Here's What No One Tells You About What It's Really Like To Be A Surrogate

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Eloise Drane, an Atlanta-based young woman — just 22 at the time — was in California to donate a kidney to her cousin in 1998, and saw an ad calling for egg donation. “I applied through that ad, and I was an egg donor a couple of times,” she tells Bustle. A few years later, another "surrogacy agency needed an egg donor coordinator; I signed up, and found out about surrogacy through them. I was fascinated.”

Already a mother of three children — she’d had her first when she was 19 and two more in her early twenties — Drane knew she wanted to carry a child for another family. After the birth of her fourth child, she decided to become a surrogate. “I started the process for my surrogacy cycle with families in Atlanta," she says.

But the process was far from immediate. First, she set up shop as the first surrogacy agency in the state — and encountered some serious red tape. “Initially, when I went to go start the agency, I couldn’t,” Drane says. “The state of Georgia was trying to start a personhood bill,” which deeply complicated matters. Though she could’ve gone it alone, she says she was pushed by her first intended parents to start a surrogacy agency. In 2008, she opened up shop and founded Family Inceptions, a surrogacy agency in Atlanta.

Courtesy of Eloise Drane

She gave birth to her first surrogate baby in April 2010, 12 years after she’d seen that egg donation ad one fateful day on the West Coast. “I had to try three times [to get pregnant]," she says. “I started the process in late 2007.” She delivered a second surrogate pregnancy in 2012, and a third in 2014.

How The Surrogacy Process Works

Various factors contribute to the quality of an embryo, according to Dr. Zitao Liu, MD, Ph.D., FACOG, a doctor at New Hope Fertility Center who is conducting an in-depth study of trophoblast cells (which "have receptors that act like velcro and help the embryo stick to the uterine lining," he says) and their correlation to implantation. "That quality, in part, dictates the implantation success of a pregnancy," he tells Bustle.

There are two types of surrogate pregnancy: traditional and gestational. With a traditional surrogacy, a woman uses her own egg combined with sperm (either donated or provided the “old-fashioned” way — through sex); with gestational, a fertilized embryo is implanted into her uterus. "There won’t be a large difference between surrogate pregnancies and regular pregnancies," Zitao says.

The factors that contribute to successful implantation "include the number of chromosomes in the embryo; the number of trophoblast cells; the differentiation of trophoblast cells; and the quality and quantity of the mitochondria in the embryo," Zitao says. "The higher the mitochondrial count, the lower the embryo quality. [Doctors can] use genetic screening on the embryos before implantation to ensure they are healthy and have the right chromosomal count. This also reduces the risk of miscarriage significantly while also ensuring the baby will be healthy."

Is Surrogacy Still A Private Matter?

Surrogate pregnancy is still shrouded in a hush-hush veil, mostly because it’s still a sensitive topic — the stigma is real, even though it's 2017 and high time to move on from all that. But in the wake of the news that Kim Kardashian and Kanye West are allegedly expecting a third baby via surrogate, as People reports, surrogacy is on the tip of everyone’s tongues at the moment. (The couple has not yet confirmed the reports. Bustle has reached out to their reps for comment, but has not yet received a response.)

Some couples prefer to embrace the baby as their own. Drane tells me that she has seen families tell some relatives that a mother gave birth to a surrogate baby herself, as opposed to using another woman’s womb. (See: the rampant Beyoncé conspiracy theory phenomenon when she was pregnant with Blue Ivy, which Bey's publicist called “stupid, ridiculous and false.”)

Regarding the news that a surrogate is reportedly carrying Kardashian’s baby, Drane says that the surrogate couldn't ever come out and say they carried her child, thanks to surrogacy privacy clauses. If the news is true and Kardashian wants to reveal anything about her surrogate, that’s between her and the woman carrying her child. But surrogates always sign contracts before pregnancy, and such clauses are part of those documents.

