Surrogacy Myths: The career woman too busy for a family

Is surrogacy a choice? Do women choose to allow another woman to carry their babies because they are too busy to do it themselves?

All too often when we start conversations about surrogacy, certain repeated themes come into the conversation. One of those themes is the idea that surrogacy is a choice. That it is something women may choose to do because they have a solid career and are ‘too busy’ to take the time to gestate their baby. Or they are ‘too old’ because they have ‘spent their lives working on their career’. In other words, people question: ‘why should we support you when you have made bad choices and are now paying the consequences for those choices?’

We heard this myth of the busy career woman in the interview last week with Dr Andrew Pesce, former head of the Australian Medical Association. While we were happy that he supported our cause for equal treatment under the Medicare laws when accessing IVF for surrogacy, we were saddened to hear him bring the ‘mythical career woman’ into the media interview.

Let’s consider this notion for a moment. Just who would this mythical woman be, that would prefer another woman to have her own baby for her? Let’s look at the case of Nicole Kidman as a prime example. Not only is Nicole potentially quite rich, famous and a very busy career woman, but she also used a surrogate to have her daughter Faith Margaret after giving birth to her first child Sunday Rose.


<Image from JustJared.com >

On the surface, Nicole Kidman could be this mythical woman. She could be the busy career woman/ celebrity who is ‘too posh to push’. The obvious question then is: Why did she keep trying so hard to have her own baby?

Kidman spoke to Who magazine about her depression, and repeated pregnancy failures:

“I had tried and failed and failed and failed. Not to be too detailed, but I’ve had an ectopic pregnancy, miscarriages and I’ve had fertility treatments. I’ve done all the stuff you can possibly do to try get pregnant.

Every woman who has been through all those ups and downs knows the depression that comes with it. So the way it just happened with Sunday was like, “What?” The percentages were so low. It is the miracle in my life.”

So if you scratch the surface just a little, any journalist worth their salt can see that there is very likely to be some underlying issues regarding WHY Nicole Kidman choose a surrogate to carry her precious second child into the world. In her own words, Kidman says in an interview with People magazine back in 2007:

“There’s a complicated background to that, given that I never speak much about many things. One day maybe that story will be told.”

Yet many persist in saying she represents this myth of a career woman who isn’t interested in carrying her own baby. We here at Medicareless believe that this example shows that celebrities can have infertility issues too. That just like the rest of the world, being rich or famous does not exempt you from being the 1 person in 6 that will suffer from infertility. In all likelihood, there is a very sound and MEDICAL justification for Nicole and Keith’s decision to use a gestational surrogate to carry their child.

The mythical career woman in Australia

To continue with this analysis – with maternity leave, the expanding right to flexible working arrangements to help modern families with implementations such as working from home or job sharing – what woman would feel the need to use a surrogate to aid her career progression? In fact, Australia topped a list of 128 countries by international consulting and management firm Booz & Company for women’s access to education, equal pay, childcare and anti-discrimination policies. Should the career woman want a baby, she can have it.

And as unfortunate as the facts are – the glass ceiling is alive and well in Australia. So the likelihood that a woman is actually in an extreme position of power that requires her to not take time off to have a baby is extraordinarily low. This shows that if this mythical ‘I can’t afford time to have my own baby’ woman does exist, she is ridiculously rare.

In fact in the Sydney Morning Herald, October 17, 2012, Helen Conway, the director of the federal government’s Equal Opportunity for Women in the Workplace Agency, said:

”In Australia, women hold just 14 per cent of board seats in Australian companies, just five CEOs of our top 200 companies are women and a quarter of our top 200 companies have no women on their boards at all.”

Ms Conway said more than 50 per cent of university graduates in Australia were women, but that had not translated to substantial increases in the percentage of women in corporate leadership positions. ”We are wasting our female talent,” Ms Conway said.

