WOMB FOR RENT

Surrogate Mothers Discuss What They've Given, What They've Gained, and What It's Like Letting Go by Amy Crelly

Mother's Day is a time for celebration, but the holiday is bittersweet for women who want to experience motherhood but can't. Infertility affects 1 in 7 couples wanting to start families. Reproductive procedures such as in vitro fertilization can help, but for women who want to have a child of their own (versus adopting) yet cannot carry a child themselves, their last hope is a surrogate. Plenty of controversies and questions surround the issue of surrogacy, but only one question sits at the heart of the matter: Why would a woman devote herself to all the trials and tribulations of pregnancy only to give up the baby? I spoke with three women who chose to be surrogate mothers. Each woman had her own unique story to tell, yet all of them had some things in common. Here, then, are their answers to the question, Why?

First of All, They're Not Crazy

Really. In fact, surrogacy agencies require surrogates undergo a thorough pre screening process which, in addition to physical examinations, includes psychological tests to ensure they're in good mental health and their motives are right. Danelle, like the other surrogates I spoke with, has always loved children and enjoyed helping people. She was first introduced to surrogacy when she donated her eggs four years ago. Comparing the two experiences, she says, "[Surrogacy] has definitely been more rewarding."

A wife and mother in her mid-thirties with two young daughters of her own (ages 5 and 1), Danelle has also mothered two foster children. Now six months into her first surrogate pregnancy, she still works full-time while her husband works part-time and watches the girls. She seems to handle all these responsibilities with a calm and decisive manner. Danelle told me, "My parents were worried initially. At first they thought I was crazy, but they've come around. They're supportive now." Just about every surrogate has had to defend her decision to incredulous family members, friends and coworkers. Some even question it themselves, and they can take months to reach a decision, during which they might attend meetings, do research and talk to parents, surrogates and clinic coordinators. But for Danelle, the decision was pretty clear. "It was not a long decision-making process," she explains.

The most difficult part of the whole experience came when they discovered that 3 of the 4 embryos introduced through in vitro fertilization had successfully implanted. In their legal agreement, Danelle stated she would carry no more than two babies. The mother's religious beliefs made her opposed to selective reduction, yet she respected Danelle's choice, especially considering any health complications that carrying multiples might entail. Danelle wrestled with the issue, weighed her risks and finally decided she would carry all three to term, knowing it was what the mother would have chosen if she could have borne the pregnancy herself.

Danelle understands her parents' skepticism stemmed from concern for her family and her health. But, for her, these issues don't seem to be causes for concern. "Everything's going along fine," she tells me. "I haven't slowed down. I don't see that it's taken away much from my family," although she does wish she could pick up her 1 year old whenever she wanted. She is also grateful for all the help she's received from her husband, his parents, her parents and from the director of the agency. Still, what about the toll that pregnancy (and carrying multiples especially) can take on the body? Danelle is like most surrogates in that she was quick to tell me she enjoys being pregnant. It may seem strange to many of us, but for some women, the experience of being pregnant can be an end unto itself.

Do What You Love

These women enjoy being pregnant- not having babies, not building families, but the experience of being pregnant, in an of itself, feels good for them, better, perhaps, than it does for the average woman. Or perhaps not. M'lyn Butterfield RNMS, Director of the Family Feritlity Center, told me that not all cultures see this as unusual. Noticing her friend's wistful gaze at a pregnant lady in the market, a South African woman might turn to her friend and ask, "Feeling broody?" "Broody" describes the craving to be pregnant. Not the craving to hold a baby, not the wish to have a child, but that feeling mothers sometimes get when they see a pregnant belly and wish it could be theirs again. "Feeling broody" means wishing for that happy glow that comes with pregnancy, and, perhaps, that sweet kind of attention even complete strangers give women who are showing. It's that strong desire to be pregnant just for the sake of being pregnant.

Our own culture lacks a term like "broody," and it's telling. For the most part, Americans seem to find this concept foreign. We're quick to wonder: What's so appealing about morning sickness, indigestion, swollen ankles or stretch marks? But plenty of moms, modem American moms too, will tell you that they love being pregnant. Most of us can understand this in terms of sacrifice and reward: The joy of expecting your little one outweighs any suffering, and the knowledge that these aches and pains are part of the childbearing process can somehow transform them. But that's somewhat beside the point. Mingled inextricably with the experiences of sleepless nights and morning sickness, some women seem to get a natural high from being pregnant, and pregnancy simply comes easier to them, maybe in much the same way that some people's bodies and temperaments are made for doing gymnastics, running or cycling.

Heather is a warm, friendly 35 year old mother of two (with a daughter, 11, and a son, now 8). Having served as a surrogate twice (giving birth to triplets her first time, and twins the second time). Heather thought about being a surrogate for some time, even before having children of her own, but she decided to wait until she was done starting her own family. Five years ago, Heather saw an ad for a Sacramento fertility center in Sacramento Parent magazine. The ad seemed to jump out at her, and she experienced what she said, "felt like a calling." "I feel like I have a gift in that area," she says, "so why not share it?" Comparing the numerous failed attempts that intended parents suffer and the relative ease and success surrogates have with their pregnancies, it seems she has a point.

This is not to say that surrogates don't suffer the normal discomforts of pregnancy. They are human, and they get sick, tired, tender and sore just like the rest of us, but they also seem to suffer less. What suffering they do experience is well worth it, in their eyes, if it makes a parent's dream come true.