As times change, the shroud is slowly lifting. According to a report from the Council for Responsible Genetics in 2008, each state welcomes an estimated average of nine children via surrogate mother per year. Though five states still have restrictions in place in regard to what Drane terms "commercial surrogacy" and the other 41 all have guidelines in place and attorneys must be involved, the conversation is rapidly shifting. Celebrity couples have assisted in this slow but sure shift — hi, Sarah Jessica Parker and Matthew Broderick! Hey, Nicole Kidman and Keith Urban! What's up, Neil Patrick Harris and David Burtka! “Surrogacy is becoming so much more mainstream,” Drane says, “so a lot of people are becoming OK with being out about it.” But it’s a slow process.

How Money Applies

According to TMZ, Kardashian is allegedly paying her surrogate only $45,000 to carry her child for nine months, which may sound shocking, but Drane says the figure is average. While it's farfetched that her surrogate doesn't know she’s carrying a baby for one of the most famous women in the world, that could actually happen: Surrogates don’t always have contact with the families for whom they’re carrying the baby, though that’s less common. And as to money, surrogates don't get to set a price based on a family's means. “When a surrogate comes in the door, before we present their profile, they upfront agree to the compensation they are going to receive,” Drane says. That way, the agency avoids a situation arising in which a woman says something along time lines of, “I know you’re a millionaire now; I want you to give X amount of money,” Drane says, instead of going with an already decided fee.

In any event, money can’t be the deciding factor for a woman to carry another family’s baby. “If her only motivation is money, she is going to be a horrible surrogate and you aren’t going to want to work with her,” Drane says. Legit deciding factors vary. “Some want to give back,” Drane says. “Some are religious and feel it’s a way to serve and help somebody else. One time, I had a surrogate who could carry a pregnancy, but she couldn't produce eggs.” Using donated embryos, she had two “100-percent perfect pregnancies,” Drane says. “She wanted to give back, because of the family that helped her out” and provided eggs for her own children.

Who Qualifies As A Surrogate?

Courtesy of Eloise Drane

To qualify for surrogate pregnancy, a woman needs to have had a baby that she delivered through a healthy pregnancy and also raised herself, Drane says. A woman can’t have been pregnant in the past and put that child up for adoption — her previous pregnancies must have resulted in offspring whom she then proceeded to raise. She must be financially secure, too. “If she’s on any form of government assistance, she’s automatically disqualified,” Drane says.

“All these childbearing women — you would think, ‘Oh, yeah, you can be a surrogate,' and it’s so far from the truth.”

Moreover, the woman can’t go it alone, though single women can be surrogates as long as they have proper support. “She has to show that she has a support system,” Drane says. “If she has a partner, her partner also has to agree,” as well as undergo the same psychiatric evaluation and medical screening, and sign the same contracts.

In other words, surrogate mothers are few and far between. “All these childbearing women — you would think, ‘Oh, yeah, you can be a surrogate,' and it’s so far from the truth,” Drane says. She estimates for every 20 women who apply to be a surrogate, only two qualify.

As one would imagine, surrogates are in high demand. “As quickly as you get a surrogate in the door and get her screened, she’s already matched,” Drane says. If a would-be surrogate has had pregnancy issues in the past, she might be disqualified. Same goes for women who previously experienced postpartum depression, or take antidepressants or other medication. There are also surrogates who are perfectly healthy, but don’t have a wide support network and thus can't participate.

How Do Couples Select Surrogates?

So — what might Kardashian’s baby look like, if she really is using a surrogate? “My first couple was Jewish; the second was Caribbean; the third was Caucasian,” Drane says. “I’m African-American.” In other words, the ethnicity is usually the last thing on hopeful parents’ minds. “There are people that do want to have the same race,” Drane says. “There are others I’ve had that didn’t want to have the same race. One woman felt that it would be a better connection for her and her husband if the person [carrying their child] was of a different race."

Generally, the major factors contributing to a family’s selection of a surrogate are her stance regarding abortion or termination of a pregnancy; where she’s located (so the family may attend doctors’ visits with her if they so desire, and be present at the birth); and if her insurance provides quality maternity care, though that’s not always a concern. Surrogate costs are covered by the expectant family, and gaps in insurance care can also be covered if need be.

