Surrogacy: What does it mean? How does it work and what are the issues?

Everything you need to know about surrogacy...

For most people the path to parenthood is straightforward, but for others it's a much more complicated journey and can involve years of trying and failing, disappointment, emotional upset, as well as intensive medical and physical intervention.

While IVF remains one of the first steps in the process for couples with fertility issues, in recent years there have been a number of high profile cases where prospective parents have turned to surrogate mothers in their attempt to have a baby. This option seems particularly popular in the celebrity world.

Cristiano Ronaldo, Ricky Martin, Nicole Kidman and Keith Urban, Sarah-Jessica Parker and Matthew Broderick, Elton John and David Furnish; all these famous faces have created their families with the help of a surrogate.

If you're struggling to start a family naturally and have decided against adoption, then could surrogacy be right for you? It's an area slightly shrouded in mystery, misunderstanding and confusion so it's important to do your research and find out as much as you can about the process before you begin. There are organisations that can provide support for anyone who is considering the surrogacy option and that can even introduce you to surrogate mothers who could help you achieve your hopes of having a child.

Not for profit organisation Surrogacy UK was founded in 2002 and has over 100 registered surrogates. Since it started connecting childless couples with surrogate mothers it has seen around 180 successful births among its members. It even arranges social events and conferences where intended parents can meet others going through the same process and where they can get to know potential surrogates.

Kate Dobb is the Communications Manager for Surrogacy UK and had her twins with the help of a surrogate. She explained: 'Surrogacy UK is really supportive no matter what stage you’re at. Whether you’ve just come to surrogacy, or you’re in a team and you’ve had a failed IVF cycle and your surrogate isn’t pregnant yet, there’ll be someone else who is in the same situation.

'Everyone’s thrilled in the community when someone falls pregnant. When a baby is born everyone celebrates.'

So before you set off on this life changing journey, what do you need to know? Read on to find out more.

What is surrogacy and who can it help?

Simply put, surrogacy is a way for couples who can't have a baby to become parents, with the help of a surrogate mother carrying their child. It can be a successful option in the following situations:

Whatever your personal circumstances, it is essential that you have not only come to terms with the reality of your infertility issues but that you have also stopped trying to get pregnant yourself. It can be a long and stressful period so you need to be fully prepared as a couple for the toll it can take.

Are there different types of surrogate procedures?

Yes. There are two ways in which a surrogate mother can help. Which one is best for you depends on your own fertility problems.

1. Straight (or traditional) surrogacy

This is the most uncomplicated and least expensive form of surrogacy and involves the surrogate mother becoming pregnant with the use of one of her own eggs and the semen of the intended father.

The surrogate mother can either use an insemination kit at home or it can take place at a registered fertility clinic. While this procedure requires less medical intervention and seems like a more 'natural' way to conceieve, it can be more difficult emotionally for both the surrogate mother and the intended parents.

2. Host (or gestational) surrogacy

This version of surrogacy uses IVF, with the eggs of either the intended mother or those of a donor. The surrogate mother's eggs are not used and therefore she is not genetically related to the baby.

This process is much more demanding physically, more expensive and always takes place at a fertility clinic. This option can be more popular with surrogates who aren't comfortable using their own eggs and with intended parents who would prefer the surrogate mother wasn't genetically connected to any child that is conceived.

There are three main stages to host surrogacy:

There are also additional tests, checks and screenings required in gestational surrogacy and your chosen clinic will advise on which are needed for your particular circumstances. The clinic may also insist that its ethics committee approves your case before going ahead and will require you to take part in counselling about the implications of using a surrogate mother.

Who can become a surrogate mother?

A friend or family member may volunteer to carry a baby for a couple who are in need of help or couples can be put in touch with women who are willing to become surrogates through organisations like Surrogacy UK. The specific motivation for each surrogate mother is different but most simply want to help couples struggling to conceive on their own, so that they can experience the joy of being a parent.

Currently there are no official HFEA(Human Fertilisation & Embryoloy Authority) regulations to be fulfilled by a prospective surrogate mother, but if a couple is looking to use host surrogacy where IVF is necessary, then all involved should be aware that the fertility clinic may have its own recommendations with regard to the surrogate mother's age, previous obstetric history, obesity and mental health.

Future surrogates should also be made aware of the potential physical risks and complications that could stop them being able to complete their own families at a later date.

Linder Wilkinson is a surrogate mother registered with Surrogacy UK and gave birth to her first surrogate child three months ago for Mari Carmen Doria and Alan Barroso. She explained why she wanted to become a surrogate mother: 'You have to give serious consideration to the impact that pregnancy and birth will have before deciding surrogacy is for you. I feel so fortunate to be a mum. I enjoyed being pregnant with my daughter and wanted to experience that again.

