Stop 1: California

Firstly – Happy New Year! To those of you at home in Australia, it is already 2016, while I still have a couple of hours left in 2015. It is very strange to think that you are already in tomorrow!  This year has ended in a whirlwind for me – I can barely believe how fast the past few months have gone.

But to work!  The past few days held some incredible meetings with some amazing people.  I feel so grateful to everyone who has shared their time and expertise with me already (and not just those I have met face to face, but also those who have already “met” me by Skype over the past few months).

I should start by making the observation that I am NOT encouraging any Australians to travel overseas to engage a donor or a surrogate.  These services are available, legally, at home.  From where I work and live in Queensland, if you travel overseas to engage these services you are breaking the law, and the offence is significant.  Rather, I am reporting the information I have gleaned from people in the industry here.  For anyone who chooses to travel overseas for treatment, please at least do it safely and knowledgeably!

So far I have been struck by the similarity in what I am hearing – whether I am speaking to a lawyer, a doctor, and counsellor or an agency service provider.  And the message is this:

Firstly: Many, many Australians are coming to California each year to engage donors and/or surrogates.  Each of the service providers I have spoken to indicate that a significant proportion of their work involves Australian clients (one person indicated that 40% of their business is coming from Australians).  This number has decreased in the past couple of years (probably due to the significant costs, and the poorly performing Australian dollar,  and the availability of other (Asian) clinics), but recent international developments (in surrogacy availability) mean that there is an expectation that the numbers will begin to climb again soon.

Secondly: The majority of Australians (seen by the professionals I spoke to) seek some form of ongoing relationship with their surrogates, and often also with their donors (if they use one).  It was generally indicated that Australians are very open regarding ongoing contact and value the opportunity to let their child/ren grown up knowing the women (not so much the case with sperm donors, but this seems to be an interesting historical trend) who were involved in helping them to be born.  This surprised me, as I think that there is a general assumption at home that anonymity is one of the key reasons Australians are travelling overseas for surrogacy/donor treatment (maybe those that want anonymous relationships are just choosing other destinations than California??).

So perhaps there is another question to answer there: why do they come to California? The simple answer is availability.  It certainly seems to be the case that Australians who travel do NOT feel that they can find a suitable donor or surrogate at home.

Thirdly: There is an increasing number of medical practitioners who are advocating for fertility treatment which is much more like what you would expect to see in Australia. That is, (comparatively) lower intervention (such as only using treatments like PGD when it is really indicated) and encouraging single embryo transfers (with a real focus on reducing the risks associated with multiple pregnancies).  I was really heartened to hear this, and I think it is incredibly important that anyone who chooses to travel thinks carefully about the medical advice they received at home from their local fertility specialists.  If you would choose to undertake medical treatment one way at home, why would you suddenly make very different decisions overseas?

Fourthly: The system is incredibly confusing for someone accustomed to the Australian fertility system.  Even with the advance knowledge that there was a very different system, I found figuring out “who’s who at the zoo” to be really very difficult.  And there are a lot of interconnections (sometimes very nepotistic ones, and not in a good way!)  You really need to spend time understanding which surrogacy and/or donor agencies will take good care of you, and they can help to guide you to legal, medical and counsellor services. But do your research here separately as well. It’s probably best if there is a level of independence between the services.  And all of this is further complicated by the state by state differences, and a general lack of regulation.  The primary constraints appear to relate to management of ESCROW funds (a type of trust fund that manages any monies paid to agencies in advance for services) and this has been regulated only very recently, and only in response to some really serious embezzlement of funds by some agency owners over the past few years – dodgy stuff!

Finally: I did learn about one surrogacy agency that provides what seems to be gold standard care to intending parents (IPs) and to surrogates.  Unlike many agencies who focus on an initial assessment of the parties, then seem to drop the ball a bit with the ongoing support, this agency provides ongoing support for as long as 18 months – through the assessment phase, right through the pregnancy and then through the post partum.  They provide regular check-ins to ensure all is ok, help with any ‘relationship management’ between the IPs and the surrogates and generally make sure everyone is doing ok.  I love this model.  It is totally congruent with my own belief that as long as everyone is communicating, and problems/concerns are being aired, then everything can be managed and will end up ok in the end.  I would love this to be the standard at home as well, and will be following up on what we can do to make this a “normal” part of Australian surrogacy practice.

The key advice for those that choose to undertake donor/surrogacy treatment in California, is that if you are going to do it, do it “right”.  Take care in choosing the agency that will provide you with support, andhelp you to find your donor/surrogate and choose a doctor with a good reputation.  If you try to save money you are probably cutting some dangerous corners.

Particular thanks to Dr Michael Feinman, Hilary Hanafin, Andy Vorzimer, Andrea Bryman, Rich Vaughan and Robin Newman who all gave me a significant amount of their time and knowledge.  Particular thanks to Robin for giving me advice on what NOT to do (see my next post) and to Andrea who gently tolerated a fair amount of my tears during our meeting – Andrea had the misfortune of meeting with me in the midst of a terrible attack of homesickness, and was very kind in taking good care of me at a tough moment.

And (somewhat) tangentially, while I was in LA, I was lucky to spend a morning exploring the Los Angeles County Museum of Art (LACMA).  In between my joy at seeing incredible works by Mondrian, Dali, and so many others, I was struck by how many of the works reinforce our concept of “womanhood” equalling “motherhood”.  It made me think (again) about how much pressure there is to have a family.  I am sharing the images of a few of those works here.