The last word: My baby, her womb

When <em>New York Times</em> writer Alex Kuczynski turned to a surrogate to carry her baby, she had no idea how to feel about either the woman or herself. Then an unlikely friendship developed.

When New York Times writer Alex Kuczynski turned to a surrogate to carry her baby, she had no idea how to feel about either the woman or herself. Then an unlikely friendship developed.

I can’t remember when I first became aware of gestational surrogacy, but the idea of hiring a woman to bear my child found its way into my brain sometime in early 2007. I was 39 years old. My husband, Charles, and I had spent a half a decade trying to bring a baby into the world together. My fourth pregnancy had just ended in a fourth miscarriage, and it was becoming clear that if we wanted a child who was genetically related to us, we might have to find a woman with a more reliable uterus. To be sure, this was a desperate measure, one complicated by financial, religious, and moral questions. But we were wrung emotionally dry by years of in vitro fertilization followed by miscarriage when we decided that April to try gestational surrogacy just once.

On May 11, 2007, we sent an e-mail message to a New Jersey lawyer who specializes in hiring surrogate mothers. In July, my doctor in New York coaxed eight egg cells from my ovaries and fertilized them with my husband’s sperm. By the beginning of August, a substitute schoolteacher from Harleysville, Pa., Cathy Hilling, was pregnant with our child. On May 11, 2008, I was holding my 3-week-old son in my arms. It was Mother’s Day.

Before in vitro fertilization became a standard fertility treatment, about 15 years ago, the only surrogacy option available to infertile couples who wanted some genetic connection to their child was what is now called traditional surrogacy. That is when the woman carrying the baby is also the biological mother—the child having been created from her egg and sperm from the donor father. Now that there are hundreds, if not thousands, of doctors in the United States who can perform in vitro fertilization, surrogacy agencies report that the numbers have shifted markedly away from traditional surrogacies toward gestational surrogacies, meaning those in which the surrogate mother carries a child genetically unrelated to her.

In early 2007, when my husband and I first met with the surrogacy lawyer, Melissa Brisman, she informed us that the typical cost for gestational surrogacy would be anywhere from $40,000 to $70,000. Shortly after the meeting, her office started to send us profiles of potential surrogates.

It felt strangely like getting a letter from the roommate who would be sharing your dorm room freshman year. They described themselves, their lives, their ambitions. Their household incomes were not, on the profiles I saw, more than $50,000. Most asked for about $25,000 to carry a baby, more for twins.

The information in the packets provided by potential surrogates offered a rich picture of the country. There were married women and single women, women in their 20s and women in their 40s; women who would be willing to bear a child for a gay couple and women who would not; women from the Bible Belt, the Rust Belt, the Pacific Northwest, and the industrial Northeast.

None was living in poverty. Lawyers and surrogacy advocates will tell you that they don’t accept poor women as surrogates for a number of reasons. Shirley Zager, director of a national surrogate-parent support group, told me that the arrangement might feel coercive for someone living in real poverty. Poor women, she also told me, are less likely to be in stable relationships, in good health, and of appropriate weight.

When we came across Cathy’s application, we saw that she was by far the most coherent and intelligent of the group. She wrote that she was happily married with three children. Her answers were not handwritten in the tiny allotted spaces; she had downloaded the original questionnaire and typed her responses at thoughtful length. Her attention to detail was heartening. And her computer-generated essay indicated, among other things, a certain level of competence.

In our conference call with Cathy and her husband, Mick—the vice president of marketing for a credit union—we felt immediately comfortable. They had three children, two of whom were in college. Cathy and Mick sounded compassionate and intelligent. And she was experienced at surrogacy: She had delivered a baby boy the previous year for a couple in New Jersey.

Cathy was 43. Some clinics will cap the age of a potential surrogate mother at 40, or even younger, but my doctor told us that as long as Cathy was healthy, her age was largely not relevant. In her case, age lent maturity and experience.

Cathy told me that her motivations were not purely financial, although she was frank about the fact that the money would help with her two children in college. She and her husband had taken in 17 foster children for short periods over the years; their new house was a bit small for more foster children. But the experience of having a baby for the New Jersey couple, Cathy said, provided her with a deep thrill, and the feeling that she was needed in a profound way. There might always be other willing foster parents, she said, but there would not always be willing, able surrogate mothers.

I appreciated Cathy’s warmth and straightforward manner. But there was something else that drew me to her. She and her husband were college-educated. Her daughter Rebecca, then 20, wanted to be a journalist. They lived in a renovated mill house on a creek in a suburb of Philadelphia. They seemed, in other words, not so different from us.

