Thoughts on Surrogacy

Now that the babies are here and have been properly introduced to their family and friends, allow me to present Jaxon and Delaney!

Jaxon (left) and Delaney (right)

They are precious and perfect and I am so honored to be part of their story.

Surrogacy has been something I've wanted to do for quite some time and I'm so glad I got the chance to experience it. That said, I am one and done. Even if I could safely be pregnant again, I couldn't possibly top the experience I had with these Dads so my uterus is officially retired.

Surrogacy is a beautiful thing but also so surreal. You know that feeling when someone in an airport asks you to watch their stuff for a minute? Like, it's so much responsibility from someone you don't know? Well, surrogacy is like that, times 1000. I have a great relationship with the Dads and we bonded right away, but I still can't believe they just GAVE ME THEIR CHILDREN to grow and then give back.

Surrogacy is also hard. Some people don't understand how or why you would do this for someone else. The IVF meds you have to take are no joke. You can't be a surrogate without having kids of your own - I'm glad my kids are older and self-sufficient but being pregnant at 36 is way harder than being pregnant at 25 or 28.

Giving the babies back is hard. My brain doesn't want any more kids, our family is complete. My heart knows these babies have always belonged to someone else, and I am excited to give them the gift of building their family. But my hormones aren't quite up to speed yet. I am not a crier (I often joke that I'm dead inside) but I have shed lots of tears these past few days. When you have a baby to take care of, the hormones have something to focus on. When there is no baby, and you're bored out of your mind but too immobile to take on a project, the hormones sneak up, and the next thing you know you're sobbing in the shower and considering getting a puppy just to have something to do.

All that said, I wouldn't change a thing. I have been dubbed "Auntie Allison" and have been told we're a part of the family, so I know I'll get to see these babies grow up and be part of their lives in some way. When you sign up to be a surrogate it's never a guarantee that you will stay in touch after delivery, but I feel so much better knowing this wasn't just a transaction for them. 

I am struggling to find a way to end this post, perhaps because I don't want this journey to end. Perhaps because this journey will never truly end for me, much in the same way you're still a parent long after your children are grown. Yet I am running out of words to say, so I will simply end with this:

If you are given the chance to be a part of something bigger than yourself, do it. You won't regret it.

Recovery

After 22 hours of labor and an eventual c-section, it was time for rest and recovery. First we all headed back to my labor room for a short visit and picture taking. We were all exhausted but elated to have the babies delivered safely. 

I promise I know how to hold a baby, it just looks weird because my arms were still numb from the epidural.

Seeing them with their babies was the best feeling in the world.

I can't say enough nice things about these Dads. They were so great throughout our journey, but especially in the hospital - they trusted me to take care of their babies and followed my lead when it came to medical decisions. I've heard stories about pushy parents with unreasonable expectations, but they were perfect.

I won't bore you with a play-by-play account of the recovery, this is more of a highlights reel.

Timing - the delivery was Friday evening and both the babies and I were discharged Monday morning. We were all ready to bust out of there - the nurses were amazing but there's only so much hospital food and boredom a person can take.

Blood pressure - the last few weeks of pregnancy my blood pressure had been wavering between normal levels and slightly elevated. I typically have excellent blood pressure, so this was for sure because of being pregnant. It was still elevated in the hospital and continued to go up after delivery. The doctor even considered keeping me until Tuesday for monitoring, but they decided my numbers were low enough that I could be released and monitor from home. I'd been hovering in the same range Monday and Tuesday and it's just started to trend down as of this morning. It will be a big relief if I can make it through the next few weeks without having to be put on blood pressure meds!

