Step in Surrogacy 4: Pregnancy and Birth

If your surrogate’s pregnancy is confirmed by hCG test, congratulations! You are almost there in welcoming your own child into this world. At this moment, you just have to sit back and relax while your surrogate carries your fetus.

Overview of Prenatal Care

Prenatal care during pregnancy in surrogacy cases is similar to that in a traditional pregnancy. Let’s take a look at what’s involved.

Prenatal Check-ups

Regular medical check-ups are important in surrogacy, just as they are in traditional pregnancies. These appointments help monitor the health of the surrogate and the development of the baby. Typically, check-ups will occur:

• Monthly during the first two trimesters.
• Bi-weekly starting from the 28th week until the 36th week.
• Weekly from the 36th week until delivery.

During these visits, healthcare providers will check the surrogate’s blood pressure, weight, and overall health, and perform various tests such as ultrasounds and blood tests.

• Ultrasound tests help monitor the growth of the baby. The doctor might share the ultrasound pictures with you.
• Glucose tests are done to detect the development of gestational diabetes in your surrogate.
• Blood tests are done to check the fetal DNA in the surrogate’s blood.
• Amniocentesis may be done to check for any birth defects or genetic problems.
• Tests may be conducted to screen for any sexually transmitted diseases.

Home Visits and Emotional Support

Some agencies may offer additional support for the surrogate during pregnancy. These might include:

• Counseling sessions offered to your surrogate
• Support groups for surrogates may be made available to your surrogate
• A social worker from the agency might visit the home of your surrogate and make sure her living conditions are safe and comfortable

Communication between the Intended Parent and the Surrogate

Effective communication with your surrogate is important for a successful surrogacy journey, particularly during pregnancy. Often, intended parents become a lifelong friend with their surrogate. However, initially, the relationship between the intended parent and the surrogate can be potentially rich in emotional nuances. Intended parents tend to want to know everything that’s going on in their surrogate’s life and sometimes even try to “micromanage” the surrogate. It’s because they feel lack of control and insecure as they are faraway from their fetus which is carried by someone else. Here are some strategies for managing the relationship with your surrogate.

Establishing Expectations

At the outset, it’s crucial for both parties to set clear expectations about the frequency and mode of communication. Whether through scheduled calls, messages, or in-person meetings, defining these preferences early helps prevent misunderstandings. Intended parents and surrogates should discuss and agree upon the level of communication they are comfortable with, considering the emotional and physical boundaries of the surrogate.

Regular Updates

Regular updates are probably important for you during pregnancy. These might include updates from doctor’s appointments, ultrasound scans, and milestones in the pregnancy. Surrogates can share this information directly with you or through your agency, depending on what has been agreed upon. Do keep in mind to not overly demanding for an update.

Emotional Support

The emotional landscape of a surrogacy journey can be complex. Intended parents should offer emotional support to the surrogate, acknowledging the physical and emotional contributions they are making. Similarly, surrogates should feel empowered to express their needs and any emotional support they require from the intended parents.

Navigating Challenges

Should any challenges or concerns arise, addressing them promptly and respectfully is vital. This includes discussions about health concerns, pregnancy complications, or personal circumstances that may affect the surrogate or the intended parents. A mediator or counselor specializing in surrogacy can facilitate these conversations if needed.

Unreasonable Demands

In rare cases, some surrogates make unreasonable demands. If you feel that your surrogate is making an unreasonable demand that has not been previously agreed to, involve your agency coordinator. The same goes to the intended parent. Before making a demand to your surrogate, think, is it unreasonable? Am I micromanaging the surrogate’s life?

Preparing for Birth

As the due date approaches, communication should include discussions about the birth plan, roles during delivery, and expectations for contact post-birth. These conversations are important to ensure that the day of delivery goes as smoothly as possible, with all parties feeling prepared and supported.

Mode of Communication with Your Surrogate

In general, there are several ways that intended parents can communicate with their surrogate. Often, the agency places a restriction on how intended parents can communicate with the surrogate, so make sure you ask this question when you are choosing an agency.

1. Direct communication with the surrogate. An intended parent may be allowed to directly communicate with the surrogate. This might involve direct WhatsApp call or video meetings without the agency representative being present. You arrange the call time with the surrogate and talk to them directly. Note that if you don’t speak Spanish, you may need to hire a translator or use a translation app. The advantage of this method is that your communication with the surrogate is private as it’s not overheard by your agency coordinator. The disadvantage is that there is no one to act as a witness if there is a disagreement between you and the surrogate.
2. Agency-facilitated communication. This is where your agency schedules a 3-way call between you, your surrogate, and the agency coordinator. It can be a group call on WhatsApp or a video meeting. Your agency schedule a call with the surrogate, not you. The advantage of this method is that your coordinator can translate Spanish to you and your English to Spanish. Also, your coordinator can act as a “buffer” between you and your surrogate, helping both of you if there is a disagreement. The disadvantage is that you lose a bit of control; calls might not be scheduled as frequently as you would like, for example. Also, you might not be able to discuss sensitive topics with your surrogate that you don’t want your coordinator to hear.
3. No communication allowed. Some agencies choose to disallow communication between intended parents and their surrogate. The agency will still send you ultrasound reports and updates, but you are not allowed to talk to the surrogate.

If communication with your surrogate is important, make sure you raise this point with your agency, ideally before you enter into a contract with them. In the surrogacy contract between you and your surrogate, it may be a good idea to specify how communication will take place and how frequent the communication might be.