So this collectively imagined mythical woman, at the top of her career and totally focused on her position as CEO or CFO, unfortunately, is an incredible rarity and is not one we should be focusing on when discussing the very real, and very immediate needs of surrogacy patients wanting a family.  This rare case of a woman who is willingly “choosing” surrogacy should not be used as a political vehicle of manipulation to implement rules that deny the majority of genuine patients from medicare benefits.

So if it isn’t career, what are the real issues that require a woman to seek a surrogate to carry a child? We took an informal review from our small community and have made a list of the medical issues that have forced them to seek a surrogate to have a family. Note not one of them lists ‘my thrilling career’ as the reason for surrogacy.

All of these women deserve a chance to do IVF and receive equal treatment under the Medicare law when trying to have a family.

  • Age 35 : Survived cancer twice. Now in remission and wants a family. No children.
  • Age 36 : Severe fibrosis followed by multiple failed IVF cycles. Dr. confirmed that the patient would be unable to fall pregnant when she was 35. No children.
  • Age 31: Emergency hysterectomy aged 26 as a result of eclampsia/organ failure/hemorrhage during childbirth. One child aged 4.
  • Age 34: Severe post-partum hemorrhage and uterine inversion resulting in emergency hysterectomy at 34. Still 34 now with one six month old baby.
  • Age 38: Rare blood clotting disorder that causes deep vein thrombosis when pregnant. 3 failed pregnancies, each resulting in massive clotting with risk of stroke, heart attack, death. Began trying for children at 29. Recently recommended for surrogacy after another failed pregnancy and blood clotting episode. No children.
  • Age 40:  Autoimmune disorder, antiphospholipid antibody syndrome. This caused the death of two of three boys (pregnancies). Now has a mechanical mitral valve after 2 open heart surgeries and is on warfarin which is counter-indicated for pregnancy. One child aged 4.
  • Age 34: Heart-double lung transplant recipient age 24 required due to developing pulmonary hypertension and right heart failure which resulted from a ventricle septal defect at birth. Risks of carrying a child include birth defects, very high risk of miscarriage, kidney failure, very pre-term delivery. No children.
  • Age 30: Cardiomyopathy (heart failure). Patient is healthy on drug therapy but cannot carry a child as she will have a heart attack or stroke and most certainly will die. Additionally the drugs are also not compatible with a developing baby. 21yrs old at age of diagnoses. Have been trying a number of options to have a baby for the past 4 years. No children.
  • Age 38. Heart transplant at age 26 due to a virus. No children but surrogate currently 9 weeks pregnant and all looking good for a birth due 26th November.
  • Age 35: Born without uterus. MRKH syndrome. Diagnosed at 17. No children.
  • Age 29: Hormone positive breast cancer at age of 26, had a mastectomy, did chemo, hercepton and radiotherapy. Cannot risk a pregnancy because of high chance of recurrence and on breast cancer medications that cause deformities when pregnant.
  • Age 35: Marfan Syndrome. Open heart surgery at 32 to replace aortic valve and entire ascending aorta. Life long warfarin therapy which is counter-indicated for pregnancy. Twin boys now aged 3 yrs born through surrogacy at age 35 on 4th and final attempt.
  • Age 27: Numerous clots. Clotting disorders- Antiphospholipid syndrome, prothrombin gene mutation g20210a and lupus. Age 16 when first diagnosed. No children.
  • Age 35: Emergency hysterectomy at 35 during childbirth. Have 10yo and 3yo sons. Did IVF for 6 years to have 2nd son (genetic condition means only 1 out of 8 eggs are viable). “Our daughter is in heaven”.
  • Age 30: Diagnosed with rare autoimmune disease (Takaysu’s Arteritis) at age 24. Waiting for open heart surgery and will be on medication that is counter-indicated for pregnancy. No children.
  • Age 32: MRKH Syndrome born without a uterus. Diagnosed at 17yrs. First gestational surrogacy attempt at 30yrs resulting in 1 child (now 22mths), lost her twin. Second attempt lost baby at 17wks.
  • Age 29: MRKH Syndrome diagnosed at 16 age. No children.
  • Age 42: MRKH Syndrome diagnosed at age 6. Not only not a full kidney but no uterus, no fallopian tubes, no cervix but thankfully has ovaries so did IVF last year & have 6 embryos ‘on ice’.
  • Age 27: Breast cancer, recurrence in lymph nodes when pregnant with son at 26 years old. The cancer was estrogen receptive, so doctors advised to not get pregnant again and that removal of the ovaries was a good idea to lower the estrogen to ensure no more recurrences. Full hysterectomy. One 8 month old child.