Catheter - also known as Battle Royale: Woman vs Bladder - I was dreading this part since it happened before during Josie's c-section. As part of my c-section prep the nurse placed a foley catheter, which was then removed 12 hours later (6:00 am Saturday). I was told I needed to pee on my own within 4 hours (I didn't) otherwise I would get an in-and-out catheter (I did). The catheter brought immediate relief but didn't do anything to remind my body how to pee on its own. This time I had a 12-hour window, which came and went with nary a drop of pee. I tried all the tricks but nothing worked. Then I got a second foley catheter (10:00 pm Saturday) that had to stay in for 24 hours. That catheter came out Sunday night and finally, FINALLY I could pee on my own which would allow me to go home on Monday (blood pressure issue notwithstanding). This is very common after anesthesia but it doesn't make it any less frustrating to not perform a basic bodily function.

Pain - so far the pain was and continues to be manageable. The only time the incision really hurts is when I have a full bladder pressing on it, or if I twist too much trying to get up. I'm trying to find the right balance of rest and moving around so that I don't overdo it, but also don't get too stiff from sitting too long.

Aftermath - perhaps the most sobering part of the whole thing is that I was told I shouldn't carry any more babies. On one hand, that's totally fine - our family is complete and I wasn't planning on being a surrogate again. But on the other hand, there's something so painful and final to say "I can't have more children." As usual, my coping strategy is to make jokes, so I told my husband he has to behave since I no longer have the option of starting over with a new husband and a new family.

Birth Story

 Gather 'round folks, it's time for a birth story.

When I last left you, I had seen my OB for my 36-week appointment and scheduled my 38 week induction, even though the OB didn't think I'd last 2 more weeks. At this appointment, I learned that all twins are moved to the OR for delivery at 7-8 cm and I could only have 1 support person in the OR with me. This was a huge bummer because I had really hoped to have my husband and both IFs in the delivery room with me, but I understood because of the higher risk factors.

I went back to work and started tying up loose ends "just in case." I'm an Architect and project manager; the other PMs at my firm are certainly qualified to take over my projects for me, but there's a lot of project-specific information that only I knew so I felt the pressure to leave things in good shape in case someone had to step in for me. I went home for an uneventful evening of TV watching and eating leftover Indian food.

At 8:45 pm Thursday night, still sitting on the couch, I felt 3 gushes that saturated my undies and pants. I was gun shy to declare my water had broken after the first false alarm, but my husband was certain that's what had happened. I obviously wasn't peeing myself and the gushing just wouldn't stop, so I called my Doctor's answering service. While we waited for the midwife to call us back, I climbed into the empty tub, called my IFs, and told them to start their 2.5 hour drive to the hospital. Around this time my mom arrived to stay with the kids - we're so lucky she lives close by. I had put together a little "birthday" gift for the babies but hadn't wrapped it yet, so Mom wrapped that while we waited. After speaking with the on-call midwife we got the official green light to head to the hospital. 

Sitting in an empty tub on a Friday night, nothing weird here.

We arrived just after 10:00 pm and went to a triage room. I wasn't having any noticeable contractions, but they quickly confirmed that my water had broken and was continuing to leak, checked the babies on the monitors, then moved me to a labor room. At this point, I was 4 cm dilated and still 70% effaced. My contractions picked up at 10:30 and progressed slow and steady. I had a chat with my midwife and labor nurse about labor goals (I've learned by now that there can be no birth plans, only goals) and I was still committed to vaginal delivery, no epidural.

IFs arrived at 1:00 am and I was so glad to see them! We agreed on a delivery rotation - my husband would be in the OR with me as I finished laboring, IF 1 would step in for me to deliver Jack, then IF 2 would take his place for me to deliver Marsha* - following the 1 person at a time rule but allowing all the guys to participate. By 1:30 am my labor was progressing slowly enough that we all agreed to try to sleep. Fortunately, the labor wing wasn't fully occupied so the IFs were given their own room to sleep in. 
*I had nicknamed the babies Jack and Marsha and called them that until the IFs formally shared their names via a birth announcement. I knew the babies' names already but that wasn't my good news to share.

