Episode Transcript
[00:00:00] Speaker A: Becoming a surrogate is honestly one of the most amazing things you can do for someone.
But let's be real, there's a lot that goes into it. We're talking medical appointments, travel timelines, and figuring out what kind of support you'll have along the way. It's a big commitment, and knowing how it all works ahead of time can make a huge difference. A lot of women who feel called to become surrogates are really clear on why they want to do it.
But the how, that's where things can get a little fuzzy. What does the process actually look like once you're in it? How do you juggle it with work, family and life in general? And who's helping you keep it all on track? That's what we're getting into today. We're talking about what it really looks like behind the scenes. The logistics, the timing, the support.
So if you've been thinking about surrogacy and want to know what to expect, you're in the right place.
Welcome to the Fertility Cafe, where we explore the beautiful complexity of modern family building.
I'm your host, Eloise Drain, and this is a space for honest conversations about surrogacy, egg donation and the journey to parenthood. With expert insights and real stories, we're here to guide you through the medical, legal and emotional aspects of third party family building.
We believe that love has no limits and neither should parenthood.
Welcome to Fertility Cafe. I'm your host, Eloise Drain. In today's episode, surrogate logistics, travel timelines and support, we're diving into the practical side of surrogacy, what the journey really looks like from the start to finish.
We'll break down how surrogacy works from the initial screening and matching process to medical protocols, travel expectations, and what the typical surrogacy timeline looks like. We'll also talk about the support you can count on throughout the experience because no one should feel like they're doing this alone.
Whether you're seriously thinking about becoming a surrogate or just starting to explore the idea, this episode will help you get a clearer picture of what's really involved and and what life might look like during the process.
Joining me is April Whitford, Journey manager at Family Inceptions. April has helped guide hundreds of surrogates through their journeys and knows all the ins and outs of how it works. She's here to share what really happens behind the scenes and help bring clarity to all the moving parts.
[00:02:34] Speaker B: So welcome, April, to the show. I appreciate you being on here.
[00:02:37] Speaker C: Thank you. It's A pleasure to be on the show. So.
[00:02:39] Speaker B: So before we dive into the logistics, let's start with a little a bit about you.
[00:02:44] Speaker C: Well, I've been with family inceptions since almost actually this month. It's actually a decade in one form or another. That sounds so.
[00:02:53] Speaker B: Oh, no, I'm playing.
[00:02:54] Speaker A: Go ahead.
[00:02:54] Speaker C: I was saying April of 2015. My current role is as a journey manager, working with the surrogates and the intended parents and that kind of stuff. And I've been doing that since a couple of months before COVID I have LMSW from Florida State University. I've been doing family building now for 25 years. Actually, this year will be 25 years, and there's not a part of it I haven't touched. Foster care, relative placement, adoption, surrogacy. I did a brief stint in domestic violence. Like, I've done all the things. And then personally been married for 22 years, and I have three kids, one of whom is about ready to go off to college and leave the nest.
[00:03:33] Speaker B: They come back, though, so I keep telling. Come back. So over the years, you've also obviously work with so many surrogates through the different stages of the process.
How has that experience shaped your understanding of what really matters most when it comes to preparing someone for the journey?
[00:03:51] Speaker C: To remind people that this is a marathon and not a sprint. If there is one thing I could tell any surrogate coming in is be patient.
This is a process that is not going to be over in 30 days or 60 days. It is literally 18 months.
And there's going to be a lot of pieces where you're going to be, hurry up and wait, Hurry up and wait.
And if you're going to come into this space, just have a lot of patience because there's so many moving pieces that we got to get through.
[00:04:18] Speaker B: Yeah, most definitely.
So let's kind of start from the beginning. Right? So somebody comes into family inceptions or they go into another agency, what can they expect kind of going into that process? So that once they say, okay, I've decided that I'm going to be a surrogate, I've selected my agency. Now what?
[00:04:41] Speaker C: Well, then be prepared again, hurry up and wait. The process is long to get from, yes, I want to do this to I'm going to be matched with somebody. We have to look at your medical records. You, we send you out for blood work. You may have to have, like, in our case, we. You'll have a psychological evaluation with you and your partner.
All of those pieces have to be done in a Proper order to make sure that you are healthy enough and ready for this journey. So by the time we match, we can hit the ground running.
[00:05:10] Speaker B: And I would also add to that as part of our process that we interview the candidates to find out about them, get their background, their understanding, their lifestyle, all of the things. But as part of our process, we go ahead and we do a kind of a lifestyle evaluation with the candidates prior to them coming into our program and interview them. What happens during that process?
