Tuesday, January 13, 2015

International Surrogacy Considerations, Making Tough Decisions

The past year has brought many changes to the landscape of International Surrogacy.  Keeping up with all of those changes is a full time job requiring long trips, long meetings with doctors, clinics, attorneys and Embassies, while managing the expectations of clients who find themselves having to adjust mid-stride.   The second half of 2014 was certainly the most stressful 6 months for Intended Parents and their surrogates, and for agents, doctors and facilitators.  Bangkok closes, push to Mexico to find the best available resources there, get started and news articles and meetings with governmental officials suggest that there will be a shut down of "altruistic" surrogacy for anyone but those living in Tabasco.  Nepal opens as what appears to be the "final stop" on the International scene.   Fly to Nepal to see if it's manageable even with a doctor with whom we have been working for a long time in India.  Spend months developing and prepping to take a first group in.   It's a whirlwind of thought, time, and ethical considerations balanced against the desires, needs, and wants of so many people who are at their most vulnerable.

Everyone considering surrogacy Internationally really needs to understand FULLY that it is NOT the USA.   If you are at all afraid of long travel to places that may not have some of the conveniences that Westerner's take for granted, may feel primitive, or even unkempt, or if you feel that you need to have hospitals that look like 5 star resorts,  if you are looking for regulations, ratings and rankings as we have in the USA, then do NOT go through surrogacy Internationally.  Save your  money for a several years and try it in the USA.  Or Canada.   But, I will caution that even the US and Canada do NOT come with guarantees of success - no surrogacy or pregnancy, for that matter, in any part of the world, in even what appear to be the most perfect of situations can guarantee that you will have a healthy baby. (more on that later).

IF you are understanding of the above, and you want to have an excellent chance of having a family in a unique way that will hopefully allow you to still afford diapers and formula without taking a bundle of second mortgages, then DO by all means consider International surrogacy options.   Just realize it's going to be HARD.  No matter what.  We are down to just a few viable options, and those will not be around for very long based on the constantly changing landscape.  No country wants to be considered negatively when it comes to such a sensitive matter, no one want to be a "baby factory".

My clients so desperately want options to stay open.   They assume the risks associated with any pregnancy anywhere, but add extra intensity to it by doing this halfway around the world in another woman's body, in countries that do not have the ability or resources to, say, handle a micro preemie.  (Typically, outside viability in countries like India and Nepal is 29 weeks - on the outside).  It's stressful and highly emotional.   I tell all of my clients up front what I can and can't do for them - I can help guide clients through tough situations during the pregnancies but I can't make decisions for them medically, this is their surrogacy and their children.   Those decisions, and the decision to sign on to any program in particular is up to the Intended Parent.  Period.  Most of the time risks are mitigated and everyone goes home with healthy babies, rarely there are complications and outcomes that no one can control, not the doctors, not the agent, not the IP.   I've been extremely fortunate, I think to see so many wonderful outcomes, I celebrate each one of those.   And, I hurt deeply for the IP who does not have a perfect outcome.

  In the past, I have given many free and significantly reduced services to certain clients showing need.   I will no longer be able to do free or reduced agency fees  given the ever moving target that IS the International Surrogacy - an industry in which I still believe is a good option, and would (and frankly may) assume for my own family.  This also allows me to take fewer clients so that service is even better.  This is a boutique agency, not a churn and burn huge enterprise.  The intensity of the work, combined with the time away from home, and the development of new programs has increased the price for everyone involved, from clinic, to facilitator, to IPs.  Surrogate compensation is higher in Nepal due to the time away from home towns in India, and the living expenses are higher too.  Hospital delivery charges are higher as well.  The IVF doctors travel back and forth between their clinics in India or Germany, that also adds cost to the packages.

As of now, everyone feels a sense of desperation to get in and out of the countries as they come up.  Some people are able to handle the challenges and risks with minimal anxiety, and some need a lot of extra help, especially if complications arise.  As an agent/facilitator, we are here to help, but we too have limits on what we can logically provide, but we try to find for you the resources to minimize the anxiety and the information to manage some of the unknown.

On that note, new to the program this year is the inclusion of a therapy session with a licensed counselor who specializes in infertility and surrogacy, available to any IP who is feeling the need for support above what we can provide.  Also new is the addition of assistants and partners to the programs.   Nepal is going to present some challenges in convenience, but the two major hospitals in Kathmandu are truly well staffed, surprisingly modern, and clean (not BNH, but we can't have that anymore).  The hospitals seem eager to please, and I have met with all staff from the CEO down - the CEO and hospital admin have promised to assist IPs and me with all that they can.  The OBGYNs and Neonatologist and his staff were frank and open when I met with them and toured the NICU, delivery rooms, and recovery rooms.   Many in Kathmandu desire the infrastructure medically and in other ways that surrogacy can bring to a country.  This will enable even the locals to receive specialized care that they would have not experienced without the doctors bringing in equipment and the extra technology required for labs and IVF, and the additional equipment to the nurseries and NICUs.    Most of the doctors starting up in Nepal are world class and experienced physicians.   I anticipate seeing more resources and communication shared between top agents, a few of us are working on that presently.   It's going to be quite different for those who had first surrogacies in, or were considering, Bangkok.   But, we will have many babies through the Nepal programs who would not be possible without the brave surrogate mothers, the clinics, agents, facilitators, and Intended Parents who will work together halfway around the world to have the chance, the hope of a family.

 International surrogacy is not perfect, surrogacy in general isn't perfect anywhere, but it does provide options and chances for family that just did not exist openly even 10 years ago.   Again, consider your own fortitude and mental resources, not just the financial aspects of this process - be honest with yourself and make sure that you have all of the physical and mental support that you can possibly can before signing any contracts,  International, or maybe surrogacy in general, is perhaps not the best choice for each and every person who looks into the option.  Only IPs can make this decision for themselves.   But for those with that fortitude and who truly are wanting a chance at a family, and who can understand and accept the risks,  it can be the path to the family of dreams.

We are redeveloping our website to highlight the new programs and services that we offer, as well as sharing the photos of the families we assisted in 2014.  Please visit us at www.completesurrogacysolutions.com.

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