A Growing Number of Military Wives are Becoming Surrogate Moms

MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh. You're listening to These Days on KPBS. In the 21st century, the term surrogate mother is an established part of our mainstream lexicon. We hear it in everything from casual conversation to celebrity gossip shows. And, yet, not that long ago, the idea of a woman carrying and giving birth to a child intended for another couple was highly controversial. Looked at closely even today, surrogate motherhood can still raise issues about money, social class and exploitation. It's been reported that women married to men in the military seem to be more likely than most women to agree to be surrogates. Last summer, Tom Fudge talked about surrogate motherhood with Dr. Samuel Wood, medical director for the Reproductive Sciences Center, and he also runs a local surrogacy agency called The Select Surrogate. And Kasia, a local military life – wife, that is, who has been a surrogate mother. KPBS agreed not to use Kasia's last name. Here's that interview.

TOM FUDGE (Interviewer): Well, Dr. Wood, I think I'm going to throw a couple of questions to you first. Can you briefly talk about the need for surrogate mothers? I mean, why do couples look for women sometimes to carry their children?

DR. SAMUEL WOOD (Medical Director, Reproductive Sciences Center): Well, I think surrogacy is an amazing advance in the field of infertility. Ten, fifteen years ago, there were many couples that could not have a biological child because the woman had lost her uterus, perhaps, due to cancer or due to radiation. Perhaps she was born without a uterus or after many attempts at becoming pregnant, she was unable to do so or perhaps there is a abnormality with her uterus, and so these couple then had no option but to choose adoption. With surrogacy, now they can have a biological child and it's really an amazing and wonderful experience to see these couples that felt like there was no chance to have a biological child be able to through surrogacy.

FUDGE: Let's talk a little bit further about the biology behind the surrogate relationship because I would assume that some people think that surrogate motherhood involves artificial insemination, in other words, you take the sperm of the father and, you know, put it into the womb of the surrogate mother and then she has a child. But it sounds like what is going on, what you're talking about is in vitro fertilization.

DR. WOOD: Well, there are two types of surrogacy. The first is called traditional surrogacy in which the egg comes from the surrogate. And in a case like that, frequently, inseminations are done. But that is actually a rare procedure now because of potential complications legally from doing that. And so now what couples do is the intended mother donates her eggs, so they're extracted during an in vitro fertilization process. The intended father provides the sperm. And then in the lab we mix the sperm and the egg to create an embryo, which is then placed back into the uterus. So there's no genetic connection between the embryos and the surrogate.

FUDGE: And, as you say, that makes things a little simpler legally, perhaps personally as well.

DR. WOOD: We have patients come from around the world to California because the case law in California is so strong about gestational surrogacy. In a situation like that, where there's no biological connection to the surrogate, the courts have ruled the child does belong to the intended parents. And, in fact, they've gone further and said that when the child is born, the intended mother and intended father's names actually go on the birth certificate. In other states, you actually have to adopt that child, so California's probably the best state in the country to do a surrogacy.

FUDGE: So when you have a surrogacy in California, is it rare for the surrogate mother to try to keep custody of the child? Is that not something that doesn't happen very much?

DR. WOOD: It just simply doesn't happen in California, at least hasn't happened for many years.

FUDGE: Because that's…

DR. WOOD/FUDGE: …the law…

DR. WOOD: …is so clear about that.

FUDGE: Yeah, all right.

DR. WOOD: It's just not an issue. There was a case in Pennsylvania not long ago you may have heard of where the surrogate mother decided to keep the child and the courts actually ruled it was hers. It was later reversed but it shows you how dicey this can be in states other than California.

FUDGE: And we're going to be speaking with Kasia in just a moment to find out why she made her decision but let me ask you, Dr. Wood, what characteristics do you look for in a potential surrogate mom? And why would you say that military wives have been noted as being common surrogates?

DR. WOOD: Well, it's actually a complicated question. And one of the things that The Select Surrogate does is try to find surrogates that have the whole range of characteristics that we've found over the years to be important in being a surrogate, and there's some obvious ones. She needs to become pregnant immediately. She needs to have no complications during her pregnancy. She needs to be psychologically healthy and understand that that's not her child, that that is the intended parents' child in the end. She needs to have had no medical problems in the past. She needs to have no history of anything that would affect her ability to care for that child. And she needs to not have any medical problems that would put her at increased risk because she was a surrogate. In addition to that, we do extensive background checks, home visits, psychological screening. It's quite a process to become a surrogate and our surrogates are very proud when they finally make it through the screening process and they're able to become what we call a select surrogate.

