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While certainly exciting, embarking on a gestational carrier arrangement can also be a daunting task, both emotionally and logistically. How do you trust another person to carry the baby that you so want?

As an Intended Parent (IP), the process of selecting a Gestational Carrier (GC) to carry your baby can be likened to dating. Both parties, the IPs and the GC, are trying to quickly get to know each other and to know what each expects from the arrangement before committing to an intense, long-term relationship.  Whether you are planning to work with someone you already know (a friend/family member) or to work with someone previously unknown to you, there are a number of considerations to review and conversations to have before moving forward.

Before even meeting with a potential GC, you should sit down with your spouse/partner and think though what your preferences and expectations are.

  • Type of relationship desired. Relationship expectations can range from business-like to the development of a lifelong friendship and maintenance of contact years after the baby is born. What kind of relationship do you want during the pregnancy in terms of communication and attendance at doctors’ visits? What about during the birth? Is it important to you to be in the delivery room, or are you more comfortable waiting outside the delivery room?
  • Preferences for after the birth. What level of contact do you anticipate having after the child is born? Will you continue to meet in person? Will you send pictures and cards on holidays?
  • Willingness to travel. Do you prefer to work with someone locally, or are you willing to work with someone out-of-state? It’s important to consider that gestational carrier laws differ from state-to-state, and it’s important to consult with an attorney about laws in the GC’s state. Regardless of the location of the GC, you will need to meet with a lawyer to draw up a contract.
  • Feelings about multiples. How do you feel about the prospect of a multiple pregnancy (e.g., twins, triplets)? How many embryos are you hoping to transfer?
  • Number of cycles to attempt. If the first embryo transfer doesn’t work, will you want your GC to try again?
  • Your views on prenatal testing, selective reduction, and termination for birth defects. In a traditional pregnancy, you would not need to think through these issues unless or until you were faced with them. However, when you bring a third party (e.g., a GC and her spouse/partner) into the equation, it is important that everyone is in agreement on these issues.  There is no right or wrong opinion to have, but you need to match with someone who shares your views on these decisions.

After you’ve figured out your own hopes and expectations, you’ll be more prepared to find a GC who is going to be a good match. When you’ve found someone you might like to work with, who also might like to work with you, it’s advisable to spend some time together.  You’ll want to have some specific conversations, but it’s also a good idea to get a general feel from the GC and her spouse/partner. Some people choose to visit their GC’s house and to invite their GC to see their house as well. Additionally, some people choose to run a background check.

Topics to cover with your potential GC:

  • How did she become interested in becoming a GC? What motivates her to do this?
  • Are her friends and family members supportive of her decision?
  • How supportive is her spouse/partner?
  • Does she have any religious beliefs that might affect the arrangement?
  • Are you all in agreement on the major IP-GC issues, such as: type of relationship/communication desired during and after the pregnancy, number of cycles to attempt, feelings about multiples and number of embryos to transfer, openness to prenatal testing, selective reduction in the case of multiples, and termination for birth defects.
  • Finally, while discussing finances can feel awkward, it’s crucial to the arrangement. You’ll need to learn what are her general expectations regarding finances and compensation.  You should also try to get some sense of her financial stability. There’s nothing wrong with being compensated for her time and effort, but it’s important that she doesn’t NEED the money to get by.

After the match.

After you and your potential GC have decided that you want to work together, you will all need to complete a psychological consultation. The psychological evaluation has three components:

  1. A psychological evaluation of the carrier (including her spouse or partner).The purpose of the psychological consultation for the GC is to make sure that serving as a GC will have a positive, rather than negative, effect on her life. The consultation will cover potential psychological risks for the GC and help her to anticipate difficulties that could arise during the arrangement. It will also assess whether she will be able to provide a safe environment for the unborn baby during pregnancy.
  1. A psycho-educational meeting between the psychologist and the intended parents. The meeting with the IPs involves an evaluation of the IPs’ expectations and relationship with the GC, and it will help the IPs to plan for emotional and logistical issues that may arise and think through plans regarding disclosure.
  1. A joint meeting with all parties: GC, her spouse/partner, and the IPs. The joint meeting between GC, GC’s spouse/partner, and the IPs is an opportunity to ensure that all parties have the same expectations and to identify and plan for possible rough patches in the relationship.

A well-planned GC-IP arrangement can be a beautiful thing.  In the words of Benjamin Franklin, “an ounce of prevention is worth a pound of cure.”

 

Dr. Ryan Blazei is a licensed psychologist in private practice in Cary, NC.  She is a member of the American Society for Reproductive Medicine and counsels on infertility and family building options.  Dr. Blazei can be reached at [email protected]  (919) 720-1452 www.RyanWBlazeiPhD.com. She also facilitates a free drop-in support group on the second Wednesday of every month from 7pm-8pm in the lobby of Carolina Conceptions.  All are welcome to attend.