Surrogacy


Intended Parents and Surrogate

Surrogacy is a beautiful gift bestowed upon intended parents and is also incredibly rewarding for the surrogate/gestational carrier! Every surrogacy journey looks different and we are here to share with you the amazing journey surrogate mothers go through. Aileen Miller of Four Element Photography, one of Perth’s leading birth photographers absolutely loves the positivity surrounding a surrogacy birth and would be incredibly honoured to be part of your special story!

What is surrogacy?

Surrogacy is when a fertilised embryo is planted into the uterus through IVF of a woman that has no biological connection to the embryo.

What type of scenarios are likely for surrogacy?

Fertility issues – some women have issues conceiving and can either not get pregnant or cannot sustain a viable pregnancy. Women who choose surrogacy for this reason have generally tried for years and have been unsuccessful. Unsuccessful use of medications, unsuccessful attempts at insemination or IVF or women with recurrent pregnancy losses (miscarriage and stillbirth). Woman who have or are currently receiving chemotherapy are likely to have fertility issues as well as women who have been exposed to high levels of radiation through work or environmental causes.

Health issues – sometimes women are born with issues that affect the functionality of the reproductive organs and some women also sustain injuries to their reproductive organs over their life through STI’s, previous birth injuries, ectopic pregnancies, cervical cancer, terminations and unfortunately sometimes caused by assaults.

Age – as women get older their eggs are more likely to become damaged and be less likely to result in a viable pregnancy as well as the toll pregnancy would take on their body being a common concern.

Same sex couples – when there is a same sex couple (generally male) that would like to expand their family, surrogacy is a wonderful option. They can choose to have the embryo fertilised by one of their sperm or by another sperm donor.

Surrogacy Laws in Australia

Are there any legalities surrounding surrogacy?

- In Australia it is illegal for you or your partner to be paid to carry a surrogate baby however there will be negotiated allowances for pregnancy, birth, and postpartum expenses to be covered

- It is illegal to enter into a commercial surrogacy agreement internationally (Western Australia)

- Intended parents and surrogates can advertise their desire for surrogacy however they are not allowed to pay for the advertising of the desire

- Intended parents must be 18 years of age or older

- Must be a single female or a heterosexual couple/marriage (only applies to Western Australia)

- Surrogate and her partner must be 25 years or age or older

- If the surrogate mother chooses to keep the baby the law can not enforce the surrogacy agreement

- If the intended parents choose not to accept the baby, the law can not enforce the surrogacy agreement

- If the surrogate mother chooses to keep the baby, the intended parents can legally enforce the recovery of prescribed costs related to the baby

- When the baby is born, it will be registered in the state it was born in

- When the baby is born, the surrogate mother and her partner are listed as the parents on the birth certificate

- After the birth has been registered, the intended parents file to court for a Parentage order in the state they reside in. The birth certificate will then be reissued with the intended parents’ names and the surrogate and her partner’s name will be removed. This process much been done after 28 days following the birth and before 6 months of life

- All parties of the arrangement (intended parents, surrogate, and surrogate’s partner) must seek independent legal advice, counselling, and medical suitability screening at least 3 months prior to the arrangement

- Arrangements must be in writing and signed by all parties (including donors)

- The surrogate must have previously given birth to a live child

- Surrogacy must be approved by the Reproductive Technology Council (Western Australia)

- An intended mother must be unable to conceive naturally, unable to deliver safely or would likely conceive a child with a genetic abnormality or disease

What are the criteria that need to be met to be a surrogate?