FUDGE: Now this business of military wives becoming surrogates, I guess we're talking about that for a couple of reasons. First of all, we're in San Diego, which is a military town, and also there have been some articles in popular magazines like Newsweek about this, sort of noting that military wives are very frequently – well, not frequently, but are more likely to be surrogate mothers than most women. Why do you think that is?

DR. WOOD: You know, I haven't been one myself, obviously, but being a military wife, it's a difficult thing. Their spouses are frequently gone for long periods of time. Any woman who's going to be a surrogate must have had a child on their own, so they're really a single mother. And so they tend to be very mature and very responsible and they typically are in a community that provides a great deal of support when the spouses are gone. So it's a very nice situation and it's one that our intended parents find very attractive. And I think one of the myths that I've seen in some of these articles is that they're being selected because of their insurance plan, when, in fact, they have many of these other characteristics that make them wonderful surrogates.

FUDGE: Well, we'll talk about the insurance issue a little bit later but first, Kasia, why did you want to become a surrogate mother?

KASIA (Surrogate Mother): Well, I first came across it in our newsletter because I live on military housing.

FUDGE: Umm-hmm.

KASIA: And I wasn't sure. I didn't know what it was. And my husband, he wanted me to go find a job and I was like, okay, but it's very difficult like Dr. Wood just said. You know, my husband's frequently gone and his job is very demanding and so it's very hard for me, a mother of twins, to find a job that's going to be very flexible in my hours. So I went ahead, I got online, I checked it out. And I was really interested and I just thought, wow, I can actually help parents who, you know, want children and they obviously can't carry them and so I could help them and at the same time I could help us financially because my husband doesn't make, you know, the greatest amount of money, being in the service.

FUDGE: Well, it's clear that the financial issue was one thing that attracted you. Let me ask you, how much did you – how much were you paid to be a surrogate mother?

KASIA: Well, it varies. I don't want to disclose how much I, personally, was paid. But it can go from $22,000.00 up to $35,000.00…

FUDGE: Okay, so…

KASIA: …depending, yeah.

FUDGE: …and we can assume, though, you don't want to say how much you got, we can assume that what you got is in that ballpark.

KASIA: Somewhat, yeah.

FUDGE: Okay, and you say that you were already the mother of twins.

KASIA: Yes.

FUDGE: And what was pregnancy when you had twins, what was pregnancy like for you? Did it – was it something you enjoyed? Did it go fairly well?

KASIA: I don't think any pregnancy's ever easy. You know, you have to make sacrifices. You have to give up some things. I love to snowboard so I have to give up snowboarding in the winter and other activities I love to do. Obviously, I'm not a fan of the first trimester. It's not fun. It's morning sickness and I don't like that. But after that, it's just phenomenal. And being a surrogate, I get to work with incredible people. I mean, my IPs are just remarkable.

FUDGE: I'm sorry, IPs?

KASIA: IPs are intended parents.

FUDGE: Okay.

KASIA: Are just incredible and…

FUDGE: What kind of relationship do you have with the intended parents? I mean, you know, you – okay, so you agree to be a surrogate mother, you get in touch with somebody who makes the arrangements, somebody like Dr. Wood. And do you meet the intended parents? Do you have a conversation with them?

KASIA: You do meet them. It has to be a mutual decision between all of us that we all want to work – because, obviously, we're all going to work together for the what, the next 40 weeks of the pregnancy.

FUDGE: Umm-hmm.

KASIA: So you all have to be willing and like one another and see that you guys all match well. And so I do meet with the IPs to begin with and then from there, if we like each other, obviously, our – the agent, she'll call us and ask us our individual opinions. And then we go from there, and if we like each other, then we go ahead and start contract and then we go into meds and then the embryo transfer and pregnancy and baby is born nine months later.

DR. WOOD: And there's no doubt…

FUDGE: Go ahead.

DR. WOOD: …that getting the relationship right is the key. This is a ten-month relationship usually, maybe longer depending on how things go. And Robin O'Day, who does our matching, she has a critical role in finding intended parents and surrogates that are going to get along well. Just like any other relationship, they may or may not. And so we have to find people that feel the same way about pregnancy, that want the same amount of contact during the pregnancy, that agree on things like reduction if there's a genetic problem with the fetus. There – there are a wide variety of issues that they need to agree on to mesh. But ultimately, I've said this before, it's almost like a date.

FUDGE: Umm-hmm.

