Surrogacy: Keys to Building a Successful Surrogate, Couple Relationship Part I

Entering into a surrogacy relationship as both a surrogate carrier and a recipient couple is a major life decision. It represents an all-encompassing personal commitment on behalf of the fulfillment of one's highest goals and family ideals. Bringing together individuals and families whose paths may never have met, in service of common but distinctly different goals, is the first and foremost task. Exploring the long-term implications of surrogacy for each partner in the relationship and coming together on a decision to work together is the most important step. The decision to move ahead deserves to be thoroughly examined from the personal, psychological, physical and financial impact this decision carries. What is often overlooked in this process is an understanding of the key emotional elements of a satisfying and positive surrogacy relationship. The emotional commitment and willingness to accommodate to these important understandings are vital to the success of the surrogacy arrangement. Therefore, they need to be addressed and reviewed at the very beginning of the decision making process when the expectations for the arrangement are being considered. Surrogate carriers and recipient couples have lifetimes of experiences that have shaped their understandings of themselves and others. Reviewing prime emotional elements can provide insight for each partner in the relationship and contribute to the overall success of the experience. Surrogate carriers and recipient couples come to this arrangement as a way to fulfill significant intrinsic goals and ideals. It is the responsibility of the professionals consulted during this process to provide their own verbal or written list of important elements for consideration by each at the start of the arrangement. Typically, having an understanding of the psychological concerns and expectations of each other proves invaluable in avoiding different levels of conflict and negative feelings. Mental health counselors are called on during known and previously unknown surrogacy arrangements to foster communication and conflict resolution. Counseling on some important psychological considerations at the beginning as well as during the experience provides a safer and richer foundation from which to begin.

This article addresses building the surrogacy relationship between the couple and the surrogate carrier, previously unknown to each other. We can address the relationship within a family or working with a known, directed, surrogate carrier at another time. As such, we will be moving ahead over the initial steps in getting to this point. The process of choosing surrogacy as a family building option as well as selecting and psychologically evaluating a surrogate carrier are critical items that we know have come before in this process. This counselor advocates professional and legal guidance as a mandatory part of the selection process.

As I have discovered in my work with surrogacy, there are concerns that are important for the couple to understand and act in accordance with, for the surrogate carrier to feel connected and positively valued. This is key to the creation of a successful relationship.

Likewise, the couple has major considerations that the surrogate ought to understand and value. Increasing the understanding on both sides is the single most effective approach to work together with a strong level of success and satisfaction.

Although at the outset of the arrangement it can feel strange to both the couple and the surrogate working together, with time, patience and a willingness to be open and accepting, both the couple and the surrogate can create a close and fulfilling relationship. It is so wonderful when the surrogate and the couple come to like each other and share a mutual respect and satisfaction with the relationship. I submit these considerations in service of promoting the enjoyment of the experience for all of the members of both families which will share and receive the joy of the gifts of surrogacy.

The most important considerations that the recipient couple should know regarding their surrogate carrier.

Honest, consistent communication is necessary as the basis for a successful relationship.

It should be self evident, shouldn't it? However, when the stress and strain of creating a precious family is the main objective, couples don't always adhere to this. Surrogate carriers have been screened and evaluated with directives to be honest about their lives, their goals and their expectations for the relationship . Surrogate carriers depend on what the couple similarly share. Inconsistencies and secrecy are detrimental to building a safe, open relationship which will ultimately be in the best interests of both and the child. A surrogate and her family carry great respect for their intended parents and typically begin their long term relationship with high regard. Being diligent in following through with appointments, phone calls, and visits to the doctors protects that respect and loyalty in all ways. Couples that continually schedule visits, or phone calls which are cancelled or rescheduled or forgotten leave a surrogate feeling disregarded.

Respect the surrogate carrier's schedule when planning medical appointments. This is especially important to remember. Sometimes, participants have highly demanding professional careers and expect to be able to make the appointments around their work schedules. Often, a carrier might not feel entitled to ask for more consideration of her schedule. Maybe she feels that as a stay at home mom or working at a lower income level, she is not permitted to make such requests. Working as a team to negotiate the scheduling leads to positive feelings and a stronger relationship

Allow the carrier private time with the physician at a medical appointment.

It's a sensitive dilemma, however, it's important that the carrier can ask her personal questions in privacy. Asking for private time can set up anxiety in the couple feeling that something might be kept from them. Pregnancy brings strange surprises and women would like some time alone with their physician.

