This is the latest in a series of informational posts I’ve been doing on the gestational surrogacy process. This is for those of you who might be where I was about 5 years ago, weighing the options you have for becoming a parent… or for those who are merely curious about the process. This time, I’m sharing my advice on what questions you need to ask your surrogate before deciding if you’re a good match.
To the rest of you, I apologize. More peepee poopoo jokes next time, I promise.
Meeting with a potential surrogate is like the most awkward first date imaginable. You’re face-to-face with a woman you barely know, and both of you spend most of the time talking about making a baby together. Talk about rushing things.
There are probably a million things you want — and need — to know. I’ve seen some websites that suggest you approach your surrogate with a massive checklist of questions, many of which are not exactly subtle, like:
“Do you smoke?”
“Are you sexually active?”
“What were the results of your last pap smear?”
Sure, those are great things to ask… if you want the surrogate to throw a drink in your face and slap an instant “No Vacancy” sign on her womb.
Remember, this isn’t a job interview. She can reject you, too, and if you treat her like an employee or a menial laborer, she probably should.
Don’t worry, if there are any red flags, they’ll turn up in her medical and psychological exams, and you’ll be made aware of them by a professional, neutral third party.
When you sit down face-to-face with a potential gestational carrier, try to empathize with what she’s going through. After a huge amount of deliberation and soul searching, she’s decided to do something incredibly generous, terrifically inconvenient, and more than a tiny bit risky, for a virtual stranger. She’s nervous to meet that stranger, but also a bit thrilled.
Then you come in and ask about her pap smears.
So what should you discuss in your first meeting? First and foremost, it’s time to take the mystery out of your relationship and just get to know each other. If things go well, you’ll be creating a life together.
That being said, it’s not exactly a first date. You need to check your compatibility on some pretty weighty matters.
If you’re working with an agency, much of this subject matter will be covered by them, but if not, these are the questions you need to ask, in increasing order of unpleasantness.
1. What made you want to be a surrogate?
No one’s going to reply, “I need the money,” and if they do, you should probably run away as fast as you can. Sure, the money is a nice perk, but with all a surrogate goes through, she’s going to earn that cash, and it is a limited sum. No one’s getting rich as a gestational surrogate, so it’s a safe bet she has bigger motives.
Our surrogate heard a report about gestational surrogacy on the radio when she was 19, and it made her cry. She turned to her mother and said, “Someday, I’m going to do that for someone.” Once she’d completed her own family, she googled surrogacy agencies, and that’s how she was eventually paired with us. It was such a sweet story, and it told us so much about who she was as a person.
Raising this basic topic is a great way to get to know your surrogate and to show her that you appreciate the sacrifice she’d be making on your behalf.
2. What were your other pregnancies like?
Again, the medical exam will clue you in to any relevant technical info, so try to keep this as light as possible. How bad did her babies kick? Did she get morning sickness? You may not know very much about the surrogate at this point, but you know she’s been pregnant before (at least in most cases, since most gestational carriers have a proven history of successful pregnancies).
You, on the other hand, in all likelihood have never been and never will be pregnant. Show some curiosity and empathy by asking her to describe exactly what she’d be going through for your benefit. This is also a great way to show you appreciate the sacrifice she’ll be making on your behalf.
And if you find out pregnancy makes her crave pickles and ice cream, file that away. Someday, when she’s carrying your child, you’ll know just what to put in her care package.
3. How do your friends and family feel about you being a surrogate?
Surrogacy is physically and emotionally demanding, and no one can do it alone. Make sure she has a good support system, people who care about her who appreciate what an amazing thing she’s doing. If she’s religious, it’s very helpful if her spiritual leader is on her side as well.
This is especially important for gay intended parents. If your surrogate has a homophobic husband or goes to a gay-unfriendly church, you’re not off to a good start. Someday soon, she might find herself at the Wal-Mart in her tiny town when a woman comes up, points at her belly and says, “Aww, lucky you!” She’ll have to reply, “Oh, he’s not mine. I’m having this baby for George and Steven.” Is she ready for whatever may come next?
Let her know what kind of homophobia you’ve faced and how you’ve persevered. It can be very difficult for a (most likely) straight woman to willingly expose herself to homophobia, but that’s what she’ll be doing by having a baby for a gay couple.
One surrogate my partner and I met with had previously carried a baby for a gay couple, and she hadn’t encountered any resistance, so we knew she’d be fine this time around as well.
4. Are you comfortable with me/us being in doctor’s appointments and the delivery room?
Sorry, guys, when you came out of the closet, you probably thought you were exempt from discussing (and possibly seeing) ladyparts. Not any more. Obviously, let the surrogate know that you’ll respect her privacy as much as possible. But one of the main benefits of having a baby with a surrogate is being able to participate in all the exciting prenatal moments, like finding out the baby’s sex or seeing him or her for the first time on a sonogram monitor.