- Surrogate and her partner must be 25 years of age or older

- You do not require a partner to be a surrogate mother

- Surrogates can not be peri-menopausal or menopausal

- Must not have a history of pregnancy-related illnesses or complications

- Must not suffer from any significant psychiatric disorder that could impair the decision making

- The surrogate is not allowed to use her own eggs

- Surrogates must have previously birthed a live baby (NSW and QLD exempt)

- You are not able to have intercourse during the time from conception attempts beginning and a confirmed positive test. This is to ensure that the successful pregnancy is indeed the intended parent’s embryo. Some intended parents choose to include in the contract that the surrogate is not to engage in intercourse through the whole process (agreement signed to after the birth of the baby)

- If you have previously been married and have not finalised the divorce, this could affect the agreement and parentage orders

- Laws regarding surrogacy need to be followed based on the laws of the state the intended parents reside in

- You need a medical clearance that your body is in optimal form to sustain a healthy pregnancy and delivery

What are the criteria that need to be met to have a surrogate?

The laws surrounding your individual surrogacy journey will be controlled by the surrogacy laws of the state the intended parents reside in. In Western Australia single men and same-sex male couples can not pursue surrogacy unless they go through an international agency. Northern Territory do not have any surrogacy laws meaning they do not allow or prohibit it. Women with fertility issues will not qualify for surrogacy unless they have attempted to use donor eggs in their own uterus first. Inability to carry a pregnancy due to psychological needs will be considered for surrogacy.

- Single men

- Same-sex male couples

- Single women and heterosexual couples where the woman does not have a uterus (born without a uterus or received a hysterectomy due to medical reasons)

- Single women and heterosexual couples where the woman can not carry or should not carry to term due to medical conditions (chronic health condition, medications incompatible with pregnancy, history of recurrent miscarriages, still birth or preterm birth)

- Same-sex female couple where both women have been deemed medically unable to carry a baby to term

Do I have a say in my birth?

Yes. Body autonomy is maintained throughout your pregnancy and birth. A care plan and birth plan will be negotiated between the surrogate and intended parents, however the surrogate is able to make to final decision regarding her body, even if it effects the baby. There are no rules regarding what the surrogate can and can’t do with their body while carrying the baby of intended parents, but surrogates will generally treat the pregnancy and the baby much the same as if she were pregnant with her own child. If there are differences between the surrogate and the intended parents about how she will manage the pregnancy, it is best to work through those issues prior to conception. If there are disagreements about anything to do with how the surrogate will manage the treatment, pregnancy, or birth, ultimately the surrogate can make the final decision.

The surrogate has full rights to keeping her medical details private regarding past medical history and current medical treatment. Prior to conception, information-sharing needs to be discussed with legal advice and include an outline of what can and can not be shared directly from health care professionals to the intended parents. Majority of surrogates choose to inform the intended parents of every step along the way, but they are not required to and do have a right to privacy and medical confidentiality. If consent is given to share information once, it is not a blanket consent on all information. Consent must be obtained each time medical personnel share information about the surrogate with the intended parents.

Termination of pregnancies needs to be discussed before attempting to conceive. Intended parents can not force a surrogate to terminate and a surrogate can not be forced to continue a pregnancy. Termination is not a likely scenario, but it does need to be discussed where the boundaries and guidelines are.

- Is the surrogate happy to continue a pregnancy with complications?

- Are the intended parents happy to continue a pregnancy and receive the child with high likelihood or confirmed genetic abnormalities?

Do I have a say in the baby’s future?

That is completely up to you and the intended parents, however most times the intended parents are thrilled to have you as a continued part of their life.

Feeding options

- Breastfed during first 48 hours (optional)

- Exclusively formula fed

- Mixed fed (formula and expressed breastmilk)

- Donor breastmilk

- Induced lactation of one or both intended parents

What is included in a surrogacy contract?

Finances – medications, IVF process fees, bloodwork, tests, ultrasounds, birthing classes, hospital and birth fees, travel, allowance for clothing and compensation due to inability to work on medically approved bed rest orders (check your states laws on compensation for loss of income)

Risk and Liabilities – pregnancy symptoms, pregnancy complications, birth complications, miscarriage, stillbirth, preterm birth, damage to reproductive organs, IVF risks and complications, infection, risks of a multiple’s pregnancy (twins, triplets, etc)

Emotional Risks – hormonal changes, prenatal and postnatal depression, grief and loss emotions, stress on the surrogate’s partner and/or family

Restrictions – diet, smoking, drinking, illicit drug use, prescribed drug use, terminations, tests performed during pregnancy

Do I get paid to be a surrogate?