Include the surrogate's family in the relationship. Remember that the woman carrying the pregnancy does so with the entire family supporting her commitment. This includes her extended family as well. Sometimes it's a little harder for her mother to accept the surrogacy than maybe a husband or children. Feeling that her daughter, the surrogate, is carrying a child that should be their grandchild may surface. It is crucial that recipient couples are caring and inclusive of her family as well even though the focus is often solely on their family . It is imperative that the surrogate's children be allowed to see the new baby(ies) with their new family. Excited new parents are often anxious and fear that the surrogate or her family will have extended grief or anxiety if they see or enjoy the new baby. Conversely, the anxiety and fear surfaces when the children of the surrogate do not witness the new family together and in turn, fantasize about where the babies disappeared to after their mom had carried them for so long. Couples do not need to suspect that their carrier or family will not be able to separate from the new baby. In addition, they must grant the surrogate a chance to be alone with the baby if desired and an opportunity for the children to have a supervised viewing of the new baby and family together.

Both partners(if its not a single parent surrogacy) should be available and willing to talk with the surrogate

Understandably, the tendency is for the wife in a traditional marriage to manage the communications with the surrogate carrier. Women have shared with me that when they call or meet for an appointment, they like to be acknowledged by Dad as well. Typically, if they call the home the response is, "Hold on, I'll get my wife." Surrogate carriers are happy to carry the child for Mom and Dad and its important for both partners to be available to talk and share.

Show trust that the surrogate carrier can make good choices regarding the pregnancy and consult with her when possible regarding ongoing decision making.,

There are few things more anxiety producing than entrusting another person to care for your child for many, many months. Its an especially anxious time for couples who have experienced a very painful history of loss and disappointment. Surrogacy is never a first choice for couples wanting to have their baby. The carrier, however, needs to feel the couple's trust that she can carry successfully and will care for this child(ren)to the best of their ability. It's a balance to show interest in how they are feeling, physically and to be able to contain the anxiety if they do share any physical or emotional issues.

Include the surrogate carrier if possible in your own social event such as a family get together or baby shower.

How considerate it is to invite the surrogate carrier to be part of your life in a social way. The highest compliment would be to be included at the parents' baby shower, carrying the precious baby(ies).

There would be no better way to build a successful relationship than to be attentive in this way. Surrogates enjoy the attention that comes from this choice, it could be the highest motivator for choosing to carry and relinquish a pregnancy.Therefore, showing your pride by including her and her family with your own is an integral part of creating a strong relationship.

Consult with a counselor or case manager or support personnel regularly to receive support and help handling any issues that might arise. As a competent woman, a surrogate might resist any requests for help, attention or consideration from their case manager or psychological support professional. A regularly scheduled, psychological support session should be part to the program because a surrogate often has a difficult time asking for extra sessions which may cost the couple hourly fees. It is optimal for the surrogate to be able to contact the counselor in confidence about any issues that are bothering her.

Kindness and thoughtfulness can be shown in small ways which carry meaningful feelings. A surrogacy arrangement is a financially huge commitment. Even so, it is important throughout the relationship, to show acts of kindness and thoughtfulness. This could be having a meal together after a doctor appointment or gifts for a birthday or sending over a meal or housekeeper to help the surrogate and her family manage while she is carrying the pregnancy. At certain times, these last ones will be mandated by the terms of the agreement. It is even more special when the massage or the out to dinner invitations come when they are not required.

A long lasting gift at delivery represents something special that the surrogate carrier can take home when the couple goes home with their new baby.

Undoubtedly, couples become overwhelmed with the constant outpouring of expenses to be covered during a surrogate pregnancy and the extra financial responsibilities that need to be paid. Even so, when a couple brings home their beloved baby(ies) it is crucial to have a special gift for the surrogate . Sometimes it is a small piece of jewelry and can have the birthstones of the two moms or baby's birth month. Sometimes the gift is annual passes to a favorite theme park that the surrogate family enjoys. A favorite gift is a weekend hotel reservation for the surrogate to enjoy and begin to reconnect with her partner or husband. A gift that speaks to the surrogate mother is an important one and not to be overlooked as it helps with the post partum adjustment to completing the surrogacy and the special relationship that she enjoyed.

This article will be continued in the next issue of Connect. An optimal surrogacy arrangement is a special and balanced bond. It starts out as emotionally uncharted territory and at its conclusion, all of the individual members that started out on different sides of the arrangement are now joined and forever changed by the experience. Always uppermost has been the dream held by both the carrier and the parents..the dream of the new life that has been created.

Part II will be titled, " The most important considerations that the surrogate carrier should know regarding their recipient couple."

Ellen Speyer, MFT has been a practicing psychotherapist for twenty five years. Ellen is happy to share that as a therapist working with surrogacy for eighteen years, she has helped almost two hundred happy babies go home with their families after being given a wonderful start by their devoted surrogate carriers.


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