I know all this should have been irrelevant. But it was easy to imagine Cathy carrying my baby. She wasn’t desperate for the money, so our relationship wouldn’t have to feel like a purely commercial enterprise, or a charitable one. The only major factors separating us were the fact that Cathy could have a baby and I could not—and we had that $25,000 at hand.

In August, when Cathy came to New York for the embryo transfer, I sat with her mother, Ann, when Cathy disappeared with a nurse. After an hour resting with her legs elevated, Cathy came out beaming.

“I think it worked,” she said. “But then again, that’s why they call me the Easy-Bake Oven.”

Two weeks later, we got the test back, confirming what Cathy already knew.

During the first trimester, Cathy came up to New York for a monthly checkup; for the rest of the pregnancy, she and I went to her OB-GYN in Pennsylvania. After the second checkup, we walked home to my apartment for lunch. We talked about how she had played on her college tennis team. She was an accompanist for a children’s choir and had brought her piano sheet music so she could practice. She played our Steinway while I got lunch.

I was numb. I can hardly play the piano. I never played on my college tennis team. Back in those days, I was smoking and dyeing my hair black. For Pete’s sake, I thought, this woman can do all those things—and have my baby.

The respect Cathy inspired helped when she joined her husband at a conference in Las Vegas later that fall. At first, I took the news badly. My tiny child—who I by then knew would be a boy—was out there in Vegas at a craps table. I worried about the flight and whether the pressure would harm him. The thought crossed my mind to ask Cathy if it was really necessary to go, but I knew I couldn’t. I had given her my baby, and I would have to give her my trust as well.

As the months passed, something curious happened: The bigger Cathy was, the more I realized that I was glad—practically euphoric—I was not pregnant. I was in a daze of anticipation, but I was also secretly, perpetually relieved, unburdened from the sheer physicality of pregnancy. As the constraints on Cathy grew, I was happily exploiting my last few months of non-motherhood by white-water rafting down the Colorado River, drinking bourbon, and going to the Super Bowl.

While I sometimes envied the ease with which Cathy slipped into a very different role—that of the pregnant woman—she never flaunted it. She always gave me the clearest sonogram pictures to take home from our doctor’s visits. She called me Mama with cheer and affection in her voice. After one doctor’s appointment in Pennsylvania, she noticed over lunch that sipping cold water made the baby wiggle. Whenever she took a sip, she would press my hand to her belly. “His butt is right there,” she would tell me.

She wasn’t condescending. She wasn’t pushy. I owed her so much, and yet when the baby was born, it was she who brought a gift to the hospital: a statuette of a mother, father, and child holding one another.

I searched the literature for a way to understand our relationship, one that is unprecedented in the history of human association. No writer or psychiatrist or medical ethicist offered an easy answer for how to behave. When Cathy told me that she considered the couple for whom she gave birth a year earlier as close as extended family, I wondered: Do we all have to have Thanksgiving together? If so, for how many years? And which husband carves the turkey?

Cathy was not only good at being pregnant; she seemed to like it. She liked being the person who was known to everyone as a giver, a fulfiller of dreams.

Two weeks before the baby’s due date, Cathy called on a Wednesday to tell me her cervix was dilated 3 centimeters. I booked a hotel room near the hospital where Cathy would give birth, and said goodbye to my husband with promises that I would call in the middle of the night if necessary.

I spent two peaceful days with Cathy, her husband, Mick, and their 11-year-old daughter, Michaela. In the early evening, Mick barbecued burgers and made frozen margaritas, and the four of us sat by the creek behind their house listening to the starlings and finches. On Thursday, Cathy’s doctor suggested we check into the hospital the next morning. My husband sped down from New York.

Birth is not a tidy business. As Cathy went into labor, Charles stood respectfully by her head to avoid being on the more visceral end of things. Cathy’s two daughters and her husband were there, too.

I found my son’s birth to be a terrifying event. When the baby crowned, my brain did back-flips. There was the mind-bending philosophical weirdness of it all: There is our baby—coming out of her body. And then there was the physicality of it: the torture of childbirth, of being split open, of having your body turned, it seemed, inside out to produce this giant, beautiful baby. Cathy vomited; I vomited.

In the delivery room, a crowd watched as “Max” came squalling into the universe, his body sheathed in a coat of buttery vernix. I cut the umbilical cord.

From a longer story originally published in The New York Times Magazine. © 2008 by Alex Kuczynski. Used with permission. All rights reserved.


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