[00:05:37] Speaker C: Basically, not unlike what we're doing here. We sit down and talk about every aspect of your life. In fact, I will tell. Tell surrogates when I interview them, if I. If you were going to give me your kids for the next 10 months, you'd want to know a lot about me, wouldn't you? It's the same concept. I want to know what's your relationship like with your husband? What's your relationship like with your friends?
Who's going to be the person you call at 3am if you need somebody to watch for your kids? What does your job think about all of this? Are they going to be able to let you go to appointments? Because there's a lot more appointments than just your standard pregnancy. Is there anybody in your family that would be against it, that would stop you and say, I don't want to do. I don't want you to do this? If you're involved in your faith, what does your church say? What does your pastor say? All of those pieces and parts have an effect on the journey because you have to have a great support system in order to do this journey. You're not an island, just doing this kind of out there in no man's land.
[00:06:25] Speaker B: Okay, so we've gone through this interview, we've completed the psych eval, we've done the insurance verification. We're all set, we're ready to go. And then it should be matching, right? We should be jumping right into the matching process.
[00:06:40] Speaker C: The first thing we do is we sit back and we look at your application. We look at all the things that are important to you in this match. What kind of person do you want to be matched to? Or do you have a preference? What are your preferences on if you want to have a midwife, do you want to have an ob?
And we get into some delicate subjects too, like termination, like what would happen if something happens, goes wrong with the baby? Or what do you want to have happen if something happens with your own life? What happens if you get pregnant with twins?
We look at all those pieces and Parts down to.
Do you want to text with your intended parents once a week or would you rather just see them at various appointments and that's the end of it? Do you want to be besties when the journey is over or you want somebody who's like, hey, thanks for the baby, and we're out?
All of that has to do with matching. I used to, there was a commercial back in the early 2000s and it was a dating commercial. Was this guy was like, we match you based on 14 points of compatibility. And he was very used car salesman. But it's an actual thing. Like we do this, we look at all these pieces and we talk about it and we talk about it and we talk about it and we talk about it some more. And then we land on one person for you.
We think, okay, this is going to be your intended parents. They line up with all, everything you want, everything looks great. We show you their profile and then you get to read all about them. You get a letter from them, pictures about them, everything that has that has to do with. And if you like them, then we send all of that vetting we've done, all the medical records, we've pulled your application, that psych eval, all those things, we send them to your clinic because it's not just them approving you or us approving you.
There's a whole other set of medical professionals that have to approve you.
And we do that in advance of matching to make sure that when we get to Match, we're ready to go. Nobody wants to be heartbroken at Match to realize that somehow that clinic's not going to work with you or something's not going to go right. And then we wait two and three weeks and the clinic comes back and says, yep, we'll work with her. And then we send the intended parents your profile with your letter and your pictures and this huge 400 question application that you do. And then if everything looks right, we sit down and have a match call, which will be the most awkward first date you've ever been on. But I'm there for you and I will, I will walk you through all the pieces and parts. Well, you're essentially looking at somebody saying, I'm going to carry a baby for you. I've never met you before. All I know about you is what I've gotten off of 15 pages pieces of paper.
But here, let me take the most valuable thing you've ever created and I'm going to carry it for you for nine months.
[00:09:06] Speaker B: I mean, does it always work the first time with the match does it. When we look at candidates with intended parents and we do the call, does it always work?
[00:09:19] Speaker C: Well, if I can brag on us a little bit, 98% of the time it has. I've only ever had two matches in six years that did not fly after the match call.
[00:09:26] Speaker B: And let's talk about why it's important that we do this lengthy process with making sure that, that the surrogate and the parents, that it's a good fit.
[00:09:36] Speaker C: It's viably going to be one of the most intimate journeys you'll ever be on. Just like your marriage, your relationship with your children. It's this infinite entanglement between you and them that you better be on the same page about a number of things or it's not going to go well. And do you want to spend 18 months of your life going on this journey with people you don't care much for or that you don't line up with?
Or worse, they may ask you to do something that you're not comfortable doing.
It's not just, oh, this surrogates ready? This set of intended parents is waiting. Let's push them together and make this match. It's important to put that together in the right way, to make sure that those 18 months are as smooth as we can be, that if there is a hiccup or a speed bump or something worse, we have all the pieces and parts in place, that everybody's going on the same page. Everybody's already kind of predetermined what will happen if we hit those various speed bumps. And that makes things a lot better for the surrogate, for the intended parents, for me as the journey manager, all.
