As if the recent news that Beyoncé and Jay-Z's twins were reportedly born wasn't enough amazing celebrity baby news to last a lifetime, it looks like we could soon be blessed with another famous tot: according to People, Kim Kardashian and Kanye West have reportedly hired a surrogate to carry their third child (!!). Kardashian has been open about her issues with fertility on social media as well as on Keeping Up With The Kardashians — namely, her struggles with placenta accreta, a condition where the placenta attaches itself too deeply into the uterine wall. Because of this, it might not be safe for Kardashian to carry her next child herself; fortunately, surrogacy is an option available to Kardashian and other women who, like her, struggle with fertility issues. But how exactly does surrogacy work?
“Surrogacy is a process where a woman agrees to carry a pregnancy for another person or couple, who will become the newborn child's parents after birth," Dr. Pavna Brahma, M.D., and Reproductive Endocrinologist and Fertility Specialist at Prelude Fertility, tells Bustle. "Surrogacy involves the process of in vitro fertilization. During IVF, an egg and sperm are combined in the laboratory to create an embryo. The embryo is later implanted into the surrogate's uterus for her to carry the pregnancy."
There are a lot of reasons someone would choose to use a surrogate — but ultimately, the choice is totally up to the couple and their doctor, and a woman should *never* be shamed for choosing surrogacy. Here are five common reasons that a woman might use a surrogate to have a child.
1. They Have Uterine Issues
The uterus is an amazing organ — it's literally life-giving. Unfortunately, some women have uterine issues that prevent them from successfully carrying a baby to term (again, nothing to be ashamed of at all).
“Surrogacy can be used when a woman is unable to carry a pregnancy for a number of reasons," Dr. Brahma says. "One of which is uterine issues, including extensive fibroids or ashermans syndrome (uterine scarring) [which] can make it difficult to carry a pregnancy to term."
2. They Have A Pre-Existing Health Condition
Aside from uterine issues, there are other medical conditions that might mean surrogacy is the best or safest option.
"Certain health problems, including heart or kidney issues, can make carrying a pregnancy extremely dangerous for a woman," Dr. Brahma says. "Due to the complex physiological changes of pregnancy, surrogacy could be the safest and best option in these cases. Also, certain medical conditions require medications to maintain a woman's health which are completely unsafe in pregnancy and could cause fetal harm."
3. They've Had A Hysterectomy As A Result Of Cancer
If a woman has cervical or another kind of cancer that requires a hysterectomy as part of the treatment process, that means she will be unable to conceive a child in the "traditional" way in the future.
"Certain cancers may have caused a woman to have a hysterectomy prior to beginning her reproductive life," Dr. Brahma says. Having a hysterectomy doesn't have to mean you can never have children — it simply means you'll need to explore other family-planning options, like surrogacy or adoption.
4. They've Had Problems With A Previous Pregnancy
If a woman has been pregnant before and experienced severe problems resulting from that pregnancy, she might choose surrogacy as a safer alternative for both herself and her baby.
"Some women have had previous pregnancy complications which could put both the mother and baby in harm if she carried again," Dr. Brahma says. "Pregnancy complications such as cervical incompetence and severe preeclampsia can sometimes be managed during pregnancy. But a woman's doctor may also advise that surrogacy is a safer option, these are all individual decisions between a woman and her doctor.”
5. There Are Other Logistical Limitations
According to Dr. Brahma, aside from medical reasons, a couple may choose surrogacy because of lifestyle or logistical limitations (LGBTQ couples, for example, may require a surrogate in order to conceive). Whatever a couple's reason is for choosing surrogacy, all that really matters is that they're making the best choice for their family — regardless of outside opinion.
"Prior to planning surrogacy, it is important to assess all of the potential psychological and legal implications," Dr. Brahma says. "Taking the needed steps ahead of time can help prevent possible difficulties. Reproductive psychologists can help assure that both a surrogate and intended parent or parents are fully comfortable with their choices.”
If the news is true, and Kardashian continues to be open about her fertility issues, she could be helping to bring awareness to the fertility struggles that many Americans silently face, as well as sparking an incredibly important dialogue about women's health.