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Surrogacy Q&A part II - From a Surrogate's perspective (or two)

Last week I posted my interview with Alex from @wheneverybodymatters in regards to her surrogacy journey. This week I wanted to share my interviews with two different surrogates so we could try and get a better understanding of the process from their perspectives. I was lucky enough to interview two women, each on different journeys. Christina Pitts, who is currently undergoing treatments to go into a transfer soon and Jenasa Staples, who is currently carrying twins for her surrogate family. These women are incredible and it's so amazing to me to see everything that goes into surrogacy, truly such a selfless act and one that I know not very many are cut out to do.

Christina Pitts

Below are the questions I asked both of them with each of their answers. And much like IVF and infertility, everyone's surrogacy journey is different as you can see from both of their answers to the questions below. I hope you enjoy learning about them and this journey as much as I did!

Jenasa Staples

Tell us about yourself and why you chose to become a surrogate?

CP-I’m Christina - mama of four beautiful littles, native San Diegan, childbirth educator. We are a super adventurous homeschooling family, we love hiking, surfing, fishing, glamping, hanging out at the beach, exploring the zoo and museums and all that our beautiful city has to offer. 

I first had the idea to be a surrogate when my oldest was a baby. I had suuuuuuch a difficult transition to motherhood - breastfeeding complications plus unrealistic expectations made for a lot of tears and doubt and feelings of shame and isolation and what I now recognize as probably some postpartum depression. At the time I didn’t think I wanted to have any more babies, BUT I absolutely loved being pregnant and I had the most beautiful and empowering birth experience. So I had the thought that maybe I could help another woman grow her family.

J- I was born and raised in a small town in Maine. I was blessed the best gift five years ago, on my 21st birthday, my son Abbott. I am currently an entrepreneur who has a podcast called #CreateYourEarthLife (Erin has been one of the amazing guests on it), I also have a YouTube channel dedicated to educating and sharing my experience of surrogacy and parenthood, and I am in the process of writing a self-help book. I chose to become a surrogate mother because I LOVED being pregnant with my son, was starting to have almost like a craving to be pregnant (I’m guessing maternal hormones) and I wasn’t ready to have another child for many reasons (was single, not financially stable, already have my hands full with being a single mother and trying to start a career). All of these factors encouraged me to start doing research on becoming a surrogate mother. Why not use my body to help another family? It seemed like being a surrogate mother would be a perfect match for me.

How many times have you carried for other families? 

CP-I have done three embryo transfers for a very sweet family. Unfortunately, none of them resulted in a baby for them - one was deemed a chemical pregnancy (for a minute they even thought it might have been ectopic!), one was a very early miscarriage, and the last one didn’t implant at all. It was devastating. I would have stayed with those intended parents and tried again, but their doctor suggested they try another surrogate, even though they did a really extensive pregnancy loss panel on me and everything came back as all clear on my end. I have since been re-matched with a different family, and we have a tentative FET date of September 23 *fingers crossed*

J- This is my first time carrying children for another family. I am currently 32 weeks pregnant with twins for a family that is outside of the United States. There is a possibility I will become a surrogate mother for a second time but I haven’t made any final decisions.

How were your pregnancies in the past? Have you ever had any reproductive difficulties? 

CP-All four of my own pregnancies were incredibly easy - I never had any complications, hardly even any first trimester queasiness…nothing. I had no difficulty getting pregnant either, and never experienced any losses. Honestly, I think that made me a bit arrogant walking into this surrogacy journey. I thought we’d be pregnant on the first try, easy peasy. Boy was I wrong. This whole experience has been extremely humbling, and my heart aches so badly for everyone who has to walk this road to grow their family. 

J-The only other pregnancy I have had was with my son and everything went really smooth. Up until now, I have not had any reproductive difficulties.. which may be one of the reasons I was accepted to become a surrogate. When you become a surrogate mother you have to pass a few screening’s which included two mental health screening’s and a medical screening. The medical screening required blood work, a cervical exam, and the records that shared your pregnancy history.

Is this something you’ve discussed with your husband or partner? What are his or her thoughts on surrogacy?

CP-He was not thrilled about the idea at first. I brought it up a lot over the last decade and he always shot it down immediately. But he didn’t really understand how it worked - that the baby would be in no way genetically related to me. Once he understood that it was totally their bun and I would just be the oven, he was on board. Even more so when we got to meet our intended parents and hear some of their story.