[00:10:31] Speaker B: The things, and ultimately the baby too.
[00:10:34] Speaker C: Because the whole point is to be.
[00:10:35] Speaker B: Able to have someone who is as healthy as possible to give that baby the best chance of being in a healthy environment and coming out healthy and whole.
[00:10:44] Speaker C: We all know now, like, what's there. There's all these studies coming out about what stress does to the body and what stress can do to pregnancy. And if you're in a good relationship with your intended parents, that's one less stress you have to worry about.
[00:10:55] Speaker B: Yeah, absolutely.
[00:10:56] Speaker A: So once someone is matched, how long.
[00:10:59] Speaker B: Does it usually take to get to the embryo transfer? Because, you know, everybody is just like, yeah, we're matched.
[00:11:05] Speaker A: Let's go.
[00:11:06] Speaker C: There's a few pieces and parts that you have to kind of get through because a lot of it are like, okay, we're matched. When do I start meds? Roughly 90 days from now. My goal is always match to delivery in roughly 12 to 15 months. We do want to push it through fast. We don't want to lollygag around. But I would say healthily, 90 to 120 days from the day you match to embryo transfer. And that's all things being equal. Clinics are ready to go to do medical screening. The attorneys are on point. The minute we get legal clearance, we're ready to start meds, all of those pieces and parts. But I would say healthy, 90 to 120 days.
[00:11:41] Speaker B: So what kind of things can slow down the process?
[00:11:44] Speaker C: Your period? We have a medical screening centers around woman's cycle. So if we match you and you're like, hey, I'm on day six of my period. We got a whole month to get through day one for your next one. If a clinic says, hey, we wanted to come to us, versus being able to do it, local attorneys, they go on vacation, they have their lives, they do those things too. And attorneys that work in this field are so specialized that they're. There may only be one or two attorneys per state. So then they're handling all of those state surrogates and all of those states intended parents, along with birth orders that come after you're pregnant. That's a whole nother piece of the equation. That comes after the transfer and after the pregnancy started. So you've got to wait on them to sit down, look at pieces and parts, that kind of stuff. Then there's people don't think about. Like today I solved a problem with a surrogate who didn't get her medication because there was horrific thunderstorms and floods where she lives. Well, then we had to rally and find her meds in another place. Sometimes those can slow things down. So Mother Nature can slow things down if she feels like it.
[00:12:44] Speaker B: You know, obviously you alluded to the whole travel, what travel might be involved during, you know, the stage and how does it normally get handled?
[00:12:54] Speaker A: Who pays for it, who makes the arrangements?
[00:12:56] Speaker B: You know, all of those specifics.
[00:12:59] Speaker C: So you'll travel at least once no matter what. You have to go to the clinic to do the embryo transfer. It's easier for me to move a person than it is for me to move an embryo.
So I can put you on a plane without too much of a problem and send you to the clinic. Some clinics require you to go twice, so once for a medical screening to make sure that you're healthy enough on the inside to do this, and then again for the transfer. Other clinics, it's just for the transfer. They'll let you do your screening locally, and that is clinic specific.
So if I have somebody who calls me and says, hey, I only want to match with a clinic that will only make me travel once, that's a thing. But then it excludes some clinics. As far as travel goes, your journey manager should be your everything, including your travel agent.
So when I have a surrogate that says, okay, I'm going to travel from Charleston, South Carolina, to Atlanta, Georgia, and I'd like to fly, I make your flight arrangements, I make your hotel reservations, I set you up on an Uber, and then I pay for it all up front so you're not waiting to be reimbursed, which I don't know about. Again, I'm partial to family inceptions for obvious reasons, but I take care of all of that for you. I even send you cash ahead of time for your food, so you don't even have to worry about submitting receipts like, oh, I ate it, you know, Joe Schmo's Diner. And I have this receipt for $21.
How do I get reimbursed? Oh, no, I've sent you cash ahead of time. Make sure you can eat while you're there. We take care of all of that for you. We'll take care of everything, including your food. All you have to do is show up at the airport, get on that plane, go to the transfer and come.
[00:14:27] Speaker B: Home, or potentially screening and transfer. But either way, whether it's the screening or whether it's the transfer or all of that is happening, even if it has to happen multiple times, because unfortunately, doesn't always mean that the first embryo attempt is always going to work.
[00:14:44] Speaker A: Right.
[00:14:45] Speaker C: And sometimes you have to go back a second time and possibly a third. But for the most part, we like to live in the whole. It's going to work on the first time.
