What does surrogacy counselling cover?

With Repromed Team Counsellor, Helen Nicholson

Surrogacy counselling is intended to inform and support intended parents and surrogates on the process ahead and to explore the relationships you have with one another. It also aims to prepare you for the surrogacy journey including focussing on coping strategies and support systems, as well as discussing the plan for logistics and risk management. There can be many uncertainties along the surrogacy pathway and counselling aims to prepare you to think about some of the possible outcomes before the actual experience. 

Below are three key areas that our highly experienced team will explore to help you so you are well-equipped and empowered ahead of, during and after your surrogacy journey. 

Note, that the Ethics Committee on Assisted Reproductive Technology (ECART) requires surrogates and intended parents to have a minimum of two sessions each with a counsellor before they have a joint session together. There could be further sessions and that will be discussed with both parties at the time, according to needs.

 

1. Introductions and gaining insight 

As a first step, our counsellors get a clear picture of the background of the intended parents and surrogate, not only from a medical and health perspective but also how the surrogacy plan came about. Key information about the legalities will be provided so all parties are well informed from the beginning. 

Here are some of the things we will cover:

  • Discuss medical and mental health history.
  • Explore any current personal transitions or life stressors.
  • Consider coping strategies and support systems – your relationship strengths and people in your life who can anchor you emotionally.
  • Provide information on the legislative framework:
    • The HART Act and a surrogate-born child’s right to know their birth story.
    • Awareness and acceptance of legal issues including general discussion on adoption, the involvement of Oranga Tamariki – Ministry for Children and referral to lawyers experienced in providing legal advice.
  • Explore each parties’ values, beliefs, and expectations:
    • What values are shared and what are different? 
    • Understanding the motivation for the surrogacy offer, i.e. how did the plan come about?

 

2. Defining communication

Clear communication between all involved in a surrogacy arrangement is a key factor in any surrogacy plan. Interpersonal relationships are built and maintained on communication. Good communication builds trust, provides reassurance and understanding and is the ‘glue’ between all the people involved. In counselling, we look at the different stages of a surrogacy arrangement and explore how communication might function in each stage, including:

  • Information sharing between intended parents and surrogate in the planning stages, during a pregnancy and after a baby has been born, if successful: 
    • The mode and frequency of communication.
    • Needs, preferences and boundaries.
  • Communication with others outside the ‘surrogacy team’ including communication with children, such as:
    • How the intended parents’ plan to talk with others and their resultant child about the surrogacy arrangement.
    • The surrogates’ plans to talk to their own children about being a surrogate.
  • Expectations for future contact with the surrogate’s family. This may include discussing:
    • Contact with an egg donor who shares a genetic connection through the surrogacy arrangement. 
    • How much involvement between families each party wants.

3. Making a plan 

Part of surrogacy counselling also includes exploring with you the plans you are making. This includes talking through the following.

Plans for treatment:

  • If you are going through a clinic or doing a traditional surrogacy with home inseminations, we will talk through your plan and what could be expected.
  • The plan includes logistics and what might be pressure points or times of challenge for both parties, such as a surrogate’s availability.
  • We will discuss the uncertainties about what is involved with treatment, and any concerns.

Plans for pregnancy, ante-natal care and delivery: 

  • We will discuss attitudes towards prenatal screening, birth plans and lead maternity carer, and ‘Plan Bs’.
  • We will go through logistics:
    • Attendance at appointments.
    • Managing geographical distance and travel if this is a component of the arrangement.
    • Supporting pregnancy expenses and life insurance for a surrogate, and each parties’ approach to discussing money together and asking for help.

Managing risks:

We will talk about the different outcomes and risks, the anticipated feelings and grief response around each, identifying the support systems for each person and providing clear problem-solving strategies. We will also ensure that both parties agree to the process for resolving disputes during treatment, pregnancy and post-birth. These risks could be: 

  • If there is a change of mind.
  • If a termination of the pregnancy is required. In this instance we would look at each individuals’ views on termination and the circumstances when it may need to be considered and make sure both parties understand the law. 
  • If a surrogate may not relinquish the baby or the intended parents may reject the baby.
  • If there is no pregnancy or the pregnancy ends in loss.

 

We’re here to support you

Surrogacy arrangements can be an intense process, with both highs and lows, and even the most straightforward arrangements and pregnancy experiences can involve complex feelings. 

Each person involved in the arrangement whether they are an intended parent, a surrogate, or an egg donor (if involved), may all experience different feelings at different times. Each person brings to the arrangement their own unique worldview and ideas. Sometimes these are aligned with those of the other people involved and sometimes they are not and this can add complexity, anxiety or stress to an arrangement. 

These highs and lows and difficult feelings are all normal! Our empathic and supportive counsellors are here to support you through the journey, answer questions and provide information when they can. 

 

Get in touch

If you would like to discuss surrogacy as an option for your family, please get in touch with our Donor Team today to schedule an appointment.

Published June 2023.

Megan Black

Nurse Manager

DipNurs

Megan leads the nursing team through the continually changing face of IVF. She works in a multidisciplinary team, providing the essential organization between the doctors and laboratory and ensuring communication between all departments.

Megan started her IVF nursing career in the United Kingdom, working in two large London clinic’s before returning to New Zealand. She is also the Secretary of Fertility Nurses of Australasia.

I love working with people and see nursing as a vocation, not a job. I usually spend my downtime absorbed in a good book and planning my next travel adventure.