A Surrogate's Perspective

“We never get good news in these rooms.” Those are the words I remember most in what was, looking back, a memorable and terrifying journey.

Rewind to my younger years, a relatively worry-free life. I was married and wanted to start a family of my own. Amazingly, I got pregnant really fast. Unfortunately, I miscarried very early on. In fact, if I hadn’t tested early, I would have never known. I was just so excited about the idea of having my own baby. The loss was devastating but a few months later I was pregnant again. And of course tested early, again. The same thing happened. I lost another one.

On my third attempt, I finally had a successful pregnancy and I gave birth to my first son in 2007. Being pregnant was one of the most fabulous times of my life. Really! I absolutely adored being pregnant. I loved everything about it.

Changes in life happened, and years later, I was divorced and remarried. We decided we wanted a child of our own. We were pregnant within two months of trying. We had another boy! A year or so later, I didn’t feel like I was done. I wanted one more child and I wanted to try for a girl. We got pregnant and guess what? We had a boy! I was a tad disappointed when I first learned it was a third boy, and I took my time to grieve the fact that I wouldn’t have a girl. But the minute I saw my happy, healthy baby any thought of wanting him to have been a girl went right out of the window.

After having my own children and realizing just how complete they made me, I decided I wanted to be a surrogate. Also because of the two losses I had. That was a very difficult time for me. I honestly thought for a short period that I would never be a mother and I wanted to help someone who might be feeling the same. I was so grateful to have been able to have my boys, and I wanted another family to feel the joy I felt when I looked into their eyes. I knew that I was done building my own family, so why not help someone else while I still could?

My husband supported my decision and I signed up with an agency. The IP’s (Intended Parents) I was potentially matching with had been through a quite whirlwind already with other potential surrogates, so we took the unconventional step of going through medical clearance before we met. This way they didn’t get too disappointed if I didn’t work out for some reason. I really felt the pressure of their past difficulties and had some serious chats with my body during that time! I did not want to disappoint them. I wanted to be the one to bring them their baby! Luckily, medical clearance went well and I “met” my IP’s one afternoon during a phone call. A few weeks later we went in for medical and psychological evaluations. All went great again! I was excited and thought to myself, Man, this is easy! Little did I know.

After we got the contract details straight, we were able to do the embryo transfer, which was successful. At our first ultrasound appointment, we were able to see a little flicker but it was too early to tell much. But at the next ultrasound appointment, we found out I was pregnant with twins! The embryo had split. My IP’s were shocked, but excited and optimistic.

The pregnancy went smoothly in the beginning, but just prior to the 9 week mark it was discovered that I had developed a DVT (Deep Vein Thrombosis). I was terrified. I spent one long night in the hospital, but thankfully, was released the next day with a prescription for a blood thinner I would have to inject myself with twice a day for the remainder of the pregnancy. A few weeks later I had a bleed, a SCH (subchorionic haematoma). These can be common unfortunately in an IVF journey, but the good news was that the babies were well.

When our 16 week MFM (Maternal-Fetal Medicine) appointment came, my IM (Intended Mother) flew in to accompany me. The ultrasound showed they were girls. We were so excited to find out their gender! After the ultrasound, I got dressed and they ushered us into a little office to wait for the doctor. We had no indication that anything was wrong. We chatted excitedly about the girls and what my IM would need for their arrival.

Finally, the doctor came in. She sat down opposite us and started talking about TTTS (Twin To Twin Transfusion Syndrome), a rare but serious condition that can occur in pregnancies when identical twins share a placenta. Abnormal blood vessel connections form in the placenta and allow blood to flow unevenly between the babies: one baby does not receive enough oxygen and nutrients to grow, and the other baby receives too much for it to handle, which can result in heart failure.  The doctor explained that although there was only a tiny size difference in the babies at this early stage of pregnancy, the likelihood was that the TTTS would progress to a point that would threaten the lives of both babies. I was devastated. I kept wondering what I had done wrong and what I could have done to prevent this.

