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Where have all the surrogates gone?

June 4, 2021, 12:00 PM UTC

As we begin to enter the post-pandemic era, hitting life’s play button once again, couples hoping to start families with the help of surrogates are doing the opposite: They are hitting the pause button, with some even forced to hit stop.

While during the height of the pandemic, the world saw intended parents—parents whose children are delivered by surrogates—unable to retrieve their newborns because of lockdowns, now a new roadblock has emerged: There aren’t enough surrogates.

The pandemic-fueled roller coaster

According to surrogacy agencies across the country, the number of available surrogates has gone up and down like a roller coaster since the onset of the pandemic; so too, have the number of intended parents seeking surrogacy. 

“When the country shut down in mid-March [2020], there was silence,” says Diane Hinson, owner and founder of Creative Family Connections in Washington, D.C., which matches U.S.-based surrogates with intended parents from all over the world. “We heard from nobody—the surrogates, the candidates, the parents,” she says. Considered nonessential medical facilities, many fertility clinics shut down for a period of time at the beginning of the pandemic, some longer than others. 

Then, by summer of 2020, surrogacy agencies saw an increase in the number of women applying to be surrogates—but not because they “needed the money,” says Karen Schafer, CEO of United Surrogacy in Boise. Legally in the U.S., surrogates cannot offer to carry a child for money; compensation is for their “pain and suffering.” The American Society for Reproductive Medicine (ASRM) requires surrogates to be between the ages of 21 and 43, and have had at least one full-term healthy pregnancy and delivery but no more than five. 

The uptick that Schafer saw was more about time: “These young women were out of work as a result of pandemic layoffs; they were home with their children and had time on their hands.” 

By this point, however, a large percentage of intended parents were holding off on starting their surrogacy journeys. “The fact that our surrogate candidates were coming back sooner than new, prospective parents meant that we were whittling down our wait time for [existing intended] parents,” says Hinson. Her agency’s wait times dropped from a pre-pandemic nine months to four, the lowest numbers in the company’s 20-year history.

“Their eyes would light up,” says Hinson of the shorter wait times she was able to quote her intended parents. “They were just gleeful.”

And then there were those who waited.

Already a confusing, emotionally draining, and expensive process—ranging from $75,000 to $200,000 or higher depending on a number of variables including where the surrogacy agency is located and whether the surrogate is carrying multiples—individuals and couples unable to conceive naturally have found that building a family through surrogacy in 2021 is tougher than ever. More than a year after the height of the pandemic, surrogates have disappeared again, leading to longer waiting periods for intended parents to find a match. 

“Some of the prospective parents have said to me,Yeah, we didn’t really start the journey while COVID-19 was at its height, and now in retrospect we’re wondering if we should have,’” says Hinson of the conversations she’s having with intended parents who are lately, as we enter a post-pandemic world, being quoted much longer wait times. Creative Family Connections is now quoting intended parents six to nine months, twice the wait times of last spring.

Where did all the surrogates go?

“The number of women exploring gestational surrogacy has dramatically decreased,” says Tina Dettlaff, managing principal at the Surrogacy Experience, based in New Jersey. It’s “more than a 60% decrease from previous years.” Dettlaff says her agency, which works with surrogates all over the U.S. and intended parents from all over the world, currently has a 10- to 12-month waiting period for new intended parents to start the matching process.

“Pre-pandemic, as an agency, I was quoting intended parents three to four months before I could match them with a surrogate. In 2020, during the pandemic, it was one to two months. Now it’s seven to eight months or longer,” says Boise-based Schafer. Dubbed the surrogacy capital of America, one in 15 children born at Boise’s largest hospital is delivered by a surrogate. 

“We usually see an uptick in applications for surrogates in the spring, but this year, it’s flat,” she says. 

With the world reopening, last year’s glut of surrogates have dispersed. Schafer says as the vaccine became available, some of her surrogates began pulling their spring, summer, and even fall availability. Their reasons included taking family vacations and visiting long-unseen relatives. Many surrogacy contracts include a yearlong commitment that limits surrogate travel for medical reasons only.

Dettlaff says some of her surrogates “simply just want to wait until things settle down,” while others are working from home while homeschooling their children and “have too many other commitments to start a journey.” Still others remain nervous about the risks of contracting COVID-19, or their spouses are worried about increased pregnancy risks as a result of the virus, says Dettlaff. 

But for those surrogates who are ready, often the vaccine is the dealbreaker. “For our agency, approximately 90% of our intended parents are requiring that a gestational carrier get the COVID-19 vaccine prior to starting a surrogacy journey, while only 10% of the carriers we are working with are willing to get the vaccine,” says Dettlaff. “The political viewpoints are causing a huge expectation gap.” 

For Growing Generations, a national surrogacy agency based in Los Angeles, the wait times being quoted are “a little longer” than those pre-pandemic. But Kim Bergman, a senior partner in the company, says it’s less about surrogates not wanting to be vaccinated and more about finding surrogates and intended parents who are like-minded about the vaccine while also matching in other respects. 

“By and large our intended parents do want surrogates to be COVID vaccinated,” says Bergman, and 75% of its surrogates are. However, “we actually have just had to turn down—for one set of intended parents—four or five surrogates because they’ve all been vaccinated and these parents don’t want their surrogate vaccinated.”

But the key delay issue, says Bergman, who wrote Your Future Family: The Essential Guide to Assisted Reproduction, is about standards, not applicant numbers. Some of the agency’s standards, she says, “have become harder to meet during COVID.” For one, the surrogate and her family need to meet the agency’s income requirements. “And unfortunately, through no fault of their own, there are certainly surrogates and their husbands who have lost their employment because of COVID, and they no longer meet our financial requirements, which we don’t waive,” Bergman says. 

Stress levels are another factor; the pandemic has increased stress levels for a lot of her agency’s surrogates, even those who meet its income requirements. “Children have to be homeschooled, or they’ve lost relatives who were there to support them in the past,” says Bergman, who adds that the stress requirement is there to protect the surrogate. “We want to be really certain that the process is not going to do any harm to her; that it’s not going to increase or add a level of stress that will be deleterious to her health, mental and physical and any other way.”

‘Family is important’

Pew Research reports a 4% decline in the number of births in 2020 as a result of the pandemic. “A look at December 2020—the month when babies conceived at the beginning of the pandemic would have been born—shows an 8% decline from the previous December, suggesting that women may have postponed pregnancies in response to the ongoing public health crisis,” the report notes. 

But while Pew is projecting close to 300,000 fewer births in the U.S. in 2021, Hinson is witnessing a flurry of activity, which she says began in late May 2020 when the clinics reopened. Many intended parents who had already started the surrogacy process were able to finally return to their surrogacy journeys. “Any transfer cycles that were even mid-cycle were shut down,” says Hinson. Then, when clinics reopened, “all the transfers that stopped, restarted. And those who were waiting to start, started.” Forty weeks later, between March and May and even into early June, all those babies started being born. We’re having “a little baby boom,” says Hinson. 

And she believes that as the world continues to open up, the influx of intended parents will continue: “The fact is that people who have put it off are now saying, ‘Now’s the time. Family is important. I don’t want to wait any longer.’”

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