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  • Writer's pictureJanene Oleaga, Esq.

How Does Surrogacy Work? What it's like to be a Surrogate from a 2x Gestational Carrier

Updated: May 6, 2023

If you are curious about what it's like to be a gestational carrier, you're in the right place.

Two-time gestational carrier, Jen, tells me all about her two surrogate journeys.


*Note: A traditional surrogate contributes the egg used in conception and gestates the pregnancy. A traditional surrogate is genetically related to the child she carries. A gestational carrier (sometimes referred to as a "gestational surrogate") does not contribute the egg used in conception. Instead, one of the intended parents or an egg donor provides the egg used to create the embryo that is then transferred to the gestational carrier's uterus. The gestational carrier carries a child she is not genetically related to for the benefit of the intended parent or parents. Gestational surrogacy is the more common form of surrogacy in the United States.

Gestational surrogate, Jen.
2x Gestational Carrier, Jen

My work has led me to cross paths with some of the best people on planet Earth. I am in awe of the strength of my intended parents, and the gestational carriers, gamete donors, and fertility doctors who make parenthood possible.


For three years I was lucky enough to have a front row seat to Jen's generosity, commitment, sense of humor, and all around good-nature. Her Intended Parents are lucky to have her. Her surrobabes are lucky to have her. Quite frankly we are all lucky to have her. The world is brighter because of Jen and countless other gestational carriers who help people fulfill their dreams of parenthood. Jen said it best: "[S]urrogacy restores my faith in humanity."


- Janene Oleaga


 

Question: What made you want to be a gestational carrier?

Answer: As you’ll hear from almost all gestational carriers – I really enjoyed being pregnant. I just happened to be fortunate by having easy pregnancies, only mild nausea and mild discomforts. I also had relatively easy births, received amazing care from my work family (I was working as a maternity nurse at the time), and from my phenomenal OB doctor. As a result, I had nothing but fond memories of pregnancy and birth. I vividly remember returning to my OB’s office for an annual checkup following my son’s birth and being flooded with nostalgia. The emotion was mixed with sadness that I would not get to have that experience again, as my husband and I had agreed that our family was complete. What was I to do with this feeling of wishing I could experience pregnancy again but not wanting to have more children?


Shortly after, it occurred to me that my problem had a perfect solution. I always knew I wanted to be a mom, and understood the path to parenthood was not as easy for everyone else. I could empathize with how heartbreaking that would be; to have that desire to be a parent but not be able to. I thought, hmm… how amazing would it be to get to be pregnant again, while not having more kids, AND get to help someone else achieve their dream of having a child? It seemed meant to be.


Furthermore, surrogacy restores my faith in humanity. Not to be bleak, but do you ever find yourself discouraged after watching the news? Hearing all the stories about how humans can be so terrible to each other can be depressing. Knowing there were women out there who were capable of doing this act of kindness for complete strangers is pretty beautiful. I wanted to be one of those people, experiencing the joy firsthand.


Q: How did you select a surrogacy agency to work with?

A: I knew a coworker at the time of that fated OB checkup who had completed several gestational surrogacy journeys. I reached out to her and asked some basic questions about her experiences. Her responses solidified my feeling that gestational surrogacy was something I wanted to do. She told me about a Facebook group that reviewed various agencies, while also offering her personal experience with her most recent agency. I joined the Facebook group, but quickly became overwhelmed with all of the options. I checked out the website for the agency she had a good experience with, which had a lot of helpful information. In my eagerness, I quickly jumped into their application process.


A couple months later (note: the application process is a lot more cumbersome than I initially realized…), I received an email that I would not be able to be a gestational carrier due to my history of a pregnancy complication. I was crushed at the news, as I realized how much my heart had become set on the idea. I was also confused, because I didn’t have the pregnancy complication they noted. My OB wrote a letter attesting that the mention in my medical records was an error, but for whatever reason the doctor reviewing candidates for the agency still said no. It felt like suddenly someone else was deciding I would never experience pregnancy again, instead of me getting to make that decision for myself. As I shared my disappointment with my coworker, she revealed she happened to know another agency owner through her personal life, and offered to connect us. I exchanged emails with the new agency owner, and asked if it was possible to make sure this error on my records wouldn’t be denied again. Quite frankly, I didn’t want to spend another several weeks on the application process only to be disappointed again. Luckily this doctor accepted the letter from my OB, and I was able to proceed with the rest of the application process with no issues.


