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

Jillian’s long two weeks ahead

Wow it’s here already. Today I start my injections for my first IVF cycle.

I’m not really sure how I am feeling – maybe anxious, nervous and even a bit pressured. Not pressured to go through with the cycle –  I would do it ten times if I could!  Pressured because I know I must succeed with this precious cycle. Without Medicare benefits this may well be my only chance.
Many women going through their first cycle are aware of the slim success rate and already start planning a second attempt. For me (and many of you following our blog) a second cycle would be what dreams are made of! Its like winning the lottery!

Unfortunately, we just can’t afford it as is.
In fact, when looking at the statistics, and my chance for success, I almost went straight from thinking about doing my own IVF cycle with my own genetic (but potentially not young enough) eggs, to the “safer financial idea” of a donor IVF cycle, where a younger woman would donate her eggs so we could have a family. I was justifying this idea in my head as “better value for money”.

What was I thinking?

How could I even start thinking that way? My desperation for a child was turning into a financial decision!!! It was only when my mother in law said to me “you don’t want to be left wondering ‘what if…’ ” and she is right. What if? What if my eggs work? I have to find out.
This should be the most exciting two weeks of my life. Many babies are created in a night a passion with those we love the most. But for us the process is far more complicated. For some of us the medication tends to make us somewhat “moody” and for others it’s a breeze. The stress causes arguments in our lives often with our partners who tread on egg shells (pun intended) as they support us over the two weeks it takes to do the stimulation to collect the eggs. Never-the-less, I know our love will withstand these pressures. We made it this far –  there’s no turning back!!!
I have my fingers crossed! Two weeks seems forever, but its going to be positive thinking all the way!!!
To all the amazing people following our blog and supporting our fight –  I thank you. Your support is wonderful.

Are you crazy? Why are you doing this in Australia and not overseas?

So often amongst our community of people accessing surrogacy, we (the women doing altruistic Australian surrogacy) are asked ‘Why do you bother trying to do it here in Australia?’ and ‘Don’t you find it all too hard?’
The truth is, the Australian system really IS making it too hard for couples. Clearly we are in agreement that the law should protect the interests of the child as paramount, and we understand that is the objective of the laws. Yet what in practice is happening is that altruistic surrogacy in Australia is so unclear and challenging – that a money making industry has popped up to ‘assist’ women such as us.

IVF Clinics

Those people that ‘assist’ us are most often lawyers and IVF clinics. The IVF clinics, as you know from this blog, charge an incredible amount of money per attempt of IVF. Between 12 and 18,000 per cycle, with no access to Medicare.

Every clinic has a different approach to the cycle. Some of them will insist on absolutely crazy and detrimental protocols, like egg quarantining. Yes, a clinic can request you to quarantine your donor eggs even though eggs on their own DO NOT work in about 85% or more of cases. Who cares? The IVF clinics are not paid on your successful outcome. So it makes no difference to them if your outcome is successful or not.

Some clinics will have a good process in place to support surrogacy but still insist on a 6 month quarantine of embryos. So after years of struggling, you find you have to wait 6 months before you can even start. This is incredibly frustrating.

Ethics Committees

Then there are the ethics committees. The doctors that have to certify that you are truly eligible for surrogacy. I must say that being certified as infertile is not a pleasant experience. Conversely, I don’t know of too many women that would willingly give up being pregnant either, or who, by choice, would like for someone else to carry their baby. To nourish it and grow it for them. Generally speaking, this is quite a personal task, and one that people like to do themselves, so I don’t quite understand why there is an assumption that women would rush to do surrogacy unless they absolutely had to. Some of us wonder if we will ‘fail’ the ethics committee as we haven’t ‘failed’ enough times in our IVF attempts. It is deeply distressing and the guidelines are not clear, which only makes it more messy.

Then comes our favorite topic –

IVF and Medicare.

Kate, from the blog Our Surrogacy sums it up perfectly.