DR. WOOD: They just meet and they click. There's either chemistry between the intended parents and the surrogate or there's not. And if you don't get that chemistry, you don't want to go forward with that match because there are good times and bad times during a surrogacy and if you don't have a solid relationship, it can be difficult. If you match well, they go extremely well.

FUDGE: You used a word that I – that slipped me up a little bit, reduction. What are you referring to? What do you mean?

DR. WOOD: Well, sometimes there are multiple pregnancies and…

FUDGE: Oh, I see.

DR. WOOD: …for example…

FUDGE: Okay.

DR. WOOD: …in a triplet pregnancy, some couples will consider doing a reduction.

FUDGE: Do you…

DR. WOOD: Or sometimes there'll be more than one child and…

FUDGE: Uh-huh, yeah.

DR. WOOD: …one will be found to have a genetic syndrome and you have to make sure that the two parties agree on how to handle that type of situation.

FUDGE: I'm afraid I have to use a dirty word here. You're talking about abortion. If – You're saying if there are triplets, is one of them going to be aborted or two of them going to be aborted? That's something…

DR. WOOD: Well, I mean, I suppose you could call it that. Technically, an abortion is the ending of a pregnancy. And a reduction is not end of pregnancy, it continues.

FUDGE: Umm-hmm.

DR. WOOD: But it does reduce a pregnancy from three fetuses to two fetuses, for example.

FUDGE: But since you raised the subject, I mean, you know, abortion is obviously something that people have a lot of very strong feelings about and if the fetus ends up, even if it's a single fetus, if it ends up having genetic abnormalities…

DR. WOOD: Umm-hmm.

FUDGE: …I guess that's something you've got to get straight, right?

DR. WOOD: You need to decide up front. It's – You don't want to get to 18 weeks and then have your first discussion about how to handle…

FUDGE: Umm-hmm. Right.

DR. WOOD: …a genetically abnormal fetus.

FUDGE: And my guests are Samuel Wood. Dr. Wood is Medical Director of the Reproductive Sciences Center, also he runs a local surrogacy agency called Select Surrogate. Kasia is my other guest. Kasia is a local military wife who has been a surrogate mother. Let's take a call from Tara in La Jolla. Tara, go ahead. You're on the show.

TARA (Caller, La Jolla): Hi. I just wanted to provide a comment. When I was 29 years old, I had to undergo a hysterectomy due to cancer and of course it was very devastating and heartbreaking but this whole program just provides me with a lot of hope, knowing that there – California's a great place for this to happen and being in San Diego, learning about the military wives who are doing such a tremendous thing, it's just absolutely amazing what they're doing. And I just wanted to say that I'm very thankful and hopeful knowing about this.

FUDGE: And, Tara, thank you very much for calling. I have a stupid question I need to ask you. Do you still produce eggs?

TARA: I do. I do. I do have my ovaries so…

FUDGE: You have your ovaries but…

TARA: Yeah.

FUDGE: …you just can't bear a child yourself.

TARA: That's right.

FUDGE: Okay. All right.

DR. WOOD: She's a classic great candidate for surrogacy. Twenty-nine years old, very young, could easily have gotten pregnant if she'd had a uterus. But now with a surrogate, she's able to do that and it's – it's absolutely amazing. And, as I mentioned, something that could not happen even a few years ago.

FUDGE: Jim is calling from downtown. Jim, go ahead. You're on the show.

JIM (Caller, San Diego): Hi. My comment had to pertain to where the surrogate mother received her care and who paid for that. I'm familiar with situations where intended parents will pay for the hospitalization and the additional fee that Kasia talked about earlier. And with that, I don't have problems. The problems I have are when the military is required by statute to provide care to the dependents of the service member and that would be, in this case, Kasia. And if she were to get her prenatal care and her delivery at a military treatment facility, then the – that would benefit individuals who are not required to be provided care for by the military, namely the intended parents. And it creates a very difficult situation for military hospitals and I can imagine that – I don't know if they currently have a policy regarding surrogate motherhood, but it creates a problem whether it's someone who's married or, in particular, if it's a single female sailor or Marine who, through her deliberate actions, now is essentially taking herself out of regular duties by virtue of engaging in the surrogacy contract.

FUDGE: Right, right, but…

JIM: Thank you.

FUDGE: But, Jim, you realize that's a different situation. It's different between – There's a difference between a member of the military being a surrogate and a military wife being a surrogate.

JIM: Correct.

FUDGE: Okay.

JIM: Yeah, I understand that the military wife would have the ability to control her own fertility, if you will, and obviously carrying this child, however, if it – if the military wife or even the intended parents desired that all the well baby care and the delivery occur within the military treatment facility, that casts another…

FUDGE: Okay.