In retrospect, I got lucky. I should have done more homework comparing different agencies and looking at reviews. Knowing what I know now, I would encourage anyone looking into gestational surrogacy do so to protect their experience. Fortunately, the agency I ended up with was everything I could have asked for! They walked me through every step, offered personal support at every stage, and provided access to a community of other gestational carriers that I am still a part of today.


Q: How did you match with Intended Parents (IPs)? Did you have any specific criteria?

A: The surrogacy agency helped facilitate my matches. Part of the application process was completing a profile, sort of similar to a dating profile. It asked me questions about my previous pregnancies, my hobbies, my family, my job, my motivation to become a surrogate, etc. It also asked some tougher (but necessary) questions like how much communication I wanted during and after the pregnancy, how I felt about carrying multiples, selective reduction, and termination for medical reasons. One question asked what type(s) of families I was willing to work with (i.e. heterosexual couples, homosexual couples, single parents, international parents who speak English, international parents who don’t speak English). Ultimately, I checked the box for all scenarios except international couples who didn’t speak English, because I imagined it would be hard to build a relationship without a shared language to communicate through. The communication piece felt very important to me. I didn’t expect to be a part of their everyday life, but the idea of regular contact during the pregnancy and periodic updates and photos after the baby was born felt right for me.


From what I understand, the IPs received a few gestational carrier profiles to consider before selecting someone to meet. It was only a short time after my application was completed that I received an email saying someone was interested in meeting me. I was offered an opportunity to review their profile to decide if I was also interested in meeting them. At that point the agency connected us by email, and let us arrange a time to meet via video chat. All my matches happened to be international couples, so video chat was logistically necessary. After the initial chat, each of us had an opportunity to let the agency know if we wanted to move forward together. Luckily the feeling was mutual, and I moved forward with each couple after that first call.


Q: What was medical and psych evaluation like? Did you travel? Who did you meet with?

A: Psych evaluation seemed intimidating at first, but ended up being no problem. With my first journey it amounted to a 30-ish minute phone call, during which I was asked more or less things I expected. Why do you want to be a surrogate? What is your support system like? How do you handle conflict? Do you have any concerns about becoming a surrogate? That sort of thing. On my second journey the practitioner was a bit more thorough, but asked a lot of the same questions. I met with her via video chat for about an hour, which included answering a series of multiple-choice questions about my personality. This practitioner also met separately with my husband, reviewing similar topics.


Medical evaluation was more of a fun adventure, as I did need to travel for those. We’re talking about a time when I hadn’t traveled for years due to raising two small kids! So getting to travel on a plane to anywhere and stay in a hotel felt like a mini-vacation. The fertility clinic for the first IPs I matched with was in Connecticut. I flew over, stayed overnight, went to the appointment in the morning, and flew back that afternoon. At the appointment I met with their surrogacy program coordinator, and we reviewed a lot of paperwork and consent forms. I met the reproductive endocrinologist (RE), and talked more about what to expect. I had some blood work drawn, and the RE performed a saline sonogram to look for any structural abnormalities. Shortly after this, the world started shutting down because of the pandemic. The IPs I had matched with both lost their jobs, and understandably, and sadly, had to abandon their journey. The next IPs I matched with (who became the first couple I carried for) were using a fertility clinic in Oregon. This clinic was willing to accept the results of the medical evaluation I already completed, and we were able to move forward without repeating it.


The second couple I carried for happened to be using the same fertility clinic in Oregon as the first couple. This time I did travel to Oregon for the medical evaluation, and the content of the visit was very similar. The hardest part of the medical evaluation for me was the logistics to travel on short notice. The fertility clinic asked me to call each month to report the first day of my cycle (aka the first day of my period). The medical evaluation was to take place sometime between day 6-11 of my cycle after completing legal contracts. As such, while I had a rough idea when this might happen, I only had about a week notice for the exact dates. Not the easiest thing to juggle with work and family. On my second journey, it happened to fall on the week of Thanksgiving, when I was already also traveling to Boston to complete orientation for my new job. Thank goodness I had a super supportive husband who helped me make it all work!