If you have been moved by this list, and feel that the Medicare laws that do not allow these women equal access to fertility rebates is unjust, please download and sign our petition before June 5. We welcome your support.

Trewy’s Surrogacy Story

In response to our media story on Channel 9 News Tuesday, 9th April, we received words of encouragement from Trewy and his wife, an ordinary couple facing the difficulty of a surrogacy without Medicare. Trewy decided to share his story for us below.

“After, marrying my wife Rach in October 2010. We discovered Rach has fertility problems.

Fertility problems in Australia are not rare with 1 in 8 couples needing treatment. However, Rach has a more rare and costly medical condition which prevents her body from producing eggs. No eggs, is a not a big problem. If you have a family friend you could be lucky. If you wait for donor eggs in Australia, it will take about 5 to 6 years according to the doctors.

[Moderator note – http://www.eggdonationaustralia.com.au is an excellent not for profit site dedicated to egg donation in Australia and recipients can find donors within a few months, so for those needing an egg donor, don’t lose hope and don’t believe the doctors!]

Rach and I have been lucky to find an egg donor and harvest three eggs at a cost of $12500. This was a straight out-of-pocket expense and not covered by our private health or anything. It’s worth noting that in Australia, no money is allowed to be paid to an egg donor.

I thought having three 3day old embryos (3 potential children), our hurdles and dramas would be over. Sadly, it was just the beginning. After months of drugs and money being used to try and get Rach ready to have an embryo transferred,  we have only managed to kill one of our potential children, kill my equity in our beautiful home, beat up our credit card and become ever so saddened by our grim outcome.

See the IVF train is a slow and expensive train. Suddenly, your life goes from a newly married couple to counting down days till the next cycle of drugs, and loads and loads of tests with more and more delays.

Financial stress plus emotional stress can start to beat you up. I would be lying if I said “I have never considered divorce’’. I would even give up my house, even body swap with a terminally ill person, if only I could have a son who could catch a ball with me. A son to share his first beer. Sadly, if I bear no children, then there will be no grandchildren either. All I can look forward to is a lonely retirement.

This is where you can help. IVF is a kind of high risk investment. Except IVF investment is a rule breaker as it is investment with emotion. I don’t want to be father of the year, just a father.

This year we are switching from IVF to surrogacy. Sadly, life makes Rach a poor microwave. Rach has found a surrogate. A person, who will not receive money for their priceless gift, to us. Sadly, the costs of surrogacy are about $60000 to $80000. This is lawyer costs to create the legal surrogacy agreement (2 lawyers $15000 each). The costs of counseling, insurance to be able to obtain a parentage order under the surrogacy agreement. Then all the medical costs that are not covered by Medicare or our useless private health which follows the laws set out by Medicare.

Morally, I feel obliged to continue with this course of action, because those two embryos are technically alive and just frozen. Even after this process we may not have a child. I’m sure the cost would double if we are lucky to use both embryos.

I have begged the banks for a low interest loan, and even contacted my superannuation to help cover the $60000 for surrogacy. I have not been very successful. So, goodbye dream home and boat. Sadly, the dream of having a family is killing my dream of financial security. However, you never know…..I could win lotto.

How can two tax paying government employees with private health cover and a small mortgage be forgotten? We’ve never received a government handout, and we’ve paid all of our HECs debts. We have been described by our friends as the ‘unlucky couple in the lucky country’.

How can you help? I have no idea. Bring attention to this situation, government assistance, I remember former Prime Minister Kevin Rudd, giving a speech containing the word family. Family first and family this. Well, after I’ve written letters to Labor, Liberal governments both state and Federal, I’m sad to say that no replies have been received.

