The Unsung Heroes Behind Surrogacy

The recent birth of Nicole Kidman's daughter has brought surrogacy back into the spotlight. Surrogacy is a treatment option for women who are unable to successfully maintain a pregnancy and have a health baby on their own. There are two types of surrogacy, traditional and gestational. Traditional surrogacy is when the surrogate is inseminated with sperm from the infertile woman's husband or partner and there is a biological connection to the baby. Gestational surrogacy is done more frequently. It means the intended mother or an egg donor's eggs are used and the intended father or a sperm donor gives sperm to create an embryo. The resulting embryo is transferred to the gestational surrogate There is no biological link between the surrogate and the baby. Surrogacy is generally an option when other infertility attempts have been unsuccessful. It is the most complicated family building option in terms of medical, financial, legal, and societal challenges.

Sharing a pregnancy with another woman presents its own set of challenges. A surrogate can be a family member, friend, or complete stranger. They dynamics of this most delicate of negotiations can be influenced by the existing relationship between the parties involved. Each surrogate arrangement involves mapping out a unique agreement with ongoing dialogue between the consenting parties about what role the intended parents will play in the pre-natal care, pregnancy, labor, and birth of the child. Issues like what role will the surrogate play in the child's life after birth must also be explored. What happens if something unexpected like a medical problem during pregnancy occurs? Who makes decisions about the medical treatment for the baby and the surrogate?

In her recent New York Times article, "Meet the Twiblings," Melanie Thernstrom described taking time out to meet the husbands of the two women who eventually became her surrogates. I remember saying "bravo" out loud as I read that. I thought about it and realized that was the first time I heard somebody recognize the significance of the husband of the surrogate. Ms. Thernstrom said "The role of a gestational carrier's husband is in some ways more difficult then that of the carrier herself." I thought Fie, her surrogate, stated it beautifully. These husbands are "a bystander to a miracle who partakes in the inconvenience of his wife's pregnancy but has fewer of the emotional rewards." The surrogate and her husband as a team must respond to questions and concerns that arise from their own children, other family members, friends, and sometimes the judgments imposed by society. The husband is directly impacted in the event that a medical problem arises during the pregnancy.

Hilary Clinton said "it takes a village to raise a child." In the world of infertility it sometimes "takes a village" to create a child. It takes a special woman to agree to be a surrogate and give the ultimate gift to people wanting to build a family. I believe it takes a special husband to support his surrogate wife in making this possible. We should honor and acknowledge the role of these men and women. You can be sure the lucky families that find them do.

Iris Waichler, MSW, LCSW, has a Master's Degree in Social Work and has been a licensed clinical social worker for over 30 years. She has done workshops, individual, and group counseling with people experiencing infertility. Ms. Waichler is the author of the award winning Riding the Infertility Roller Coaster: A Guide to Educate and Inspire. She currently writes freelance infertility and health related articles.

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