It was hard to sleep with all the machines beeping constantly but I got a few hours sleep until the contractions woke me up at 5:15 am. The midwife had me try several different positions, both to encourage contractions and to try to get Marsha to turn head down. By 10:00 am I was 90% effaced but still only 5-6 cm dilated. Considering I was 4 cm when I was admitted, the limited progress was disappointing. Dr S, the on-call OB, came in at the same time and we discussed options. He still thought a vaginal delivery for Jack was possible, but Marsha was still sideways and would need to be manually manipulated into position after Jack came out. This would be intense and painful for me, with Dr S having to reach up into my uterus, so he recommended an epidural. Additionally, if Marsha ended up needing a last-minute c-section, there might not be time to give me a spinal block and they would have to put me under - another reason for him to recommend an epidural. I really didn't want one, but that seemed like the best option for vaginally delivering both babies so I agreed. Unfortunately, from this point forward I was very sleep-deprived (and hungry and thirsty) so I don't have a solid timeline for everything.

I got the epidural placed (around noon?) and it was awful. I really don't do well with needles and getting that put in is one of the worst things I have ever experienced in terms of pain and discomfort. After I was numbed I continued to slowly progress, with the midwife helping me into different positions. I eventually made it to 7 cm / 90% effaced and hit a plateau. The midwife wanted to give me a small dose of Pitocin to get me up to 8 cm and into the OR but Dr S was opposed because Pitocin is not recommended for laboring women with a previous c-section scar. Another hour of contractions and still no real progress. 

At 4:00 pm Dr S came back to discuss a c-section. His reasons were if Jack were going to fully engage with my pelvis and dilate me to 10, he would have by now. Further, Marsha was still sideways and still wasn't likely to turn on her own. Even though I didn't like the topic at hand, I felt very comforted that we were discussing it as a whole birthing team - me, my husband, the IFs, Dr S, the midwife, and the labor nurse - and I didn't feel pressured or forced about anything. My initial reaction was to labor for one more hour and see what happened, but the more we discussed it, it seemed like foregoing vaginal delivery and setting up for a c-section for both babies was our best choice. I could labor for several more hours and still not be dilated enough to push. I could deliver Jack vaginally and still need a c-section for Marsha, and I really didn't want to recover from 2 types of delivery. And there was also the small, but catastrophic, chance of a uterine rupture if my body didn't respond well to Pitocin or pushing. On top of that, I was running on very little sleep and wasn't sure I had the energy to labor much longer. The medical staff stepped out and the "family" agreed to a c-section. I realized that my preference for vaginal delivery was just that - my preference - but this wasn't about me and a c-section seemed to be the safest way to get these babies delivered. I consented to the c-section at 4:30 pm so we just had to wait for an OR to become available. We also agreed that my husband would be in the OR with me and both IFs would wait just outside in a staging area with babies taken to them right after delivery.

Even though I knew what to expect I spent the waiting period getting nervous. I remembered how hard the recovery was last time and I was sad the IFs wouldn't be in the room as their babies came into the world. Throughout my entire stay, I wasn't allowed to eat or drink anything but ice chips, and my last meal was 8:00 pm the night before. Even worse, the hospital air was dry which made my thirst even worse.

Could all these Dads be any cuter?

At 6:15 all the guys suited up and we headed to the OR. As they put me on the table the anesthesiologist upped my epidural... and he was "generous." I felt numb up to my chin, I had to constantly wiggle and squeeze my fingers to make sure I didn't entirely lose feeling in my hands, and it felt like a weight was sitting on my chest. I also felt tired and light-headed so the nurses literally had to remind me to breathe. Being flat on my back and congested didn't help matters either, so I was breathing through my mouth which only made me even thirstier. I remember asking for water over and over.

So glad I was able to have my husband in the OR for support and picture taking. 

