So, you’re married to the man of your dreams, and all the world is rosy. A few years into this idyll, you begin to feel the need for a little one in your midst. It would complete your circle of love. Most young couples end up welcoming baby in the natural course of things. But, increasingly, getting pregnant, carrying a baby to term and giving birth are getting to be fraught with unexpected bumps. Environmental stress is fast emerging as one of the lead causes of such complications.

Many couples are turning to Surrogacy as an option to fulfill their parenthood dreams. We will take you through a 2-part series that will address:

- What is surrogacy and should you opt for it?
- What are the challenges & rewards?

What is Surrogacy?

Simply put, ‘surrogacy’ is an arrangement where a woman carries a baby in her womb until birth for the intended parents. Think of the surrogate-carrier as a safe-house for your little one to get ready to pop into the world, hale and hearty! Surrogacy is a miracle of medical science that has allowed women who are unable to carry their babies to full term – to become proud moms and experience one of life’s deepest joys.

How does it work?

Eggs from the biological mom-to-be are harvested from her uterus and fused with sperms of the intended father in the lab, to create an embryo. This fertilized egg or embryo is then surgically implanted into the womb of the surrogate carrier.

If the intended father or mother are unable to provide healthy sperms or eggs, donors may be tapped. There is a sound process in place for this and your clinician will advise and help you through it.

Possible Hiccups

The challenges are several, and we will talk about them in detail in the final piece of the series but here is a glimpse of the practical problems that may arise at the outset.

First off, there is the trepidation and anxiety of stepping into an unknown space, beyond the conditioning of one’s background, where in India childbirth was always thought of as deeply personal and intimate life-changing event between the intended parents. But rest your concerns. Today surrogacy is a common and popular practice the world over, and have led to many couples becoming fulfilled parents.

The first practical hiccup of the process of surrogacy is that fertilization is not guaranteed. It may not happen at all. And if it does, the embryo may be rejected by the carrier-surrogate’s womb for several medical reasons that cannot be checked in advance. This translates to additional expenses and the continued trauma and anxiety through multiple attempts. It is best to be aware and prepared for this possibility.

On IVF-surrogacy, doctors in India are agreed upon the fact that there is a 30-40 per cent chance in the first attempt, which goes up to 80-90 per cent when tried thrice. Couples are known to try up to 6 times or more.

Common myths & facts

Is IVF the same as surrogacy?

Not at all. In-vitro fertilization (IVF) is a process that couples turn to when they are unable to conceive in the natural way. The process is used to help with fertilization of a woman’s eggs, embryo development, and implantation of the fertilized egg. The implantation of the fertilized egg may be into the womb of the biological mother herself – because while she (or the intended father) may have medical problems that prevents fertilization, her womb is perfectly able to carry her baby full term.

Naturally, all surrogacy pregnancies must happen through the IVF process – where the fertilized embryo is implanted in the surrogate.

Surrogacy merely implies the carrying of the baby to full term for the intended parents – a surrogate, in effect, lends her womb to help grow and nurture the foetus till baby is ready to be born.

Surrogacy is for women who want to keep their figure

This is an ignorant but surprisingly common perception about surrogacy. The desire to have a baby and the much-anticipated joys of motherhood naturally far outweigh considerations of maintaining the hourglass figure!

The surrogate is the biological mother of the child.

Again a notion based on ignorance but widely prevalent. As the word implies, the surrogate carrier merely carries the baby for the intended parents in her womb. The eggs and sperms that lead to the creation of the embryo may belong to the intended parents or may have been procured from donors.

It is difficult to bond with a baby born to another woman.

A ridiculous notion, and one that goes against the very grain of being human. Science has proved that it is nurturing the baby, holding him or her, caring for her daily, bathing her, having her around is what develops bonding, not the physical act of carrying a baby or giving birth. Think about this: we end up getting deeply attached to our pets, will we not love a human child?

What if the surrogate mother refuses to part with the baby?

Surrogacy is an arrangement that must always be supported by a legal agreement to prevent such a sad situation from arising. Today, counselling and a deeper understanding of the concept, makes this unlikely.

The Legal Landscape

Having an offspring is often thought of as one of life’s biggest joys, making it deeply fulfilling and meaningful. Parenthood is an experience that is dearly sought-after by many couples and even singles, all over the world. Surrogacy has helped millions of people who dreamt of being parents but were unable to for medical reasons.

In India too, over the years, the practice became popular but along with the pros, the biggest con was that of exploitation. Surrogates, often in need of money, were contracted commercially, and deeply exploited, often by third parties who organised the process.

This is the root cause why the government decided to take action and implement the Surrogacy Bill which has recently become a law.

The Surrogacy Law lays down strict provisions that are intended to put an end to the exploitation of the surrogate. However, the law comes as a big jolt to the booming commercial surrogacy industry in the country. It remains to be seen how the situation pans out on ground but here are the highlights of the law:

Criteria for intending parents

The law has put down several conditions that must be satisfied before a couple can be considered eligible for surrogacy.

• You must be an Indian heterosexual couple, married for a minimum of five years.
• The man should be between the ages of 26 to 55 years while the woman should be between 25 to 50 years old.
• The couple should have no biological, adopted, or surrogate child. A mentally or physically challenged child or one with a life-threatening disease is the only exception.
• The couple in question is required to have a ‘certificate of essentiality’ which includes a certificate of proven infertility of one or both persons, a Court order on the parentage and custody of the child born through the surrogate, and insurance cover for the surrogate mother for 16 months including post-partum delivery complications.
• The abandoning of a child born through surrogacy by its commissioning parents is punishable by law.

Criteria for surrogate carriers

To prevent the exploitation of surrogates, strict criteria have been laid down for anyone choosing to be a surrogate mother.  

• The surrogate should be between 25 to 35 years of age.
• She must have been married at least once in her life.
• She should have a child of her own.
• She should be a close relative of the intending parents.
• No woman can be a surrogate more than once in her life.
• She needs to be certified for medical and psychological fitness.
• Written and informed consent of the surrogate is necessary ahead of the procedure for surrogacy.
• The surrogate can withdraw her consent any time before the implantation of the embryo.

Challenges and Rewards of Surrogacy

Watch this space for the next piece on the 2-part series on surrogacy: Challenges and Rewards of Surrogacy?’

The article will provide expert-backed pointers – medical and psychological – that will help you answer the question for you, if you are considering surrogacy, or helping someone take the decision.