[00:14:53] Speaker B: Yes. I mean, all of us in this perfect world that we create in our minds would love to, but the reality is it's not always that case. So. And the whole thing is to just make sure that people are prepared with all of the different pieces. Like you say, pieces and parts to this whole entire process. So.
[00:15:11] Speaker C: Well, and that's one of the things we talk about during that big interview in the beginning is all of these pieces and parts. Because it's not just, let me learn about you, it's here. Let me give you some information about this journey you're going to embark on, because you can read the horror stories and you can read the perfect endings, and your journey may show up Somewhere in between.
And you've got to be ready to pivot on a dime. Hey, the clinic wants to see you tomorrow morning for another lining check to make sure that new medication's working. That means you've got to go to the clinic. It's not like, well, I don't feel like it. Or, hey, that kind of stuff. You've got to have some flexibility, and you've got to be able to roll with the punches.
[00:15:45] Speaker B: Yep, absolutely. And unfortunately, it's not always predictable as much as we think sometimes we want it to be. But I can't say that it's been always predictable, you know, and let's. So let's talk about medication. What's the typical medication schedule like leading up to transfer?
[00:16:04] Speaker C: I could put six doctors in a room and come out with six different protocols. I will do my best to kind of shoot.
[00:16:09] Speaker B: And that's the whole point that I want people to know. Like, there is no one set protocol.
[00:16:14] Speaker C: No, the amount we don't know about what works for one woman and what works for another woman could fill books. It is definitely an art, not a science. And like I said, you. I have multiple surrogates that have done multiple journeys with different clinics. And I hear, oh, my first clinic only put me on estrogen and then progesterone, but this clinic wants to put me on Lupron. Are you sure it's going to work? Yep, positive. Everybody has their own protocol for the most part. You have two different protocols. One is a Lupron cycle and one is an estrogen cycle. 1. A lot of clinics will use Lupron. It's an injectable med, goes in your tummy, stops you from ovulating. You'll be on that for a couple of weeks. And then you start taking estrogen. It gets the lining of your uterus nice and fluffy. And then once they determine that it's fluffy enough, you'll start progesterone to kind of lock it into place and help it be a great environment for that transfer. And then you go for transfer, an estrogen. Only one just lops out the. The Lupron. A lot of clinics, though, they like to use birth control pills, too, to kind of plan for everything.
We have surrogates that even are on birth control pills even if their husband or their partners had a vasectomy or they've had their tubes tied. I have one young lady who has no tubes at all, and she's on birth control pills. Not because we think she's going to get pregnant, but it helps Prevent ovulation, scheduling, that kind of stuff. So don't be surprised even if you come to us and say, I'm done, I had my tubes tied, my, my partner had a vasectomy, I'm not having any more kids. And I look at you and go, so what kind of birth control you want to be on? So it's all part of the process. And the medications can come in different forms. That's the other thing is Lupron is almost exclusively an injection. It's sub Q. It's in your tummy. It's a little tiny needle. Estrogen can be pills, patches, injections. Again, some combination therein.
Progesterone usually comes in an intramuscular injection. It's the injections that people talk about going in their butt that nobody likes. Some use suppositories, some use a combination. Therein. You may be asked to be on antibiotics, you may be at be able to ask to be on steroids.
And if that doesn't work, you may have to. If that doesn't work for a first transfer, they may put you on a trigger shot, help you ovulate, then start on the meds all over again. There's no one set protocol, but it could be some combination therein to be all rapidly confusing about the whole process.
There may not be one. Just expect all of it.
[00:18:27] Speaker B: Yeah, exactly.
[00:18:28] Speaker A: What's one logistical aspect of surrogacy that.
[00:18:31] Speaker B: Often gets overlooked or catches people off guard?
[00:18:35] Speaker C: The amount of appointments that you have to have just to get ready for the embryo transfer. And then afterwards, why do they need to go look in my uterus every 38 hours?
The constant lining checks. I work with a clinic out of New York that you get seen weekly for an ultrasound and a lining check from the beginning of meds to 12 weeks post or 12 weeks into the pregnancy. And it is every week. And people don't realize that there's just going to be a lot of appointments. It's not just take all these meds, do the transfer, pee on a stick at home, oh, I'm pregnant. And then you go to the OB and everybody's happy. It is a ton of appointments and all of that. So that's the one thing I think that takes a lot of people by surprise, is how many appointments there are going to be.
[00:19:16] Speaker B: You talked about earlier in the beginning that when someone is considering surrogacy and how much support is so important. What kind of support do surrogates usually need and where does the support come from?