Q: What was the legal process like for you?

A: The contract phase took longer than I expected – about a month total. The majority of that time was waiting for the intended parents’ lawyer to send over the first draft. I was also surprised at how long it was – about 45 pages! It was very thorough, and covered topics I had not thought about. Because the contract was so eye-opening about the various scenarios that needed to be discussed ahead of time, I remember feeling grateful that I was going through an agency (who then connected me to a lawyer who specialized in this specific type of law) who could walk me through this crucial step. My husband and I read through it, and were given opportunities to negotiate various terms until both parties were satisfied with the contents. After finalized, my husband and I both went to the town hall to have our signatures witness by a notary public.


Later on, around the second trimester we met again to complete the pre-birth order. I was proud to later realize that Maine was a state that had more progressive views on this matter, and were more friendly to surrogacy type agreements. This meant we were able to file all the documents and meet with a judge to establish the intended parents as the legal parents before the baby was even born. As such, the intended parents’ names went directly on the birth certificate, and they were given full parental rights immediately upon birth. I imagine that was a great relief to the intended parents, but also gave my husband and I peace of mind that we would not be responsible for making any medical decisions on the baby’s behalf, should that have been needed.

Fortunately, I would say both matters went smoothly for us.


Q: What was it like taking meds in anticipation of embryo transfer? Was it painful? How many shots?

A: Taking the medications involved in being a carrier is probably my least favorite aspect of the process. I am a nurse, and a pretty organized person by nature, and even I thought, “woah…this is a lot” when I learned what it all entailed. Every fertility clinic has their own protocol, but my clinic used a combination of pills, injections, and vaginal suppositories. The correct timing of the medication is very important to have a successful transfer, and the dosage for things changes depending on the results of your timed bloodwork. I was so thankful that the fertility clinic provided an individualized calendar outlining what to take each day to keep it all straight.

fertility medication

I took these medications for about a month before the embryo transfer, and then continued some of them for an additional 8 weeks to support the early pregnancy. Some were worse than others – mainly the injections. The lupron injections were small and easy to give to myself, in the abdomen. Per my clinic’s protocol, I did those daily for 4-5 weeks before the embryo transfer. The estradiol and progesterone in oil injections were more difficult, and painful. The estradiol injections were twice a week from the week before transfer through the 8ish weeks after, and the progesterone shots were daily during that same time. Some rather talented gestational carriers figure out how to administer these injections themselves (in the upper-outer butt region), but I found that to be super tricky. Luckily my husband is also a nurse and could reach way more spots than I could, although he hated doing them as much as me. He did his best to rotate injection sites, but when you are taking them every day, you quickly run out of non-tender options. He said he hated causing me pain, and was just as excited for us to graduate from shots as I was. I found it most helpful to sit on a heating pad afterward to disperse the medication. Other surrogates find it helpful to numb the area before with ice, and/or massage the area afterward.


While the meds aren’t so fun, it’s such a small part of the entire experience. When I think about the months of preparation beforehand, and the months of pregnancy that follow, those 12 weeks or so of medications feel short in comparison.


Q: What are the ups and downs of pregnancy?

A: A lot of the early parts of pregnancy brought a mixture of excitement and nervousness. I was super fortunate in my surrogacy journeys because all my pre-transfer test results were good, and achieved a successful pregnancy with the first transfer both times. That is definitely not the case for everyone, so the worry that results wouldn’t be favorable was always there. Every appointment or test was a build up of nervousness, followed by relief that everything was ok to proceed. The pressure of wanting a good result felt more intense than my own pregnancies, because the outcome didn’t just impact me. Being a gestational carrier comes with a sense of responsibility for the pregnancy to turn out well, even though there’s only so much about it we can control. Making it through the first trimester successfully was when I felt able to relax and just enjoy the pregnancy. I think that moment was more delayed for my IPs, as both couples waited longer to share their pregnancy news with friends and family. I became excited for appointments, and would look forward to chatting with my IPs after to share updates and/or ultrasound pictures. It made me so happy to hear how excited they were with each step we took in the pregnancy.


Delivery nurse in hospital with gestational surrogate and baby.

