Like any pregnancy, a pregnancy carried by a gestational carrier has risks for both the baby and the gestational carrier. But managing those risks, both medically and personally, comes with challenges that are unique to the surrogacy experience.
For example, when one of a couple of new parents is carrying a pregnancy themselves, in the event of risky complications to the pregnancy, it’s understood that these are risks that the family is taking themselves. However, in pregnancies carried by surrogates, it’s the surrogates, and their families, who take on those risks, rather than the family the baby will be born into. While women gestational carriers take the safety of the babies they carry very seriously as an important responsibility that’s been entrusted to them, the calculations surrounding those risks can be different.
- Placenta previa: It’s not clear why, but pregnancies conceived through in vitro fertilization (IVF) are at a higher risk of the pregnancy complication placenta previa which, if it happens later on in pregnancy, can cause excessive bleeding and other dangers to the pregnant woman. Placenta previa is also more common in twin or multiple pregnancies, which are more common in surrogacy than in traditional conception. The main symptom of placenta previa is vaginal bleeding, which is why it’s important for gestational carriers, as for all pregnant people, to check in about any bleeding with a healthcare provider. Placenta previa doesn’t always have symptoms, but it can be confirmed by an ultrasound.
- Multiples: With an increase in the chances that surrogates will conceive multiples (depending on the number of embryos transferred) comes an increase in the risks that come with multiples, including an increased risk of preterm birth, C-section, and a longer hospital stay.
Handling those risks with a surrogate or gestational carrier
One factor that intended parents will be reminded of throughout the surrogacy process is that complications in the pregnancy will have an impact on the gestational carrier’s own health, life, and family. Since the gestational carrier has ultimate control over her own medical care, there is no specific degree to which intended parents are usually informed about medical complications in the pregnancy as they develop.
Working on maintaining a strong, trust-based relationship with your surrogate or gestational carrier when everything is going well is vitally important in case of anything going wrong. If you already have a strong relationship with your surrogate or gestational carrier, and feel comfortable communicating with them, in the event that something goes wrong, you’ll already have a relationship and some trust to build on.
- The American College of Obstetricians and Gynecologists, Committee Opinion. “Perinatal risks associated with assisted reproductive technology.” American College of Obstetricians and Gynecology. ACOG, 2018. Retrieved February 6 2019. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Perinatal-Risks-Associated-With-Assisted-Reproductive-Technology?IsMobileSet=false.
- Kalsang Bhatia, Elizabeth Martindale, Oybek Rustamov, Anthony Nyesbaum. “Surrogate pregnancy: An essential guide for clinicians.” The Obstetrician & Gynaecologist. 11: 49-54. Web. 2009. Retrieved 6 February 2019. https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1576/toag.184.108.40.206468.
- “Placenta previa.” March of Dimes. March of Dimes, January 2013. Retrieved February 6 2019. https://www.marchofdimes.org/complications/placenta-previa.aspx.