As Dr S started the incisions he commented that my uterus was paper-thin, so we definitely made the right call not to give Pitocin or try to push. He easily delivered Jack (4 lb 12 oz) at 6:51 pm with Marsha (5 lb 10 oz) following at 6:52 pm. Wouldn't you know it, she flipped head down as soon as Jack was out of the way - what a rascal! After she was born, Dr S said she had 2 knots in her cord and had her cord wrapped around her neck! Neither of those things were causing her distress in the womb but could have quickly turned dangerous had I tried to deliver her vaginally. I'm not a big believer in fate or destiny, but the universe certainly knew what it was doing when we decided on a c-section.

Jack (left) and Marsha (right) in their birthday suits

I got to hear the first cries and see each baby above the drape as they were delivered, and my husband was allowed to take photos, then they were quickly taken to their waiting Dads in the staging area for their clean-up and vitals check. Despite being born at 36 weeks 1 day, they were very healthy.

The second half of the surgery seemed to take forever and all I wanted was to drink some water and have the epidural wear off. Everyone went back to my labor room for a quick visit then we were moved to 2 recovery rooms to get some much-needed rest.

Next up, recover and some final thoughts on surrogacy.

Let's Get Caught Up, Shall We?

 As I mentioned last time, I was saving the blog for the "big" posts and everything else would be posted to my surrogacy Instagram account. But for posterity's sake, I thought I'd drop in a quick timeline on the ole blog, too.

May 26 - Transfer day, transferred 2 male embryos (1 from each IF)

June 9 - Negative beta, meaning the transfer failed

August 18 - Second transfer day, transferred 1 male and 1 female embryo (1 from each IF)

September 1 and September 3 - Positive betas, meaning the transfer was successful!

September 18 - confirmation ultrasound with RE, 2 healthy babies on board, due May 6

October 1 - second ultrasound with RE, released to my OB for the remainder of the pregnancy

October 8 - final progesterone shot, still had to take some pills but so glad to be done with shots!

October 31 - my close friends and family already knew, but I went "public" with my pregnancy and surrogacy the only way my dark sense of humor knew how... by dressing as a Handmaid for Halloween.

Yes, I made my husband put on his tux just to be my Commander for the photos. Totally worth it.

November 28 - IFs came to visit - we went out to lunch, they gave me a prenatal massage gift certificate (saving that for later), and we did a little photo shoot for their Facebook pregnancy announcement

December 7 - Level 2 ultrasound, both babies looked healthy and we confirmed we had a Boy (on my right) and a Girl (on my left). I didn't want to call them Boy and Girl or A and B, so I nicknamed them Jack and Marsha. Also learned that my due date was moved forward to April 22. Since I was carrying twins they didn't want me going past 38 weeks.

December 10 - 19 weeks, halfway there! At this point I was still feeling cute and comfortable... silly me didn't know what was to come.

February 4 - Hello third trimester! Really starting to feel uncomfortable and have trouble sleeping with all the restless legs and heartburn.

February 9 - 1 hour glucose test, which I failed.

February 11 - 3 hour glucose test, which I passed (barely).

March 19 - This is the first in a series I would later name "False Alarm Friday." Just after lunch I felt a big gush and was pretty sure my water had broken. I called the OB office and they had me go straight to the hospital. I called the IFs and put them on standby but told them not to start driving unless I got admitted to the hospital. I was put in a triage room and 5 hours later we determined my water had not broken. I didn't pee myself either, so we don't know exactly what happened other than "you're pregnant, sometimes things just leak out of you." So gross.

March 23 - Finally cashed in my massage gift certificate and it was heavenly. Until I looked at the tag on the robe they gave me - 4XL!! How rude.

March 25 - Another OB visit, another ultrasound. Jack had been low in my pelvis and head down for quite some time. Marsha had been up in my ribs and was never in the same position twice. She still had time to flip head down, but it didn't look promising.

March 26 - False Alarm number 2. I was watching TV with the family and I started having heavy contractions. I had been having Braxton Hicks for weeks, but these were strong, 30-45 seconds long, and only a few minutes apart. I called the answering service and they told me to head to the hospital. I hadn't finished packing my bag so I got up to pack and take a quick shower, which made the contractions come to a dead stop - no need to go to the hospital after all.

