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By: Susan S. Fricks, M.S.
COMPONENTS OF A SUCCESSFUL SURROGATE ARRANGEMENT
Working in the field of assisted reproductive technology followed five years of my own personal struggle with infertility. The difficulties and intense feelings from those years of longing for a child left me wanting to share with others on a personal and professional level. I have been able to integrate my experience and my knowledge as a psychotherapist for a number of years and have found the work to be quite gratifying. Helping fellow infertile women and couples come to terms with the challenge and stress of infertility and then moving toward alternate ways of building a family or childfree living is both healing and powerful. Each opportunity of being with couples as they open themselves up to "another way" to have the child they want so badly is an ongoing tribute to patience, tenacity and the human spirit. This is my first attempt to write about my observations in what makes an arrangement between a couple and a chosen gestational carrier a successful one. This is not a research project but rather a synopsis of my experiences with couples and surrogates, where the process has worked and where it has not. It is my hope that this effort will be of help to others as they try to put together the constellation of people needed to conceive and carry a pregnancy.
It seem to me that whether a gestational carrier is known or unknown to a couple a certain chemistry needs to exist. I have often heard a friend or a sister who plans to be a surrogate say, "I just love Jane and Tom, and I want them to have a child more than anything." This special feeling can be from years of shared history or a first meeting where everyone seems to click. The ability to communicate the strong desire to have a child gives the surrogate a way to join the couple in the quest. The surrogate needs both a sense of enjoyment and connectedness to the couple to want to join them in their efforts to have a child. The couple needs those same feelings to want to entrust themselves to commit to a surrogate.
Like so many other things in life, "timing is everything." The couple needs to have a sense of completion of infertility treatment if that has been their experience. A feeling of readiness to move on and a willingness to venture into other possibilities is very important. Both members of the couple need to be somewhat together in this decision. It is seldom that partners have moved at the same pace or shared the same feelings in dealing with infertility treatment. However, when you move into an arena that involved another person making a commitment to you, the readiness and desire need to be mutual. Without this mutuality, the effort can be undermined by the uncommitted spouse. It become clear in meetings that include physicians, attorneys, therapists and the surrogate if one partner is dragging his/her feet or just not ready. A surrogate wants to know that "we are in this together and each partner is ready and willing to pull their weight." In addition, practical matters involving timing for the surrogate are important. Many surrogates have a specific time frame in mind, for instance, doing the surrogacy in a time when the surrogate plans to be staying at home or is between jobs or school. Fitting the experience into a time when the pregnancy would be least disruptive to themselves or their children can be extremely important. Therefore, the symmetry of the couple's readiness and the surrogate's timing needs to exist.
It has always been interesting to me that matters involving conception and pregnancy touch on very deeply held beliefs of people. It is also important to note that some large religious bodies do not support assisted reproduction. In interviewing couples and surrogates I always ask if their spiritual or religious beliefs have played a part in their decision-making. Persons who have not reconciled their own beliefs with the stance of their church may have serious misgivings about using a surrogate. Many times couples and surrogates hesitate to tell important family members, friends and supervisors because of fear of their disapproval. How many times have we all heard "If it is God's will you will have your child." How many times have we heard we should accept God's will? How does this fit with taking control of this desire for a child and literally making it happen? The couple and the surrogate need a stronger belief that what they are doing is good and right in order to handle the various reactions and comments of others. This belief will be called forth in interactions with everyone from relatives to casual acquaintances who make comments to the surrogate about the pregnancy or who run into the couple with a newborn never having seen them pregnant.
A team of professionals who are both supportive and knowledgeable are a must. A physician who is willing to perform the procedures for conception to take place and a physician who is willing to care for the surrogate during pregnancy and delivery is also vital. You will find that physicians have belief systems, too. It can be quite a task to find those who will assist you in reaching your goal. An attorney who has written surrogate contracts in your state is also essential. You may have to do a lot of searching to find a specialist in surrogates law. In addition to the contract, an attorney may assist you in considering questions about care of the surrogate that you would not have examined. Arrangements between family members and close friends are often spoken with such love that there is hesitancy to seek legal advice. It is my opinion that there is even more complexity in these relationships and a legal contract is very important in spelling out possible ramifications and outcomes. therapists serve a role in both evaluation and clarification. In meeting with all parties in a surrogacy arrangement I am often told of worries, fears and questions not previously voiced. A safe place to deal with these concerns helps the process flow smoothly rather than running into unexpected roadblocks. A therapist should also be available during and after a pregnancy to provide needed support.
It is my opinion that a surrogate needs to have had a successful pregnancy experience prior to agreeing to be a surrogate. Though the carrier may never have been a surrogate before, if she has had a pregnancy she at least knows what it entails. One never knows exactly how a particular pregnancy will go but a prior experience gives a beginning road may. It has also been my experience that the surrogate who has really enjoyed a prior pregnancy but who may not want another child is the best option. The ability to verbalize and to appreciate the difference in having your own child versus being a host womb is also essential. This understanding defines the kind of attachment that will develop during the pregnancy. The support of those closest to the surrogate is also important. They will be the ones most directly affected by the medical experience prior to conception, the pregnancy and post-partum. Seeking their input in the evaluation process assures that they, too, know what to anticipate and are "on board." The couple's ability to appreciate what the surrogate and their family are agreeing to do for them is vital.
The above considerations may not be exhaustive but are the essential in my observations about those agreements that come to fruition as compared to those that break down along the way. While a couple may not be able to check off each of these elements as being present in their situation, I would certainly say that most need to be there. Identification of potential problem areas ahead of time also gives couples the opportunity to address those issues in the planning process.
I wish for all infertile couples the resolution and the willingness to take the risk to build their families in a way they might not have considered otherwise.
Copyright 1996. The American Surrogacy Center, Inc.(TASC), Marietta, GA
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