J-The process of becoming a surrogate mother from when you find an agency to when you get pregnant takes approximately a year. During that time I was single. I decided while pregnant to get the ball rolling on dating and assumed I would hopefully weed out the men that weren’t right for me while pregnant and find someone compatible once I gave birth. Things don’t always work out how you plan them and surprisingly have been happily dating someone for about a month now.

Have you talked with your children about surrogacy? How do you plan to talk with them about it? How do you think this decision might affect them?

CP-We have talked to the kids about it a lot, and explained the different parts of the process to them. They love watching my injections and all that, haha. We told them what we were thinking about doing and asked what they thought about it before I officially submitted an application for surrogacy. We explained how some families want to have kids sooooooo badly, but they need help because their bodies can’t do it on their own. Their response was “well of course if we can help them, we should!” They think it’s all fascinating - I’m a childbirth educator so they’re all very familiar with pregnancy and birth, and even with their more than average knowledge of the subject it’s been a great science/biology lesson

J-I have talked with my son about surrogacy and he is very aware that we will not be keeping the babies. I started talking to my son about being a surrogate mother very early on in the process. When I flew to California (where the clinic is that I had my IVF transfer), I explained to him that I was flying across the country so that I could have eggs put inside me that would grow into babies for another family. He was concerned about me being cut open so then I explained to him what was going to happen. I have used this time to educate my son by answering any questions that he has.

What are the legal processes involved in surrogacy? 

CP-SO many contracts. There is paperwork for everything. For the agency, for the clinic, for the financial stuff, for insurance, etc. The contract between the intended parents and us is huge and covers everything you could possibly think of, all the laws, all the what-if scenarios, lots of specifics. Thankfully the agency appoints an attorney to us to help us sift through it all, because it’s really overwhelming. 

J- From my experience of working with an surrogacy agency, everything ends up being apart of the legal process. There is a contract that the intended parents and myself signed that discussed everything from medical expectations, foods I am allowed to eat, activities I am allowed to engage in, to the payments I would receive and what for. There are additional legal forms we filled out later on in the pregnancy that basically gave the intended parents rights to the children so when they are born, I have absolutely no responsibility to them.

What if any are the risks of surrogate pregnancy?

CP-The risks are the same as any IVF pregnancy, and the medications all have their own risks and side effects as well. 

J-It is discussed that taking hormones (estrogen and progesterone) that there can be risk for your health. Also, pregnancy and delivery in general can be risky. In the contract it is discussed what would happen if I lost an organ, if I had to have a hysterectomy, if I died, etc.

Are you able to travel for surrogacy-related procedures and appointments?

CP- California is one of the most surrogate-friendly states, so a lot of intended families and surrogates travel to clinics here. The clinic that my first family was working with was in Pasadena, so I had to go there for some of the monitoring appointments and for the embryo transfer. The family I’m matched with now is using a clinic in downtown Los Angeles. Some do travel internationally too, though I don’t know how common that is. I had one friend who did several surrogacy journeys, and with her last one she flew to Brazil for her embryo transfer. 

J- I had to travel summer 2019 to have a medical exam in California. In February 2020 (right before everything was shut down because of Covid-19) I traveled to California again to have the IVF transfer. Since the IVF transfer resulted in a positive pregnancy test, I have been able to have all my appointments in Maine.

How do you feel about carrying multiples?

CP-At my age, I don’t feel comfortable with the additional risks that come with carrying multiples. So I made sure to express from the beginning that I’m not willing to transfer more than one embryo at a time. But when they asked if I would want a reduction if that embryo was to split into twins (I was asked this question by multiple people, so apparently it’s not uncommon?), I said no. Because if that happened then I guess it’s meant to be for these parents to have two babies.

J-I am very excited to be carrying twins. I wasn’t sure if I would ever have the experience on my own of carrying twins so I feel very blessed to have this experience now.

How do you feel about termination and selective reduction? Under what circumstances would you consider these procedures?

CP-This is also something that is asked in the beginning on the surrogate application, before you’re even matched with a family. And then put into the contract. Since the baby is the intended parents', I would do whatever they felt was the right thing to do when it comes to termination. If we somehow ended up with more than two fetuses, which would be a verrrrrrrry slim chance with only transferring a single embryo at a time, we would selectively reduce to two. 

J-To be completely honest, from when I started the surrogacy process to where I am at now, my feelings have changed a lot when it comes to termination and selective reduction. When I was asked these questions by the agency over a year ago, I was open to termination under certain stipulations, for example, if the child had a heart defect. I was also open to selective reduction if the two embryos used had split and I became pregnant with four babies. I think if I become a surrogate mother again I will have different answers which may result in different outcomes. I don’t think, now, that I would feel comfortable with termination of selective reduction. Which means, if I become a surrogate mother again, I would only be alright with one embryo being transferred and pray for the health of the baby/babies and myself.