Payment to the Surrogate

While payment schedule to the surrogate varies, it generally follows this structure:

1. Start of Medications: When the surrogate begins any necessary medications to prepare for embryo transfer.
2. Embryo Transfer Fees: A fee is paid every time embryo transfer is done.
3. After Confirmation of Pregnancy to Birth: This is often after a medical confirmation of pregnancy through an ultrasound at around six weeks. A monthly compensation is paid to the surrogate for the duration of pregnancy. Also, an additional amount may be paid to the surrogate for monthly expenses.
4. After Delivery: After the delivery of the baby, your surrogate will receive the remainder of the compensation. Some agencies make this final payment the largest amount in order to keep the surrogate motivated to the end.

The detailed payment schedule should be specified in the surrogacy contract between you and the surrogate. Make sure to review it with your lawyer before signing it.

Payment Method

There are several methods that you can pay the surrogate. Again, this is also something you should talk to the agency before sign a contract with them.

• Direct payment to the surrogate: The intended parent directly pays the surrogate based on the payment schedule as agreed on the surrogacy contract. Payment can be made through wire transfer or another method of international payment. Your agency is not involved in the payment to your surrogate.
• Payment through the agency: You pay the surrogacy agency the contract amount as agreed on your contract with the agency. The agency pays the surrogate according to the payment schedule on the surrogacy contract between you and the surrogate.
• Payment through an escrow agent: A third-party escrow agent is used. You pay the total surrogate compensation to a mutually agreed escrow agent. The escrow agent releases the payment to the surrogate according to the payment schedule on the surrogacy contract. In Mexico, some lawyers can act as an escrow agent, but you will be charged approximately 5 to 10% of the total amount paid to the surrogate.

Birth of Your Child

Well, this is the most exciting moment – the birth your child! As the due date approaches, emotions run high with anticipation, joy, and a bit of nervousness, which is entirely natural. The delivery should take place at a reputable private hospital near where your surrogate lives because private hospitals have a better quality in Mexico than public hospitals. Here are some general things to prepare for and consider to ensure everything goes as smoothly as possible:

1. Communication Plan: Make sure that you have a clear communication plan in place with the surrogate and the medical team. Understand how you will be updated during the labor process and immediately after the birth. Some intended parents opt to be in the delivery room if possible, while others might wait nearby.
2. Hospital Preparations: Familiarize yourself with the hospital or birthing center’s policies where your child will be born, especially concerning surrogacy arrangements. Know where to go, whom to speak to, and what to bring with you. It’s also helpful to have all necessary legal paperwork readily accessible to avoid any administrative hiccups.
3. Support for the Surrogate: Show support and appreciation for your surrogate. She has carried your child and will be undergoing the delivery – a significant physical and emotional event. Discuss in advance how you can best support her during this time, respecting her wishes and privacy.
4. Coming to Mexico: You will have to come to Mexico to welcome your child and do the exit process. If you have a C-section scheduled for delivery (see below), you can arrive 2 to 3 days in advance of the scheduled C-section. If you opted for natural delivery, you may have to come a week or two in advance in case the delivery happens earlier than anticipated.

The delivery can either be through natural vaginal birth or through C-section. For surrogacy cases in Mexico, some agencies, doctors, intended parents, and even surrogates prefer C-section over natural birth because of its predictability. If there is no medical necessity for using C-section, the ultimate decision should lie between the intended parents and the surrogate. The advantages of C-section delivery are:

• Predictable schedule: Because C-section can be scheduled ahead of time, some intended parents and surrogates choose C-section. Intended parents can come just a few days before the scheduled delivery, and the surrogate can have a set schedule for delivery, making it easier for her to plan her schedules around it.
• Avoidance of Labor Complications: C-sections can be used to avoid complications that might arise from a vaginal delivery, especially in cases where the surrogate has a known medical condition or when the baby is in an unfavorable position for natural birth (e.g., breech position).
• Reduced Risk of Physical Trauma: In some cases, a C-section might reduce the risk of physical trauma to the baby, particularly in situations where the baby is expected to be large or where the surrogate has a narrow pelvis.
• Safety Net: For surrogates who have had complications in previous pregnancies or deliveries, a C-section might offer a safer alternative to vaginal delivery.

There are disadvantages to C-section deliveries as well.

• Longer Recovery Time: The recovery period for a C-section is typically longer than for a vaginal birth. This means the surrogate will require more time to heal and may experience more postoperative discomfort.
• Increased Risk of Complications: C-sections carry the risks associated with major surgery, including infections, bleeding, or reactions to anesthesia. There are also potential risks in future pregnancies, such as the risk of uterine rupture.
• Impact on Future Pregnancies: Women who have undergone a C-section might face complications in subsequent pregnancies, including issues with the placenta like placenta previa or placenta accreta.
• Higher Cost: Some agencies charge a fee for C-section delivery. It can be around $4,000 USD.

Being in the delivery room and seeing your baby

Most, if not all, intended parents want to be in the delivery room when the baby comes out. However, sometimes, this is not possible due to hospital policies. The original birth certificate in Mexico will list the surrogate as the mother and intended father as the father of the newborn, unless you have obtained a court order affirming your parentage before birth. This means that some hospitals may not allow the intended mother to be in the delivery room because they might not recognize that the parentage of the intended mother. Again, this largely depends on individual hospitals’ policies. You may need to check the hospital policies and talk to the hospital staff with your surrogacy agreement in hand.

Next Step: Exit Process

Exiting Mexico by getting your birth certificate, doing Amparo trial (if needed), and applying for citizenship and passport for your child