How Does Baby Surrogacy ACTUALLY Work?

"Understanding how baby surrogacy works turns out to be more complicated than it might seem at first."

- The Infographics Show

How Does Baby Surrogacy ACTUALLY Work? is a video on the Infographics Show that explains exactly what surrogacy is and goes through famous celebrity and other legal examples of the practice over many states of the U.S.

Synopsis
When a couple in love decides to grow their family sometimes they can run into fertility issues, that's where a surrogate could step in and carry the baby to term for the hopeful couple, after paying a whopping sum of money. Find out everything you ever wanted to know about surrogacy in today's new video!

Transcript
First comes love, then comes marriage, then comes the baby in the baby carriage. At least, that’s what most would-be parents are hoping for. Sadly, it’s not always as easy to get pregnant as a couple might expect, and some hopeful parents need a little help to make their family dreams come true. When fertility treatments aren’t enough, some aspiring parents turn to surrogacy to expand their family.

So, how does baby surrogacy actually work? It’s more complicated than you might expect. There are many reasons that someone may not be able to have children of their own. Some medical issues can make pregnancy extremely risky for the mother, or there could be struggles with fertility for women and men, or the prospective mother might be too old to have children naturally. In some cases, the prospective parents are a same sex couple who need a surrogate to help them become biological parents, and for others it’s simply a personal choice not to carry their baby themselves.

Many celebrities have used a surrogate to add to their family. Tyra Banks and her boyfriend Erik Asla welcomed a baby boy named York to their family in 2016 via a gestational surrogate. Grey’s Anatomy star Ellen Pompeo’s second child was delivered by a surrogate in 2014. Niel Patrick Harris and his husband David Burtka welcomed their twins in 2010 – they inserted two eggs into their surrogate’s uterus, one inseminated with each of their sperm. In any of these cases, a surrogate can be the answer to the aspiring parents’ dreams.

A surrogate is a woman who carries and delivers a baby for aspiring parents who are unable or unwilling to have children of their own. While surrogacy seems pretty straightforward, it can raise a lot of questions, like: “Is the baby related to the surrogate?” or “Who are the ‘real’ parents?”. The answers to these questions depend on what type of surrogacy is used.

There are two types of surrogacy available for prospective parents - traditional surrogacy and gestational surrogacy. In both cases, the surrogate carries and delivers the baby for the intended parents, but there are major differences between the two types. In traditional surrogacy, the surrogate provides both the womb and the egg, and is artificially inseminated with the sperm from the prospective father or a donor. In cases of traditional surrogacy, the baby will be related to the surrogate as the egg - and therefore half of the genetic material - came from the surrogate parent. In gestational surrogacy, the baby that the surrogate will carry is not related to her - the embryo is created with the eggs and sperm of the parents or donors and implanted in the surrogate. About 750 babies are born via gestational surrogacy in the U.S. each year.

As for the question of who the ‘real’ parents are, traditional surrogacy can complicate things since the baby shares DNA with the surrogate, and for that reason it is the far less common option for aspiring parents looking to have a child through a surrogate. In gestational surrogacy, the surrogate is the “birth mother”, but the biological mother is the woman whose egg was used. In either case, as long as everything is done properly, the intended parents are the “real” parents, whether or not they share DNA with the baby - just like in the case of adoption.

Gestational surrogacy may seem pretty straightforward, but it’s actually quite a complicated and expensive process. Once a couple has decided that gestational surrogacy is right for them, the first step is to find a surrogate willing to carry and deliver their baby. For Jenn and Brad Nixon, this step was one of the easiest parts of the process. After 2 years of trying unsuccessfully for a baby, the couple finally became pregnant with the help of fertility treatments, but sadly they lost the pregnancy at 16 weeks, and Jenn discovered that she had a heart condition that would make pregnancy unsafe for her and her baby.

They were incredibly fortunate to have a close friend who volunteered to be their surrogate, and agreed to carry their baby for free. Even though they did not have to compensate their surrogate, the cost of medical bills and legal fees added up quickly. In the end, it still cost them nearly $35,000 dollars to have a baby through surrogacy, but the couple were happy to pay the price if it meant finally having a family of their own.

It’s not always so easy to find a friend or family member willing to act as a surrogate. Being a surrogate is a huge commitment - the person has to be willing to undergo pregnancy and delivery, understand the impact of giving up the baby after birth, and work closely with the couple for a year or more. Thankfully, there are agencies that will help match aspiring parents with willing surrogates and help with every step of the process. There are around 100 of these agencies in the U.S., and working with an agency gives prospective parents access to willing surrogates who have usually passed the agency’s rigorous evaluations. There are currently no regulations for who can be a surrogate, but most agencies require surrogates to be over 21 years old, to already have had at least 1 healthy baby, and to have passed psychological screening and medical evaluations, including STD screening and immunization tests.

Jessica and Ryan Benson had tried unsuccessfully for years to have a child of their own before their doctor recommended gestational surrogacy. Not knowing anyone personally who could act as their surrogate, they turned to a local agency for help. They met with a case manager who helped them create their surrogacy plan and had them complete a lengthy questionnaire detailing their preferences for a surrogate - everything from the surrogate’s sexual orientation and personality to her preferred level of contact throughout and after the process - as well as helped them complete their own profile to show to prospective surrogates.

