What to Expect When Your Surrogate is Expecting

July 18, 2018 by Frank Golden

pregnant woman holds ultrasound.

Surrogacy journeys are exciting. They embody hope, joy, and in many cases, pride. They can also embody anxiety and a sense of uncertainty. For many Intended Parents, their anxiety doesn’t involve the surrogacy agreement, legal documents, or building a relationship with their surrogate. For many Intended Parents, their biggest source of anxiety is the pregnancy itself. We’ve noticed that, in particular, many of our gay Intended Parents aren’t fully aware of what pregnancy entails and what each stage looks like.  While we aren’t gynecologists or medical professionals, we do have an understanding of pregnancy and what it entails. In this blog, we are going to give a general explanation of “What to Expect when Your Surrogate is Expecting.” The surrogacy process is multi-layered and complex as it is. If we can remove some anxiety by educating our Intended Parents on pregnancy, then we’ve done our job as a surrogacy agency, and I’ve done my job as a former Intended Parent.

The first phase of a surrogacy pregnancy is the embryo transfer. The embryo transfer comes after several months of matching, getting to know your surrogate, signing legal documents, and preparing your surrogate for transfer. Some Intended Parents suggest that after all of the preparation getting to this point, the embryo transfer seems like the completion of the journey. It’s true that the embryo transfer is the completion of one part of the journey, but it also marks the beginning of the most crucial part of the journey: pregnancy. Embryo transfers are highly successful and with advancements in medicine, the success rates continue to grow. With that said, there is always the possibility of a failed transfer. If a transfer fails, we recommend being prepared to manage your emotions and the emotions of your surrogate. Surrogates tend to feel like they failed their Intended Parents, they worry that their Intended parents are mad. If your first or second embryo transfer fails, please try to offer your Surrogate reassurance.

After the embryo transfer, Intended Parents and Surrogates anxiously wait for confirmation of pregnancy. We recommend that you touch base with your Surrogate during this time, but we ask that no pressure is put on the situation. We implore you to avoid asking your Surrogate if they “feel” pregnant or requesting them to take home pregnancy tests. After transfer, Surrogates should rest and remain stress-free; you can contribute by remaining calm, understanding, and patient.

After all of the waiting, your Surrogate is finally pregnant! This typically provides a great sense of relief to Intended Parents as well as to Surrogates. Achieving pregnancy is definitely something to celebrate, but it’s crucial to remember that the pregnancy phase of the journey is just beginning, and while our Surrogates have a history of uncomplicated pregnancies, pregnancy is unpredictable and should always be entered with a certain level of caution.

The first trimester, the first three months or 12 weeks of the pregnancy, is exciting. Your dreams are coming true. We want everyone involved to be excited, but as with any pregnancy, we recommend being cautious and aware of potential complications. Women’s bodies go through many changes during this initial phase of pregnancy.  Surrogates might start experiencing fatigue and emotional ups and downs. At this point in the pregnancy, Surrogates are still taking fertility medication. The combination of the fertility medication and the pregnancy hormones might make them exceptionally emotional. We encourage you to support your surrogate through this phase by checking in on them and expressing your gratitude. We also suggest sending her a small gift to express your appreciation. This first initial phase of pregnancy is a great time to solidify the relationship between you and your Surrogate. As the pregnancy advances further into the first trimester, Surrogates might experience morning sickness and fatigue. She might gain a few pounds or she might even lose a few pounds – both are perfectly normal and her doctor will assess her specific situation. Surrogates also might experience some spotting. Spotting can occur for a number of reasons. It’s natural to assume the worst, but we’d like to stress that spotting does not always indicate a problem, or in the worst case scenario, a miscarriage. If a Surrogate begins spotting, remain calm until she has been assessed by a doctor.