[00:19:33] Speaker C: You need support everywhere. At home, you'd want you, if you're in a partnership or married or something like that, you want your partner to be on board. Quite frankly, you're going to be hopped up on some hormones and they better know that that's coming. They also need to make sure that they're going to be, they're going to be supportive. During a pregnancy, you need to have support in your surrounding areas because like I said, what happens if, at 3am you have to go to the hospital? If your mom is not okay with you being a surrogate, is she going to show up to watch your kids at 3 o' clock in the morning? Because you've got to go to the hospital. So you've got to have family support, church support, whatever support that you need in your daily life. As far as medical support that's going to come from your clinic, they're going to be the ones that you call and go, I have this really weird place, I need to put this shot. Can you send me a video on where to put this shot? Or is this a normal side effect for estrogen? What are, what are my results from this blood work? My beta is zero. What does that mean? When do I stop the meds? When do we try again? Then as far as an agency, my rule is if you will be pregnant, I will take care of everything else. And if you need somebody to talk to because your best friend doesn't understand what you're going through, you can call me. I can sit there and talk to you and say, hey, I know this is, this is a situation and it's rough and talk about this. Or if your husband's like, why do we have to keep giving all you all these shots? Yep. Call and vent and get support and all of the pieces and parts, so. And then I take care of the coordination of all the appointments so you don't have to worry about that. I will be your personal concierge to make sure that this fits into your life and not the other way around. We are here to meet you on your level and to make this work for you.
[00:21:11] Speaker B: And the reason why we do that is obviously surrogacy is a big ask, as we know, and we want to make sure that it fits into your life just like you said, because there's.
[00:21:25] Speaker A: A lot that happens.
[00:21:27] Speaker B: This is most often your first time. You don't know sometimes what comes next.
We do.
[00:21:34] Speaker A: So being able to make sure that.
[00:21:37] Speaker B: We can move things along for you, letting you know, of course, every step of the way what we're actually doing. But still being able to do it for you so that you're not flailing around like I don't know what's supposed to happen.
[00:21:51] Speaker A: Where, where am I supposed to go, what am I supposed to be doing? Who am I supposed to be checking with?
[00:21:55] Speaker B: Who, what phone call am I on the agency side? This is how we help you fit surrogacy into your life.
[00:22:03] Speaker C: Like you said, there's going to be asks. I'm going to have to ask you to maybe miss a morning of work and go to the, go to that appointment. So if I can make it easier on you by saying, hey, these are the appointments that are coming up or here, let me make these travel plans for you, then that's what I'm going to try and do because like I said there's, it is a big ask, it's a huge ask and not everybody's going to be able to do it and everybody's going to want to do it at the end.
[00:22:23] Speaker B: Exactly how important it is to, is it to have your family on board, especially when it comes to obviously childcare, clearly that's you know, a no brainer. But also even the emotional support, I.
[00:22:38] Speaker C: Can think of a story and I don't remember where maybe it was one of mine from way back in the day about a surrogate that had been matched with a, a wonderful gay couple. They were all on board and the night before she supplies to start meds, her in laws come to her and say we don't agree that you're caring for a gay couple. And they had been provided, they provided daily child care. And they said if you go through with this, we're not going to provide childcare. And so their whole daycare was going to be ripped away from them if they went through on this. If you don't have that support, things like that can happen. And we don't, we don't ever want anybody to have to choose between their family and surrogacy. We don't want anybody to ever have to choose between whether or not their mom's going to talk to them because they're caring for somebody that maybe their mom is in agreement with. And we go into these subjects, we talk about all that non politically correct stuff like could you be matched with a gay couple? Could you be matched with a couple of a different religion, couple of a different race? And it's not just you, you may be fine with it but maybe your dad isn't going to be okay with it. And if he, and how uncomfortable are you going to be for 18 months if he's not okay with it. Yeah, I remember that. I remember that from very early in my career that I remember that match.
[00:23:49] Speaker B: Yes.
[00:23:49] Speaker C: That broke apart based on somebody not having an extended family that was on board. So we asked about that. We're going to ask how's your mother in law going to feel about this?
[00:23:58] Speaker B: Yep, yep, absolutely.
[00:24:00] Speaker A: What are some ways surrogates can help.
[00:24:02] Speaker B: Prepare their partners and kids and family for the journey?
[00:24:06] Speaker C: Just be transparent, talk about it all the time.
