Let’s start by clearing one thing up right away – make no mistake, all surrogacy is compassionate. Any woman who agrees to be a gestational carrier rightly deserves to be called compassionate.
But aside from using the term compassionate to describe the kindness of a woman willing to dedicate her body to having a baby for someone else, it’s also a term used to describe a particular kind of surrogacy – surrogacy in which the woman receives no compensation for her time and effort carrying a baby. Uncompensated surrogacy is also sometimes called altruistic surrogacy (and again, all women who carry children for others can be described as altruistic, but in the infertility world, altruistic surrogacy is a term used when a woman receives no payment).
Compassionate surrogacy is by far the most common in, though certainly not limited to, cases in which a woman carries a baby for a family member or a friend. In these situations she has an already-existing close tie to the infertile (or male) couple and offers to help them as their gestational carrier. While a woman who undertakes a compassionate surrogacy does not receive payment, she may be reimbursed for any actual costs she incurs during the pregnancy and delivery such as co-pays, deductibles, charges for prescriptions, etc. and she could be reimbursed for lost wages in the case of bed rest or for the cost of child care should she need it due to the pregnancy. Each case is individual.
It’s also important to understand that just because a woman and a couple undertake a compassionate surrogacy arrangement and are family or close friends, it does not alleviate the requirement for a full contract between the two parties. In fact, the contract for a compassionate surrogacy and a compensated surrogacy should be identical, with the exception of the section on payment amounts and method.
Also, intended parents and gestational carriers who undertake a compassionate surrogacy agreement should conform to the usual steps taken when there is payment involved, in order to protect each of the parties. These measures include psychological screening prior to beginning a cycle, review of the surrogacy contract by an attorney who represents the gestational carrier, as well as candid discussion on issues such as the number of embryos to transfer, views on selective reduction and termination, desired contact during the pregnancy and afterward, etc.
There is no doubt that a woman who undertakes compassionate surrogacy is giving a couple an incredibly generous gift, one that can never be repaid. This does not mean, though, that a woman who seeks compensation for her services as a gestational carrier is any less kind or should feel selfish in any way. Since most couples and carriers who work together are strangers at the outset, the fact that payment is conferred helps ensure that both parties feel good about their role in the process. Intended parents need not feel like they’re taking advantage of the woman who’s dedicating her body to their child, and the surrogate mother need not feel taken advantage of. Each party has their own end benefits with a compensated surrogacy agreement.
Also consider that pregnancy and birth, just by their very nature, can be a complex and somewhat risky process. When a woman carries a baby for someone who is a stranger to her at the outset, the compensation arrangement (along with good medical insurance and a life insurance policy) can help offset and mitigate the risk.
Compassionate or altruistic surrogacy is truly one of the most profound gifts anyone could offer to another person, and it’s very likely to be a beautiful and rewarding experience for all parties involved. If you’re considering this kind of arrangement though, just be sure to treat the process with the same amount of care, reflection, dialogue, and legal protection that you would put into an agreement with someone you didn’t know so well, in order to protect all of the parties involved.
Though it may seem like a lot of hoops to jump through with someone you already know and feel comfortable with, it’s a small step to ensure peace of mind and a happy outcome for everyone.