'When I met my husband we knew our family was complete and wanted to share the joy of parenthood with another couple.'

Will the surrogate mother want to keep the baby?

This is perhaps the biggest worry for most intended parents who are considering using surrogacy. The pain of not being able to have a baby is upsetting enough so the thought that after a long and emotional journey, your chance to be a parent may be taken from you, is understandably unbearable.

Surrogacy UK insists, however, that the surrogate mothers it works with all enter the process with the full knowledge that any child created will not be theirs. The organisation has never had an instance of one of its registered surrogate mothers wanting to keep a baby for herself. It credits this to the importance it places on the surrogate mother and intended parents forging a strong friendship over three months before any agreement is entered into.

Kate Dobb said: 'I think initially before intended parents have met anyone else who has ever done surrogacy they’re quite fearful about things like "will the surrogate want to keep the baby". But as soon as they join an organisation such as ours and meet other people in the community who have done it, then that disappears.

'It’s all based on trust. You don’t go ahead with a surrogacy journey unless you really trust each other, so that’s why our 'getting to know' period of three months is very important.'

But it is also important to understand that until a Parental Order has been issued, the baby is not legally seen as yours so the surrogate mother could keep the child if she chose to.

In fact the HFEA website goes further saying:

'You should bear in mind that the surrogate has the legal right to keep the child, even if it is not genetically related to her. Surrogacy arrangements are not legally enforceable, even if a contract has been signed and the expenses of the surrogate have been paid. The surrogate will be the legal mother of the child unless or until parenthood is transferred to the intended mother through a parental order or adoption after the birth of the child. This is because, in law, the woman who gives birth is always treated as the mother.'

Linder Wilkinson says, however, this was never a worry for her. She said: 'I never had any concerns. I was giving her back to her parents after looking after her for nine months, she was never mine in the first place.

'Her mum and dad were there at the birth and she went straight into her mother's waiting arms. It was an incredible feeling to watch my friend holding her little girl and knowing that I had made it possible.'

How long will it take?

Like with any route to having a baby, this is almost impossible to answer, as even with medical intervention in a host surrogacy, it could take multiple attempts. And the first hurdle is to find the perfect surrogate mother for you. Surrogacy UK offers conventions and social meet ups for hopeful parents and surrogates so you can get to know each other and decide if you can enter into this deeply emotional process together.

How much does surrogacy cost?

The law in the UK is very clear on this matter. It states that no surrogate mother can receive payment before, during or after a surrogacy agreement has been entered into. The intended parents, however, are allowed and expected to pay for any expenses incurred by the surrogate mother. These may include; travel expenses, maternity clothes, loss of earnings, childcare for when the surrogate mother is away from her own children and professional counselling services so she can work through any issues that arise during the process.

Surrogacy UK says that such expenses payments can range between £7000 and £15,000 but that these are totally reliant on the specific circumstances of each surrogate mother and should obviously be discussed in detail before any agreement is made. For those couples who will need the help of IVF and a fertility clinic for a gestational surrogacy, these costs will also need to be met.

How do I become the legally named parent of the child?

The surrogate mother and her husband or partner are regarded as the legal parents of any child she gives birth to, even if there is no genetic connection. If the surrogate mother is single then the genetic father can be named on the birth certificate. A parental order is therefore required to transfer all legal parental rights and responsibilities to both intended parents and to extinguish the rights of the surrogate mother.

For a Parental Order to be granted the following requirements must be met:

In addition:

Consulting a law firm or solicitor that specialises in fertility and family law should be a priority. They can help draw up agreements between intended parents and surrogate mothers as well as help at the time of applying for the parental order.

Can I take maternity leave if I am using a surrogate mother?

The law in this area has changed in recent years and you could now be eligible for Statutory Adoption Leave and Statutory Adoption Pay if you take time off to have a child through a surrogacy arrangement. Your employment rights, including rights to pay rises, to return to work and to accrue holiday, are also protected while you're on Statutory Adoption Leave. Check out the latest information on Adoption Leave in a surrogacy arrangement here.

There's a lot to take into account but as Kate Dobb explains it could be the perfect way to start a family. She said: 'It’s a really positive experience. Our surrogate is a really close friend of ours, we still see her really regularly.

'Surrogates feel extremely proud that they’ve helped create a family and obviously parents are overwhelmed and overjoyed that somebody’s helped them become parents.'

For more information on surrogacy:

https://www.surrogacyuk.org/

http://www.hfea.gov.uk/

https://britishfertilitysociety.org.uk/

http://www.nataliegambleassociates.co.uk/

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