Say, hey, talk to me about what your issues are for kids. There's actually kids books out there now that you can read to your kids about being a surrogate. So that's pretty cool. But as far as the adults in your life, keep talking about it, have them welcome their questions, introduce them to things like the podcast and all the literature that's out there. The number one thing I hear a lot is from a surrogate's mother where they look up and go, are you sure you want to put your health on the line? You sure you want to do this? You sure you want to do this? And I've had surrogates will come and go, you were totally fine if I was having your grandchildren, but I want to go through pregnancy for somebody else. And now you're like, have you thought about the health issues?
Do your research, show them the research you've done. But keep those conversations going. Don't just like, hey, I think I'm going to be a surrogate. Pass the mashed potatoes. And that's where the conversation ends. Because then, then you're going to get into sticky places in the journey.
[00:24:55] Speaker B: Oh yeah, and speaking of having conversations and continuing to have conversations, what about conversations with an employer about being a surrogate and what impact that's going to have on their job?
[00:25:09] Speaker C: That's one of the first things we always ask, is how flexible is your job? I mean, like, are, are they going to be okay that you're taking off several mornings for appointments? Are they going to be okay if you have to travel for three days and you don't know until the week before? Are they going to be, is your job covered if you have to take a maternity leave and it's not your baby? There's, there's different rules because it's not your baby you're delivering. So is your employer going to be okay with that? Are they going to be flexible? Even down to logistics? Is, does your employer offer a short term disability plan that would cover surrogacy? So like when you go out on maternity Leave. Are your wages covered now? Yes, we cover them. But are you going to have a job there? Do you going to have to take fmla?
You need to have those conversations with your employer because nobody wants to find themselves unemployed at six months pregnant.
[00:25:54] Speaker B: Yeah, that would be a significant issue.
[00:25:56] Speaker C: Yeah, that kind of would be. And it's not that it's ever happened, but we have found ourselves in waters with employers that are not okay with the fact that they're surrogates and the surrogates are hearing about it at work. Oh, well, that's not your baby. So I guess you're going to have to take another appointment. That makes for a really uncomfortable work life and you need to make sure your employer's on board. So we ask those questions. Are your employer going to be okay with the flexibility?
[00:26:18] Speaker B: So we've gone from onboarding, we've done the matching, we've done screening, we've completed our legal contracts, we've gotten our legal clearance, we've gotten our medical clearance, we've, you know, have had our embryo transfer and it's successful.
Have a positive heartbeat. Now what? Can I go to my OB yet?
[00:26:38] Speaker C: Almost. Probably in a lot of cases, yes. So once you've had that beautiful heartbeat and everybody sees the, the shrimp baby, you see that flicker. Usually the clinic wants you to go back about two weeks later, make sure that baby's still growing, keeps you on your meds, that kind of stuff. And then after that, generally you are released to your OB and it goes on as a fairly normal pregnancy after that. There's some legal things to contend with. You might be considered a high risk pregnancy on the sole basis of the fact that it was an IVF baby. Every OB is going to be different on how they treat your pregnancy. Once you're kind of, you'll even get an email that says, hey, congratulations, you're eight weeks pregnant, you've graduated from the clinic, here's your last day of meds and go and be and we release you.
[00:27:16] Speaker B: Are they still taking meds even though they're released to obese?
[00:27:20] Speaker C: Usually till 8. Some clinics are 9 weeks, some clinics are 10, some clinics are 12.
Again, as many aries as there are med cycles, there are as many res that will tell you when to stop meds. Some will stop you cold turkey, some take you down and wean you off. But yeah, usually about the end of the first trimester, you're off of med.
[00:27:39] Speaker B: So what can they expect when they go to their first appointment for their OB visit?
[00:27:44] Speaker C: Probably the same as they would in their normal pregnancies, like a pregnancy that occurred out in the wild family history, you may have the intended parents be on facetime or visible. They may do an ultrasound for their own records to as a starting point usually they'll do more blood work, make sure that you're not anemic. They may do NIPT testing at this point, prenatal testing. But basically what you would have at a typical pregnancy out in the wild, what's different is, is that instead of saying oh this child was conceived, this is my last menstrual period, it's my husband and I's genetics or my partner and I's genetics or you know, this is our genetics, this is the intended parents genetics. You may be 20 years old or 30 years old and have a geriatric pregnancy because the embryo was from a 40 year old woman and a 41 year old man. And because the embryo is from a geriatric quote unquote, in that world person, it may be deemed a geriatric pregnancy solely because of the embryo quality. The OB may may put you through more testing or less testing depending on the quality of the embryo.
[00:28:41] Speaker B: Some tender parents like to be for every visit. There are some that will just be on video, there are some that may not be able to be there at all and they're just going to wait for you to give them an update. What about paperwork and records and things like that?