The doctor was kind and had a gentle voice, but the only words I heard were “dead baby,” and “brain or heart damage to the surviving baby,” both of which she thought were possibilities. The term “selective reduction” was used several times and I had to fight back the tears.

We were referred to a specialist a few hours away. After another scan, we were sent back to our doctor for her to share the results. We sat and waited for her to come in. You could literally hear the clock ticking. You could almost hear our heartbeats as we waited for an update. My IF (Intended Father) then broke the silence: “We never get good news in these rooms.” It was the most gut-wrenching feeling of helplessness. I kept telling myself, no matter what the news is, I will bring at least one healthy baby into this world for them. Of course, we all wanted two, but the way the doctors talked it didn’t sound hopeful.

The main issue was my DVT. In its absence, a selective reduction would have been the recommendation, but because of my blood clot, neither our hospital or the one we went to for a second opinion would perform the surgery. Any surgery is risky, but with an existing blood clot, things would be a lot riskier. I immediately went to Facebook and joined every TTTS support group I could find. Many suggested a certain specialist, which I mentioned to my IP’s as an alternative even though they were very concerned about continuing the pregnancy. Yes, they wanted a baby, but they knew I had a family of my own to care for and put my well-being before anything. When it was recommended that we consider termination, I remember texting the IM back and forth for days. I did not want to terminate the pregnancy; there just had to be something we could do. She would tell me it would be alright, that they had more embryos, but that they could not live with themselves if something happened to me. They were the most caring couple and I know they truly cared about my health and wellbeing, but the memory of my own miscarriage lingered and I just couldn’t let them lose their babies. I was more determined than ever to carry to term.

When we went back to our high-risk doctors to discuss next steps, they did another ultrasound and, this time, it looked like things were at a point where we didn’t have to do anything except monitor further. Their thought process was that we could wait and see how things progressed. If with time it looked like Baby B was deteriorating, we could then step in and perform a reduction once we were further away from the commencement of my blood clot. A concern was that if Baby B passed away on her own, her death could then cause brain and or heart damage to the developing baby. During that appointment my IP’s agreed that we would go see the specialist I had recommended. I felt relieved. I had heard such good things about him.

We flew to Florida to meet him the following week. The doctor confirmed it looked like TTTS, but we had not yet met the staging criteria for laser surgery. Laser surgery would mean going through the uterus and the placenta to sever the connections between the babies in order to give both babies a chance for survival.

A week later, we flew back for a follow-up, and things had progressed: the doctor referred me to the hospital for surgery the next morning.

The IM (Intended Mother) and her mother were there. My husband and kids were back home. I was terrified, but hopeful. The surgery was successful and both babies survived.

The next morning’s ultrasound showed that both babies were doing alright. The doctor said that most patients are placed on bed rest after this surgery but that I was not his average patient. He then told me that I was the only patient in the world who had ever been in this situation! There were no statistics to compare me to. He said that I could call him 24/7 if I needed anything at all. We continued to fly in for weekly check-ups.

In the second week post surgery, at 21 weeks, my IM and I sat for yet another ultrasound. “There’s Baby A,” he said, and then he went quiet… “Baby B is gone.” My IM reached out and squeezed my hand; we were both fighting back tears.

I was devastated, again, and wondered what I had done wrong. But I had to muster the strength to remain optimistic and hopeful for the healthy baby that was still growing inside of me. I needed to stay calm and I wanted to be a good “host.” A few weeks later we were released back to our MFM.

Fast forward to my 6th month of pregnancy. As if I hadn’t been through enough already, this time I fell on the ground, hard. I was still on blood thinners, so it made things more complicated. I ended up being admitted to L&D for a couple of days of monitoring, but thankfully, baby girl was okay! As for me, I just couldn’t sit, lay down, stand, or anything without being in pain. I was left with a large hematoma that didn’t allow me to sit or lay flat. At that point, I questioned my fate and wondered what was going to come next. How many things could go wrong when you’re trying to do something so good?

