Termination: Why It's Important to be on the Same Page
Attitudes toward termination are one of the key questions intended parents, and surrogates, are asked at the beginning of their journey. It’s a difficult question but one that needs to be addressed before any matches are made.
Termination, a medical abortion, can be suggested for a variety of reasons. If the health of the surrogate mother is at risk, if there is a malformation of the fetus, or if a multiple pregnancy results in a presumed high risk pregnancy - all of these are considered reasons for termination of a surrogate pregnancy.
No one wants to terminate a pregnancy. But if there is a discord in how each party views termination, it’s simply not a good match.
Marni Denenberg is the Director of Private Client Services at Donor Concierge, helping intended parents find egg donors and gestational surrogates. Marni says prior to matching a gestational surrogate with an intended parent it is essential for the parties to discuss the difficult area of reduction/ termination.
“We ask these questions up front before any profiles are shared. We review the surrogate profile and ask, how does the gestational carrier feel about termination/reduction due to medical concern? Does the intended parent share the same view? Optimal matches occur when the parties mutually agree on all aspects of the gestational surrogacy journey.”
Lisa Schuman, a New York therapist and Director of the Center for Family Building sits her patients down to go through all of these difficult issues, to help them understand the ‘what ifs’. Schuman says that while the lawyers and doctors typically discuss this with the surrogate and the IPs to try to ensure that they are on the same page.
“This is a subject that will come up many times and I have seen some difficult situations. I take a different angle. The surrogacy contract has a laundry list of "what ifs". I say that it's like looking at the back of a Tylenol bottle. The what ifs (like what if the gc falls into a coma, would her partner keep her body alive to save the baby) are so daunting that many people get lulled into the idea that they have covered everything. However, that is not possible. There are two problems. First, there are so many possible problems that you couldn’t possibly list all of them in a contract. Second, there is so much grey area. For example, if all parties agree that the gestational carrier will terminate if the fetus needs to be on life support to survive, what if the doctor said there is a 20% chance or a 60% chance. There are just too many possibilities.”
Schuman, who is also the Director of Mental Health at RMA-Connecticut meets with all parties to discuss which issues fall into the decision making bucket for the carrier and which issues are the responsibility of the IP's. “This way, Schuman says, “if something goes wrong, four people are not trying to decide upon issues that are the responsibility of two people.”
When faced with a crisis, people react in all sorts of ways. Sometimes those reactions even surprise themselves. I have seen this happen and I have seen difficulties arise when the crisis is complicated by the opinions of four people.
Managing a crisis on a journey is a stressful experience at best. The clearer all parties are in the beginning about which decisions belong to which couples, the more likely they are to be able to manage those problems well if they occur.