[00:28:58] Speaker C: Well, one, you're not carrying your own baby so you're going to have to sign some releases for some people, one the agency, because I'm going to follow along, want to make sure that there, if there is anything coming down the pike, we see about it and we can, we can put mental health therapy in places there's something wrong with the baby, something wrong with the surrogate. But you're also going to want to sign releases so the intended parents can call in and ask the OB about what's happening with their baby. Because yes, it's your body, it's their baby. So there's going to be two separate people involved. It's your body, their genetics, their baby. They're going to want to know and maybe your blood pressure is a little high, okay, you ran in from the car, whatever. And the intended mother wants to have a conversation with the OB about that. You need to sign a release to make sure that your intended parent can talk to the OB about how pat looks during the pregnancy. If there's any issues, maybe the NIPT test comes back and one of the values is off. The intended Parents may have questions. You're going to seem to need to, they're going to want to talk to your providers as well.
[00:29:55] Speaker B: What about being able to work with my OB that delivered my kids versus do I have to work with OB that the intended parent selected?
[00:30:06] Speaker C: No, you can work with your own ob. At least we allow for it. You can generally work with your own OB only without getting into weird insurance waters. 90% of the time you can work with your own, your own OB and deliver at the hospital that you're used to be delivering it. Like I said there, there's some differences in there, but for the most part you work with your providers, the people you're comfortable with.
[00:30:25] Speaker B: So let's talk about what kind of insurance they get, how insurance actually works. Because obviously we get a lot of people from, with all kinds of different insurance to no insurance at all. So how does that actually work?
[00:30:39] Speaker C: If you come and say, hey, I have insurance, we're going to verify that your insurance is good for surrogacy because not all insurance will cover a surrogacy pregnancy. Again, subrogation and liens. If it's not going to cover, we need to know about that. If your insurance isn't going to cover it or you don't have insurance, or you're on Medicaid, or you have a child on Medicaid, so you get Medicaid by proxy. We need to find another plan for you. You can't have a pregnancy and not be insured. That, that's like a no go. We may find you an ACA plan, We may get you a specialty plan. We may find another.
Make sure that you have health insurance coverage for pregnancy. Because we know that is one of the primary ways that people have healthy pregnancies is if they have the ability to go to the doctor and go access that care. And that comes in the states through health insurance.
[00:31:24] Speaker B: What about protective policies when you sign.
[00:31:27] Speaker C: On to be a surrogate because it is a health risk. We also get you a life insurance policy. An accidental, an accidental death that covers you. Right now, I think it's up to $750,000. So if you die as a result of this pregnancy, your spouse, your partner, your estate gets 750,000. It also covers if you end up having to have a hysterectomy. It will cover if you become permanently disabled. It covers if you have an allergic reaction to your meds and end up in the hospital and need somebody to cover those medical bills.
So we put a lot of protective policies in place to make sure. That if something goes wrong, we can at least account financially for it. And that's a part of every surrogacy journey from the beginning is to make sure that the surrogate, because she's the one putting her health on the line, is also covered.
[00:32:14] Speaker B: Absolutely.
So we're released to the ob. Pregnancy is going well, but I want to make sure that once I have these babies or this baby, that they're not coming home with me.
[00:32:26] Speaker C: Sometime around the end of the first trimester, between the end of the first trimester and the anatomy ultrasound, we start another legal process. We reach out to the attorney in this state, usually it's the surrogate's attorney, and say, okay, we need to start a parentage action. And basically to boil it all down, it legally says that when that baby is born, it's not yours, it's the intended parents. And it tells the hospital and vital records, this is their baby, not mine, and I'm not taking it home with me. It's a very involved process. We have to get affidavits from everybody. It takes months to put together to boil down to not my baby, theirs.
[00:33:02] Speaker B: Yeah. And, and you do, obviously you and your partner, if you're married, are definitely involved. You have to sign paperwork, you have to kind of follow along because you can't just not do your part. You, you have to do your part on this and in a timely fashion.
So you don't want to not. Or just let. Allow it to just sit there when, when you feel like it.
[00:33:27] Speaker C: Oh, no, that, that's a lot of. My follow up is like, hey, did you get that piece of paper? I'm a notary in South Carolina. I've actually driven to surrogate's houses and notarized paperwork to make sure it gets done. And I can bring it back all full service over here. But I've set up with electronic notaries so I can pin them down and say, you've reviewed this, you've notarized it on this date. We can make sure it gets done. Because any, any lapse in that paperwork and you run the risk of the hospital telling you that's your baby.