” A refusal of support to assist something so positive for no real reason other than that I can’t carry the baby myself (was like rubbing salt into the wound).  I have had a hysterectomy under hugely traumatic circumstances.  Otherwise I am a healthy, active, young person desperate to complete our family.  why should I have to pay triple or more what other people would pay for the exact same treatment simply because those other people are infertile in a different way?

When I started to look into it further I discovered that some clinics do give medicare rebates to people who have had a hysterectomy – what??!!   Even amongst the clinics and IVF world here in Australia there is inconsistency.

Kate on her wedding day

Technically I ought to have been entitled to medicare rebates as at the time I had no surrogacy arrangement in place and I could have had a cycle and frozen the embryos to either send overseas or use for surrogacy here later on.  When I called Medicare they agreed that technically, you should only not be entitled to the rebate where a surrogacy arrangement was in place.  But my clinic would not budge.  I would be up for $12,000 minimum for one cycle; no rebate.  I can’t blame them, they were doing things by the book and didn’t want to get into trouble.  But the injustice that other clinics would turn a blind eye and bill the cycle in a different way seemed too much on top of the basic injustice that medicare won’t cover surrogacy.

In comparison, me, my husband and son can all fly to India, stay for almost 3 weeks and get a full IVF cycle with transfer to surrogate for less than that.  Yes we will have the fee to the surrogate and other costs on top of that but so would there be additional costs doing it here.  So, rather than stay here, give business to the IVF clinics here, and perhaps be safer, unfortunately I feel as though my whole family is being forced overseas to pursue something that could have been achieved here had the rules, regulations and costs been a little more user-friendly and accessible.” Read more of her blog here.

Lawyers

To do altruistic surrogacy in Australia, you need to complete a pre-surrogacy contract and then apply for a parenting order post surrogacy. When I first started looking into surrogacy, I met some wonderfully kind lawyers. They seemed so nice. However, I have since found that they spend time making a connection with you as they want to charge around $15,000 – $20,000 for the process. That’s right. They seem so nice and lovely, but by any estimation, that is a lot of money. And if you worked that out on hours….well let’s examine this idea together?

If a top rated lawyer were to charge  $450 an hour then it would be 33 to 44 hours of work. These lawyers are family lawyers. Our local family lawyer charges $250 per hour. So, by that standard we would be looking at even more hours of work. Is this realistic? Honest? When the pre-surrogacy contract is not legally enforceable? When it’s largely a cut and paste of a template that they already have on-hand…can they possibly find themselves doing a week’s worth of work on this project? I have since found lawyers that will charge the reasonable rate of about $750 to $900 for a pre surrogacy arrangement and $5,000 for a post surrogacy arrangement. But I had to really look hard for them because the industry cogs are well in place.

As one lawyer laughingly (but not jokingly, there is a major difference) said to us recently, “$60,000, (his estimated cost of altruistic surrogacy in Australia) Well, anybody can get their hands on that nowdays!” I guess at that rate of pay, it would be a correct statement.

Does this make Australian Surrogacy truly altruistic?

My feeling is that altruistic surrogacy is altruistic for only one person – the lovely lady that offers to carry the baby for you. It seems strange that the woman doing the most vital of all jobs is always the one called on to be the most accountable in terms of financial gain, erstwhile a huge industry cogs its wheels around her, making money at every step. She cannot be given a holiday post birth to celebrate a job well done. She can’t be given more than $10,000 in expenses over the 9 months she is pregnant, including lost wages, or a red flag goes up. So how can a lawyer ask for 15 to 20 thousand? And an IVF clinic 12 to 18,000?

With the confusion and the grey-ness of the law, with the industry that preys on people that need surrogacy in Australia we can see why many opt to go overseas where the laws are clearer and the expenses are laid out clearly and contractually.

We have made a choice. And we want to change the system.

We choose to do altruistic surrogacy in Australia because it’s what is right for us, but we understand why those who opt for overseas options think we are a little crazy. However, maybe we are just the right kind of crazy to get these laws changed enough to make the system fairer for all? To make the system clearer and more honest? We choose to start with the Medicare law, as it’s the most obvious one that needs changing.

Changing the law to make it fairer is worth being a bit crazy about!

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