baby/babies!
Interested in Adoption?
If you decide that adoption IS for you, after considering these options, be sure to check out the laws in your state! You can find a state-by-state guide here.
A note about pronouns, respect and understanding for LGBT families in pregnancy, birth and postpartum: Please be sure you use a provider that respects you and your family enough to use proper pronouns. If you prefer non-binary or alternative pronouns, or non-gender specific references as opposed to ‘mom’ and ‘dad’ for example. If they cannot respect you enough to make this simple change, they will likely not respect you in birth, either!
You want to give back to society with the extra that you have, and make a little extra money, seems easy, right?
There are many ads that pop up on Google, Facebook, the radio, and more, encouraging women to do a great service by donating their eggs and market the process as short and simple for $6000+ WHAT?! What a deal!
…..but here is what they DON’T tell you.
The process of egg donation is as follows, the same as the first half of IVF, known as a stimulation protocol:
Before you can even think about medications, you have several steps to go through, that are unpaid, and sometimes, out of your own pocket, to start. This includes a fertility screening through vaginal ultrasound and may even include a saline hysteroscopy. Blood tests will be drawn and a general pelvic exam will be performed. You will be checked for blood type, drug use, titers, infectious diseases, and general health. You and your partner will likely be required to go through an STD panel. You will be checked for genetic disorders and your family history of health issues will be analyzed in depth. Then you will go through a psychological screening to make sure you are sane, consenting to this process and have intentions beyond the dollar value. You will have an opportunity to speak with the reproductive endocrinologist that will make your protocol and perform your retrieval, it is very important that you ask and they share all the potential risks you can encounter. If they do not disclose this to you in full, RUN AWAY.
You will be put on birth control until you begin your medication protocol. This is to align your cycle with the recipients cycle, so they can immediately get the recipient pregnant, with your eggs, if there is a parent on stand-by! Otherwise, it is done so that the clinic is in control of your cycle and dates that they will begin specific medications, to align with scheduling convenience of the retrieval procedure.
First, you will need a medication to suppress your body’s natural LH (luteinizing hormone) surge and ovulation, until a bundle of eggs are ready to be released. This may be a GnRH-agonist or GnRH-antagonist. The medications that may be used include Lupron, Ganirelix, Cetrotide, Firmagon, Elagolix, Plenaxis, Zoladex, Trelstar, Vantas, Synarel and more. These same medications are used to prevent puberty in children that may want to go through hormone therapy to shift gender.
Side effects of these medications include bone softening, headaches, nausea, low libido, dizziness, hot flashes, weight loss or gain, yeast infections, swelling, skin peeling, severe depression, seizures, urinary tract blockage, liver damage, and incontinence of bowels. These medications have been linked to an increase in diabetes and cardiovascular disease.
These medications are typically injections that will need to be injected into your lower abdomen daily.
Next, they will give you a FSH (follicle stimulating hormone) product to stimulate the production of multiple eggs. Examples of medications you may use for this, include Follistim, Bravelle, Menopur and Gonal-F, which are also injections. Side effects may be headache, bloating, pain, vaginal bleeding, fever, severe swelling, fatigue, dizziness, stroke, labored breathing and hives. This is done for about 7-12 days until the clinic has deemed that enough eggs have been developed.
Then, you are given an HCG “trigger shot” for final maturation of the eggs, for extraction. They have to monitor you very closely at this point for several risks, including OHSS and release of eggs pre-extraction.
This stage is where OHSS (Ovarian Hyperstimulation Syndrome) can occur. This is a very serious syndrome, involving risks such as rapid weight gain, severe abdominal pain, extreme nausea and vomiting, blood clots, lack of urination, ovarian torsion, hospitalization, and even death. It can develop anywhere from 1-10 days of the trigger shot. It occurs only 3-6% of the time, fortunately, but it is something to be mindful of.
Using a reproductive endocrinologist familiar with Prolonged Coasting can decrease your risk of developing OHSS, should you decide to move forward with egg donation.
When eggs are ready to be retrieved, the doctor will use a speculum to slightly open the cervix and insert a needle with suction, guided by abdominal ultrasound, to gently pull the eggs out. This procedure can be slightly uncomfortable and cause bloating and cramps immediately to follow. Infection and injury is also a minor risk of the egg retrieval. If you have had any reactions to a form of anesthesia, be sure to let the doctor know, or you may not want to move forward with egg donation, as they may use a form of anesthesia on you for the procedure.
Doctors say that an egg donor can return to their normal activities, the day following the procedure, but based on egg donor experiences, recovery can take about a week or so before the woman actually feels normal enough to get back to her routine, some can hardly even get out of bed. So, be sure to prepare effective childcare and work coverage, if you choose to move forward with egg donation.
Make sure, that the egg donation agency you go through, provides you with health insurance and life insurance coverage, in the event that something terrible happens to you as a result from medication or any procedures within the donation process. This is absolutely essential and if they do not provide this, they are not reliable.
In the long-term, many egg donors have reported that they have developed breast, colon, ovarian and/or cervical cancer. There are not enough studies to prove direct correlation, but many studies are following egg donors closely, due to the reports. This will be crucial to know, in years to come, so there can be true informed consent in the egg donation process. All agencies, until it is proven, are legally allowed to say that there are no long-term effects of egg donation. It is important to keep this in mind, regardless of the fact that there are not enough studies to fully back the claim yet, and also be mindful of the fact that egg donation can permanently disrupt your own fertility, and you should be done with your own family 100% before moving forward with egg donation.
It also must be known, that egg donation agencies will write-off your compensation as a tax reduction on their part, and you will receive a 10-99 in the mail, come tax time, so be prepared to put aside 15% of the income you receive as an egg donor, to give back to the IRS or be prepared for them to come looking for it!
Egg donation can be a beautiful thing, and make someone a mother, do not get me wrong, I get it… BUT it is important for you to also have complete informed consent, because the egg donation agencies are looking out for their pockets, not for the individuals trying to help someone.