The path to parenthood isn’t always plain sailing and for many couples and individuals who are unable to conceive for themselves, surrogacy makes their dreams of having a child possible.
Surrogacy is a type of pregnancy whereby a woman carries the child for someone else (the intended parent/s).
It’s legal in the UK but it’s important to note a surrogacy agreement is not legally-binding. The surrogate will remain the child’s legal mother until parenthood is transferred from the surrogate to the intended parent by way of a parental order.
There are two types of surrogacy available. Traditional or straight surrogacy is when a surrogate conceives with her own eggs and the intended father’s sperm (or sperm donor) and is therefore biologically related to the baby.
In host, full or gestational surrogacy, the egg is provided by the intended mother or an egg donor and transferred to the surrogate via IVF. The embryos are either made using both intended parent genetics or one intended parent plus donor eggs or donor sperm. There is therefore no genetic connection between the baby and the surrogate.
For male same-sex couples wishing to start a family, one of the fathers can use their sperm to fertilise the surrogate’s egg through artificial insemination, or they may choose an egg donor, fertilise the donated egg and have the embryo implanted in a gestational surrogate.
While surrogacy remains prohibited in the majority of Western Europe and four U.S. states, altruistic surrogacy – whereby no monetary compensation is offered to the surrogate, except for their reasonable expenses – is becoming increasingly more popular in the UK and other surrogate-friendly parts of the world.
In this interview, we spoke with both surrogates and intended parents about their personal journeys with surrogacy, from common misconceptions to things they wish they knew and the unique joy of making someone else’s dreams come true.
Laura
What made surrogacy the right path to parenthood for you?
It meant I could still have a baby that was biologically ours, without having the risk associated with having to come off my life-saving meds.Laura
I was diagnosed with chronic myeloid leukaemia in 2011 and although it didn’t affect my fertility as such, when I came off my cancer drugs to try for a baby, the cancer increased making it too risky to carry a child myself. We were told that if I did become pregnant, later in the pregnancy I may have to choose between saving my own life or the baby’s life. A devastating thought. I feared my chances of having a family were over then my sister-in-law offered us the ultimate gift – that she would carry our child. It meant I could still have a baby that was biologically ours, without having the risk associated with having to come off my life-saving meds. It was the best and most wonderful option that I will be eternally grateful for.
What surrogacy path did you choose to go down and why?
Gestational/host surrogacy
What were your initial doubts, if any?
I was worried it was too big an ask to ask my sister-in-law to do this but actually, on a whole, there was very little doubt. It just seemed like the logical (and very lucky) option.
Do intended parents have to meet certain requirements?
This never came up for us. Perhaps handled differently because of my illness but we did have to go through counselling and many tests.
How much contact do surrogates and IP have?
We had a lot of contact, just as we would naturally because Jayne was family anyway, but I was conscious of not overly contacting her more than I would as I trusted every move she made.
What factors should an IP think about before going through surrogacy?
It’s a long process and initially, you think it will solve all your problems but it doesn’t always work and certainly not always the first time. We nearly gave up hope before getting pregnant with our last frozen embryo.
What are typical Intended Parent expenses?
We covered all of Jayne’s clothing, extra food/medical needs but in our case this was minimal. I think it can reach approx £20,000 for some people.
A lot of prospective intended parents may worry about how they can bond with their baby during pregnancy and immediately after birth, how did you find the emotional transfer experience and how would you describe your bond with your baby now?
My husband and I were in the delivery suite with my sister-in-law and her husband and it was the most wonderful day. We laughed, cried and I got to help deliver Penelope, being the first to bring her into the world – that was truly special. Both Jayne and I spent the night in the room with her and it didn’t feel strange at all – just lovely to be all together. She has never felt like anything but ours – we are so lucky, I know that.
What’s been the best thing about the surrogacy experience for you?
Gaining a beautiful daughter I would not have been able to have otherwise, first and foremost, but building a strong bond with my sister-in-law and being able to pass on advice to others who had never considered surrogacy before, and tell them our happy story, has been a real gift.