April 2 - False Alarm number 3. Almost identical set up as before, contractions started Friday evening after dinner and the timing suggested I head to the hospital. Gun shy from the previous false alarms, I decided to shower BEFORE I called the midwife on-call and they stopped. Again. This was getting old. Even though they didn't appear to be real labor, all the contractions were very painful.

April 8, morning - 36 week OB appointment, I had an ultrasound to check baby positions and had my first cervical check. Jack was still head down and -2 station, Marsha was sideways and still up in my ribs, cervix was 70% effaced and almost 3 cm dilated. We scheduled my induction for April 24 (38 weeks 2 days) but the OB was confident I wouldn't last that long.

April 8, evening - water broke for real!

Sorry to stop on a cliffhanger, but this is where I leave you. Up next, the birth story!

May 21 - Wine and Muffins

Wow, I’ve been slack on posting but not because nothing is happening. Partly it’s because I’ve started an instagram account for the surrogacy journey* and partly because I’m “home schooling” my kids and therefore mentally exhausted.

So, let’s see, where are we? Our clinic was allowed to resume transfers so things are back on track. I was still apprehensive but their safety protocols seem very reasonable and my IFs graciously offered me their guest suite over the garage to use whenever I need to come for an appointment. Both those things eased my mind and I agreed to proceed.

April 30 - first Lupron injection. The needles are tiny and it’s not a big deal.

May 8 - monitoring appointment with the RE. I drove in the night before and stayed in the guest suite. They left me the sweetest gift basket with yummy muffins, hand sanitizer, and a new water bottle that I am now obsessed with. They also chilled me a bottle of wine and I discovered the joy of drinking in the shower.

Lab results were good so I moved to the next stage of meds.

May 19 - another monitoring appointment, again staying in the guest suite. More wine and binge watched The Great, then got a delicious muffin on my way to my appointment. I’m sensing a theme here.

More positive lab results, and my lining was adequately thick.

Huzzah!

Transfer day is officially scheduled for next week.

May 21 - lots more pills and first day of Progesterone. I feel like it’s really not fair to start with itty bitty Lupron needles, which gives you false confidence, only to switch to a giant needle full of thick Progesterone oil. Yeowch.

Cross your fingers and toes for a thick lining and sticky embryos!

*I think the phrase surrogacy journey is cheesy, but it’s a fair description and I can’t think of a better phrase.  

March 18 - It's The End Of The World As We Know It...

We're in the midst of Covid-19 and it feels like we're in the upside down. My kids schools closed as of Monday and my family (me, husband, 2 kids, and my mom) are all self-isolating and working/schooling from home. It feels scary, yet some people think it's not a big deal and are "free to live their lives."

But back to surrogacy. I just got off the phone with my RE clinic and, based on recommendations from ASRM, they have put a hold on all transfers for both IVF and Surrogacy. It's a huge bummer but I'm relieved. The pre-transfer testing involves many doctor visits, which increases my exposure. There's not enough data to know for sure, but scientists are starting to say that babies and pregnant women might be at a higher risk. And, last but not least, my contract has specific language that requires me to not knowingly or willingly put myself and the fetus at risk. How do you even go about doing that during a pandemic?

While I am absolutely disappointed, I'm hoping this is temporary and that we'll pick back up in a few months. The good part is all the pre-requirements are completed so we're in a good place to lay low without risk of back sliding. Keep your fingers crossed for us!

March 3 - Completed Contract

It's hard to believe it, but we finally have a signed contract! There were no major problems that caused the delay, contracts just take time to make sure both parties feel protected - after all, someone is trusting me with their baby! The lawyers sent the legal clearance letter to the RE clinic, so we should be moving forward with meds soon. Obviously, we blew past the mid-January transfer we were planning on, but we're all so excited to take the next step!