After the first trimester, pregnancy gets a little less scary, but as we mentioned before, we recommend maintaining a level of caution throughout the entire process all the way up until the baby is born. The second trimester, weeks 13-27, are typically a more comfortable time for Surrogates. Morning sickness and fatigue tend to diminish, and they begin to feel  “like themselves” again. Some pregnant women experience morning sickness throughout the second trimester, and even into the third trimester. This is a normal occurrence and as long as Surrogates visit their doctors, it shouldn’t be cause for concern. At this point in the pregnancy, Surrogates start to notice a “baby bump” forming. They might even feel the baby kicking. A major millstone during this phase is the 20 week ultrasound in which Intended Parents can physically see their baby’s development in the womb. The 20 Week ultrasound is an extremely memorable experience and we highly recommend that you rearrange your schedule to be present at the appointment. As an Intended Parent, I can tell you that the 20 Week Ultrasound is unbelievably special. It was the first time Adam and I saw our children. It made us appreciate the process more, it made us love our Surrogate more. Please do whatever you can to attend the appointment for your own experience and for the experience of your Surrogate.

While the second trimester is less dangerous than the first, problems can still occur. Your surrogate might be diagnosed with a pregnancy-related complication. Two common conditions are gestational diabetes and placenta previa. Your surrogate’s doctor will be able to diagnose and develop a treatment plan for either condition. If your Surrogate gets diagnosed with these conditions, or another common condition, please don’t blame your surrogate. Many times, these conditions appear in otherwise healthy women regardless of their diet, lifestyle, work environment, etc.. Like I mentioned earlier, pregnancies are unpredictable and issues can arise. If the pregnancy is uncomplicated at this point, it’s the ideal time to treat your Surrogate to a short trip. Have her visit your hometown or fly out to visit her and her family. You might also want to treat your Surrogate to a day at the spa or anything that makes her feel pampered.

The third trimester, weeks 28-40, is one of the most exciting times for Intended Parents. It’s also one of the most stressful times for Surrogates. Parentage papers have already been signed and Surrogates are getting ready to give birth. At this point, Surrogates are getting bigger and more uncomfortable. They may have trouble sleeping due to back pain, general discomfort, and frequent bathroom use. Their energy levels might be low and they might express feeling fatigued throughout the day. Surrogates might also express feelings of anxiety about the upcoming birth. They realize that they will soon undergo labor, they realize that their Intended Parents will see the labor, and they realize that this journey is coming to an end. It’s a lot to take in. We recommend staying in close contact with your Surrogate throughout the final trimester. You should begin planning travel arrangements for the upcoming delivery and should also discuss the terms of the post-pregnancy relationship you want to maintain with your surrogate. When Adam and I had Sophia, we didn’t realize how emotional we would get saying goodbye to our Surrogate, Debi. Even though we had a healthy baby girl in our arms, the end of our journey felt bittersweet. Debi had become our friend, our family. Many Intended Parents experience the same level of sadness upon the completion of their journey. Surrogates, while they’re elated to have given birth to a healthy child,  still feel emotional about the journey coming to an end. Many times, Surrogates don’t want to impose on their Intended Parents by asking for a relationship beyond the pregnancy; they worry that once their job is done, they will be forgotten. While the journey isn’t necessarily about the Surrogate, she has dedicated her life to giving you the gift of life and deserves some gratitude. At the very least, we suggest getting your Surrogate a present after delivery, commonly referred to as a “push present.” I’m happy to help any Intended Parent decide on an appropriate gift.

As a surrogacy agency owner, I have seen my share of pregnancies, births, and beautiful new beginnings. I am not a medical professional, but I am in the field of family building. The examples provided in this blog are based on my personal experience as an agency owner and an Intended Parent. As a fellow Intended Parent, I want to be as informative as possible. I don’t like to focus on the stuff that can go wrong, but I feel that being realistic and aware of the potential dangers is important.

Our biggest takeaway, the point we’d like to emphasize, is that throughout the entire journey, and after you bring your baby home, please remember to thank your surrogate. She’s your surrogate, but primarily, she is a person with feelings and she deserves to be treated as such. Our agency stresses the importance of a strong relationship between Intended Parents and Surrogates. We think it makes the experience better for everyone involved.  For Adam and I, our surrogacy journeys resulted in two beautiful children. It also resulted in two beautiful women, two women we now consider part of our family. What can you expect when your surrogate is expecting? Excitement, fear, anxiety, and hope. Expect your life to change, not just by becoming parents, but by witnessing the selflessness of the women who made it all possible.