How do you plan to tell your child about their surrogacy story? Is this something agencies help prepare you for?
I hope she’s proud of how much love went into making her and that she’s happy to tell her story if people ask. Laura
In our counselling session, they suggested writing a book of Penelope’s journey down and giving it to her when she’s old enough. I am doing that but I will tell her the exact reason – mummy’s tummy was too sick to carry you so auntie Jayne did. It is perfectly normal to me and I hope it is to her too. I hope she’s proud of how much love went into making her and that she’s happy to tell her story if people ask. I have been lucky enough to meet another family in the same boat and the little girl is now 6. She’s amazing and knows exactly where she came from. That gave me hope and I hope Penelope will look up to her if she ever wants to chat with someone who has been through the same.
One thing you’d like to say to intended parents considering surrogacy…
It’s not the easiest journey but hopefully, it will have the most special result. Do it and good luck x
Emiliana
Tell us about your experience – what’s the screening process like and what requirements do surrogates have to meet?
My experience was more of a self-screening process (!) as I am close friends with the parents so I wasn’t applying to be a surrogate via an agency. The clinic of course made sure I was physically and mentally fit for the process by asking me questions both with Sophie (interviewed below) and Jack present and separately too. Previous pregnancy history, reasons for being a surrogate and checking I had considered the emotional side of the journey were aspects they asked me about. They also had a session with my husband James to make sure he understood the process and was happy to go ahead.
What made you want to be a surrogate and is it something you’d always wanted to do?
Being a surrogate wasn’t something I had ever thought about until I saw my best friend experience severe fertility struggles. I don’t think I even knew it was legal in the UK until I started researching it for them. I knew my own pregnancy and birth experiences had been straight forward so I believed it was a really hopeful option for them.
Before becoming a surrogate, did you have any reservations about it?
I realised that being selfless and doing something for someone else is actually a really powerful thing to role model to your childrenEmiliana
I was concerned about my own children and the impact it may have on them, but the more I thought about it the more I realised that being selfless and doing something for someone else is actually a really powerful thing to role model to your children. I gained pride and the happiness of helping my friends have their baby, but there was no financial or material gain involved. It’s important that children see these kinds of situations too, so that concern was quickly eradicated! I of course worried about if it didn’t work, but I also told myself that just trying was all we could do and I knew Sophie and Jack were incredibly grateful for that.
How much support and guidance did you receive from the agency, doctors, friends, family?
The reality is it’s not a ‘normal’ situation in the UK (yet!) but lots of people supported us unconditionally. A few others struggled with the concept, but really, that’s life and not everyone understands everything from your perspective and that’s ok. We just made sure we spent time with people who were 100% behind us.
Medically we had incredible support from our midwife who happened to be my midwife from when I had my 2 children. She made sure Sophie and Jack felt included every step of the way and supported us to have a planned abdominal birth (even though I had home births with my babies) because she respected our decisions. That really made all of the difference to us all.
What kind of relationship did you have with the IP, how involved were they with the pregnancy journey?
We are the best of friends! So we were together pretty much every step of the way at appointments in person or via FaceTime as a minimum. I lead a fairly busy life bringing up my 2 young children and running a business and they really respected that. It was never intense or OTT as you might expect it to be in this situation, we really all just carried on as normal and enjoyed the milestones together.
How did you feel during the pregnancy and after the birth?
After the birth, I felt relieved, exhausted, just so unbelievably happy.Emiliana
During the pregnancy, I was just living in the moment really. I don’t think you can do anything else and stay calm when in that situation. I felt tired of course but knew it was all for a very good reason. After the birth, I felt relieved, exhausted, just so unbelievably happy. It was like completing 10 marathons!
What’s the most challenging part of a surrogacy journey?
For me it was the many appointments and the logistics of having 2 young children at home and life continuing as normal for me. It was a challenge I knew was going to happen and I expected it, and I guess just the reality of committing to being a surrogate! But yes that was the most challenging part for all of us as a family.
And, the best part?
