"Keeping Surrogate Motherhood in the Family" - February 14th, 2011

The National Post
February 14th, 2011
"Keeping Surrogate Motherhood in the Family"
By Sarah Boesveld

She had supported her daughter through years of trying, helping her through the anguish of failed pregnancies and rounds and rounds of in vitro fertilization.

When nothing worked, 61-year-old Kristine Casey offered the very last thing she could: her healthy, post-menopausal uterus.

Last week, the Virginia woman gave birth to Finnean Lee Connell via cesarean section at a hospital in Chicago, where her daughter Sara Connell lives.

While some have lauded the birth as miraculous, a sacrifice of love akin to donating a vital organ, ethicists and observers worry that it takes advances in infertility treatments too far.

“The central question is what’s in the best interest of that child?” said Margaret Somerville, a medical ethicist and founding director of the McGill Centre for Medicine in Montreal. “I think in this case [the concern] is more the confusion of the relationships within the family.”

Family structures could be compromised if a child is confused about the roles, she said.

“I make a distinction between repairing nature when it fails and doing something that would never happen in nature,” she said. “A grandmother giving birth to her grandbaby is something that could never happen in nature, and so I’d say no, that’s really suspect.”

Canadians should expect more relatives to volunteer as surrogates in light of last December’s Supreme Court decision to keep payment for surrogacy a criminal act, said Sherry Levitan, a Toronto-based lawyer who specializes in third-party surrogacy law.

But it could also mean siblings or perhaps even parents could be pressured into offering up their body to surrogacy.

“The concern is not so much a mother caring for a child, but what if there are two siblings and one can’t carry? The parent could exert a lot of pressure on the other sibling to carry,” she said. “That raises a lot of red flags and we’re very concerned about those kinds of situations.”

Ms. Levitan, who calls the 61-year-old grandmother “an extraordinary woman,” said she sees about 10% of surrogacies involving relatives — mostly sisters and close childhood friends, which she counts as relatives.

“I think the real bonus is seeing your family member so happy,” she said. And women who have a relative for a surrogate also tend to be more trusting. Rarely is there a litany of do’s and don’ts handed down to a relative, whereas a paid surrogate, who is often a stranger, would have a number of restrictions, she said.

“There’s a very different shift of power during the pregnancy or even when they’re trying to get pregnant,” She said. “You can’t say to your mother or your sister, ‘You have an appointment next Tuesday at 8 a.m.’ You have to say, ‘Would it be convenient?’.”

At the end of the day, women who use family members as surrogates tend to be far more grateful, she said, seeing the surrogacy as an act of love.

Ms. Casey is not the first woman to give birth to her own grandchild. Ms. Levitan handled a case about five years ago in which a man’s mother carried his baby on his behalf.

“The mother came off hormone replacement therapy to do this,” she said. “It went beautifully. I think there was a little bit of friction between the mother-in-law and daughter-in-law, which is not unusual between any woman and the surrogate.”

In November 2008, 56-year-old Ohio woman Jaci Dalenberg carried her daughter’s identical twins, which were delivered by cesarean. In January 2004, a woman based in Gujarat, India, carried her grandchild on behalf of her daughter.

Ms. Levitan had never heard of a woman over 60 giving birth to a child even as a surrogate, but you do see older people stepping up as surrogates, said Sally Rhoads, who runs Surrogacy in Canada Online, an information, referral and support site for people considering surrogacy.

“Often a doctor will joke that a menopausal body is the ideal body to be cycling with,” she said. Women who are going through menopause are not ovulating, which provides better conditions for invitro fertilization, she said. An ideal surrogate is someone who has already had at least one child, and it’s recommended that surrogates have finished their own families before donating their bodies, because fertility can often be compromised with more and more births.

But of course older women also face greater risks. They must be in excellent health, without any pre-existing conditions, she said.

Ten and a half months ago, Gena Lucas’s step-mother gave birth to her healthy child Ava — and it was one of the best gifts anyone had ever given her.

Still, the Victoria, B.C., woman said she doesn’t treat her husband’s father’s wife Sue any differently than other grandparents involved. They get the same number of updates and phone calls about how little Ava is doing, she said.

“In the future, for sure there’s going to be an unbelievable bond when Ava realizes she’s respoonsible for her being here,” the 39-year-old said. Sue was 48 when Ava was born and now Ava shares a birthday with one of Sue’s daughters.

It had been 30 years since Ms. Casey last gave birth, but everything went smoothly during the delivery, Ms. Connell told the Chicago Tribune.

And when she heard her firstborn son cry, “I lost it,” Ms. Connell said. Everyone in the crowded operating room was overcome with emotion, according to hospital staff who attended the birth.

Ms. Casey intends to go back to Virginia and take on the traditional role of grandmother.