Risks to Surrogates

All women considering surrogacy should be aware that there are serious risks with IVF, fertility medications, pregnancy and childbirth. The list compiled below is an extensive list of all types of side effects, complications and serious risks that surrogates face.

Surrogacy contracts often have sections discussing the risks that the surrogate is willing to take. However, they are often very limited in detailing them. All women should read this list of risks and feel confident about continuing with a surrogacy arrangement. Some surrogate mothers end up with serious complications and/or loss of their reproductive organs after a surrogate birth and this is why it is often recommended that surrogate mothers have completed their own families.

Common side effects during pregnancy…

– exhaustion (weariness common from first weeks)
– altered appetite and senses of taste and smell
– nausea and vomiting (50% of women, first trimester)
– heartburn and indigestion
– constipation
– weight gain
– dizziness and light-headedness
– bloating, swelling, fluid retention
– hemmorhoids
– abdominal cramps
– yeast infections
– congested, bloody nose
– acne and mild skin disorders
– skin discoloration (chloasma, face and abdomen)
– mild to severe backache and strain
– increased headaches
– difficulty sleeping, and discomfort while sleeping
– increased urination and incontinence
– bleeding gums
– pica
– breast pain and discharge
– swelling of joints, leg cramps, joint pain
– difficulty sitting, standing in later pregnancy
– inability to take regular medications
– shortness of breath
– higher blood pressure
– hair loss
– tendency to anemia
– curtailment of ability to participate in some sports and activities
– infection including from serious and potentially fatal disease
– (pregnant women are immune suppressed compared with non-pregnant women, and are more susceptible to fungal and certain other diseases)
– extreme pain at delivery
– hormonal mood changes, including normal post-partum depression
– continued post-partum exhaustion and recovery period (exacerbated if a c-section — major surgery — is required, sometimes taking up to a full year to fully recover)

Occasional complications and side effects:

– hyperemesis gravidarum (morning sickness)
– temporary and permanent injury to back
– severe scarring requiring later surgery (especially after additional pregnancies)
– dropped (prolapsed) uterus (especially after additional pregnancies, and other pelvic floor weaknesses — 11% of women, including cystocele, rectocele, and enterocele)
– pre-eclampsia (edema and hypertension, the most common complication of pregnancy, associated with eclampsia, and affecting 7 – 10% of pregnancies)
– eclampsia (convulsions, coma during pregnancy or labor, high risk of death)
– gestational diabetes
– placenta previa
– vasa previa
– anemia (which can be life-threatening)
– thrombocytopenic purpura
– severe cramping
– embolism (blood clots)
– medical disability requiring full bed rest (frequently ordered during part of many pregnancies varying from days to months for health of either mother or baby)
– diastasis recti, also torn abdominal muscles
– mitral valve stenosis (most common cardiac complication)
– serious infection and disease (e.g. increased risk of tuberculosis)
– hormonal imbalance
– ectopic pregnancy (risk of death)
– broken bones (ribcage, “tail bone”)
– hemorrhage and numerous other complications of delivery
– refractory gastroesophageal reflux disease
– aggravation of pre-pregnancy diseases and conditions (e.g. epilepsy is present in .5% of pregnant women, and the pregnancy alters drug metabolism and treatment prospects all the while it increases the number and frequency of seizures)
– severe post-partum depression and psychosis
– research now indicates a possible link between ovarian cancer and female fertility treatments, including “egg harvesting” from infertile women and donors
– research also now indicates correlations between lower breast cancer survival rates and proximity in time to onset of cancer of last pregnancy
– research also indicates a correlation between having six or more pregnancies and a risk of coronary and cardiovascular disease

Less common (but serious) complications:

– peripartum cardiomyopathy
– cardiopulmonary arrest
– magnesium toxicity
– severe hypoxemia/acidosis
– massive embolism
– increased intracranial pressure, brainstem infarction (stroke)
– molar pregnancy, gestational trophoblastic disease (like a pregnancy-induced cancer)
– malignant arrhythmia
– circulatory collapse
– placental abruption
– obstetric fistula

More permanent complications:

– hysterectomy (removal of uterus)
– salpingectomy (removal of fallopian tube)
– future infertility
– permanent disability
– death