Giving my friends the gift of parenthood- seriously what is ever going to top that! The moment they had their baby in their arms was what it was all for. I just can’t describe that feeling of relief and pride for all of us as a little dream team.
What’s the most common misconception about being a surrogate?
That you’re going to want to keep the baby! Honestly, it’s the question I got asked the most about and it didn’t annoy me, it just reminded me how people don’t understand what it’s all about.
What’s your advice for women who want to become a first-time surrogate? Anything you wish you knew?
Think about the impact it will have on your immediate family, not just you. They have to be behind you 100% of the way otherwise it could be a very stressful journey for you. Perhaps completing your own family first is something that might be important for some too.
Sophie
What made surrogacy the right path to parenthood for you?
After six months of discussions, we thought it would give us the best chance of having a baby which was our end goal! We knew it was time to try a different route. Sophie
During the six years myself and my husband tried to conceive we suffered two ectopic pregnancies (which resulted in both my tubes being removed) and five early miscarriages. We never got to the point of seeing a heartbeat during any of our seven pregnancies. I also had a very low egg reserve (amh) to add to the complications. We underwent six rounds of privately funded IVF to give us the best chance possible. Unfortunately, the viscous cycle of miscarriages continued and it was then that one of my best friends offered to be our surrogate should we have chosen to try that route. After six months of discussions, we thought it would give us the best chance of having a baby which was our end goal! We knew it was time to try a different route.
What surrogacy path did you choose to go down and why?
We chose gestational surrogacy which used mine and my husband’s embryo which was then implanted into our surrogate Em. I was still able to produce eggs so this was the best scenario for our situation.
What were your initial doubts, if any?
My initial doubts were how would my friend feel carrying my child, would she feel like the baby was hers and would I feel like the baby wasn’t mine because I hadn’t carried it. These doubts were very quickly squashed as we started going through the process but it’s important to allow yourself to have these doubts and work through them.
Do intended parents (IP) have to meet certain requirements?
Not necessarily. However, clinics do require you to have special counselling to make sure that surrogacy is the right decision for you and that you have really thought it through.
How does the process of finding a surrogate work and how long does it take to find a match?
It sounds like a long time but there is lots to organise and work through so it goes quicker than you think!Sophie
With our friend offering for us, it was more a case of deciding that it was the right route to go down for our situation. Once we decided to go ahead, it took another 18 months to get to a transfer, mainly due to Em only just having her second baby. In other situations, if you use a clinic or find a surrogate independently, it can take 18 months to over two years to get to a transfer. If you go down an International surrogacy route this can be less. It sounds like a long time but there is lots to organise and work through so it goes quicker than you think!
How much contact do surrogates and IP have?
From our own experience of using a friend, she will be in ours and our baby’s life forever. Each situation is unique and it really does depend on what works for both IP’s and surrogates. Some develop very close bonds and others still have contact but not as often.
What factors should an IP think about before going through surrogacy?
The process may not be easy at times. Do you have support around you? Financially are you prepared for the expenses? Think about what is important to you for the contract you will write between you and your surrogate. Make sure you understand the legalities of surrogacy in the UK and the process of the parental order. There is a lot of trust involved in the process so you have to be prepared to completely trust your surrogate.
What are typical Intended Parent expenses?
In the UK you can only pay a surrogate reasonable expenses which can range from £0 to in excess of £20,000. The average being around £15,000. On top of this, you need to pay out for the IVF to create embryos and donor if you are using donor eggs or sperm.
A lot of prospective intended parents may worry about how they can bond with their baby during pregnancy and immediately after birth, how did you find the emotional transfer experience and how would you describe your bond with your baby now?
To enable both myself and my husband to bond with our baby during the pregnancy we made sure we were at every midwife appointment and scan. We recorded ourselves reading stores so that Em could play our voices to the baby and also recorded a playlist of our favourite music. I made sure I felt him kick whenever the chance arose and we also found out the sex at 17 weeks which helped us visualise a real-life baby! This also helped us decorate his nursery and buy him bits, again helping us to bond.