Finally, the time came to birth this sweet baby girl. We were induced at 37 weeks in the middle of a hurricane! How else could this pregnancy have ended, right?

Prior to being induced, I was very nervous. I was terrified something else could go wrong. I was worried after having been on blood thinners so long that I might bleed out after she was born. What if I didn’t make it? The night before I left home I wrote a letter to each of my three children in the event that I didn’t come back. I wanted them to know how much I loved them and that I always would.

My husband was supposed to be my support person at the hospital, but our 3 & 1-year olds decided that they needed him more! So plans quickly changed and it was my 11-year-old son who traveled with me and stayed by my side, along with my IP’s and their respective moms.

The process went slowly. They started by giving me a dose of Misoprostol around 9 AM and I didn’t have my epidural until around 8 PM. It was my IM and me in the room with a nurse and the anesthesiologist. It was taking a bit. He did it once and then had to remove it because of some “heme.” The nurse in front of me held my hands. After a few more minutes the nurse said she needed to sit down. Apparently, she was also pregnant and hadn’t eaten much that day. She got dizzy from standing there. So my IM and I were trying to make sure she was alright while I had a man with a huge needle right behind me. Finally, the epidural was in and then they started the Pitocin. Through the night, my son laid on the sofa beside me and I laid there drifting in and out, wondering when she might decide to make an appearance.

At 9 AM the next morning they came in and broke the waters. A couple of hours later I felt the urge to push. I told my son to get the IP’s and possibly a nurse which he did. My IM and a nurse and the grandmothers all came in! It was time!  My IF had just run out to grab something (it took all day and night, who knew it would suddenly happen so fast). The nurse checked me and she said it was actually time to push. She was there. She wanted me to give a couple practice pushes while they were setting up. One practice push and she said, Okay, no more. She’s right here. There were nurses, doctors, and everyone else piled into this small room ready to handle it all. My IM stood beside me as I pushed. Just a few pushes and baby girl was here! They plopped her onto my belly and my IM was given scissors to cut the cord. I, of course, had tears streaming. Watching her see her baby for the first time and cutting that cord was simply one of the most beautiful things I’ve ever gotten to witness.

My IF walked in shortly after and my IM took the baby to meet him. I watched her introduce her new baby girl to her father and the waterworks began again. Seeing those three together and the smiles on their faces just brought me so much joy.

I am asked very often how I felt at that moment of giving birth. Giving birth to a baby that would be placed on me, but then “taken away.” First, I have to remind them that she wasn’t “taken away.” She was given back to her parents. I was just the “extreme babysitter.” Of course I developed a bond with her while I was growing her. Of course I cared about her and what happened. But it was 100% different than having my own babies. When I had my own babies I wanted them to be given to me as quickly as possible. I wanted to hold them ASAP. With this birth, I wanted her parents to feel exactly what I felt the first time I held my children. And they did. Watching them share those first moments with their daughter was amazing. It made me think back to my own births and it was like I got to see a glimpse of how it was from the other side.

My husband and I took a trip to visit the family 7 months after she was born. It was great seeing all of them again and spending time with them. Baby girl was so chunky and adorable! I think she recognized my voice when they brought her out to see me. My husband’s too; she practically jumped into his arms when she heard his voice. It was pretty incredible. We were supposed to visit again this past year, but COVID happened. My oldest son really wants to make a trip out one day to meet her. He was very involved in the pregnancy and even the birth. We both follow them on Instagram so we get to see her grow from afar, which is awesome. She is the most beautiful little girl and obviously very much loved by everyone.

The day before she was born, the grandmothers gave me a bracelet with a charm. My IM gave me a necklace. I will keep them near and dear to my heart forever. On her birthday this past year I received another charm to add to my bracelet. I may have cried a bit! It means so much to me that they think of me even after these two years have passed by. I think of them often, too, and it just makes me so happy that I was able to help them create their beautiful family, and to finally give them some good news.