When the world was blindsided by the COVID-19 global pandemic, I never would have predicted how swiftly things could change. Business have closed, reopened, then closed again, the debate about what to do with schools rages on, and the guidelines and regulations we all have to follow seem to change on a daily basis. At the beginning, it was common to joke about the boom of "quarantine babies" that would inevitably follow the shelter-in-place orders in much of the United States. And while that may be true, as weeks stretch to months, there are many hopeful parents who might not get the child they're expecting.
In March, as COVID-19 swept the globe, The American Society For Reproductive Medicine (ASRM) and the European equivalent, the European Society of Human Reproduction and Embryology (ESHRE), released multiple statements on the varying guidance of Assisted Reproductive Technology (ART), which essentially put a pause on thousands of fertility treatment cycles and advised doctors to follow their state regulations as to when they could resume practicing. Months later, that guidance still largely holds true, and the US states that are currently shut down have their own set of rules as to when businesses, adoption and surrogacy agencies, and medical services, such as fertility treatment, can resume, leaving many patients without a clear idea of when they can pursue their path to parenthood.
But there's also another group of people who still must wait — those who plan to become parents through adoption and surrogacy. Right now, adoptions are hindered, and in the case of gestational surrogacy, there are some intended parents (IPs) that have no idea when they can be united with their child. Again, the best practices are murky. Domestic travel isn't restricted, but IPs who are based outside the US (a fairly common practice, as surrogacy is illegal in some countries) or travelled outside the country to enter into a surrogacy agreement, may be unable to witness their child's birth or bring their child home due to international travel restrictions. Even if they can cross state or international borders, travelling could pose a large risk, as cases in many parts of the world — and throughout the US — continue to rise.
What happens if travel restrictions are not lifted by the baby's birth? What happens if the intended parents cannot get to their baby? Or the baby cannot get to its intended parents? I am a mother of two deliciously cute little girls through the gift of surrogacy. I remember witnessing the birth of both of my daughters and the feelings that came over me when I held them for the first time, and my heart breaks for those parents who don't know if they'll get this opportunity. So as the weeks tick past and due dates near, both gestational carriers and intended parents are rightfully uneasy at best.
"Everything is up in the air right now, with no timelines to go off of. People are hoping for the best but preparing for the worst."
Janae Krell, a previous gestational carrier and founder of All Things Surrogacy, is well aware of the uncertainty intended parents and gestational carriers are facing. "Everything is up in the air right now, with no timelines to go off of," Krell told POPSUGAR. "People are hoping for the best but preparing for the worst. In this instance, I [would recommend to gestational carriers that they] gear up with some essentials in preparation to go home with the IPs' baby, should the IPs not be able to make it, or have a representative present to take the baby on their behalf. I am seeing a lot of people within the surrogacy professionals community come together to see who can help with these scenarios."
Although travel has created perhaps the largest problem for people who are pursuing surrogacy, there are other barriers resulting from the confusion created by COVID-19. The process of gestational surrogacy is often complicated and long, with multiple steps to overcome. When I began trying to get pregnant years ago through IVF, that was the sprint. Deciding to pursue surrogacy was the long, sweaty, mentally exhausting marathon. Basically, surrogacy contains three parts: the legal aspect, where both parties need to have legal representation (and this changes based on country, state, etc.); the psychological aspect, involving mental evaluations for both parties; and finally the medical aspect, where the embryo is harvested, fertilized, and transferred to the gestational carrier. All of these phases are affected by COVID-19 closures. Particularly hard to navigate are the third-party reproduction cycles (when someone other than the IPs are involved in the reproduction process), which like any other fertility treatment, fall into the grey area of treatments on hold due to COVID-19.
"There are additional things that need to be considered if an egg donor stimulation cycle, or a transfer to a gestational carrier, would need to be cancelled because of a COVID-19-related reason. It is important to consider how that will impact the donor medically and how financially that will be handled. Clearly, it seems inadvisable to have any donor travel from out of the area in order to do a cycle, as that could potentially put the donor at increased risk during her travels," Kristin Bendikson, M.D., a reproductive endocrinologist from USC Fertility, told POPSUGAR. This situation leaves many families in the lurch, without guidance on how to move forward — or how to cope with the emotional effects these delays can wreak.
People are already dealing with the mental toll of isolation. For those who have difficulty having a child on their own, the impact of COVID-19 has magnified their grief. "Pursuing adoption or surrogacy comes with its own set of stresses. And after possibly years of struggling to build a family, intended parents have already experienced a toll on their mental health," Rebecca Flick, vice president of communications for RESOLVE: The National Infertility Association, told POPSUGAR. "We urge people in this situation seek the care of an online infertility or adoption or surrogacy support group or reach out to a local mental health professional for additional support during these extraordinary times."
Which is why, in times like these, an extra dose of kindness goes a long way. While everyone is grappling with their own set of life's uncertainties, we also must acknowledge those who maybe impacted in ways that were not foreseen. And with many of these questions still unanswered, those hoping to build their family through surrogacy are still wondering: what's next?