We recorded ourselves reading stores so that Em could play our voices to the baby and also recorded a playlist of our favourite music. Sophie
As he was being born, during an elective c section, we played our favourite song for him and there wasn’t a dry eye in the room. Straight after his birth, he was passed to me for skin to skin which was the most amazing moment of my life. I then passed him to Jack and Em always says it was totally surreal watching us become parents. Em held him later on in post-recovery and I will be forever grateful to her for giving Jack and me that time during those first moments.
The bond I have with our little boy now is what I imagine would be exactly the same had I carried him. It’s like nothing I’ve ever experienced before. I look at him and feel like the luckiest woman in the world.
What’s been the best thing about the surrogacy experience for you?
Surrogacy gave us back our hope during a very difficult and dark time. Without the science of surrogacy and without a very special woman helping to grow our baby for nine months, then we wouldn’t be parents right now. It really is magical.
How did you / do you plan to tell your child about their surrogacy story? Is this something agencies help prepare you for?
I have printed a picture book explaining in basic terms that mummy’s tummy was broken and that special Auntie Em helped to grow our little boy and help us start a family. We intend to be very honest with him so he knows just how much he was wanted and how his story started.
One thing you’d like to say to intended parents considering surrogacy…
Don’t be afraid. It’s a scary concept but thats only because it isn’t the ’norm’ in this country. I was worried I wouldn’t feel like a mother because I hadn’t carried my child but that really couldn’t be further from reality. Our path to parenthood may have been a slightly different one but that just makes it that little bit more special!
Ariel
Tell us about your experience – what’s the screening process like and what requirements do surrogates have to meet?
The screening process for a surrogate is extensive. There is a number of criteria to be met in order to qualify including age restrictions, BMI restrictions, already having a child, being financially stable, non-smoker/drug user, no criminal history, and having an adequate support system. It is also recommended that a surrogate complete her own family before becoming a surrogate. This is due to a slightly increased risks of complications in an IVF pregnancy and the chance of losing her own fertility. Once a surrogate meets the basic requirements, she will have to undergo a medical and psychological screening. This includes a review of previous birth records, ultrasounds, bloodwork, drug tests, and a meeting with a psychologist. As well, if the surrogate is partnered, that person would also be required to have bloodwork, drug tests, and infectious disease screening. Both parties may also be required to have a background check or home study done. Once the surrogate is medically and psychologically cleared, they would be able to proceed.
What made you want to be a surrogate and is it something you’d always wanted to do?
Initially, when I began my surrogacy journey, I just wanted to help someone. It had taken me a year to become pregnant with my own daughter and we had just begun basic fertility testing when I found out I had a partial blockage in my fallopian tube. It was cleared and I was able to become pregnant but the thought of potentially requiring fertility treatments made me very much aware that not everyone is able to get pregnant so easily. and some couples simply require the use of a surrogate to carry their embryos and I knew I wanted to help someone become a parent.
A medical condition that prevents someone from carrying, a lack of a partner in the case of a single parent by choice, or for same-sex couples; surrogacy is one of the only options. Ariel
If you ask me now, after nearly 6 years in the fertility world and having given birth to 3 surrogate children, I continue to be a surrogate because everyone deserves the opportunity to become a parent if they choose. A medical condition that prevents someone from carrying, a lack of a partner in the case of a single parent by choice, or for same-sex couples; surrogacy is one of the only options. Because of people like me, there are thousands of couples that now have their children earthside. I think that is so special.
Before becoming a surrogate, did you have any reservations about it?
I wouldn’t say I had any reservations exactly, I just didn’t know a lot about it. If I am being honest, I did not do as much research in the beginning as I would suggest other people do. I just jumped right in and learned as I went. If I had the chance to go back, it may have been wise to learn a bit more about the process first. I truly did feel like surrogacy was something I was meant to do and now after multiple journey’s, I have no regrets for choosing to carry my Intended Parent’s children for them.
How much support and guidance did you receive from the agency, doctors, friends, family?
Having support as a surrogate is extremely important. I was so thankful that my partner and the rest of my family was very supportive in the beginning and continue to be supportive through each pregnancy.