In Australia it is illegal to be paid to be a surrogate however the intended parents must pay for all out of pocket expenses. This includes doctors and specialist appointments, bloodwork, ultrasounds, and hospital expenses that are billed to the birthing mother. Most surrogate mothers also have an allowance in their contract for food, travel, and clothing.

How much does having a surrogate cost?

Unfortunately, this is not going to be a black and white answer as it depends if you go through an agency or independently. There are many factors that will vary the price including, the purchase of eggs and sperm, IVF process and specialists, medical expenses (ultrasounds, bloodwork, psychological counselling, birth fees and hospital fees) allowance for personal expenses (food, travel, and clothes), social workers, legal fees and insurance fees. Hiring a surrogate can cost up to $250,000 AUD. Some intended parents choose to include luxury services in their covered expenses. For example, a doula and/or birth photographer however these are not required to be covered in the contract.

Should I go through an agency or independently?

There is pros and cons for both scenarios. There are a few reasons people are likely to choose independent surrogacy. Many women who choose independent surrogacy already have a connection with the birthing woman either as a friend or is family. Independent surrogacy is also less strict in the process and commonly less expensive as well. Independent surrogacy can also cost a great deal more due to fees that are not calculated into the planning costs. Working with an agency means that all things surrounding the process are taken care of and you can focus on building a relationship with the intended parents. Agency’s are also aware of the ever-changing laws surrounding surrogacy to make sure all parties are protected. Agency’s also screen both the donors and surrogate to ensure that the pregnancy is likely to be viable, safe and that the surrogate and intended parents are a suitable match. Just be aware when selecting an agency that you are aware of all the likely costs involved. Some agencies have a fixed price whereas others have variables that are not quoted in the original estimate.

Surrogacy Process

What is the surrogacy process and how long does it take with an agency (all time figures are approximate, and the process may take more or less time)?

Consultation and sign on (1-3months)

- Consult with agency

- Sign agreement for services

- Introduction video call

- Match with egg donor (if needed)

- Create embryos

Matching with your surrogate (2-6months)

- Matching process and approval

- Introduction video call with surrogate

- Start journey to pregnancy

Medical and legal (1-2months)

- Surrogate medical screening

- Legal contracts written

- Medications and monitoring

- Embryo transfer

- Beta testing

Pregnancy (9months)

- Ultrasounds

- Create birth plan

- Establish parental rights

- Hospital/Birth center/Home birth and delivery prep

- Baby’s birth

Parenthood (birth and beyond)

- New parent glow

- Arrange baby’s passport (if required)

- Say thankyou and goodbye to your surrogate and her family

- Travel home

Clinics offering surrogacy in Western Australia

Concept Fertility Centre 218 Nicholson Road Subiaco WA 6008 Tel: 08 9382 2388

www.conceptfertility.com.au

Ms Liz Beadle concept@conceptfertillity.com.au Dr Peter Burton concept@conceptfertillity.com.au

Genea Hollywood Fertility Hollywood Private Hospital Monash Avenue Nedlands WA 6009 Tel: 08 9389 4200

www.hollywoodivf.com

Ms Laura Jones laura.jones@genea.com.au

Ms Debra Hope-Lind

Debra.hope-lind@genea.com.au

PIVET Medical Centre 166-168 Cambridge Street Leederville WA 6007 Tel: 08 9422 5400

www.pivet.com.au

Ms Anne Wigham awigham@pivet.com.au

The Australian Surrogacy eHandbook

https://sarahjefford.com/surrogacy-handbook/

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