And then there's a whole slew of other problems that can happen.
[00:33:54] Speaker B: Yeah. And we don't want to walk those problems down. So.
[00:33:58] Speaker C: No.
[00:33:58] Speaker B: And now. Okay, so we've done the parentage orders, we've gotten all that, and we're now.
[00:34:03] Speaker A: Into our third trimester.
[00:34:04] Speaker B: Any birth plans and preparation things that we need to be doing?
[00:34:08] Speaker C: Yeah. We got to tell the hospital that there's going to be a whole other family involved in this. Again, this is not the surrogate's baby. And we need to make sure that the intended parents can be present. So generally around 32 to 34 weeks of pregnancy, I start calling the hospital, hey, by the way, this is a surrogacy journey. This is not a routine. She's going home with the baby. We need to make sure where the baby bands the electronic bracelets go. That doesn't need to be on the surrogate. The baby. That needs to be on the intended parents and the baby. The intended parents need to be able to stay with their baby. You know, they need to be able to have a room because that surrogate and that baby are no longer connected the minute that baby takes its first breath.
It's no different than if I doctor tried to put my kids in a room with you.
The HIPAA laws, again, those babies are divided. We want to make sure that the intended parents are treated with the respect as well that they are the parents. We run afoul a lot of hospitals who will, oh, it's an adoption. No, it's not an adoption.
This is their child. This is their biological child. It happened to be with somebody else for gestation, but this is their biological child. They need to be treated as such.
[00:35:11] Speaker B: What about or how the birth goes? Who has the say?
[00:35:15] Speaker C: The surrogate first. She's the one in the most vulnerable position. She can look up and say, yes, I want people in the room. No, I don't want people in the room. If something goes wrong, we always default to the ob. If the OB looks up and says, okay, we got to do a crash C section, nobody's allowed in the room. Okay, well then that's how it is. And okay, we're on. But past medical professionals, the surrogate, she's the one pushing the baby out. She's the one that's got to have pain control. If she wants to swear a blue streak and she's worried the intended parents are going to be offended so she wants to kick him out, then that's her right and privilege at that point.
So hopefully we put all these matches together that by the time we get to delivery, nobody's being kicked out of a delivery room for non medical reasons. Labor and delivery is a very personal, vulnerable place and we want to make sure that surrogates taken care of at all cost.
[00:36:03] Speaker B: So any final words to someone considering surrogacy? And you know, you've gotten to a point where you're just like, yes, I.
[00:36:12] Speaker A: Want to do this. This is the most amazing thing, and I really want to make this happen.
[00:36:16] Speaker B: And then all these middle pieces and, you know, okay, now I'm ready. Do you have any last parting words?
[00:36:27] Speaker C: The patience is worth it if you can have the patience to get through it. The end result is phenomenal. I have gone to two deliveries, and it was by far probably one of the most amazing situations I've ever seen. If you can. If you can hang on through the boring and the hurry up and wait and all the. The meds and the. The. Did the attorney get back to you, is the clinic gonna do this?
When you hand over that baby to that intended parent and you realize you just made a family, it's worth it all. All the 18 months and the shots and the frustrations and the.
All of it, because you just got to make a family in the most intimate way that most people don't ever get to experience, and you got to do that. Is all of it worth it? 100%. But, yeah, have the patience because it's worth it.
[00:37:16] Speaker B: Absolutely.
[00:37:16] Speaker A: Well, thank you, April, for coming on and.
[00:37:18] Speaker B: And sharing our process with everybody.
[00:37:21] Speaker C: Sure. I appreciate you having me on. It was. It was fun to talk to you about all the ins and outs.
[00:37:27] Speaker B: All right, well, I appreciate you.
[00:37:28] Speaker A: Thank you so much.
[00:37:29] Speaker C: Thank you.
[00:37:31] Speaker A: I hope today's conversation gave you a clearer picture of what the surrogacy journey really looks like, beyond the emotional side and into the practical, everyday details.
When you know what to expect, it's so much easier to step into the process feeling confident and supported.
If you like to learn more about surrogacy logistics or connect with us, visit familyinceptions.com youm can also watch the full video version of this interview on our YouTube channel.
And remember, love has no limits.
Neither should parenthood. Thank you for joining us at the Fertility Cafe. If you found value in today's episode, please subscribe, leave a review and share with someone who might benefit from this information.
You can find, show notes and resources from this episode in the description or visit the fertilitycafe.com for more information.
[00:38:29] Speaker C: Sample.
