Psychological component of surrogacy
The majority of people knows what surrogacy is. The number of babies born in this way is growing every year, because this is one of the few opportunities for infertile couples to experience the joy of being parents. Giving the baby up at birth is considered to be an enormous difficult decision, which can lead to a serious psychological trauma for a surrogate mother.
In fact, during the pregnancy, a woman can consult a psychologist at the UKRCOM agency. One of our tasks is to help to overcome the difficulties associated with carrying and giving birth to a baby. A surrogate mother knows that she is carrying genetically someone else's baby, so she does not create an emotional connection with him/her for her own peace of mind.
One of our SM said: “Yes, I loved him, he was pleasant to me. I stroked my belly, saying: My pretty one. But I felt that this was someone else's child, he was not mine, I understood that I would give him up. Moreover, when he was born, he looked like his biological parents. I haven’t had even a feeling that this is my baby".
Sometimes surrogate mothers experience some negative feelings after childbirth, but this disappears in the first two weeks, when the level of hormones returns to normal. Most surrogate mothers do not experience emotional discomfort due to the giving up. On the contrary, they know that they have given some people the joy of being a real family, and now they have the time and financial opportunity to take care of their family. Surrogate mothers view their mission as a job that gives them a sense of pride and self-respect, because they help people. Isn't that wonderful?
At some point, parents who have used the services of a surrogate mother should make a decision whether to tell their kids about this. There is always a possibility that the kid finds out that he wasn’t carried by his own mother.
While children are small, they do not understand how they were born, what surrogacy or adoption is. From birth to three years old, only your love and care is important to them. Between the ages of six and seven, children ask many questions about how they were born. At this age, it is better to give concrete answers which they are able to understand and to avoid abstract concepts.
Psychologists advise to tell kids about birth when they ask about it. You have to avoid biological terms that are incomprehensible to babies. You can do this with the help of special children's literature with pictures. According to different studies it is better for children to learn about this from their parents, not from other people. It is important to explain that sometimes one woman carries the baby and the other is raising, and it is normal. It is the choice of the parents whether to tell the truth to your kids or not. But they always feel that something is being hidden from them.
A specific aspect of the program is the high anxiety of intended parents: "who will they choose for us, will this candidate be a good, reliable «guardian» of our baby?» This anxiety is compounded by the fact that agencies do not recommend or even expressly prohibit direct contact between IPs and SM. This is partly due to privacy concerns, but mostly due to reasons that we will discuss in detail in our next posts. Besides, this increased anxiety is also superimposed on the long-awaited event factor – many of IPs go to this program for 10 or more years.
How does the SM behave? Isn’t she violating the regime? Is she eating well? Is she following medical prescriptions? Isn’t she doing anything that could harm the baby? Is the baby growing up healthy? These questions, directly or indirectly, come up until the moment when doctors confirm that a healthy baby was born.
IPs sometimes call us because, for example, one of them had a bad dream or it got cold outside and they are interested in whether the surrogate mother wraps up. But remember you will be the first to know about any changes, and if we don't call or write you, everything is fine, there is no reason to worry about.
Therefore, try to calm down, relax and wait with good, happy thoughts for the birth of your treasure!
So, we come to the interesting question: why don't “heartless” agencies allow the intended parents to communicate with the surrogate mother? The answer is simple, but disappointing for IPs: the parents don’t know how to do this, and this can lead to serious consequences. The relationship of the parties is determined by a written agreement, which clearly states what services are entrusted to SM, rights and obligations of IPs and SM, responsibility for non-fulfilment of their obligations under the agreement. And all disagreements that arise are resolved by the parties through constructive negotiations. This is exactly what happens when relationships are built between agencies and SM.
However, practice shows that it is almost impossible to build perfect relationships, when IPs and SM communicate directly. What does SM lose in case of an unsuccessful outcome of the program? A certain amount of time and potential reward. What do IPs lose besides the same money and time? BABY. Who loses more? Do you think SM doesn't understand this? Of course, she understands. Psychologically, the position of IPs is extremely vulnerable here, and in the vast majority of cases, the relationship "customer – contractor" turns here very quickly into "I said – you did", and, as we understand, "I said" here does not refer to IPs at all.
In other words, SM gets used to the idea that IPs owe her everything and even more. A typical example from real life. The story of a surrogate mother: “Well, I wanted a watermelon at night. After all, this is necessary for their child! I called my parents, in two hours they brought me a watermelon". The case took place in the middle of the night, but the IPs had no other option as to bring her what she wanted. As well as the following situation: “My daughter is wearing such an old down jacket. Let’s rather buy my daughter a down jacket, and I’ll manage somehow”. It is clear that both the daughter and the mother have new winter clothes.
