Womb for Rent
Why more and more infertile women are turning to others to bear their babies
How Surrogacy Works
There are three facets to most arrangements with surrogate mothers. It's vital that each is carried out:
1. THE MEDICAL PROCESS
Once tests determine that the surrogate is capable of carrying a pregnancy to term and that the intended mother's eggs are of good quality (the father's sperm is also analyzed), the women are put on medication to get their cycles in sync. Typically, this means six weeks' worth of daily hormone injections for the surrogate and three weeks of daily hormone injections to stimulate egg production for the mother.
If a pregnancy is achieved after the eggs are retrieved and fertilized (over three to five days) and embryos are transferred to the surrogate, she must continue to take daily hormone injections for another 12 weeks.
2. THE PSYCHOLOGICAL PROCESS
Potential surrogates working through an agency are required to complete a lengthy personality-profile questionnaire and to meet with a staff psychologist. Most psychologists screen for someone who's motivated by both altruism and financial gain, who enjoyed being pregnant (if she has been before) and had a healthy pregnancy, who has support from family and friends, and whose religious beliefs accept surrogacy. Surrogates must also be able to deal with the stress brought on by the medical aspect of surrogacy and to separate emotionally from the baby. Karen Synesiou of the Center for Surrogate Parenting, in Beverly Hills, CA, says that of the 400 calls she gets each month from women interested in becoming surrogates, only about 10 are accepted after the psychological screening.
Beyond that, the surrogate must be matched to a couple with whom she shares the same beliefs regarding termination of a pregnancy if medically indicated, selective reduction if there are more fetuses than expected, and the amount of contact between the intended parents and the surrogate during the pregnancy and after.
3. THE LEGAL PROCESS
Each state differs in its recognition of surrogacy arrangements. In New York, surrogacy contracts are illegal. In New Jersey, it's legal to have someone carry a child for you, but it's against the law to pay her. Some states don't recognize the intended parents' right to have their name on the birth certificate and require that they legally adopt the child, even though biologically it's theirs. Other states, such as California, are highly favorable to surrogacy. These differences make it important for couples and surrogates to work with a reputable agency or, if putting together a private arrangement, a strong team of experts (doctors, psychologists, and lawyers familiar with state laws), says Mark Johnson, an Atlanta attorney who's written extensively about surrogacy law.
Debra Morgenstern Katz has written for The New York Times as well as national magazines.