What are your expectations from us as intended parents? How involved do you like parents to be in this process?

CP-I would love for the parents to be as involved as they want to be. I’d be thrilled if they came to every appointment and if we could end up being life long friends. But I also understand if that’s a bit much for them too. With the first couple I was matched with, I found myself wishing that they reached out more frequently and got more involved - because it was hard on me too, going through all the treatment and dealing with the losses, it would have helped to hear some from them more through all that. But my surrogacy therapist (another part of the deal - monthly therapy appointments provided by the agency) said that it’s not uncommon for intended parents to remain a bit reserved and less involved until a viable pregnancy is confirmed, because they don’t want to get too attached. So I understand and respect that. 

J-I love how involved the intended parents are now. They check in about two or three times a week. I feel like I can talk to them about anything involving the pregnancy. They are very kind and supportive. If I become a surrogate mother again I would hope to have a similar relationship with new IP’s.

How do people find you?

CP-It’s kind of like a dating website, haha. You submit an application to an agency. After you go through all the interviews and provide them with lots on info and pictures and get psychiatric clearance, they create a profile for you, and publish it to their waiting list of intended parents. 

J-I answered a list of questions on video and then the agency matched me with intended parents. We FaceTimed once to get to know each other, and then let the agency know privately what we thought about each other. We ended up being a great match the first time around!

Do you feel the need to “approve” the family? How does it work from your end if someone chooses you?

CP-So after our profile is published for intended parents to review, anyone who is interested lets the agency know they’d like a match with us. The agency then sends us their profile to review, and if we agree to it, they arrange a meeting for us to all chat together. Then they ask us both separately if we’d like to move forward. I ask some basic questions, like if both parents work, what are their plans for who will care for baby…mostly I go with my gut feeling about them when deciding if we want to move forward. 

J-The family and surrogate mother both have to be comfortable with the match. If one is not comfortable with the match then it is expressed to the agency coordinator and the search for a match continues.

Do you stay in contact with the families after you give birth?

CP-Most do stay in touch and send updates and pictures. Some even visit occasionally with baby. It’s so beautiful seeing the relationships and bonds formed through these journeys. 

J-I plan to stay in contact with the family after I give birth. I will be sending them breastmilk. Once they are done with the breastmilk I plan to contact them occasionally to see how everyone is doing.

Do you go to the families’ doctor/OB/ fertility center? Or do you have your own?

CP-The family usually has a fertility center that they’ve already been working with, and has an embryo or embryos already stored there. If it’s not local to the surrogate, she can do her monitoring appointments at a clinic that is closer, and then travel just for the embryo transfer. For the OB care after the surrogate “graduates” from the fertility clinic - that’s one of the first things that gets arranged almost right away after a match, so that it can be included in the contract. Also because most health insurance doesn’t cover surrogacy, so the agency will ask for a list of your preferred OB’s and hospitals so they can try to find a policy that has them in network. 

J-I have my own. The family lives in a different country. The agency and the family supports me going to a doctor that I feel comfortable with. I wanted to have a midwife but the insurance company did not support having a midwife while carrying twins, they would only support a midwife if I was carrying a singleton.

How do you manage keeping parents involved day to day? 

CP-In my case, my intended parents live abroad, so we use an app called WeChat to communicate. For now, I usually just send them a quick text to update after my appointments…I’m sure when we get a confirmed pregnancy, we’ll be in touch a lot more frequently.

J-I don’t usually talk to them daily but I do inform them of any new information about the pregnancy. I let them know in advance about all OB and ultrasound appointments and tell them all the information I receive after every visit. They have FaceTimed with me during a couple OB appointments but our time zones are a 12 hour difference, so when I have an appointment at 11a, it is 11p where they are. It is easier to just relay all the information I am given.

Have you had a bad experience in the past? What if a family is too controlling? 

CP -I haven’t had a bad experience with the parents. They’ve been really sweet - my current IP’s have been checking in periodically during all this pandemic craziness, asking if we need anything, making sure we’re all healthy and well and safe. They’ve always said that my health and happiness during this process is important to them, so I don’t think we’ll have any issues with them being controlling. And honestly, if they were, I would probably be fine with it. I’m pretty controlling myself when it comes to the care of my kids, haha, so I think I would be understanding and try to accommodate as much as reasonably possible :) 

J-I have not had any bad experiences. The family I am carrying for right now seems to trust me which I am very grateful for.

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