Analysis of gestational surrogates' birthing experiences and relationships with intended parents during pregnancy and post-birth

Background This study investigated the surrogates' birth experiences, their levels of emotional struggle at relinquishment, how often they thought about the surrogacy children, and the surrogate-parent relationship dynamics during pregnancy and post-birth. Methods Data were collected from 06/2016 to 02/2017 using an anonymous questionnaire. Participants were Canadian gestational surrogates who had completed the process with or without a successful live birth, and who were at various stages of an ongoing surrogacy. For this paper, only a subgroup of cases with a successful live birth was selected for analysis. Results The data set included 131 births involving 90 surrogates who delivered 157 babies (105 singletons and 26 sets of twins). Their mean age at the time of surrogacy was 31.7 +/- 5 years (range: 21-47y). More than one-third (37.4%) of the cases were for intended parents who were same-sex male couples and single men. Surrogates assisting Canadian-resident intended parents had an overall better birthing experience compared with those assisting nonresidents. There was none or very little struggle with the relinquishment of the baby in 96.9% of cases. Continued contact with parents after the births was reported in 93.0% of cases. Surrogates were significantly more likely to have frequent post-birth contact with same-sex and single fathers compared with heterosexual parents and single mothers (76.6% vs 54.3%). Conclusions Same-sex male couples and single men can develop a long-lasting relationship with their surrogates even when no intended female partners are involved. The development of institutional practice guidelines in standardizing surrogacy birth practice is paramount in optimizing surrogates' care.