This is exactly the reason I went back to school and am now a Fertility Therapist that works with Intended Parents and surrogates before, during and after pregnancy.Ariel
Most agencies provide a lot of peer support in the form of Facebook groups, online or in-person meet-ups, weekend retreats and subscription boxes which is wonderful for surrogates. One area that I had noticed was untapped was specialized support for surrogates and Intended Parents in the form of counselling by licensed therapists. This is exactly the reason I went back to school and am now a Fertility Therapist that works with Intended Parents and surrogates before, during and after pregnancy.
I am happy to see that many agencies are now employing or partnering with Social Workers and Psychotherapists to provide these services and making them more accessible for those going through surrogacy.
How does it feel when you hear the news that you have been matched with intended parents?
I have often talked about the matching process as feeling like online dating a bit. When you are with an agency, they will take all of the criteria that the surrogate and Intended Parents want and work hard to match people together that have similar goals, values and ideas about the type of journey they would like to have. This includes views on termination, contact after birth, dietary or religious beliefs and proximity to each other.
Besides some of the legal matching points, it’s also important that they have a genuine connection to each other as well if that is what they want. It is a really exciting process! I had an instant connection with all of the Intended Parents I have carried for and had a feeling like I had known them my whole life. I knew right away that we were meant to be matched.
What kind of relationship did you have with the IP, how involved were they with the pregnancy journey?
For me personally, I always had a close relationship with the parents before and during the pregnancy. We would visit when we could, call, video chat and text. They were always involved in the pregnancy and were part of appointments and ultrasounds. My most recent pregnancy was a little bit different because of Covid and the many restrictions in place. The Intended Parents were not able to attend a single ultrasound for their own baby due to the one person policy. They were not even allowed to attend the embryo transfer. In some surrogate cases during Covid, the parents were not even permitted at the birth! Thankfully in my case, our hospital was very accommodating to allow both parents to be there.
I am still in contact with all of the Intended Parents I have carried for and have flown to California to visit one of the families when their son was 8 months old. The other family lives relatively local to me so we get to visit when we can. It’s so amazing to see these families I had a small part in creating.
How did you feel during the pregnancy and after the birth?
I have enjoyed all of my surrogate pregnancies so much. Of course, not every moment is glamorous and like anyone else, I experience the nausea and the fatigue and the weight gain but I generally enjoy pregnancy. Many people assume that a surrogate gets attached to the baby they carry and I would say there is a small part of that but not a motherly attachment exactly. I would describe it more as being a loving nanny or the cool aunt. I care about the babies I carry and I love to feel baby kicks and hiccups but I never have any desire to take them home and be their Mother.
I have not dealt with any postpartum depression and baby blues with any surrogate pregnancy. Ariel
I am currently about 5 weeks postpartum right now and can honestly say that I feel amazing. I have not dealt with any postpartum depression and baby blues with any surrogate pregnancy. While I still get some of the hormone crash symptoms like crying over a sad commercial or listening to a sad song, I don’t feel that any part of me is empty or missing by not having the baby after the birth. In fact, after a 2-year journey and nearly an entire year of my body being pregnant, it feels amazing to be in my own skin and be able to get back to my regular life again. Surrogacy can be a sacrifice for the whole family and my kids are so happy that I can run and climb and hike and rollerblade and do all of our fun not-pregnancy safe activities again.
What’s the most challenging part of a surrogacy journey?
I tell everyone who is interested in surrogacy to do a lot of research because it is a commitment and they should be prepared to dedicate certain parts of their life to the process. It may take 2-3 years from matching until there is a birth. In that time the surrogate will have many trips to the clinic for monitoring appointments and treatments. For myself, the fertility clinic was 2 hours away and there were times I had to be there every couple of days leading up to the embryo transfer. If a transfer doesn’t work or the couple is out of embryos, there is a waiting period for that to happen too.
Most recently, due to Covid there has been clinic closures, delay of treatment or cancelled cycles which can extend the waiting time as well.
