Third Time’s the Charm for Our Surrogacy Matching?
This week we met our potential gestational carrier (GC) or surrogate, and like the other two we matched with before her, she is amazing. She is genuine, sincere, funny, and excited to go on a journey with intended parents (IPs).
We would like to match and work with her, but like all things related to surrogacy - especially international surrogacy - there are logistical challenges.
She lives in Washington state, and she works in Oregon. In non-surrogacy birth plans, this is not an issue, but with surrogacy, it creates a challenge when it comes to the parentage documentation linked to the state where the baby is born.
Since she lives in Washington, our legal team would get a pre-birth order in that state (1). This document is used in all cases of assisted reproduction with a GC to ensure that the IPs - my husband and I - are the parents of record immediately when the child is born.
Pre-birth orders are ideal, as they allow for parentage to be determined before birth (hence the name). Some states only allow for post-birth orders, meaning that parentage can only be solidified after the child is born. If you are interested, the American Society of Reproductive Medicine (ASRM) has a list of all U.S. states and their surrogacy laws, including details on which states allow pre and/or post-birth orders (2).
With our situation, the challenge arises if we get a pre-birth order in Washington state, but she delivers in Oregon. This could happen if she goes into labor while at work, and the ambulance takes her to the nearest hospital in Oregon.
Nothing against Oregonian healthcare, but if we don’t have a birth order in that state, then we will have to get one after the child is born. We are currently waiting to hear back from our lawyer if there is a possibility to get simultaneous pre-birth orders in both Washington and Oregon, or if the Washington pre-birth order could be quickly transferred and accepted in Oregon.
Getting two pre-birth orders or a post-birth order in Oregon is not the worst possible complication. It would just mean more money for legal fees and more time in the U.S. after the birth.
While the extra cost is not ideal, the more significant of these two complications is actually staying in the U.S. longer.
My husband and I are both American citizens, but we live and work in Sweden. Therefore, we don’t have American health insurance, and our travel insurance only covers us for 60 days. We could extend this for another 30 days with additional cost, but it still adds cost and complexity to our stay.
However, our healthcare is second to that of our child, who also will not have American health insurance other than the newborn coverage we purchase. We need to get back to Sweden as quickly as possible to set up our child with a personnummer (a Swedish social security number) to allow them access the Swedish national healthcare services.
From what our Swedish legal team has said (yes, we have legal teams in each country and every international IP 100% should do this), we cannot get the Swedish social security number and finalize our parentage in Sweden from the U.S. We have to be back in Sweden.
The Swedish social security number for our child also triggers the parental leave benefits for my husband and I with the Swedish state and our employers. The parental benefits allow us to take the time off we need to take care of our child while still getting our appropriate compensation and being able to afford to live, something I highlighted in a previous article.
So, this is the dilemma. We have a risk that our child could be born in Oregon, delaying our return to Sweden and access to healthcare for our newborn as well as parental leave benefits for us.
This complexity also includes the additional costs of legal fees, supplemental travel insurance for us, any medical coverage we or the baby need while still in the U.S., a longer Airbnb stay, and the generally higher cost of living in the U.S. on a Swedish salary.
This added challenge is really only for international IPs on surrogacy journeys in the U.S. If we were living and working in America, the baby would immediately be covered under our insurance, and we could take the baby home without delays.
To get back to Sweden, we need the parental order and birth certificate in order to get our child a passport. If we were driving home from the hospital, we would not need any additional documentation for our child. Seeing as the U.S. has increased its ID restrictions for domestic flights, there may be some additional documentation needed for a newborn flying within the U.S., but it would certainly be less than what is required for international travel.
At this point, my husband and I are both thinking, ‘Are there ever not going to be surprises and changes to the plan?’
That has been the case so far when we had to break matches with our first surrogate due to newborn insurance restrictions and with our second surrogate due to her becoming pregnant with her husband.
These events were surprises and certainly not part of the plan.
Most likely, this surrogate will deliver in Washington state. She will not be working a few weeks before the delivery, and so she won’t be commuting into Oregon. The risk of birth in Oregon is more likely if she delivers early, and a premature delivery would mean an extended hospital or NICU stay, so we would have time to get the post-birth order in Oregon.
I think this decision, like many through the journey of IVF and surrogacy, is about navigating acceptable risk and letting go of control.
There are no guarantees in life and definitely not in assisted reproduction. Of all the complications that we can foresee or have with this journey, this is not insurmountable and doesn’t present any critical risk to us, the surrogate, or the baby. It’s just potential financial and logistical headaches.
Given that, we will wait to get guidance from our U.S. legal team to understand our options, but my husband and I are leaning towards proceeding with this match. We are so excited to continue on this journey and be fathers, and we don’t want to delay it any more than it already has been.
Also, worrying about our child is something we are going to spend the rest of our lives doing, so it feels like good practice to worry about them before they are even born.
References:
