Surrogacy in Australia

1) Medicare needs to be given to women undergoing IVF for surrogacy to make it easier for people to conduct surrogacy in Australia where we have superior medical facilities and surrogacy is conducted among economic equals. Read this blog to see real life surrogacy stories. We are everyday women who deserve the chance of a family just like anyone else.

2) People are heading overseas to Thailand etc, in part, because Australia makes it so hard. It’s complicated, and there are not enough protections for Intended Parents or Surrogates. There needs to be clearer regulation to ensure that a surrogate and a surrogacy patient understand what their rights and responsibilities are. Banning surrogacy is not the solution – it will only drive it underground.

3) Altruistic surrogacy is legal in Australia, after careful screening with psychological reports & in many cases police checks. Parents need to be deemed suitable, as do surrogates. A judge awards the parenting order after the baby is born, in a court.

4) We have a community of women undergoing surrogacy who all have legitimate medical reasons for needing surrogacy.  We are cancer survivors, or born without a functional uterus, or have some other serious medical condition that means we rely on the goodwill of another woman to have a baby. Our community supports women through cancer – we have giant pink ribbon days and our sportsmen wear pink – then what? We survive, thrive and want to have a family, and our community stops supporting them – there is no Medicare available when you want to have a family. This is clearly unfair and needs to change.

5) In Australia, discussions about genetic abnormalities and the risks in birth are completed with a psychologist and written in a contract. The baby Gammy story would not happen because we ensure that there is support for all involved. This is why we need to make surrogacy easier in Australia. A good start is giving women Medicare for IVF procedures for surrogacy.

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.

Alisa’s story – a cancer survivor who wants a family

In 2008, a week away from our 1st wedding anniversary I was thrown into a severe
round of chemo, radiation and brachytherapy. I was diagnosed with a very aggressive
and severe form of lung cancer that on very rare occasions attacks the cervix, which is what happened to me. I was given a 20% chance of survival regardless of my treatment, so it all looked pretty bleak.


<Image from: Journeying Beyond Cancer >

I managed to get through it with the help of family, friends and my wonderful
husband who made me laugh every day, I’m not sure how, but he did.

I don’t remember much of that time now, I did a lot of sleeping, crying and trying to
eat. I was determined not to lose too much weight as I’m quite slender to start with. I
guess you can say I was quite determined to stay alive. I still have everything intact,
but am unable to conceive or carry, which makes it very upsetting. For some reason
the choice to have my own family has been taken away from me. I am now 4 years in
remission. Right now we are looking very good. So I just want to get on with my life and that means following my dreams for a family.

Troy and I have wanted a family for years, even before we got married, but I wanted to be married first as I thought it was the right thing to do. We have nieces and nephews and so many friends with kids, and we just know that having a child will bring us so much joy.


So… after many years we are up to the surrogacy stage. Yes, it’s taken that long to get through the egg donation. We had a few offers from egg donations, but for one reason or another, they were not medically fit or time passed and we didn’t hear from them again and other ladies were helping someone else. And we’ve had a lot of stumbles too.

We eventually found a lovely lady and have 5 embryo’s freezing awaiting a surrogate.
The six month sterilization period will be up at the start of July, 2013.

We have been very fortunate to have had 3 surrogates offer, but for one reason or
another it hasn’t worked out. We are hopeful that someone out there will be able to
help.

At times we have been quite upset with the whole process to be honest and feel very lost and alone. It’s been extremely expensive so far, from taking intended egg donors and surrogates to the Dr’s – only to find that the lovely people who have offered are not “medically fit” to go ahead with, and the expense of traveling on many occasions. There’s no Medicare for any procedures so every time we start this process with someone new I am out of pocket again. And again. And Again. Still, we can’t let go of our dreams. We’ve come so far to get to this stage that we can’t just give up now.

We have also had a lot of trouble with the clinic we have been going to. Wanting
us to do things a certain way which doesn’t fit our situation, well to be frank, wouldn’t fit anyone’s situation. I won’t go into details. It’s caused a great deal of stress, but fortunately not on our relationship. The last couple of years have definitely brought us closer together.

We still have our eyes on the prize so to speak and know that we will eventually get
there. We are quite patient and know that an angel surrogate will help soon enough.

We have sooo much love to give it’s not funny. I think our cat is going slightly crazy from all the cuddles and attention it gets! Troy loves sports and I just know he can’t wait to have a child to go surfing or play football with, and I love baking and can’t wait to make special treats and birthday cakes for my much longed for child. We’ve got a big backyard planned for a pool and cubby house, and a lovely house we are slowly renovating and can’t wait for the day that we bring our newest member of the family home to share it with.

Our parents on the other hand are on another level!! They are already buying things! I’ve told them to slow down, but they are excited that we have the embryos and it’s only a matter of time and determination and we will find a surrogate.

Alisa

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If you would like to help Alisa as a surrogate, please get in contact with us via the Facebook page (linked at right). You can also support us by downloading the petition and collecting signatures – to help cancer survivors gain equal access to Medicare to have a family.

Dr Andrew Pesce: Medicareless petition will get the government to react

Dr Andrew Pesce, former head of the Australian Medical Association (AMA) and Jillian Spears, a surrogacy patient, were interviewed by 4BC radio in Brisbane on Monday, 15th April. In the interview, Dr. Pesce agreed that the Medicareless petition to change Medicare laws would get the government to react. The aim of the petition it to provide equal treatment under the law for all IVF patients, including surrogacy.

“The AMA’s position has always been where a procedure is lawful, and it is clinically necessary, the AMA believes that the whole principle of Medicare is to make sure that clinically necessary and lawful services are made available to people that need them. So this would certainly fall into that category,” he said.

The AMA represents the interests of more than 27,000 medical practitioners from all specialties and locations across Australia.

andrew-pesce

Listen the entire interview here

Partial transcript below:
Why no rebate?
“I think it’s just a historical fact, there’s probably been a slow evolution of what technology has been available for people and surrogacy only came into clinical use probably some time after the rebates were set. Governments tend to have a policy that until they make a specific decision that until they are refundable through Medicare then they aren’t. That’s why a lot of new treatments often are outside Medicare rebates. And leaves us in what is quite an anomolous situation.

Wouldn’t surrogacy give some women a better option than IVF?

There is no doubt that for some women their only option is surrogacy……Now I have to say I wasn’t available to listen to your discussion with Jillian so I have absolutely no background to her medical illness and story.

Well basically due to illness, her, and her other friends, well, she lost her womb.

Well obviously, she can’t carry a baby so there is no option for her other than there being a surrogate to carry the embryo on her behalf if she was able to donate eggs to be fertilized with her partner’s semen. So for her it is the only option.

For various other people, normally most couples would try very, very hard and exhaust all possibilities of carrying their own babies themselves, and only consider surrogacy if it seems to be the only option left available to them.

It seems really expensive doesn’t it. I mean, the average cost of a legal surrogacy is around $60,000.

In which country are you talking?

Obviously here in Australia.

So, I am not involved in the fertility industry. I guess this is in addition to the normal IVF costs, I guess it is because you need to pay for the time and pain and other things associated with the other things of having another person having a baby on your behalf. Look, I am not sure how those costs have evolved, but it certainly does sound expensive.

As the former AMA president, would you see with this petition, that there’s potential that the government may react at last and that the government may do something about this and provide some kind of rebate?

Oh, yes, I think so. The AMA’s position has always been where a procedure is lawful, and it is clinically necessary, the AMA believes that the whole principle of Medicare is to make sure that clinically necessary and lawful services are made available to people that need them. So this would certainly fall into that category.

There are some other times when surrogacy might be requested where there isn’t a medical necessity for it. Let’s just say for argument’s sake there was a woman who was too busy in her career to take the time off to become pregnant and wanted someone else to carry her baby. I think some people might say there are some examples where we could think that we don’t that taxpayer dollars are necessarily best invested. But I think that most people would agree when it’s the only option available for a couple that are desperate to have children, I think most people would be comfortable with Medicare covering it.

Channel 9 – The Today Show

For those who missed the live show, please click on the link to see us on the Today Show, Wednesday 10th April, 2013 – The Medicare loophole.

We are happy to have had the opportunity to engage with the Australian community through the Today show this morning. We are interested in any other mediums to share our story, to let people know that it is ordinary Australians that are impacted by this discrepancy in the Medicare legislation that forces surrogacy patients to pay double or triple the amount for IVF treatment as compared to other citizens.

Feel free to contact us through this blog or our Facebook page https://www.facebook.com/Medicareless 

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!

The murky waters of Medicare – Why we should update the law

The Medicare legislation is not clear in relation to rebates for medically necessary IVF. It states that if you are in an agreement to do surrogacy, you are not eligible for surrogacy. (Clause 2.37.7)

However, what if you are NOT in an agreement – say, you haven’t found a surrogate yet? Or you have just had a hysterectomy or you have just survived cancer and now you want to preserve your eggs so you have a chance of having a family?

If you are not in an agreement, and are not subject to an agreement – technically, you should be able to do an IVF cycle and be treated just like any other couple.

Unfortunately, NO.

Medicare recently replied to one of our campaigners and stated that ‘because a birth would require an ‘intended’ surrogacy’ they could not provide a rebate. However, this is clearly an interpretation of the law, and is not what the law expresses in the legislation.

Medicare state that they are committed to health services and ‘are currently looking into changes but they are NOT expected in the short term.’

This is why we are here campaigning. Now the law is being interpreted rather than expressly clarified – and it is open to interpretation at the clinic too.

Clinics are left to interpret the law, and as we have seen in the ICSI debate in an earlier posting, it means that even when surrogacy candidates are allowed to have a Medicare rebate, clinics will err on the side of NOT giving them.

We would like to clear up this mess. We would like to see IVF rebates provided equally to women who have a uterus or those who do not. Equal treatment under the law is a basic tenant of our society and we want to change the Medicare laws to reflect that.

We hope to have your support by either downloading the Petition in the files section and/or writing to your local member of parliarment and Tanya Plibersek.