It’s hard to believe that there are people selfless enough to help others physically bring babies into this world. For instance, I'm writing this with my beautiful 2-month-old baby I did not birth strapped to my chest, still in disbelief that someone able and willing to bake her for me actually would. Let me backtrack for a second: My husband and I recently welcomed our first child via gestational carrier.
While we explained to everyone who asked (and many, many people asked) that, "Yes, our journey falls under the surrogacy umbrella," and, "Yes, the baby is biologically ours," and, "Yes, we are sure of that," but, "No, it of course wouldn't have mattered if she weren't," and still, "No, our carrier is not the mother," we found the concept of a gestational carrier perplexed nearly everyone we shared our news with.
This was surprising to us in turn — gestational carriers are an increasingly popular form of surrogacy across the globe, and it's an incredibly special way to conceive.
Wondering if a gestational carrier (GC) is the right path to parenthood for you? Here is everything you need to know about them, including how they’re different from traditional surrogates and what the process of working with a GC entails.
What is a gestational carrier?
Put simply, a gestational carrier is a person who carries a pregnancy for someone else. The intended parents will provide the egg and sperm for the embryo (either their own or from another donor), and then the gestational carrier carries that embryo.[1]
Gestational carrier pregnancies have grown increasingly popular: The National Assisted Reproductive Technology Group studied more than 2 million fertility treatment cycles between the years 1999 and 2013 and saw a 1.5 percent increase in the number of GC cycles during that time.[2] GC pregnancies within the same timeframe accounted for around 18,400 births, according to the Centers for Disease Control and Prevention (CDC).[3]
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Still, very few people make the decision to pursue a pregnancy knowing they'll end up working with a gestational carrier. I can't speak for anyone else's experiences, but mine entailed tens of surgeries, a number of specialists, and one final declaration from all of them that my body and all its conditions were contraindicated to pregnancy — that neither myself or a fetus would make it.
That was what began the ultimately years-long process of working with a GC, supporting her through her fertility treatments and finally (finally!) having a healthy pregnancy and happy baby.
The differences between gestational carriers and surrogates
The biggest difference between a gestational carrier and what’s referred to as a "genetic surrogate," "traditional surrogate" or "surrogate mother" is genetics.
A genetic surrogate provides the egg and is genetically related to the baby. A gestational carrier does not provide the egg; instead, the intended parent(s) will supply an egg and the sperm, either from themselves or from another donor. In both cases, a woman is voluntarily carrying a child for another person or people.
Still, while the end goal is about the same, there are other distinctions between the two types of carriers:
Gestational carriers are much more common
Surrogate pregnancies have become almost exclusively gestational ones since the first GC case on record in 1985. It's more likely than not that when you've read about a surrogate pregnancy in the past, heard a celebrity talk about working with a surrogate, or knew someone whose mom's cousin was a surrogate, those have all been instances of gestational carrier pregnancies.
Genetic surrogates undergo more medical screening
Both genetic surrogates and gestational carriers undergo medical clearance and psychological screenings ahead of pregnancy. However, a gestational carrier does not have to undergo genetic screenings required by most clinics' IVF and egg retrieval processes. This is because no part of her DNA is transferred to a resulting child.
Working with a gestational carrier has fewer legal complications
Both types of surrogacy require paperwork and contracts, but working with a gestational carrier is typically easier on a legal front. That's because gestational carriers don't provide the egg (and the genetic link to the pregnancy).
Genetic surrogates aren't required to give up parental rights from the outset; gestational carriers are. In fact, that’s why some surrogacy agencies in the United States exclusively work with gestational carriers at this point.
How much does hiring a gestational carrier cost?
As of right now, 47 states allow gestational carriers to receive compensation for carrying the baby.[4] (Louisiana, Michigan and Nebraska allow only "altruistic" — i.e. unpaid — gestational carrier pregnancies.)
Agencies across the country cite a very vague (but always very expensive) range for the total costs of a gestational carrier journey. The nationwide average right now is $150,000, including legal, medical and process fees, says Melissa Brisman, J.D., a lawyer specializing in surrogacy.
The biggest chunk of that $150,000 or so is the gestational carrier's base rate. That typically lands at $40,000, not including lost wages, monthly stipends, maternity clothes and medical costs. It also depends if the GC:
- Is an experienced carrier
- Carries multiples
- Resides in a place where the cost of living is much higher
The cost is also a lot lower, says Brisman, when you:
- Know the carrier
- Have full insurance coverage
- Reside in the same state as the carrier
In those cases, the GC's base rate comes closer to $10,000.
Words you need to know before working with a gestational carrier
Throughout the process, gestational carriers and intended parents become very familiar with a set of terms they’d probably never encountered before their journeys began. Here are a few crucial ones to help you better understand what to expect:
Pre-birth parentage order
A pre-birth parentage order is what allows the intended parents to essentially adopt their child before birth. This also terminates a gestational carrier’s rights to keep the baby.
Post-birth order
A post-birth order also allows the intended parents to adopt their child, but it comes after the birth.[5] (Sometimes, babies come early or courts take their time.) This terminates a gestational carrier's rights to keep the baby.
Some states, like Pennsylvania, will hold the creation of a birth certificate for a few months in order to issue just a single certificate (rather than have an inaccurate one made with the gestational carrier's name instead of an intended parent's name). If an incorrect certificate is made, it's possible to amend it via a retroactive order.
Continued contact
Continued contact refers to how you'll be in each other’s lives after the baby is born. If you and your GC and any significant others involved have all decided you want to openly communicate, "continued contact" is written into the surrogacy contract.
Confidentiality
Additional clauses in the contract will clearly define confidentiality — including everyone’s expectations around internet privacy (such as social media announcements and photos), and the intended parents' decisions about what to share with the baby surrounding her origin story and when.
As with any route-to-baby, a gestational carrier pregnancy is fraught with high highs, low lows and constantly crossed fingers. As with less "conventional" routes, it is also filled with a bigger-than-usual lack of control, gigantic financial concessions and the changes that come with them, the need for an endless reserve of patience, and an overwhelming gratefulness for and closeness to another human — one you may or may not even know.
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