Christine is another surrogate I spoke with. A mother of four children (the youngest age five), she first considered becoming a surrogate for a friend. When her church opposed the idea, Christine's friend abandoned her surrogacy plans, but Christine had come to embrace the idea. She delivered a boy for a single father who now lives in New York, then undertook a second surrogacy, carrying twin girls for another single dad. Asked about the discomforts of being pregnant, Christine described sleeplessness, heartburn and being put on bed rest (one of the twins from her second surrogacy showed complications later in the pregnancy), but she's quick to add that her friendship with the intended parents made the aches and pains of pregnancy more meaningful and thus more bearable. "You're feeling it for them," she says, and as such, it's a sacrifice she is glad to make. Brimming with enthusiasm, she tells me, "I would do it ten more times if I could."

Money is the Least of It

"People think it's for the money, but it's not at all," says M'lyn Butterfield. According to her, most of the surrogates she works with are middle class women with enough income to provide the requisite stable and comfortable home environment agencies require. Women usually use the money they make as surrogates to better provide for their own children, by starting college funds, for instance. Danelle told me, the money was "definitely a part of it." A surrogate's compensation is $22-25,000, on average. In addition to payment, standard agreements provide for a surrogate's legal counsel, life insurance, health insurance and healthcare costs, lost wages, psychological counseling (if desired) and, if needed, childcare and housekeeping expenses. It makes sense, of course, that the intended parents foot all these bills, but the acts of kindness and the
attention paid to expectant surrogates is also a valuable part of the process for them. Danelle sums it up, "They really take care of you."

Heather recalled sweetly how the owner of her agency came over to her house to cook for her when she was too sick to do it herself. It's these little things, the families going out to eat after medical exams or meetings, the calls just to check in and see how she's feeling, the extra help with everyday tasks that they receive from their own family and friends, that make the role of being a surrogate feel special for these women. Far from being treated like a uterus for hire, the surrogates I talked to described lasting friendships forged with the intended parents and others involved in the process. Heather loved working with the owner of her surrogacy agency so much that she took ajob working for her. Christine still talks on the phone with the parents she helped, and she gets updates, pictures and letters about every 4-6 weeks, letting her know how the kids are doing. (For surrogates who are more comfortable in a working relationship with more professional distance, agencies are careful to match them with expectant parents who feel the same way.) The real payoff for these women is the pride and joy they feel in giving what they consider to be the ultimate gift. As Heather proclaimed, "There's not a greater gift you can give than life."

The Real Payoff

Moms themselves and able to empathize, surrogates are moved by the stories of intended parents who desperately want to have children and have every means to provide a good family home except for the means to give birth. She debated for some time whether she should be a surrogate, but when she attended an informational meeting, ''just to find out more," her heart immediately went out to the couple she heard speak. They had been pregnant, miscarried, gotten pregnant again through in vitro fertilization, and delivered twins, but the pregnancy ended at 22 weeks. They lost one baby in the hospital, then saw their second child through multiple surgeries and procedures, only to lose the baby at home. After going through the screening and matching process together, Heather became the surrogate for that couple, giving birth to triplet boys in May of2003. Born prematurely, the triplets had to be delivered by Cesarian and hospitalized for a while, but she knows they are growing up fine now, thanks to the couple's willingness to stay in touch, sending her pictures and updates regularly. She found the experience so rewarding, she became a surrogate again, early in 2005, giving birth to twins, one boy and one girl, for another couple. Despite being put on bed rest and hospitalized with both surrogacies, she says she would love to do it again, although her family prefers she didn't.

Letting Go

Asked if she experienced any kind of grieving period following the babies' deliveries, Heather said it was "sort of sad at the end." She recalled how, at sixteen, she had to give her own baby up for adoption. As she described the experience, the heartbreak of it was fresh in her voice, but the wisdom and strength she's gained in the years since then were equally clear. "That was the worst," she tells me, "It was so hard." Heather believes that experience of giving up her own child, and at such a young age, may have prepared her for the role of surrogate and the process of parting with the babies after delivery. "I think that may have made it easier." Having given up her own baby, Heather says, "I know that there is no letting go I can't handle, no letting go too hard." The parents' willingness to let her and her family visit and stay in contact also made it easier for Heather. She told me that in the weeks after delivering the triplets, she would sometimes bolt upright in the night with a strong urge to go and check on the babies, just to see them and know they were alright. She explains, it's also "very important for children to know, 'Where did [the babies] go?'"

So, how do surrogates cope? First of all, surrogates identify much more strongly with the parents they are helping than with the babies they carry. Christine recalled the first ultrasound with the first dad she delivered for, and how exciting it was for her, not because she got to see the baby for the first time but because that dad was seeing his baby for the first time. What she felt emotionally and experienced psychologically was different from what she'd felt seeing the first ultrasound images of her own children. "It was more like what you feel when a friend has an ultrasound ... That's your baby!" Not surprisingly, when I asked her if it was still hard giving up the babies, she responded, "No. It's harder to say goodbye to the parents."

All the women I talked to explained that they never thought of the baby as their own. Almost all agencies require that the surrogate be unrelated to the child she carries, precisely to prevent such attachments and the legal and emotional entanglements that might result. So, if there is an intended mother who is unable to donate eggs, a third party donor is involved, keeping the surrogate's DNA out of the picture. Danelle told me, "My close friends ask me, 'How can you do that?' They're not mine, not my genes, not me or my husband. It's really about [the intended parents], their family, their lifelong [commitment]. This is just a temporary ten month interruption in my life." Like the others, Danelle's greatest reward is the "excitement of giving them their children." That moment when the surrogate gives the babies to their parents is the moment they've all been eagerly looking forward to throughout the pregnancy. It's the moment the parents finally have the children they've always wished for and the surrogates can finally say they've made that wish come true.