Family planning: how Covid-19 has placed huge strains on all stages of surrogacy
The spectre of Covid-19 has cast its shadow over most things, including family planning – in the broadest sense of the term. Pregnant parents are facing dramatically different births than those they’d planned for; IVF, too, has been on hiatus; and anyone hoping to create a family using a surrogate abroad is facing huge uncertainties due to travel chaos and national shutdowns.
How can we protect our surrogate and our unborn baby from this pandemic? When our baby arrives, will we be able to be there? Afterwards, will we be stuck in California for months on end, with a newborn and no family to help? This has happened to others. Will it be happening in a few months? No one knows.
At a routine medical in my mid-20s it was discovered I have a heart condition called hypertrophic cardiomyopathy (HCM), which basically means one side of my heart muscle is too thick. While it can lead to deadly arrhythmias, my well-managed condition has not hugely affected my life so, after I met my husband in my early 30s, my consultants said I could carry a child naturally. However, there would be a 50% chance I could pass the condition to my baby, which may or may not be serious, life-limiting or even deadly. After much deliberation, we accepted the risks (as every prospective parent does, to a degree), and decided to try soon after we married in 2016. Over the next 18 months we had five devastating miscarriages before 12 weeks. We consulted nutritionists, acupuncturists, consultants. I reduced my working hours, we had every blood test, scan and analysis under the sun. No cause or reason was found.
Then, for the next eight months of trying, nothing.
When I was diagnosed with HCM aged 26, I spiralled through a grieving process for what I’d imagined my future to be. The discovery of my heart condition left me feeling “defective”, that no one would ever want to marry me, that I’d never have my “own” children… Time helped those feelings subside, yet I never dared to dream of a future with babies in it until I met my husband. He had the opposite experience. As a healthy man in his mid-30s, he’d never fathomed not becoming a parent. But IVF was a no-no due to the potential effects of the necessary hormones on my heart. We looked into adoption and were told that my genetic heart condition and the fact that my husband’s father had recently been diagnosed with terminal brain cancer would likely count against us. So in October 2018, we contemplated surrogacy.
The year before, I’d written an investigation into the process and found that, in terms of legal protection, ethical considerations, efficacy of medical treatment and ease of communication, America was a good place to begin a “surrogacy journey”. It’s also the most expensive. There are ethical and communication considerations with other countries which offer the practice more affordably. Surrogacy is not legally recognised in the UK and while it does happen, it’s on an altruistic basis, often informally, meaning surrogates cannot be paid, only reimbursed for “reasonable expenses”. This means there is a massive mismatch in the number of surrogates versus demand. After spending nearly three years on this journey and both almost 40, we couldn’t face several more seeking a surrogate here.
And so, over Skype, we interviewed a clinic in California, a state regarded
as offering the “gold standard” of the practice. Travel was easy and not only are surrogates available and well looked after financially, medically and psychologically, but there is legal protection for both the surrogate and us, as “intended parents”. We decided to select an egg donor due to my genetic condition. My husband will be the child’s genetic father.
Surrogacy is expensive. Factoring in costs for the medical procedures, legal fees, compensation for the surrogate and egg donor, you quickly creep into the six-figure bracket. We are fortunate: we used savings and both sets of parents helped out to enable us to pay for a “guaranteed package” that covers costs no matter how many tries we need. Expensive if it works first time, but sensible in case it doesn’t.
Two months later, on a warm and sunny January day in 2019, we were sitting on the deck of an Airbnb in Malibu preparing to meet our prospective surrogate. We’d been to the clinic; it was all systems go.
Long story short: we’re glad we got the guarantee. After three failed embryo transfers, we are waiting on the results of our fourth. For various reasons, we’re working with our fifth surrogate, an amazing woman who has helped two other families before us. It’s been hugely emotionally challenging, time consuming and nerve wracking, but of all the problems we contemplated, a global pandemic and travel ban didn’t factor.
Richard Westoby hasbeen helping people navigate the choppy waters of international surrogacy for six years and has written a book on the subject. A “surrogacy patient advocate” for the San Diego Fertility Center (SDFC), he’s British, based in the UK and a father of twins through the process.
“There are general unknowns with surrogacy and then the ‘unknowable unknowns’,” he says. “Coronavirus takes that to the extreme.”
Intended parents usually fly to the US a week or so before their baby’s due date. Post birth, the parents apply for the baby’s US passport. Ten days or so later, the new family can return to their country of residence and begin whatever immigration work is needed there.
Now, with travel restrictions in place until – potentially – 2021 and many services closed, these protocols are disrupted.
Westoby says there has been sensationalisation about people who can’t get their babies. “Everyone [Britons undergoing international surrogacy in America] can pick up their babies, as long as they go through the bureaucratic channels,” he says. “The problem has been getting back. The US passport office is closed, so the British Consulate is issuing emergency passports, but that has been taking four weeks.”
Natalie Gamble of NGA Law is arguably the UK’s most revered fertility lawyer and campaigns for law change around the practice in the UK. She has never had so many urgent cases as in the last six weeks. She tells a story of a British couple whose baby was recently born in America with a surrogate, but the passport office closed the night before their appointment. “I wrote to the home secretary and got MPs on board, trying to get the UK government to issue British passports to babies stuck overseas. This process used to take a month,” she says. “Now it’s a week.”
As well as parents struggling to bring babies home, Gamble is helping parents who can’t travel. “For the US, we now have a system involving the embassy in London granting special entry, but the timing is managed meticulously. Intended parents must not leave it too late. There is the application process to do, paperwork to get in order, flights to find and quarantining on arrival.”
Rich Vaughn, founder of Los Angeles-based legal practice International Fertility Law Group, has already helped the parents of 45 newborns bring their children home during the pandemic. “At the moment, we have 90 more cases scheduled throughout the next few months,” he says. “We have had to rescue a few people whose regular surrogacy lawyers aren’t equipped to navigate this process... We recommend beginning these plans three months before a baby is born. Intended parents will probably now need to travel a month before the baby’s due date.”
Over the past few weeks we have debated whether to continue with this process. It is so different to how we envisaged starting a family, so much more remote (we will not be able to visit during the pregnancy, as we’d planned) and so much more stressful. But we have decided to do so, because life must continue and we’ve come so far. Perhaps in the coming months, if there isn’t a vaccine, there will be an effective treatment – or at least travel insurance.
Westoby says that, despite the pandemic, SDFC – still only running a limited service – is busy with enquiries for when international patients can fly out again. “People are getting in touch saying, ‘I want to do this, how do I do it, I’ve been putting it off,” he says. “Covid has highlighted the fragility of life and above all, the importance of family.”
Surrogacy can quickly creep into the six-figure price bracket