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I know I’ll be a mother,” Shannon Bourbonnais used to tell her friends. “I just don’t know how yet.” After she suffered a miscarriage in 2001, at age 28, Bourbonnais, who teaches French at York House School, embarked on a regime of positive thinking, massage, special diets, drugs, charts, acupuncture, Chinese medicine, fitness programs and vitamin supplements. She also did hundreds of hours of Internet research.
After “trying” for a year after the miscarriage, she and her husband, Sean Dawson, a phys ed teacher at an elementary school, made their first appointment at an in-vitro fertilization clinic. There are three IVF clinics in Vancouver, and Shannon chose Genesis mostly because of its previous success rate. In the summer of 2002, she started taking Synarel, to suppress her cycle, then Pergonal and Gonal-F, to stimulate her ovaries to release eggs. In the fall, Dr. Albert Yuzpe removed ten of her eggs and, using Sean’s sperm, created three viable embryos.
Shannon’s uterine lining was too thin to support the embryos, it turned out, perhaps because of the post-miscarriage D & C (dilation and curettage) procedure. So they delayed the transfer, and for the next year doctors monitored and treated her uterus lining, starting with uterine therapy (in which a kind of balloon is inflated to stimulate tissue growth). By now, Shannon was used to rushing off from school for treatment that once would have seemed daunting and invasive. And while dealing with the monthly disappointment, fertility drugs (one of which stimulates menopause and gave her night sweats) and regular tests, she was teaching full time, acting as head of the French department, working on her M. Ed. at UBC, and teaching workshops to teachers across the country.
Finally, in the fall of 2003, doctors transferred one of the previously frozen embryos to her uterus. After two weeks Shannon prepared herself for the phone call from the clinic, but she already knew the results of the pregnancy test. “I know all the signs so well now,” she said. Already, friends were privately starting to refer to her quest as “optimistic.”
The next year, 2004, doctors did three more transfers, collecting a total of 34 of Shannon’s eggs that year and making 12 viable embryos. In the final transfer, in October 2004, in a highly unusual move, they transferred three embryos at the same time. After they all failed, she said to Sean, “OK-do you want to adopt, or try surrogacy?”
“Let’s try surrogacy,” said Sean.
Shannon was thrilled that he too wanted one last go at having their own genetic child before looking in earnest into adoption. And she was doubly thrilled when, in January 2005, her younger sister, Crystal, stepped forward and offered to carry their baby. An esthetician in Winnipeg, Crystal, then 22, had a baby of her own, which made her a good candidate in the doctors’ eyes. In March, the sisters met with the staff at Genesis. The meeting went well, but a week later Shannon still hadn’t heard from Crystal. “I’m just not sure,” Crystal said hesitantly, when Shannon called. Overwhelmed by the complexity of the procedure, she had also heard horror stories about the fertility drugs she would have to take.
The idea of surrogacy appeals to many women, but follow-through is another matter. In all, besides Crystal, five friends offered to act as a surrogate. “Actually,” said the first, when Shannon phoned to take her up on it, “I’m so sorry, but I’ve changed my mind.” The second decided to wait until after her next child. The third backed out because she worried about the effect it might have on her own family. A fourth offered right after the birth of her own child, but changed her mind because of a bout of post-partum depression.
I am the fifth of Shannon’s friends who offered. I did so almost casually, thinking it would be fascinating: the experience of pregnancy, the idea of helping a friend, the benefit of not having to leave the career world just yet. But when the time came, I was in the midst of applying for a job across the country and was starting to feel I’d prefer to have my own children before carrying someone else’s. I, too, reneged.
Shannon was learning that infertility is like a bad boyfriend: time-consuming, irrational, exhausting, hurtful. And if infertility is bad, reproductive technology is even worse, promising the world but leaving only more heartbreak. Infertility is not new, of course-in the Old Testament, Hagar, Sarah’s handmaid, laid with Abraham to bear a child for her barren mistress-but it’s never been more prevalent. In Canada, for reasons not well understood, infertility rates are higher than in most other developed countries. In Vancouver, as Shannon discovered, there are few promising options for infertile women-even those willing to pay, even those whose desperation is palpable.
She turned to the Ontario-based Canadian Surrogacy Options, which charged her and Sean a $5,500 fee to connect her to surrogates. “I’ve never felt more desperate, less in control, than when I was waiting for the match,” she recalled. “When I was doing IVF, at least I knew what was coming next.” The Ontario group sent her the names of potential surrogates, one at a time, by mail; after five months of looking at files on women all over the country, Shannon and Sean cautiously celebrated when they found a local match.
They were actually relieved, however, when, soon after the surrogate’s positive pregnancy test, the woman miscarried. They felt they hadn’t connected with her; they’d discovered that she rarely returned voicemails and was generally difficult to communicate with.
