In the weeks after Patrick and Maggie died I returned to my fertility specialist's office to gain some insight into what might happen or change in our fertility future. I asked about surrogacy and was told only that surrogacy is a very expensive option. With this limited response, we moved forward healing and planning.
We knew that we would eventually want to try to have more children and so began with the preliminary testing and soon requested an appointment to begin the process of surrogacy.
Naive though I may be, I had not anticipated that my doctor would be unsupportive, let alone for irrelevant and unfounded reasons. We were first discouraged quietly, reminded that a consultation would not be OHIP covered. Less gently, a conversation with the receptionist who explained that we simply do not qualify for surrogacy as we do not carry enough risk. I clarified that the risk of pPROM is up to 30% for me. She assured me that I would need to have no uterus at all, or have absolutely no hope of carrying a pregnancy for them to support surrogacy. I reminded her that I have two dead children; she assured me this is not enough. I asked her "how many dead babies do I need to have?" and she assured me that no number of infant deaths would matter.
Having been their patient for years, what was mind-blowing and most frustrating about this was that they had refused to proceed with previous fertility cycles with me because there was a risk of twins/multiples around 30%. I recall having a cancelled cycle and feeling so frustrated that my consent was not enough to move forward. And this simply emphasized the practice of 'covering their own butts' at the cost of patient respect. Essentially, 30% is too risky for them but not for me. The turmoil I would face in a pregnancy or infant loss is not as bad as bad PR for them.
In my frustration the clinic decided to have my doctor phone directly for an explanation. She indicated that my risk of pPROM is separate from my risk of Chorioamnionitis, which was of more concern to her. The fact that the two co-exist was over-looked in the conversation. She reminded me that I am not an expert (condescendingly, but true) but nor is she (at least she acknowledged her limitations). She suggested a referral back to the specialist who followed my pregnancy for in-put. I inquired what would need to be said in the recommendation or what percentage of risk would be required for her to do surrogacy with me. She explained that there is not a defined line and that no matter what the referral said, it would be left to the discretion of the doctors. (For the record, I saw the referral she sent and it said on it that I want to have a surrogate and they disagree with my request, ensuring an unbiased referral, of course!).
Feeling hopeless, defeated,... and then she elaborated. She began to explain her role in protecting a would-be-surrogate. She reminded me that a surrogate could face health complications (no different from all the other women she helps to impregnate). She also pointed out that the surrogate could be traumatized by giving away the baby to whom she has given birth. Basically, she implied that surrogates are uninformed and exploited women who must rely on doctors such as herself for protection and as such, should only be used in impossible cases. Paternalism! Misogynistic! Ack!
I was so insulted on behalf of would-be-surrogates I said nothing. Her comments are not founded in any research. In fact, the research seems to state the opposite - surrogates are mostly happy with their decision and many go on to carry for others again.
I was devastated that we might have reached the end of the road. I was furious that she spoke to me and about would-be-surrogates the way she did. And I was hurt that she dismissed our plea so easily. I told my spouse that we might have to undergo treatment and take our chances - we had no surrogate and we had no clinic.
xx
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