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Surrogate Mothers

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After months or even years of trying to fall pregnant, after crying buckets of tears and feeling a hopeless sense of desperation, you may believe that you’ll never have a baby.
You convince yourself that you won’t hold your own child in your arms, because your body has failed you by not carrying a foetus to full term.

There is hope.

Surrogate mothers have been carrying other women’s children for years. They provide their bodies to women who cannot have babies of their own. Surrogate mothers grow and nurture the babies for 9 months and then hand them over to their parents.

According to the Johannesburg-based fertility clinic, Medfem, surrogacy is a complex subject with many things to consider, before deciding to go ahead with such a pregnancy.

Who should opt for using a surrogate mother?

In most cases, women who don’t have a uterus would use a surrogate mother. These women may have been forced to have a hysterectomy after experiencing post-partum complications. They may also have had a hysterectomy by choice; believing that they were past their baby years. But new circumstances, such as a change of heart, or a second marriage could change these women’s minds about having another baby.

A woman who has a chronic illness, like cardiac or kidney problems, may opt to find a surrogate mother. In this situation, going through a pregnancy herself, could endanger her life.

Extensive chemotherapy may also cause damage to a woman’s uterus, making it difficult for her to carry a foetus to term.

Where does one find a surrogate mother?

There isn’t one, central surrogate mother bank, where you can view pictures of the various women prepared to carry your baby.

Medfem Clinic Co-ordinator, Pam Duffield, says its best to go to a reliable fertility clinic, where a specialist can advise you on the best way to find a surrogate mother. Sometimes, these clinics could put you in touch with women who are prepared to carry your baby.

The best option, however, is to find a surrogate mother yourself. It could be a sister, a cousin, a friend or a colleague. In such cases, you would be reassured that this would be the best possible surrogate mother to your child.

How is the surrogate mother screened?

So you’ve found your surrogate mother, what now? Well, the best way forward is to have a long, in-depth discussion with her about your expectations and hers.

The woman would have to be evaluated by a psychologist, to establish why she would want to carry another woman’s child. The psychologist will also counsel you, your partner and the surrogate about exactly what will happen during the pregnancy.

The legal stuff

You would then need to meet an attorney, who specialises in surrogacy. He would draw up a contract between the two parties, stipulating the exact agreement. It will also confirm that the woman will carry your baby and will hand it to you immediately after the birth.

Issues including which doctor will monitor the pregnancy, whether the birth will be vaginal or caesarean, how the medical bills will be paid etc should also be stipulated in the contract. This document is crucial, to avoid any problems further down the line.

The law currently states that the birth mother or surrogate mother in this case, is the legal parent. This means that you would have to formally adopt the infant. According to adoption laws, the surrogate would still have a period after birth, in which to change her mind about the adoption. This would make it even more crucial to have that contract in place long before the baby is born.

Pending legislation however would make the situation much easier for the new parents. If approved, it will allow a judge to sign documents right at the beginning of the pregnancy, stipulating that the couple and not the surrogate mother are the rightful, legal parents. This would prevent any adoption-related issues, once the baby is born.

Different kinds of surrogate mothers

There are two main kinds of surrogate mothers:

  • A gestational surrogate uses the “intended parents” eggs and sperm. She’s only a host to the baby. In-vitro fertilisation would be used to fertilise the egg.
  • A traditional surrogate is a woman whose eggs are used to create the baby. Artificial insemination would be used to fertilise the surrogate mother’s egg with your husband’s sperm. Your generic material isn’t used at all. This may be because you have a problem with your eggs as well as your uterus.

This method isn’t usually recommended, as it would make matters more legally challenging. Should the surrogate mother have a change of heart, she would probably be allowed to keep the baby, as it would be her biological child.

But what if you don’t have viable eggs?
In situations like this, a fertility specialist could recommend that donor eggs be used.

The medical stuff

The first step is for the surrogate mother to have a medical evaluation, which includes blood tests, a doctor’s examination, scan and vaginal swabs, to ensure there are no untreated infections.

Duffield says it will then be necessary to synchronise your cycle and your surrogate’s cycle. This is done by using a low dose hormone tablet, usually an oral contraceptive tablet. You will both start using the oral contraceptive at the same time, to ensure that your cycle is the same.

Once the cycles have been synchronised, you will be given medication to stimulate the growth of your eggs. The surrogate will start using oestrogen tablets on day 2 or 3 of the cycle. This will make her uterus more receptive to implanting the embryos.

After approximately ten days, the eggs will be ready to be collected and the surrogate will be started on a progesterone preparation as well as the oestrogen. The egg and the sperm will be fertilised in the lab and on approximately day 5, after the eggs have been removed, the embryo will be placed in the uterus.

A 10 to 15 minute procedure will take place. It will be no worse than having a pap smear, and will not require sedation.

Approximately 16 days after the procedure, a blood test will be done to establish whether the surrogate mother is pregnant. The necessary medication will continue until the 12th week.

Unfortunately, like any IVF case, there is no guarantee that the first procedure will be successful. It’s possible that several attempts may be necessary to eventually fall pregnant.

Financially speaking

Having a baby, using a surrogate mother, could become very costly. It is illegal in South Africa to pay someone to give you a baby. You can however agree to pay for the usual expenses that come with having a baby.

IVF fees range between R35 000 and R40 000. Couples also generally agree to pay for the surrogate mother’s clothing and transport, medical bills, confinement and loss of earnings, while the surrogate recovers from the birth.

An agreement on expenses should be stipulated in the contract, to avoid any future unexpected financial demands.

And finally

The need for surrogate mothers in South Africa is increasing all the time. Unfortunately, a lack of education about such options is making it more difficult for childless couples to find a surrogate.

Duffield says she deals with approximately 4 surrogate pregnancies at her clinic every month. But that figure could increase, as awareness about surrogacy increases.

Becoming a surrogate mother is a major decision for any woman to make, but it’s a precious gift that a couple could love and cherish for a life time.