JIM: …issue on this case.

FUDGE: Dr. Wood, he raised the issue which I guess you would say has been the most controversial in this whole discussion of military wives being surrogate mothers. These military wives, I guess, like Kasia, have taken – have used Tricare, which is a government provided medical system, to help them with their pregnancies, which, of course, if they get pregnant the government should do that. The question is, should the government do that when they're carrying somebody else's child and being paid for it? What is your response to that?

DR. WOOD: Well, it's a complicated question. But they do have maternity benefits and I think it's their job to care for one of their – for one of their enrollees who's pregnant.

FUDGE: Umm-hmm.

DR. WOOD: And does it really matter what – how that pregnancy occurred and what the outcome of that pregnancy's going to be. Let me give you an example. Let's say there's a unplanned pregnancy by a military wife. She has a couple of choices. She could abort the pregnancy or she could decide to carry it to term and adopt it out. Would it really be reasonable for Tricare to say, gosh, you don't really plan on keeping that child so we're not going to pay for your pregnancy. This is the woman's private decision, how she handles the pregnancy, why she gets pregnant, and the circumstances around that. So I think that they should cover that. They're not doing this for the intended parent. They have a responsibility to the military wife to care for her during her pregnancy and their thoughts should be about her and what's best for her care and not what might happen to the child after the pregnancy.

FUDGE: Well, and they certainly should be concerned about the military wife and I don't think anybody is arguing that people like Kasia and her husband should be paying for those – should pay for the maternity care that they receive. I guess there are some people who believe that the intended parents should be picking up the cost.

DR. WOOD: In my mind, this is – being a surrogate is a job. It's a labor of love but it's just a job. And one can imagine many circumstances where someone needs ongoing medical care in order to keep a job because of some prior illness, because of some prior injury. And so Tricare continues to take care of them as they're obtaining employment and as they're keeping employment. What Tricare is really doing here is allowing her to have a job, a job that's in the home, a job that allows to care for her children, a job that's very fulfilling for her and makes up for the fact that military pay is very low. If you look at the average military pay, it's barely above minimum wage. Many military families, especially young military families, need food stamps just to survive. And so to take these couples who are making a tremendous sacrifice for our country and give them a hard time and question their motives over really what's in a drop – what's a drop in a bucket. There's 111,000 deliveries a year. There are probably 40, 50 surrogate deliveries. So we're talking about two one-hundredths of a percent. This is having no significant, probably even minor, impact financially on the system and it does a wonderful thing for these people that are making a great sacrifice for all of us.

FUDGE: Kasia, I assume that you've thought about this issue a little bit and maybe before you agree to be a surrogate mother, you wanted to make sure that Tricare was going to pay for your maternity expenses. Anything you want to say about this discussion?

KASIA: (no response)

FUDGE: Not really? Okay, no comment from Kasia. That's okay. Let's go to Lisa in Ramona. Lisa, go ahead. You're on These Days.

LISA (Caller, Ramona): Hi. I just wanted to let you know that I have – my husband and I have a six year old son and we went through a surrogate and it was a traditional surrogacy. I had terrible fibroids and lots of problems and could never get pregnant and we tried for I'd say ten years with in vitro, you name it. And we went through an agency after lots and lots of research. I did – I went on the internet, I found tons of names of companies, got information sent to me, interviewed with people. And it was wonderful. We couldn't have been happier.

FUDGE: All right, Lisa, thank you for calling. Let's go to Julie in San Diego. Julie, go ahead. You're on the show.

JULIE (Caller, San Diego): Hi. Good morning. My, I guess, situation is a little different. I'm considering doing a surrogate for my husband and – excuse me. Excuse me. My ex-husband and his new wife. My current husband heard about the show as he was on his way to work and he suggested that I call in and, you know, get some information or listen just to see what I could find out about it. Obviously, it's a little unusual for very many reasons. My ex-husband and I are on very good terms. We do have a child together and I have a child with my current husband as well. The only thing is, my ex-husband, he is military.

FUDGE: Okay.

JULIE: And his current wife is not. She, due to health reasons, cannot carry a child full term or it will – she was told it will kill her.

FUDGE: Uh-huh. Well, I guess all I can – I – Julie, I don't know what our guests want to say. All I can say is I'm glad to hear that you're still on such good terms with your ex-husband. And it sounds like you really are interested in kind of remaining part of the family in, well, in more ways than one.

JULIE: Well, it's – I have – Like I say, I have two children, one from my ex-husband and one from my current, and…

FUDGE: Umm-hmm.

