The relationship between a gestational carrier and intended parents is one that isn’t like any other kind of relationship, because for both parties, it’s both an intensely personal experience and something that needs strict legal and financial boundaries to function healthily.
The U.S. is one of a relatively small number of countries in the world which allows compensated surrogacy, or surrogacy where the gestational carrier is paid beyond expenses (and even within the U.S., compensated surrogacy is only legal in some states). This is not because the U.S. is unaware of the potential ethical issues surrounding surrogacy, but because some states have determined that it’s possible to put the right kinds of safeguards in place to make sure surrogacy can be a positive experience for everyone involved. Some of these safeguards include making sure gestational carrier have the practical and emotional support they need throughout the process.
A lot of the practical support intended parents may end up owing or providing to a gestational carrier is decided before the pregnancy begins – for example, whether to work with an agency that offers certain supports, like therapy and support groups, and in figuring out what a gestational carrier’s health insurance will look like throughout the surrogacy.
Since few health insurance plans will specifically cover surrogacy, intended parents usually provide a separate health insurance policy for the gestational carrier to use throughout pregnancy or pay for health insurance costs out of pocket. For families who provide a separate health insurance policy, this means that, as the party providing the policy, it’s up to you to be aware of what that policy provides, not just in terms of prenatal care, but in terms of any other care your gestational carrier might need during this time, especially if using another policy means that she’ll be unable to use her existing policy. This may mean regular medication for existing conditions, or mental health care. Even gestational carriers who have never made use of mental health care in the past may find that the unique challenges of surrogacy can be helped with that kind of support.
Knowing when to step back
Especially for gestational carriers who have steady home-lives, often, the best thing the intended parents can do is just trust them to know what they need – gestational carriers have often been pregnant in the past. There’s a difference between trusting a gestational carrier to know her own needs and not offering support at all, however, and finding the balance between stepping back and offering support is the key. As with so many parts of the surrogacy process, finding that balance is going to depend on the strength of your family’s communication with your gestational carrier – both in expressing your own questions or concerns directly, and in listening to your gestational carrier’s responses, both spoken and unspoken, and responding accordingly.