If I do make it through this nightmare. I really wanted to take the egg donor, surrogate and wife –  hopefully with a child or children-  on a holiday. To thank them for their commitment to my family. However, with the cost of things coming, I may have to wait a while. A long while. Perhaps a lifetime.

Thank you for taking the time to read my story.

Trewy”

Of course, we know how you can help people like Trewy. Sign our petition for change, and send an email to Tanya Plibersek and other members for parliament. Choose from any of our ready- made email formats from the Resources tab.

Together, we can make this change, and help ordinary working couples become families. As you know we are starting to receive replies and are receiving media attention, so as a group we are making an impact – where before we were solo travelers, losing hope on our own voyages. Too many have been silent for too long!

Small Win – Medicare Rebates for ICSI

When I started working on this campaign I did quite a lot of research on the Medicare Rebates relating to IVF and surrogacy. During my research I noted that the Health Insurance (General Medical Services Table) Regulations 2011 excluded Medicare rebates for item numbers 13200-13221. In the Medicare Benefits Schedule these item numbers related to various IVF procedures.

What I also noticed that ICSI (the process of inserting the sperm directly into the egg) was item number 13251. As you can see not one of the item numbers excluded from the Medicare rebates. So I asked my fertility clinic if I could receive a receipt so I could claim my rebate. They denied me.

So I rang and wrote to Medicare asking for assistance. They initially advised that all IVF treatments used for surrogacy were excluded from the rebate. I pointed out to them that this is not what the law says. So they referred my concerns to the Department of Health and Aging.

I am pleased to say, that today I have received written advice from the Department saying that my understanding of the law is correct and that I am entitled to a rebate for ICSI.

If anyone else used ICSI for their embryo creation, I’d encourage you to ask your clinic to bill you separately for this treatment so you can claim your rebate from Medicare. If you have any issues I’d encourage you to print out this letter and show your clinic, or when you ring Medicare.

This is a great small win for us!

It also poses more questions. Why are all other IVF treatments excluded for Medicare rebates but this one is not? I think this just adds to our argument that we should be receiving the full rebates.

Don’t give up everyone, I feel a change just around the corner. 🙂

Letter from Dept Health & Aging

Response from Department of Health & Ageing

Today we received a promising response from the Department of Health and Ageing.

Firstly they “commended” us for the work we are doing to create awareness about the Medicare laws as they relate to surrogacy.

Secondly they reiterated that they are committed to medically necessary services to the public and are therefore actively considering the issues raised in the surrogacy paper. They have advised that I am welcome to contact them to see how this work is progressing and provided the contact Ms Mary Warner, Director of Medical Services.

I am so proud of this response and hope that they are sincere in their response.

Please continue the great work you are all doing in creating awareness about this issue, great joint effort.

Letter from Dept Health & Aging

Holly’s Story

Holly & Ash

Holly & Ash

At age 14 i was diagnosed with a severe mullerian anomaly with a unicornuate uterus and severe endometriosis. The endometriosis drowned my fallopian tubes and one ovary. What i was left with was half a uterus, one ovary that was not connected, one kidney and no cervix. At 14 years old this was devastating. At 18 I met Ash (23), he was beautifiul, kind and supportive. Like any normal couple our age we had a normal lifestyle, normal paying jobs and a house loan but there was just one thing missing, a child. 6 operations later the news I received was heart breaking ” I’m so sorry Holly, there is nothing more we can do” Surrogacy was our only option. I spent months resaeaching how to go about it and what to do. My gorgeous mum was the first person to offer, it was like a dream come true. Sadly Mum was diagnosed with hormone related cancer and was no longer able to carry our baby. Six months later a wonderful woman offered to carry my baby. The words estatic and overjoyed don’t even come close to what we were feeling! However those feeling didn’t last long when we were told that medicare wouldn’t cover us for IVF. We are looking at around $15,000 – $20,000. As a normal young couple this just seemed out of reach. Medicare cover everyone else for IVF but will not cover us. Not only do we have $15-20,000 for IVF but we also have another $20,000 + for other surrogacy involved costs. It is my understanding that when Medicare made this decision surrogacy was illegal, now that surrogace IS legal here in Australia the outdated laws need to change. So over all i feel discriminated against and think this is greatly unfair. Please change the law so that us and couples like us can be blessed with a family

