Conscious Surrogacy – Making the Best Decisions For Your Family
Is there such a thing as conscious surrogacy? Yes, and those considering surrogacy will be confronted with some serious ethical questions.
Conscious surrogacy is a process. It is critical to understand some of the questions, and dilemmas, that you will face if you choose surrogacy to help you have your family. If you are prepared to answer these questions before your surrogacy journey, and if you are comfortable with your answers, then you are ready to have these conversations with a potential surrogate mother.
What are some of the questions that you will face on your conscious surrogacy journey?
Do I want a single embryo or double embryo transfer? Do I want twins? One of the first questions you will have to consider is whether you want to try and have twins with your surrogate mother. Many choose this option for economic reasons. If you know that you want more than one child, consecutive surrogacy journeys may not be an option. But there is much more to consider.
Twin pregnancies are much harder on the surrogate mother. It can mean doctor ordered bed rest for your surrogate and more doctors’ visits, particularly in the third trimester. Twin pregnancies also bring a higher risk of complications for the surrogate, such as preterm labor, and hypertension.
Twins arrive earlier. A normal singleton pregnancy is 40 weeks. Most twins arrive early, at or before 36 weeks, which means that one or both of the children may require an extended hospital stay in the NICU (neonatal intensive care unit.) Some doctors state that in 50% of twin pregnancies, a NICU stay is required. This by itself may give parents pause about choosing a double embryo transfer. Studies show that consecutive singleton births result in better medical outcomes than a single twin birth. With all the information, you can make a conscious decision.
Do I want PGD or PGS? Preimplantation genetic diagnosis or screening is now being offered by most IVF facilities. PGD or PGS allows a parent to view the genetic material of their child before an embryo is implanted in a surrogate mother’s womb. PGD/S can show whether a child has any genetic disorders, the sex of the child and other genetic traits that may complicate a pregnancy. While infertile couples who use IVF (in vitro fertilization), or anyone with a preexisting genetic condition, may be familiar with PGD/S, couples or individuals who have their families with the assistance of a surrogate mother will most definitely be asked whether they want the information that PGD/S provides.
Knowing whether there is a genetic complication prior to embryo implantation may be in the best interests of all parties, however, choosing the sex of your child before it is born ventures into an ethical quagmire. Most families do not have this information and, while the technology exists, you must ask whether you want the information that it can provide. The mental and physical health of your surrogate mother must be a priority in making this decision.
Do I want to selectively reduce if complications arise? Perhaps the most important questions you will confront is whether or not to selectively reduce, or abort, an embryo or fetus if there is a danger to the surrogate mother or to the child. In reality, no state will enforce a gestational carrier contract which requires selective reduction. The surrogate mother will always have the final say. But you must know what you want first before you can discuss it with your surrogate.
While abortion is one of the most controversial topics in American society, it is routinely a part of conversations that intended parents have with their surrogate mothers. Surrogacy agreements attempt to cover all possible outcomes and obstacles that can arise during a surrogate pregnancy. The most important aspect of this topic is being able to communicate your beliefs and desires with your surrogate.
There are many more issues that intended parents will face. Conscious surrogacy is about understanding the major decisions surrounding these issues and being able to come to a place of peace with each one, first with yourself, then with your surrogate mother. Respecting her autonomy during the pregnancy will take you a long way toward reaching this goal. Maintaining open and honest communication with your surrogate mother will also help to ensure that the journey is successful for all involved.
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