Such situations can lead to revising of the essential points of agreements between SM and IPs (for example, the amount of reward). And in this case, IPs will either be forced to yield to the increasing requirements of the SM, or there is a real danger of a serious conflict, which may, for example, end by abortion by the decision of the SM or IPs.
We understand that this is a very exciting stage of your life, but trust us, we are always on your side!
Assisted hatching is an additional procedure that can be performed during IVF program. Once the embryo is created, it is surrounded by a hard outer layer of cells and for further development into a pregnancy an embryo must break this hard of cells. With the help of assisted hatching, we can help the embryo to break free, by making a small cut of the layer. This procedure is usually performed on the 3d day of embryo development. With the help of laser embryologist makes a very small cut in the layer of cells. But remember that this procedure may lead to splitting of the embryo with further having of identical twins.
The surrogate mother becomes pregnant through the IVF procedure. IVF procedure begins with the harvesting of eggs, which may belong to the intended mother or to an egg donor. The stimulation protocol is an important part and is necessary to increase the number of the received eggs. The next step is to freeze eggs for storage or to fertilise them by the sperm of the husband. The sperm may be used fresh, collected the same day of the egg retrieval, or collected in beforehand and thawed on the appropriate day.
It's good to have at least several eggs (if they belong to the intended mother, as the egg donor may produce up to 50 eggs) to increase the chances of fertilisation. The doctor transfers embryo with a special syringe into the surrogates uterus, then the surrogate mother has a rest for several hours. Meanwhile embryos need to implant themselves into the uterine wall where they will stay for the next nine months. IVF pregnancy will move forward like any other pregnancy where the baby continues to grow and develop in the womb of the surrogate mother until it’s time for the baby to be born.
Pregnancy and delivery
During the pregnancy one of the major questions is related to genetic disorders of the fetus. In case of an abnormal triple marker test result, the doctor will advise you a procedure called “amniocentesis”. This procedure is made between 16-18 weeks of pregnancy, as results may take 3-4 weeks, while the termination of the pregnancy is possible till the 22d week of pregnancy. Amniocentesis is a prenatal test, which provides an information about fetus chromosome abnormalities, genetic disorders and neural tube defects (e.g. down syndrome is the most common chromosome abnormality). To perform it, the doctor, with the help of a siringe and ultrasound scan, takes the sample of pregnant woman amniotic fluid, which includes cells shed by the fetus. One of the major risks related to amniocentesis test is miscarriage, which may happen because of: water braking, infection in the uterus and premature labor, the siringe may come in contact with the fetus. Nevertheless, the risk of miscarriage is not higher than 1%. This procedure is described as an uncomfortable rather than painful and takes 30 min.
Pregnancy is always monitored by ultrasound to avoid any abnormalities of the fetus (e.g. splitting of the palate). When necessary CGH test can be done to get an explanation of the nature of such disorder, that it is e.g. DiGeorge syndrome. CGH is a laboratory test that is used to see if the baby has a chromosome change which may explain the ultrasound findings. It can detect very small chromosome changes which cannot be seen by the standard chromosome test like karyotype.
Medical assistance during the delivery of a baby can vary from use of medicines to emergency delivery procedures. Vaginal delivery is the most common type of birth. A cesarean section, also called a c-section, is a surgical procedure performed if a vaginal delivery is not possible. The final decision about the procedure make doctors from the maternity hospital. Just at once after delivery, you will see your baby. The next 3-5 days the surrogate mother and the baby spend at hospital. All these days you are responsible for taking care of the newborn. However, do not be scared, nannies will give you detailed instructions, although until that moment you will know everything about feeding and looking after your newborn child. Sometimes the delivery begins before our clients come to Kyiv. You should try avoiding such situations, but still it can happen. If this case, the baby will be under supervision of the nannies until you come. At the hospital, you also have a chance to make a screening and to vaccinate your baby. Some of the clients are very fond of breast-feeding – it may be discussed separately.
For the clients who need assistance with shipping of the embryos/sperm/eggs to Ukraine, just let us know and we will arrange this procedure. It requires special dry shipper and licensed courier who delivers human tissues without x-ray-control to avoid damage of it.
Briefly, all the process looks like:
- liaison with both clinics to arrange the collection and delivery,
- fully charged dry shipper is approved to be taken on board aircraft as hand luggage,
- shipper is sealed on collection and the seal is broken by the receiving clinic,
- security clearance allows courier to pass airport security without x-ray-control,
- courier personally carries all the consignments,
- shipper maintains the requisite temperature for 7 days but the consignment is normally completed within 48 hrs.