Their case manager then showed them 4 profiles of potential surrogates who matched their criteria, and after meeting with the one they liked best, the 3 agreed to work together, and Jessica and Ryan finally began their journey to parenthood. Choosing a surrogate was just the beginning of the process for the Bensons, though. Once they had found someone they liked who was willing to carry their baby and they had ensured she was medically and psychologically fit for pregnancy, there were still mountains of legal paperwork to complete before they could begin their surrogacy journey.

Both the Bensons and their surrogate each had to get their own lawyers to help them finalize the surrogacy contract - and the Bensons had to pay for all of the legal costs.The surrogacy contract covers everything from how the parties would deal with any complications to how the surrogate would be compensated for her service. The contract also outlined the plan for establishing the Bensons as the legal parents of the baby, a process that usually starts once the pregnancy has reached the second trimester.

Establishing legal parenthood is usually less complicated in gestational surrogacy than traditional surrogacy, since the baby is not related to the surrogate, but it’s far from simple and parental rights are by no means guaranteed. There are no federal laws governing surrogacy in the U.S. - the rules vary widely from state to state, and are constantly changing as more and more people turn to surrogacy. In some states, prospective parents are required to legally adopt the baby after birth, while others allow the parents to state their intention to take over legal guardianship before the baby is born.

Gestational surrogacy is currently only legal in 10 U.S. states, and although it is practiced in many others, there are many legal hurdles and potential issues to be aware of. In many states, the surrogate has the right to choose to keep the baby at any point throughout the process, and some states even require that prospective parents be legally married and heterosexual to even be allowed to use a surrogate. Needless to say, lawyers and surrogacy agencies highly recommend holding off until the contracts are finalized and signed by both sides before taking steps to get pregnant.

Once the legal hurdles have been cleared, the next step is fertilization. For the Bensons, this meant a trip to the fertility clinic for all 3 of them. After taking medications to help develop her eggs, Jessica underwent an egg retrieval procedure. Jessica’s egg was then fertilized with Ryan’s sperm in the lab to create an embryo that would be implanted in their surrogate’s uterus. The Bensons were able to use their own egg and sperm, but that’s not always the case - some prospective parents use donor eggs or sperm to make the embryo that will become their baby, either because they have to or because they chose to. The Bensons’ surrogate also had to take fertility medications leading up to the procedure to increase the chances of a successful implantation.

The procedure was relatively quick and painless, and a few weeks later they returned to the clinic to find out if the implantation was successful. Luckily for the Bensons, the procedure was a success on the first try, and 6 weeks later they were finally able to hear their baby’s heartbeat for the first time. Once the pregnancy was confirmed, the Bensons’ surrogate received the first of her regular compensation payments that she would receive throughout the pregnancy. This was just one of the many costs related to the surrogacy process.

The Bensons were also on the hook for all medical costs, including fertility treatments and pre-natal check-ups, labor and delivery costs, as well as their own and their surrogate’s legal fees. They also had to cover travel expenses for themselves and the surrogate, since they had travelled to another state with more favorable laws to have the procedure. They even had to take care of the cost of the surrogate’s food during the pregnancy and pay for her maternity clothes. In all, it can cost anywhere from $100,000 to $150,000 dollars or more to have a baby via a surrogate, but most prospective parents would tell you that it’s well worth the costs. Some insurance companies offer special policies that cover the costs of surrogacy, but the premiums alone can cost 10s of 1,000s of dollars and the prospective parents are responsible for that cost, too.

Finally, after years of disappointment and months of waiting, the Bensons were thrilled to finally welcome a healthy baby into their family. They were incredibly grateful to their surrogate for helping to make their dream of becoming parents a reality. “I think she’s an amazing person who is generous beyond measure,” says Jessica of their surrogate. Unfortunately, not all surrogacy stories end as happily as the Bensons’ and the Nixons’ did, and there is plenty of controversy around the topic of commercial surrogacy in the U.S.

The infamous case of Baby M in the mid 1980s was the first court case in the country involving surrogacy, and it made headlines around the world. In this case the couple had opted for traditional surrogacy, where they had used the husband’s sperm to fertilize the surrogate’s own egg, meaning that the surrogate was biologically related to the baby. After the baby was born and the new parents took her home, the surrogate turned up at their door demanding “her” baby back and threatening suicide if they didn’t give her up. The parents reluctantly handed over their baby, though the surrogate was eventually forced to give her back.

This case is a prime example of why gestational surrogacy is preferred over traditional surrogacy, and why traditional surrogacy is not even legal in many states. Some even advocate against commercial surrogacy altogether, arguing that financial compensation for carrying someone’s baby is unethical.There is also risk on the other side of the table. In 2010, a Nova Scotia couple texted their surrogate, who was 6 months pregnant with twins, to tell her that they were separating and no longer wanted the babies. Thankfully, the surrogate gave birth to the twins and eventually found an adoptive home for them.

There’s also the 2011 case of a Connecticut couple who offered their surrogate $10,000 dollars to have an abortion after testing revealed that the baby had severe abnormalities. Instead, the surrogate fled to Michigan where the rights of the birth mother trump those of the prospective parents, and she gave birth to the baby there before another family adopted it.

But these stories are more like anomalies than typical. Thanks to modern medicine and incredibly generous surrogates, families who can’t have children of their own now have options for creating the family they’ve always dreamed of. Surrogacy is a beautiful gift to give to someone who can’t have their own children, but it is definitely not without its risks and complications.

Understanding how baby surrogacy works turns out to be more complicated than it might seem at first.