This is what a woman whom I’ll call Laurel had to do to become a “gestational” surrogate: Take an injection of hormones to knock her fully functional cycle off its orbit and suppress ovulation. Take synthetic estrogen via pill and patch and inject progesterone suspended in oil through a twenty-five-gauge needle (it’s big) into her bottom for six weeks. Along with her husband, abstain. Endure the hormones “wreaking havoc on my system,” as she describes it. Shuttle back and forth to a lab two hours away for weekly blood tests to make sure said hormones had reached adequate levels, that her uterus had resumed an amplified, robotic version of its normal cycle.
Once the uterus is deemed hospitable for in-vitro fertilized embryos, fill bladder to bursting, lie back in stirrups, and be mildly sedated so that a catheter delivering the thawed zygotes could be threaded through her cervix and into her womb. Then return home and resume the hormone regimen for another six weeks, including the daily self-administered injections, even after the morning sickness kicks in.
And that was just to get pregnant. Of course, Laurel is healthy and fertile – that’s why she offered her womb to a childless friend – but her friend wanted a child conceived of her own egg and her husband’s sperm (hence the “gestational” surrogacy), so Laurel became a fertility clinic patient. She’d done some reading to prepare herself, but she wasn’t expecting the volume of hormones or the invasiveness of their delivery. She wasn’t expecting to feel “dehumanized” by the embryo transfer. Most of all, she wasn’t expecting twins.
When the idea of being a surrogate occurred to her, Laurel envisioned a pregnancy like the ones she’d had with her own two children – generally charmed affairs with only minor discomforts that culminated in ecstatic births, her second in a birth tub with midwives. “The aftereffect was amazing – the feeling that I could do anything,” she says. But a twin pregnancy is much more physically taxing, and this one has caused Laurel debilitating, unrelenting nausea – morning-noon-and-night-sickness – from the outset.
“I didn’t really have a second trimester,” she tells me. “Even before twenty-four weeks, I had all the third-trimester symptoms: low energy, shortness of breath, uncomfortable in pretty much any position.” Many days she can barely get out of bed. I asked her if being so sick has affected how she relates to the babies growing inside her. “There have been some times that I wasn’t feeling really good about the babies, especially when I was on my knees in the bathroom, and my children needed me, and I couldn’t take care of them.”
Laurel, a “compassionate” surrogate, isn’t asking for any money for her labors, though she could. The going rate is $15,000 to $30,000 – for a job that is high-risk, 24/7, and lasts about a year, maybe more, depending on how many IVF cycles are required, how complicated the birth is, and how long it takes to get the feeling back in your butt. (No joke, another woman I talked to was numb down to the backs of her knees for seven months postpartum.) “I felt that money would somehow cheapen it,” Laurel told me. “Now, I don’t know . . .”
Gestational surrogacy, the new norm according to a recent New York Times magazine article by Alex Kuczynski, was supposed to make everything easier. “Traditional” surrogacy – when a woman uses her own egg and the technology involved in conception is usually no higher than a turkey baster – was laden with stigma. How could a mother hand over her own baby? How could you ask a woman to do such a thing? The surrogate-patron relationship had the taint of coercion. Moreover, it put the intended parents’ hopes on very shaky ground: contract or no, they could never be certain that the biological mother wouldn’t change her mind and want to keep the baby (like Mary Beth Whitehead did in 1985, known as the “Baby M” case). Psychological screening became more sophisticated following Baby M, but with assisted reproductive technology came the possibility of eliminating the mother-threat altogether: it stripped the surrogate of her parental rights. She would not be the biological mother; the baby would belong to the intended parents from its test-tube conception, and once it was born, the woman who had carried it would have no legal claim.
“The surrogates are happier,” a surrogacy agency administrator told the Times, “because they don’t want to have a genetic connection to the baby, and the legal issues are much clearer.”