JULIE: …you know, I – I'm one of these, I never really knew what I wanted to be when I grew up but I always knew I wanted to be a mom. And even before I ever even had children of my own, I saw it – what a beautiful thing it would be to be able to do a surrogate for people who cannot have them because I'm a firm believer if you don't want children, for the love of Pete, don't have them. But if you do want children, they're a wonderful, beautiful, you know, gift from God and if it's something, you know, I can do for another family, like the lady who called before, I think Lisa from Ramona, it's just – You know, they fill an amazing hole in your heart that you just never knew existed.

FUDGE: Umm-hmm.

JULIE: And they're, you know, it's something not everybody can do it.

FUDGE: Okay, well, thank you very much. Thank you very much for calling, Julie, and for telling us your story. Kasia, we haven't heard from you in a little bit. What do you think of Julie's comments?

KASIA: I think that's beautiful. I think that's just remarkable. I'm very happy.

FUDGE: Kasia, we talked – Sam Wood and I talked a little bit earlier about the laws in California. It sounds like the laws are very clear. When you're a surrogate mother, the child belongs to the intended parents. But when you're pregnant and you have the child, and then you go home and you don't have the child, it's gone to somebody else, this child you've carried for nine months, is that hard?

KASIA: No.

FUDGE: It's not?

KASIA: Not for me. No. I enjoyed being pregnant. It was a lot of fun. It was never hard. It was just so rewarding at the end to see someone else's dream come true. I mean, there's absolutely – I mean, it's just the most moving, remarkable, beautiful moment in the world. I will never forget when I delivered the baby and the IPs were just holding their son and I was just – It was just remarkable. And any – And most of all, I have a bond more so with the parents, like the IPs. I mean, I miss my IP parents more than the baby. I mean, I just miss, you know, because you just grow this remarkable bond and you do this beautiful thing for them and I'm still in touch with them and we talk and e-mail each other and…

FUDGE: Do they live in San Diego?

KASIA: They do not.

FUDGE: They don't? Okay.

KASIA: No.

DR. WOOD: But I think it points out how important it is to screen well because there certainly are women out there that want to have another child that aren't in a relationship or in a situation where they can have one and you could see where there may be some conflict. And so I think our psychologists look very carefully to make sure they have those boundaries and that they understand that that's not their child. When I first started doing this, roughly ten years ago, I thought this would be a common issue. In fact, I've never seen it once. They know from day one it's not theirs. Many times their families are involved and they'll put their hand on their mother's baby and they'll say, ohh, this is, you know, this is Bobby's baby, this is – You know, they understand and they actually are part of the process. And if you involve the children in it earlier, I think it's a very smooth process. You never really had anyone think, gosh, maybe we should just keep this baby. And the fact that there's no biological connection…

FUDGE: Umm-hmm.

DR. WOOD: …I think really helps that.

KASIA: You have to – Yeah, you have to mentally go into it knowing that you're helping a couple and be prepared that way. And my spouse is 110% supportive of me. He's supports me all the way and he loves what I do. He just thinks it's a great thing. You know, not all people in my family, they're not all for it but it's okay. I'm okay with people not being okay with it and others being okay with it. It's okay to me. But, yeah, it's just remarkable experience and…

DR. WOOD: It's not uncommon for a surrogate to get some flack about being a surrogate. And they say, how can you give up your baby?

FUDGE: Umm-hmm.

DR. WOOD: But the answer's…

KASIA: They're not.

DR. WOOD: …the answer's it's not my baby.

FUDGE: Sam, you have a surrogate child, right?

DR. WOOD: Yes. Yes, I do.

FUDGE: You and your wife…

DR. WOOD: Right.

FUDGE: …went through this so it's not just a business for you. This is also personal.

DR. WOOD: It's one of the reasons I started this agency because there are – there's some just amazing surrogates and there's some surrogates – there's some women who just really shouldn't be surrogates for psychological or medical reasons and I said there should be a place you can go to find surrogates that really have all the characteristics that you should have. And in fact, what happened with me, is as I was screening surrogates, I, in fact, saw one that I said would be perfect for me. And every single surrogate since that time, when I'm making a final decision about whether or not they should be a surrogate, I ask myself is this someone I would work with to carry my child?

FUDGE: Well, Sam Wood is Medical Director for the Reproductive Sciences Center and he runs a local surrogacy agency called Select Surrogate. And, Sam, thank you very much for coming in.

DR. WOOD: Thank you.

FUDGE: And Kasia is a local military wife who's been a surrogate mother. We…