Front Burner - Baby business Part 1: The surrogates

Episode Date: March 4, 2020

As infertility rates go up in Canada, desperate couples are turning to surrogacy. But a new investigation reveals that because there are few federal regulations on the surrogacy system, the process isn’t working for everyone. Jayme Poisson speaks with Chris Glover and Chelsea Gomez, who spent months investigating surrogacy in Canada, in the first of a two-part series.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. I think that every single surrogate at some point in their journey questions what they're doing. I think we are a certain brand of crazy, to put it kindly. But we do this because we want to help. And it is worth every second of it, but you do question every second of it as well.

For Halifax nurse Elizabeth Roberts, a surrogacy pregnancy is a beautiful and altruistic process. That's why she's given birth to other families' babies twice. But she's also learned that in Canada, being a surrogate can make you vulnerable. As unfortunate as the term may sound, this is an industry. The agencies that sometimes manage this process can pressure women to have more pregnancies faster. They're not breed mares. We're people. Women like Elizabeth are also not being warned of the very real risks to their health, which can cause permanent issues.

The complications afterwards were not anticipated. It has led to requiring surgery. And that's just not on any woman's radar. On the other side of this, there are parents who are desperate to have a child and they face all these costs that might even be illegal. They're also afraid to speak up about their concerns because they don't want to derail the process. Over the next two days, I'm talking to my colleagues Chris Glover and Chelsea Gomez. They've spent months investigating surrogacy in Canada, interviewed dozens of people, and found that it just doesn't seem to be working for everybody.

Today, we're going to focus on the surrogates. I'm Jamie Poisson, and this is Frontburner. Chris, Chelsea, thank you so much for being here. Our pleasure. So let's talk about Elizabeth Roberts, one of the women that you spoke to. And I know that she decided that she wanted to be a surrogate for another family's baby. It's something that I always thought about. It was always in the back of my mind, I guess, ever since I had my own kids. I guess they say a woman knows when she's done. But how long did it take her to find parents asking for help? Chelsea? You know, shockingly, it didn't take her very long.

One day I just decided to bite the bullet and I just googled surrogacy in Canada and a link popped up. Googled surrogacy in Canada and a link popped up. Found an agency and applied and within a week her profile was live and she was getting flooded by messages. I basically went from zero to a hundred applying and then being matched. So does that tell you there's a huge demand? Oh, there's a huge demand. And we spoke to lots of IPs that say they're just desperate because they are waiting months, if not years, to find somebody to do this for them. And IPs are? Intended parents.

It was a bit heartbreaking because I wanted to help everybody. There's so many intended parents out there and only so many surrogates. And Chris, give me a sense of these IPs, these intended parents. Who are they? Who's looking for a surrogate? So we know that there are so many Canadians who can't have their own babies for a million different reasons, right? Infertility in this country is growing. It's doubled, actually, in fact, the rate of infertility since 1980. And so that is a big source of the demand that we're finding, infertility. And so that is a big source of the demand that we're finding, infertility. But also, we know that more gay couples and particularly gay men are turning to surrogacy in greater numbers. Numbers actually from fertility clinics is the only way we can kind of cobble together a picture of how many surrogacy births there are. And they voluntarily report those numbers, the fertility clinics. They show that the last five-year period that they have access to, there were 816 surrogate births just over that five-year period across the country. Okay. And it could be even larger than that? Yeah. Well, because as I

mentioned, that's just voluntary reporting from them. And it also would require that the conception happened at a fertility clinic here in Canada. So clear that there's a real demand here. And it also would require that the conception happened at a fertility clinic here in Canada. So clear that there's a real demand here. And this is a growing need, surrogates. Chelsea, how do most parents find surrogates, by the way? Right. So it used to be where in order to find a surrogate, you would end up using a family friend or a sister or your sister-in-law, and they would volunteer to do this. Because their demand is so huge right now, that's just not possible. Most people don't have family and friends that would be willing to step up. So they end up having to go through an agency.

And there's a lot of agencies that have popped up across Canada. We've found at least a dozen over the last couple decades. They create an online community of parents that get matched with surrogates. And they recruit women to be part of their program and then offer those women to any parent that is looking for somebody. So they contact us and then we could filter out. It was sort of like online dating, but it was like online dating for surrogacy. You fill out a bunch of personal information, you toss out a couple photos as well, and then immediately you're getting inundated with all of these private messages asking for this very intimate service. Just to be clear, there are some

agencies that don't operate that way. They do have a little bit more discretion. And so the surrogates will be sent profiles directly. But there are other ones where, yeah, everything's public. Everybody, it's a free for all. You can see everyone and everything is sort of just open to individual people meeting. Interesting. And I want to ask you guys about rules. In Canada, are there any rules that govern the relationship between surrogates and parents? So the main rule that overarches everything is essentially you cannot pay a surrogate to have a baby for you. But it is totally fine for you to compensate her for any expenses that she has or to reimburse her for those expenses. You just can't pay above and beyond. So you have to make sure that you are receiving receipts, that everything is documented. And as long as it is and you can justify that whatever she's expensing is actually related to the pregnancy, you're fine.