As to why families go with surrogates: “The majority of people [get a surrogate] because of medical issue, or it’s a same sex-couple or single man,” Drane says. “There are people who do it because they don’t want to carry a pregnancy, but that is not common. Many agencies won’t work with someone who doesn’t have a medical need.” Then again, agencies aren't the only option; some women match with families independently, and I spoke with someone who is doing just that.

What It's Like To Be A Surrogate For The First Time

Jennifer* is eight months pregnant with her first surrogate baby, for a gay couple based in Richmond, Virginia. The 38-year-old has had two children of her own, who are now 18 and nine years old. She figured, “Why not?” she tells Bustle. “I’m healthy; my pregnancies were great... Why not give to a family that can’t have children? It’s amazing — I love it. I wish i would’ve done it earlier.”

In her small South Carolina town, five hours from Richmond, Jennifer is much more of an anomaly than a woman who might carry a surrogate baby in a cosmopolitan area. “It’s not very common here,” she says. People say, “Oh! You’re a real-life surrogate?”

It seems as though there are as many routes to becoming a surrogate as there are surrogate mothers out there. After learning of families in need, “I told my husband, ‘I want to look into surrogacy,’” Jennifer says. First stop: social media. “I went on Facebook,” she says. “There are a lot of supportive groups on Facebook.”

"My first transfer was August, and it did not take. It’s devastating, because it’s not like you're planning your own family. You feel like you have let this other family down."

Her inspiration for becoming a surrogate happened via Facebook in the first place. Jennifer has been breeding Great Danes for 13 years, and a fellow breeder in California inspired her to try surrogacy. Jennifer saw an article on Facebook about the woman, who was born via surrogate because her mom was born without a uterus. “She was the first surrogate to grow up and become a surrogate herself,” Jennifer says. She reached out, and the woman has provided support. “I’ve talked to her along the entire way," she says.

Drane had both gestational and traditional births over the course of three surrogate pregnancies; Jennifer’s surrogate baby was implanted. “It’s not my egg,” she says. “They had a donor egg. Mentally, I thought it was better for me.”

Jennifer didn’t use an agency. “I went independent, because I wanted to match myself,” she says. The couple contacted her and they met halfway between Richmond and her town in May 2016. “We had lunch and it was an instant connection," she says.

Embryo implantation is a tricky process, and often isn’t successful on the first try. “My first transfer was August, and it did not take,” she says. “It’s devastating, because it’s not like you're planning your own family. You feel like you have let this other family down.”

Jennifer got pregnant on the second go, last November; she has to give birth via a scheduled C-section July 21, because she had a C-section for both of her children. Though she says surrogate pregnancy isn’t difficult, it does require serious dedication. She's in touch with the couple on a regular basis — they've all become friends, and the couple will be present for Jennifer’s C-section at a hospital in Charleston. She has a great time with them, and even stayed with them in Richmond on a visit. “They’re fun,” she says.

The Reality Of Being A Surrogate

Imagine carrying a baby for nine months — the endless doctors’ visits, the feeling of life within your womb, the food cravings, morning sickness, and swollen ankles — for the express purpose of giving another family a chance at parenthood. It might sound like a tall order, but for several women, like Jennifer and Drane, surrogate pregnancies are a reality of life — and incredibly rewarding.

"You have to put your life on hold while you’re doing this."

After seven healthy pregnancies — delivering surrogate babies at the age of 34, 37 and 39 in addition to the four children she’d had in her late teens and twenties — Drane had to have an emergency hysterectomy. “It is what it is,” she says. The experience has helped her become better at doing her job. When interviewing surrogates, she can relate "the good, the bad and the ugly," she says.

“It’s an amazing experience, it’s awesome; but there can be complications during and after the pregnancy,” Drane says. “You have to inject yourself with medications for the first 12 weeks. You’re taking shots every single day. You have to put your life on hold while you’re doing this.”

Like most surrogate mothers, Jennifer is happy to be able to provide a child to a family in need — and she can’t wait to give birth and hand off her surrogate baby to the couple with whom she has become so close. Though Jennifer has enjoyed the process and had only three weeks of nausea, she’s also ready to go back to normal life. “I cannot wait to get on a snowboard again,” she says. “Girl, I’m on the countdown... But do I regret it? No, absolutely not.”

*Name has been changed.