General IVF Costs vs Surrogacy IVF Costs

Where ART is required to create embryos, provided a surrogate is not used, Medicare financially assists families by providing rebates. This is regardless as to whether the couples own sperm and eggs are used, they use donor sperm and eggs or a combination of both. Provided a surrogate is not used to carry the embryo Medicare will provide a rebate. These rebates are paid in accordance with the Medicare Benefits Schedule (MBS) and are not means tested.

Below is a table showing the average out of pocket expenses, couples can expect to pay when they do not use a surrogate:

IVF Australia, IVF Treatment Costs, http://ivf.com.au/ivf-fees/ivf-costs (February 2013)

IVF Australia, IVF Treatment Costs, http://ivf.com.au/ivf-fees/ivf-costs (February 2013)

Medicare does not provide a rebate for hospital related services, such as egg collection and embryo transfer. However Medicare may provide a rebate for the anaesthetist and those with private health may be eligible for a rebate from their fund. Out of pocket expenses for hospital related services range from $1,000 to $2,400 depending on whether the couple has private health cover.

With the assistance of Medicare, couples can expect to pay a total of $3500 to $5000 per full cycle.

There is no limit to how many cycles a couple may undertake during a year. In fact, the more cycles a couple does each year, the more Medicare will pay. When couples reach their annual threshold, the Extended Medicare Safety Net (EMSN) provides an additional rebate. Given it is usually necessary for a woman to have 3-5 IVF cycles before a successful pregnancy occurs , this can result in Medicare contributing $7,500 to $13,500.

Where a surrogate is used, Medicare does not provide any rebate for the IVF cycle. This is regardless of whether the couple use their own eggs and sperm to create the embryos or where donor eggs and sperm are used. Couples using a surrogate to carry their embryo can expect to pay between $16,000 – $18,000 for a single IVF cycle. In addition to these expenses couples using surrogates have legal costs, counselling costs and the usual pregnancy costs. Couples can expect to spend up to $60,000, provided their surrogate gets pregnant within the first or subsequent IVF cycle.

Why is it ok for the Government to help women with fertility issues but who can still carry their babies but not help women who cannot carry their own babies? There is no extra costs or extra procedures involved when a surrogate is used. The IVF procedure is exactly the same, except the embryo goes into another woman not the same woman.

For me personally I have never used IVF. I had no fertility issues. I had cancer, hysterectomy thats it. Can no longer carry my baby. I have just completed my first round of IVF. So far it has cost me almost $17,000. I only got 2 embryos. One embryo is currently, hopefully, growing in my surrogate. The other embryo is on ice. So I only got 2 shots. We cannot afford another $17,000. This is it for us.

If I had my own uterus. So far I would be out of pocket about $4000. The pressure would not be as great for one of these two embryos to become a baby, because we could have another go. We could afford another $4000. In fact 3 rounds of IVF with Medicare rebates would be less than what I have paid so far for 1 round.

Just seems so unfair to me. Why should I be treated differently to so many of my friends who have done IVF. Why should I not get a shot of having the family I always dreamed of?

These laws need to change. Equal access to Medicare Rebates to all those doing IVF!

51 Letters sent to Australian Politicians and other Community Groups

Thanks to our group who is campaigning to change the unfair Medicare laws, we have managed to send 51 letters to politicians and other community groups in a few days. Well done everyone!

But this is not enough!! If we want to be heard its going to take a lot more than 51 letters. I urge you all send letters to your politicians. We have made it easy for you, we have included template letters and contact details for many politicians.

Here is a link where you can see who has sent what letters and the responses we have received so far. Letters sent and Response to date