And is that the primary rule? Yes, because Canadian legislation is actually meant to prevent the commercialization of surrogacy. The idea that the woman's body is not a commodity to be sold, same as you would have with organ donation, you can't buy organs in Canada, it's along the same lines. Okay. And I know that this is something that we're going to dig into a little bit more tomorrow. But for the parents, are there other expenses here? So it's not just the reimbursements for the women. They also have to pay lawyer fees, fertility fees, agency fees. All of that stuff we've seen can go upwards of $100,000 or more. Okay. Wow. It's expensive. I am curious to know what you're hearing from surrogates,

why they want to do this. What are they telling you? So it's interesting because when we found out that it was supposed to be altruistic, I think our immediate reaction was there's nobody willing to do this at all. And how could someone even, how could someone volunteer themselves to do this and not get anything in return? Especially you have to consider these are for complete strangers, right? They're not doing it for their friends. Right. You're not doing it for your sister. And you mentioned expenses, but we're not talking an exorbitant amount of expenses strangers, right? They're not doing it for their friends. Right, you're not doing it for your sister. And you mentioned expenses, but we're not talking an exorbitant amount of expenses here, right? No, I mean, generally your pregnancy related expenses are clothes, vitamins, travel, extra food, things like that.

But these amazing women are doing this for a bunch of reasons, right? Like on the one hand, they just really want to help people and they feel like there's this injustice that they can't have kids. So they want to stand in and be that person for these other people. Women who become gestational carriers, they just, they have it inside of them that they, they know that this is something that they have to do. And, and this is, this is something that they can do. And then when they know the moment is right, that's when they do it. And I got the same feeling when I matched with those parents and they were wonderful people. We've also heard people that say that it's just unfair that gay men can't carry their own kids. So they want to help that part of the population. We've also heard people say their sister was infertile. I even heard one

surrogate who said she had been infertile in a previous part of her life. Doctors had told her, you're never going to be able to get pregnant. And then she found out when she was 22 and got pregnant herself, whoops, I guess I can have babies. So she personally knew the pain of not being able to have her own child and carry her own baby. So she wanted to make sure that if anybody else had to deal with that, then she could stand in and help. That's wonderful to hear. I should say this is something that hasn't come up on the podcast yet, just because I haven't really found a time to mention it, but I am actually pregnant right now. Congratulations. Thank you so much. And Chelsea, I know you were, if it's okay if I mention, you are pregnant as well. I am not pregnant.

Chris is not pregnant. He's outnumbered me in the studio. This is my first child, and I have an incredible newfound respect, not just for my own mother, but for all women who have carried children. Because while it is a wonderful experience, it also is hard. So I think it really is nice to hear some of these stories. Yeah. And especially, I mean, we know that medical advancements have come so far. But one thing that a lot of Canadians don't really remember is that it is still risky. Pregnancies are still risky, and births are still risky. And so that is what I want to get into with you both now. Because while millions of women

have children every year, it is the biggest health risk that most women will take on in their lives, just statistically. Is there anything inherently more risky about having a surrogate pregnancy? Yes, actually. And we spoke to some medical professionals that explained this for us. So first of all, what makes it inherently risky is that you're essentially doing IVF in vitro fertilization. It's an unnatural form of conception. And the reason why that is important is a you're pumping your body full of all these hormones, the most of the women are doing that pumping the body body with all these hormones in order to prepare your uterus to take that embryo. The hormones can really mess with your body a little bit. Med bloat is a very real thing, a very common term amongst us surrogates. There's an added element that your body hasn't been exposed to this genetic material before, and that can cause placental issues in a pregnancy. So they're at automatically higher risk because it's IVF. But then when you factor in the profile of a surrogate, generally, surrogates are women that have already had their own kids. They're

not doing this mid sort of family building time, prime time for themselves. They're doing it afterwards and after they're finished their entire family. And they say, I want to help someone else. So they start having kids for someone else. They're older. More often than not, they're doing it afterwards and after they're finished their entire family. And they say, I want to help someone else. So they start having kids for someone else. They're older more often than not. They've had multiple pregnancies, two or three or however many kids they want to have. And they're also potentially then more likely to have had a cesarean section. Okay. This doctor that we spoke to, Dr. John Kingdom, who works at Mount Sinai Hospital here in Toronto, he was saying the thing that is really important about C-sections is there's an incision, obviously. And so the woman needs to have time to have that incision heal and make sure that her uterine wall is safe to carry another baby and go through