In my most recent journey we received early genetic testing results that were screen-positive in one category. The chance of an actual abnormality was low, but still possible. That was a tough week, with the added concern that something might be wrong. We had the ultrasound anatomy scan the following week, and fortunately the maternal fetal medicine specialists were able to confirm there were no issues.


Both of my surrogacy journeys happened during part of the pandemic. Initially, I thought this would have a negative impact. So much was uncertain and scary in those early months, especially because I was a healthcare worker. As it turned out, the surrogacy journey became a source of comfort in an otherwise challenging time. It gave me something positive and exciting to focus on in the midst of everything else that was going on.


Towards the end of the pregnancies, I would become increasingly uncomfortable, but simultaneously super excited as we neared the time for the parents to travel to the US for the birth. The agency recommended they travel to the US about 2 weeks prior to birth. Having international IPs (and both journeys happening during the pandemic) meant we spent the entire pregnancy communicating through text and video chat. Finally meeting each other in person and getting that in-person hug was just the best.


Q: Any difference in your surrogate pregnancies compared with your childrens' pregnancies?

A: Only in the way I perceived the experience. When pregnant with my own kids, each exciting milestone was in mind of our growing family. I would mentally prepare for that child, and think about the way in which he/she would be a part of our family and daily life. With my surrogate pregnancies, I always knew the baby was someone else’s. I cared about the baby’s well-being, but I didn’t bond in the same way I did with my own children’s pregnancies. Instead, my excitement for those same milestones was on behalf of the intended parents. It was as if watching a close friend or family member experience the excitement for their pregnancy, and celebrating with them along the way.

surrogate pregnancy

Q: How did you explain surrogacy to your children?

A: Deciding to do this provided an interesting early opportunity to discuss families and basic reproduction. We talked about how families come in all shapes and sizes (mom + dad + kid(s), two moms, two dads, one parent, other family member caring for kids, blended families etc.). We explained that babies start as embryos (that are kind of like a “baby seed”) and the seed is created with one part from a boy and one part from a girl, and the seed can then be grown into a baby by a girl. As such, some families (for a variety of reasons) need help from a girl to help grow their “baby seed.” I told them I wanted to help another family grow their baby, but was also able to explain that I didn’t give the girl part of the “baby seed.” My first IPs also sent my kids this adorable book titled “My Mom is a Surrogate” that was lovely and age-appropriate.


My daughter, who was 5 at the time of this first discussion, was immediately on board and excited. Her biggest concern was how we would go about mailing the baby back to the parents in Australia after he/she was born. We quickly assured her we wouldn’t need to do that, since the IPs would come here for the birth. My son was only 3, and honestly didn’t seem to notice the first surrogacy even happened. The second time around he was 5, and while he read the “My Mom is a Surrogate” book with us, he continued to show minimal interest in the pregnancy. Rather, he seemed most excited for the IPs to come visit us and become new friends to play with.


For my second journey my daughter was 7, and remembered enough of the first journey to understand what to expect. She remembered that last time I was a gestational carrier my mom came to take care of them for several days at a time (when my husband travelled with me to the embryo transfer, as well as during my hospital stay), so she looked forward to having my mom come stay again. In fact, she recently asked if I could please be a gestational carrier again so my mom could come babysit again, haha. She was also excited to make friends with the new IPs, already planning what games she wanted to play with them, and which of her favorite stuffies to show them. She asked to read the “My Mom is a Surrogate” book often at bedtime, and was proud that “my family is helping another family grow.”


At one point during the postpartum period when we had spent some time with the IPs she asked me, “are we related to the baby?” I reviewed the basic reproduction talk we discussed earlier to conclude that ultimately no, we aren’t related. To my surprise she said, “but can we be?” I was touched to realize she had grown bonded to their family like I had, and was looking for some way to categorize the closeness of our families. Going forward, we loosely refer to the surrogate babies as “cousins” and I have been termed “Aunty Jen” to the babies as a way to try and capture that sense of closeness we have come to embrace.


Q: What was delivery like each time? Were IPs present?