Most surrogates will fully anticipate and welcome your participation in the process, but raising the issue in a polite and respectful manner will set the right tone for when those intimate moments inevitably arise.
5. What kind of communication would you like to maintain after the birth?
There’s no correct answer to this. Some surrogates and intended parents want to stay in close touch. Others might want to be your Facebook friend so they can see pictures of your kids growing up. Still others may be content merely to get a holiday card every December. As long as both parties are on the same page, anything can work.
My advice is to offer up a safe but minimal amount of contact. If you and your surrogate hit it off (as we did with ours), you can always have more contact than you planned.
It’s important to reiterate that your surrogate will have no legal rights to your child. Once your baby is born, you are well within your rights to cut off all contact with the surrogate and never see her again. I’d imagine that kind of clean break only really happens in extreme circumstances. Most people and their surrogates form a bond through the process and want to stay in touch afterward.
Once your child is old enough to understand how he or she came into the world, they’ll likely be curious about who their surrogate was, so it helps if you’ve kept up the relationship.
6. How many fetuses are you willing to carry?
My partner and I were very lucky to have twins with our surrogate, but it made the pregnancy considerably harder on her. She was confined to bed rest for most of the third trimester and there were a few scares where we thought she might be miscarrying one or both of the fetuses, which meant some late-night trips to the emergency room.
Thankfully, everything worked out okay for us, but the more fetuses involved in your pregnancy, the higher the risks. A woman carrying triplets is almost always put on bed rest. It’s not surprising then that many surrogates limit the number of babies they’re willing to carry to one or two.
If you were hoping for octuplets, in other words, you’re out of luck.
7. Would you be willing to undergo a selective reduction?
Here’s where the questions start to get really dicey.
Even if your surrogate only wants to carry one baby and you only want to have one kid, you may still want to transfer multiple embryos to increase the odds that one of them attaches.
So what happens if your surrogate becomes pregnant with two or three embryos? In that case, she may undergo a selective reduction, where excess embryos are removed from her uterus at a very early stage, leaving only the number of babies you’re willing to have.
We interviewed a surrogate who had undergone this procedure with a previous pregnancy and, for various reasons, didn’t want to go through it again. She was asking that we not transfer more than two embryos, so she could be mostly assured she wouldn’t have to carry more than twins.
Some IPs plan to transfer as many embryos as they can, then reduce down to just one or two if too many of them take. That’s fine if the surrogate agrees to it, but not everyone will be comfortable with that.
This is obviously a very tricky ethical situation, so for everyone’s benefit, it’s important to make sure you’re on the same page.
8. If we were to decide, due to complications with the fetus, to terminate the pregnancy, would you be willing to do so?
You and the surrogate are both entering into this agreement with the same goal: to make a baby. Neither of you wants to think about terminating a pregnancy, because that goes against the very reason you’ve come together.
However, everyone knows that things do sometimes go wrong, and the baby will be yours, not hers, so if there are complications and you become concerned with what your child’s quality of life would be, it should be your call to make.
There are people — surrogates and intended parents alike — who would never terminate a pregnancy under any circumstances. That’s fine, of course, but if you feel that way, it’s good to have a surrogate who would defer to your judgment in the case that your feelings change.
Again, no one wants to think about the worst case scenario. You both want a healthy baby. So bring this up now, and then forget about it. Hopefully, it won’t end up being an issue.
9. What concerns do you have about us or this process?
You never know what your surrogate may be thinking or how you may come across to her. She might have a special request that’s very important to her or a fear she’s working to get over.
Our surrogate had two requests: One, she wanted an epidural, because she went without one when her son was born and didn’t want to do that again. And two, she wanted to make sure that she wouldn’t be handed the baby in the delivery room. When doctors first handed her her son, that’s when she bonded with him. To make sure to establish the right boundaries, she didn’t want to see the baby until later on, when she was in the recovery room.
Let her know that her concerns are important to you, and in case she does have a vastly different idea of how the birth should go, it’s better to find out now rather than a trimester or two into the pregnancy.
Hopefully, you’ll find plenty of common ground with your surrogate on these topics, because once you’ve discussed them and agreed about the important things, you’ve earned the right to never discuss them again. In all likelihood, you won’t have to, and now that you’ve gotten past the tough stuff, you can talk about things that don’t really matter: what her favorite sports teams or TV shows are, what kind of sense of humor she has and what she thinks of the baby names you’ve picked out.
Then, finally, you’ll know for sure if you’ve found “The One.”