So far, everything is good. I've told my bosses and they're very supportive. I wasn't sure what to expect but they're being so sweet about it. I also told my kids are they're totally cool in that way that kids just roll with whatever happens. My son keeps confusing the word "surrogacy" with "suicide" since they sound similar - haha - but otherwise all is well.

November 20 - Psych Evaluation

About a week after my med screen appointment I got the news from the clinic that I was medically cleared! They also ran labs for Steven at the same time, and he got the all-clear as well. Obviously, my health is of higher concern to the clinic since I'm the one carrying the baby, but it was important to screen him for major ailments and confirm that he's healthy enough to be a rock star support person.

Tonight Steven and I had a video conference with a counselor for our psych evaluation. Nothing seemed to flag any issues but I'll still be glad to hear we have the all-clear on that front as well.

Now the last hurdle is the contract. My attorney is still waiting on the first draft from the IF's attorney. Once we have the draft we'll have to review it and settle any differences that may come up. Of course, the contract has to be final and signed before the clinic can start my med protocol. Still working towards a mid-January transfer.

October 16 - Med Screen

Things have officially ramped up and feel real!

As you may remember, the IFs and their RE clinic are in Charlotte, which is a 3-hour drive away from me in Raleigh. The RE clinic is being very flexible in allowing me to have some of my appointments at a trusted clinic closer to me, but I have to go to Charlotte for the 2 "big" appointments.

It was time for my medical screening so last night I drove to Charlotte. They generously booked me a hotel near the clinic and took me out for drinks so we could get to know each other. It could not have gone better! I already knew I liked them from our video chats, but in person, they're even better. We all got along wonderfully - I have many things in common with each of them - and it felt like we could be friends. I wasn't nervous about them at all, but I'm even more at ease and more excited to be working with them after our evening together.

This morning I got some work done at the hotel's business center - which was super cute, by the way - and then headed to the clinic after lunch. We covered a lot today: basic vitals and medical history, the saline sonogram, a sit-down with the doctor, a review of the med protocols, and a blood draw in their lab. Everyone was great and answered all of my questions. It is night and day from how I felt with the agency I started with. Small world, the doctor overseeing our case is friends with my Gynocologist!

Never one to pass up an opportunity, I stopped by IKEA on my way out of town. The shopping was uneventful except for the massive cramps, courtesy of the saline sonogram, that hit as I was waiting in line to check-out. Nothing I couldn't handle, but I was forced to eat lots of fried drive-thru food on my way home to make myself feel better, ha.

September 12

So, this post is a bit of a roller coaster but it has a happy ending. Promise.

Right around the time the IFs reached back out, my mom was diagnosed with uterine cancer. She's already had surgery and looks on track for a full recovery, but at the time I was in a tailspin. Not so much emotionally, but going through the logistics of how to support her - doctor appointments, chemo treatments, surgery recovery, etc - while also working, taking care of the kids, and some semblance of housekeeping.

When I learned that my medical screen appointments would have to be in Charlotte - a 3 hour drive away - that was the last straw and I almost walked away from the match. I told the IFs I wasn't out, but that I was nervous about the time commitments between now and a January transfer and I wasn't sure I could commit to many trips back and forth to Charlotte. Graciously, they worked with their clinic and let me know we could delay the initial appointments a month or two and that some of the lab work could be done in Raleigh, which was a huge relief.

Always one to choose humor over emotion,
here's the "yay you're cancer free!" card I made for her.

Now that my mom is 3 weeks post-surgery with no need for chemo or radiation, my head is clearer and I'm back to 100% enthusiasm for the match. The IFs are both so sweet I really wanted to keep working with them. Just this week I let my attorney know we're starting up again and I scheduled my initial medical screen for October 16. I'll be driving down the night before and staying in a hotel so I won't have to rush to Charlotte the day of the appointment. The IFs want to get together for drinks after I get in and I'm so excited to meet them in person!