A: All of my deliveries have included a plan to induce at 38 weeks due to a chronic blood pressure history. While this plan got started a day or two early with each of my kids, I didn’t have any problem with increasing blood pressures with my first surrogacy pregnancy. As such, my husband and I were able to calmly waltz into the hospital at 38 weeks for my scheduled induction. It was surreal, but pretty amazing. It was during the pandemic, so hospital rules at the time only allowed for one support person in the delivery room. We were all so grateful that the hospital made an exception without hesitation so the IPs could be with us for the birth. After I got admitted, the IPs came over to the delivery room to join us. The early part of inductions can be lengthy and somewhat boring, so we spent several hours hanging out and watching episodes of “Chopped.” I remember the staff remarking at how good a time we seemed to be having, since they kept hearing laughter coming from our room. The IPs were with us for almost the entire time, except for a couple hours to nap (the wonderful hospital staff set up a space for them to sleep in the vacant waiting room), and to give privacy when I was having my epidural placed. Most importantly of course, they were present for the birth, and were able to be the first ones to hold their baby skin-to-skin. One nurse was able to focus on the baby and them in one half of the room, while another team was able to finish up my delivery on the other side of the room. The whole experience lasted about 24 hours – from being admitted to the time the baby was born.

Surrobaby.  Newborn delivery. Intended parents.

The second surrogacy delivery had a little more challenges, but with the same overall success. This time, my blood pressures elevated during the 36th week, leading to some observation on the prenatal unit and moving up the timing of the induction. There was some added excitement on account of one of the IPs being out of state when the induction got moved up, a flurry of rebooking travel options, and trying to get back to Maine in the middle of a blizzard… but everyone was present before the delivery! Once again the hospital staff was amazing, and went above and beyond being inclusive of the IPs’ participation in the labor and birth process. My incredible doctor worked with us to space out the early induction to allow time for our stranded IP to return to Maine. Our intentional delays contributed to a bit of a longer experience, with about 29 hours total for the labor and delivery portion.


In both experiences, those first moments after birth were so rewarding. It was the culmination of all the time and effort that went into getting and being pregnant, into seeing that misty-eyed joy on the intended parents’ faces when they got to hold their baby for the first time. I still get misty-eyed myself when I remember those moments.


Q: What was postpartum recovery like? Physically and mentally.

A: A lot easier than with my own kids! It was rather nice to be able to prioritize my own recovery, without simultaneously jugging the needs of a newborn. I did choose to pump breastmilk for the surrogate babies so I didn’t get to sleep through the night right away, but I certainly slept longer periods than I did after having my own kids.

Truthfully, the postpartum part has been my favorite of both experiences. In the weeks that followed birth, the intended parents and baby stayed locally while handling legal documents prior to traveling home. As I was pumping milk for them, it naturally made sense for us to get together every couple of days. Sometimes I would go visit at their Airbnb and we would chat, share a meal, and I would enjoy some baby cuddles. Other times they would take an Uber to my house and visit with my family. My husband would cook a delicious meal, I would bake some special dessert, my kids would sing to the baby, and inevitably lure the intended parents into their elaborate hide-and-seek or guessing games. Our families became so bonded in those postpartum weeks, that they felt like extended family. The hardest part was saying goodbye, only because we knew logistically it would be a while before we saw each other again. It seems worth mentioning that the sadness was not specifically related to the baby leaving – rather that we had developed a closeness with the entire family and wished we could spend more time together.


Q: Do you still keep in touch with IPs?

A: Yes, definitely. With both families. I regularly text and occasionally video chat with them. When we do video chat, my kids like to hop on screen and say hello. I absolutely love the continued photos and videos, seeing how much joy the child has brought to their lives, as well as to their family and friends. I am overjoyed that I was a part of making that happen for them. We fully intend to visit each other again in the future, as our lives allow the travel to do so.


Q: Will you ever consider being a surrogate again?

A: Absolutely. For those gestational carriers who were as lucky as me to have perfect intended parent matches, how could you not? Other carriers in the agency Facebook group have said how “addicting” being a carrier can be, and I can see why. Being a gestational carrier was an experience unlike any other, and brought such fulfillment and happiness to my life. As long as I remain physically able to meet screening requirements to do so, I feel like mentally I could keep going and going. It is too soon to say, but I suppose “we shall see” what further opportunities life will offer.

 

This interview is shared with permission.


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