another pregnancy and another birth if they so choose to have subsequent surrogacy pregnancies, which is something that we've found is very common in the industry. The uterine wall has to heal up. So if you're pregnant again and it's stretching and it's not properly healed, it could break open during pregnancy, which is rare, but it's certainly enduring labor and delivery. But more importantly, if the uterus is not properly healed, the chronic inflammation in the lower part of the uterus

could attract the blastocyst to implant low down, causing low-lying placenta. So given all of this, all of these potential risks, are there any rules in place to, you know, govern who can qualify to be a surrogate and who can't? No, actually. And in fact, it's quite shocking that the women that are volunteering to do this come from all different walks of life, all different health backgrounds, and whether or not they get approved to be a surrogate is essentially up to whatever fertility clinic they go to. Every fertility clinic has different metrics. And we have heard from many different surrogates who said that the agencies that they were working with, when they see their health profile, automatically knew which fertility clinics they would pass at and which ones they wouldn't pass at. So a woman could not pass at

one fertility clinic and then pass at another fertility clinic? Absolutely. Wow. Okay. And you mentioned multiple pregnancies, Chris. Let's talk about that for a minute. What happens after a baby is born? Have you heard from surrogates about experiencing any pressures to have another baby in short succession? Some of the surrogates that we've talked to have said that right after they give birth, they have this amazing experience and they just are in love with the fact that they've been able to provide this gift to another family. Aside from my own children, these experiences were probably the most beautiful moments I've ever experienced in my life. It was just so overwhelming. The joy, the love that was

in that room. The baby went straight into mom's arms and she was perfect and beautiful. The dad looked up at me and he just had tears streaming down his face and he just said, thank you. And it was just any questions that I had ever had just disappeared in that moment. It made everything worth it. And so in the middle of this kind of emotional state where they've just given birth and they're, you know, feeling like they just did this incredible thing as painful and as awful as it was at points. Yes.

They're then approached by some of these agencies or some external forces to say, hey, you know, that was really great. And we there's so many people out there who need your help. Would you be willing to do it again? And so they come back at them. And we've heard stories of of women getting approached by somebody else within a couple of days, within a week, within a couple of weeks. Wow, even before they give birth. Oh yeah, that's true. We have heard surrogates who are seven months pregnant and they're already being approached on Facebook or whatever by another set of parents and they already kind of make this arrangement and deal to work with that family once they've had the postpartum time that they need. Okay, and I imagine there's just so much going on leading up to the birth and then immediately afterwards, physically, but also emotionally. Is it okay that they're being approached so quickly? Well, this is a question that we've had and we've really tried to dive into when we are speaking to people and to really understand the emotional effect that the surrogate pregnancy and the birth has on someone.

Because while let's say a woman gives birth and decides to wait an appropriate amount of time, if she's presented with profiles within days of giving birth and emotionally she connects to parents and she commits to them, even if it's informal or many times it's actually through formal contracts. You would feel very already pre-committed to doing a future surrogacy. So the question of whether or not you are actually doing any internal reflection about whether this is really something you want to do and whether you're in a good emotional state to make those decisions, that's questionable right after birth. I think a lot of gestational carriers hit this emotional plummet after they give birth because your brain is aware and your mind and emotions are aware that this was the arrangement,

that there is no baby afterwards. This is something that you're doing for somebody else, but your body is still sort of adjusting. Your hormones are still adjusting, and your body's still sort of looking for that baby. They're coming down from a really strong high at that point from all this experience they've had. And then on top of that, they're dealing with this idea that they knew that they were going to give up a baby. They know that that's the deal. But they essentially lose, I had so many surrogates tell us that they lost that connection with these people that they had become friends with for nine months. Oh, wow. And so once the parents receive their child, obviously because they're busy, they now have a newborn, it's almost like that surrogate gets pushed aside unintentionally. It's not malicious.

But the surrogates often feel like they are lonely because they've had this relationship with a family for so long, growing their baby, and it's been very intimate. And then it's almost like there's a wall there. Right. That's so interesting to hear and makes a lot of sense. I know I felt lost afterwards. I didn't know what else to do. And my brain kept asking, okay, so what do we do now? We've done this huge, incredible, amazing thing. What are we going to do now? And so I knew right away that I think I was going to have to do it again, because I didn't know what else to do. So we've talked about some of the health risks during pregnancy, IVF, being a surrogate in the first place. What are the risks associated with having children in such close succession? So a lot of the people who listen to this are going to say, well, I got pregnant right after I gave birth and we were totally fine.