Besides just the waiting and the time commitment, there is a lot of hormone medications including intramuscular and subcutaneous injections that the surrogate will be required to administer herself. There may be times where a surrogate is on and off medications if a transfer fails and they may go on and off birth control in order to regulate a cycle. The yo-yo of hormone medication can be a lot and it’s part of the reason having a support system is important to help with the kids and the house and managing the many commitments.
And, the best part?
Watching them become dad’s was beautiful.Ariel
The absolute best part of a surrogacy journey is finally seeing the parents with their baby. Having given birth 3 times now as a surrogate, it is still an indescribable feeling of love and accomplishment and joy. When you get to understand the infertility journey someone has been on, the miscarriages, the treatments, failed embryo transfers, chemical pregnancies, needles, hormones, etc., and finally, you get to watch them hold their baby, it’s like nothing I have ever experienced. Similarly, for the two dads that I carried for, it was incredible to know that we have the medical advances for them to have biological children of their own! Watching them become dad’s was beautiful.
What’s the most common misconception about being a surrogate?
There are two big misconceptions that get brought up. The first being that many people assume that a surrogate is getting paid a very large sum of money. That is simply not the case. I am from Canada and surrogates cannot be paid here, only reimbursed pregnancy expenses with a receipt up to around 25,000 dollars for the entire pregnancy. This includes painstakingly tracking and recording every expense and keeping over a years worth of receipts to submit. Unfortunately, our laws around surrogacy are not reflective of the current climate of assisted reproduction and are quite outdated. There is currently a Public Bill, Bill S-216, with the Senate to decriminalize paid surrogacy in Canada which would allow surrogates to be compensated that same 25,000 dollars but with the autonomy to choose what they use that money for.
Even in countries that allow paid surrogacy like the US, the compensation amount is typically around 35-45 thousand for the entire pregnancy which takes into account the pregnancy expenses but also the time commitment and sacrifice the surrogate and their family take on to help someone become parents.
The second misconception is that the surrogate will want to keep the baby. Modern surrogacy is primarily gestational surrogacy meaning that the carrier is not genetically linked to the baby. As well, a surrogacy agreement is preplanned and requires the use of IVF to become pregnant. It is very different from a planned adoption or traditional surrogacy that would use the surrogates own eggs. As well, surrogates go through a psychological evaluation to assure they understand the process and are fully informed before ever getting pregnant.
Legally speaking, in most places where surrogacy is legal, the parents are the full and legal guardians of the baby and the surrogate would have no rights to the baby even if she wanted to. It is important to note that not every state recognizes surrogacy and if there is no contract, no one is protected. Many stories of surrogates trying to keep a baby are due to a lack of contract, being in a non-surrogate friendly state or an arrangement that is not actually surrogacy. There are thousands and thousands of successful surrogacy stories where the carrier has no desire to keep the baby and is thrilled for them to finally go home to their parents.
What’s your advice for women who want to become a first-time surrogate? Anything you wish you knew?
My best advice is to just research as much as possible. There are many Facebook groups to get information about surrogacy and learn from other people who have been in the community a long time. I also recommend people review the surrogacy guidelines outlined by the American Society for Reproductive Medicine and familiarize themselves with IVF, the procedures, the acronyms in the fertility world and what all goes into the process.
I began documenting my surrogate journey on Instagram @carried.with.love because I think it is important for people to see the time commitment, the good days, the bad days, the failures and the successes. I didn’t know anyone who had been a surrogate when I started and I would have loved to follow a journey and understand more about it before starting.
I also think it’s a good idea for people to follow those in the fertility community. Those who are trying to get pregnant, using assisted reproduction for themselves or using surrogates. Once you can appreciate the long road Intended Parents have been on to grow their family, it gives the surrogate so much more perspective on why surrogacy is so important.
I hope that by me sharing my story and working as a Fertility Therapist in the community, I can help decrease the stigma around surrogacy and normalize the process. I also hope to advocate for more inclusive laws and regulations around alternative routes to parenthood so no one is left out of the conversation.