What they might not be considering is all of the different elements that are at play when it's a surrogacy pregnancy. Those things that we listed earlier about how she's likely to be older, likely to have already had multiple pregnancies, likely to have possibly had a C-section. have already had multiple pregnancies, likely to have possibly had a C-section. Each one of these things makes it already a more risky, a more dangerous process for that surrogate. And that's why the medical professional that we spoke to, Dr. John Kingdom, said you should give surrogates an added amount of time in between all of this, especially because they're taking on all of these risks for someone else. It's different

when you're taking on these risks for yourself. It's a whole other ballgame when you're going into this for another family. And so Elizabeth Roberts that we were talking about earlier. But I knew that right after the birth, I was like, that was, I think I said 30 seconds after I gave birth. I'm like, I could do that again, just because it was so wonderful. Then again, I was probably riding high on a lot of endorphins and adrenaline. So she's the one who felt that pressure herself, felt that joy. And she said that she felt proud of herself. So she wanted to do it again. She went looking for that second couple willingly, found them. And she said they didn't pressure her. Nobody did. But the point of the matter is nobody explained to her in great detail the risks that she might have in going back to back so quickly

because she left less than six months, which Dr. John Kingdom says is tight for any timeline, but with a surrogate, he would suggest even longer. Knowing what I know now, I would strongly recommend taking an appropriate amount of time in between journeys for sure. And I think that's something that the agencies should advocate on behalf of their clients. And so what happened to Elizabeth? Well, Elizabeth for her second pregnancy was actually quite great. She said it was pretty uncomplicated, but the birth ended in severe complications that we just won't geticated, but the birth ended in severe complications that we just won't get into,

but she's going to end up having to have a hysterectomy this spring. Oh, that's awful to hear. But I'm very grateful for what my body has been able to accomplish. I'm very grateful that I was able to help not one, but two families. Emotionally, I'm okay with it. I'm not saying that another woman would be though. I imagine that it might be terrifying and scary for somebody else. In the Dragon's Den, a simple pitch can lead to a life-changing connection.

Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections. These surrogates seem to be mostly women trying to do a good thing for struggling families. And it certainly seems to me like they're being managed by a business, an industry that can put a lot of pressure on them. And do the experts you've talked to worry about a lack of protection for these surrogates? Yes, some of them do. I mean, we spoke to multiple different fertility clinics about the way that they manage surrogacies, and they all have, you know, generally pretty high standards of clearance and psychological and

medical testing. But each one of them differs in how they treat any sort of back-to-back surrogacy because there are no national standards for wait times. There isn't even national standards for general women having, giving birth or women who are going through IVF themselves. And we talked about before how some clinics would allow a woman to be a surrogate and others would not. Exactly. Same goes for wait times. So we had some fertility clinics that were okay transferring in six months post a natural birth. We had other fertility clinics saying nine, 10 months at least they would wait. We had even other fertility clinics said that they wouldn't consider doing any sort of hormonal treatment with any woman, regardless of whether

she was a surrogate or a regular woman coming to do IVF herself in under a year. So it really does depend on the clinic that you're going to. Sort of a mixed bag. Absolutely. And that's showcased in the fact that we have Dr. Kingdom saying if you have a C-section pregnancy, you should wait a year before you start getting transferred with another embryo. And yet we found women who were transferred in as little as four months, even with that profile. Okay. So how do we fix these vulnerabilities, the screening for being a surrogate in the first place, proper communication, rules around successive pregnancies? We went looking for an answer to that. And I mean, the best thing we could come up with was Health Canada,

because the federal government was the one that legalized surrogacy in Canada. So we thought Health Canada might be able to give us an answer on medical guidelines here that could be followed by doctors all across the country and fertility clinics all across the country. So there wasn't this patchwork approach that you just described. But Health Canada says that because it's a medical issue and it's about medical practices, that ends up having to be up to the provinces. And they said that they just don't have the authority to step in. And I mean, we know from covering pipeline disputes and all of this other stuff

that it's tough for the provinces to agree on certain things. So if we want to have a national standard where we don't have surrogates and couples taking people across provincial borders to places where they feel like it more in lines with the timelines that they, for example, want, we would need to have some sort of a national standard. Are there even standards in the provinces right now? No, there are really no provincial standards. It's really up to each individual clinic and how they're going to operate. Okay. Guys, thank you so much for this conversation, which is fascinating, and which we will continue tomorrow.

We're going to focus on the costs, which I know are a frustration for parents and also at times the surrogates as well. So thank you so much. Yeah, thanks for having us. Thanks, Jamie. See you then. Okay, so as I just mentioned, we're going to be talking about surrogacy tomorrow. This time we're going to be focusing on the parents. I'll leave you today, though, with a few words Elizabeth Roberts had for the parents she was a surrogate for. They talk about how surrogates are brave and strong and to me the parents they're strong and they're brave. The trust that they

exchange with their carrier it's such a gift. I mean to be trusted to do that for them was amazing. That's all for today. I'm Jamie Poisson. Thanks so much for listening to Front Burner and talk to you tomorrow.