Shannon had told few people about her crusade. When she and I talked about it, she always spoke optimistically-determinedly-about the next step. “I’m type A-plus,” she joked. She was always full of stories about her students, hockey, yoga, grad school. But after that failed surrogacy attempt, she became quiet and withdrawn in a way I found disturbing.
“We call it infertility syndrome,” says Dr. Janet Takefman, a reproductive health psychologist at McGill University Health Centre, who used to work in Victoria. “There’s anger, guilt, shame, depression, isolation, social problems.” For many women it’s a life crisis with the same stress as cancer or any other serious trauma. It’s the end of a dream, and the loss of the sense of genetic continuity. Often, says Takefman, it leads to the end of a marriage.
Yet few women talk openly about it. Girls are raised to expect to be mothers. A woman without children often finds herself with little in common with friends who do, and she starts to withdraw. “There’s still that stigma, a sense that you aren’t a full woman,” says Takefman. “Even today, if you lived in Mexico or India, it would destroy you.”
Shannon’s hockey coach, knowing how desperate she was, suggested she post an ad on Craigslist, the online classified ad site. When she asked what Sean thought, he shrugged: “Sure, sounds good.””LOOK AT THIS, Skye, it’s the craziest thing.”
Skye LeBlanc, a dental hygienist who lived in Nelson, was visiting her mother in East Vancouver when her mom’s friend read an online ad. ‘Couple, early to mid-30s, seeks gestational surrogate. No financial reward.’ What a bunch of crazy people!”
“I was like, ‘Hmm,'” Skye recalls.
Skye was surprised by the posting only because it was from someone in Canada. She’d been looking at U.S. sites like Surrogacy.com, on which commercial gestational surrogates post their availability, rates and even blogs detailing current pregnancies. In Canada, it’s illegal to reimburse a surrogate for anything beyond expenses, or to charge a fee to act as an intermediary. So there are few ads or services, and even fewer surrogates.
In the States, by contrast, surrogacy is a thriving business. The going rate for acting as a surrogate is $40,000; $60,000 for twins. Surrogates are relatively easy to find, and women sometimes opt for surrogacy out of convenience-the kind of women, says Takefman, who want to avoid the “inconvenience” of pregnancy and “don’t want stretch marks.” In India, a whole industry has developed around surrogacy, and a growing number of women carry other people’s children as a way out of poverty. The going rate in India, around $4,000, is equivalent to two years’ average income
Skye was excited and nervous as she emailed Shannon via the Craigslist site: “It’s kind of like dating, you know?” she later explained. A few days afterwards the two women met for coffee and, says LeBlanc, “just kind of hit it off.” A couple of weeks later, they brought their husbands along for a dinner together. Skye’s husband, Jason, a parademic, clicked with Sean, and the possibility of surrogacy began to turn into reality.
The following week, in March 2006, Shannon and Skye made the first of many phone calls to Dr. Stephen Hudson at the Victoria Fertility Centre. Having gone through failed rounds of IVF in Vancouver with little change in the treatment plan, Shannon wanted a fresh start. She also wanted a doctor who took a more holistic approach and was, as she says, “surrogacy-friendly.”
They found their man in Hudson. “We’re taught in our culture that if you work hard enough, you get what you want. But this is completely beyond a person’s control,” he says, in a gentle South African accent. “That’s what makes it so hard.” He admires the tenacity of patients who go through something few people of his generation ever did. “When I was at university, in the 1970s, a woman who had her first pregnancy after 30, was called an ‘elder primip,’ an elderly first-time mother. It was regarded as high risk.” Now, of course, new mothers in their late thirties and even early forties are common.
After putting Shannon and Skye through medical and psychological tests, he gave them the thumbs up. In June, he put them both on the Pill to synchronize their cycles. Then, in July, as well as taking other drugs and vitamins, Shannon again had to give herself four injections a day of Gonal F and Repronex, to stimulate her ovaries to release eggs. Between the injections and blood tests, she “felt like a pin cushion.” Skye also had to take vitamins and baby aspirin and give herself two injections a day of Heparin, an anti-coagulent.
In late July, Hudson retrieved eggs from her and, under a microscope, fertilized them with Sean’s sperm. He then asked Shannon what she’d decided about giving it another try herself. To Shannon’s way of thinking, the more options the better.
Three days later, when Shannon and Skye went back to the clinic for the transfer, Hudson asked how many embryos they wanted to use. “You’ll always wonder if you don’t try,” Skye told Shannon. The women talked together quietly, then Shannon said, “Four.” Two embryos would be implanted in each woman’s uterus.
Two weeks later, when Shannon’s phone rang-“on August 5, at 12:40,” she recalled-“I knew it was Dr. Hudson. I’d already opened a beer and a package of ketchup chips, ready to drown my sorrows. I was already thinking, ‘OK, what comes next?'”
“Are you sitting down?” Hudson asked. Both women’s tests had come back positive, he said, likely twins in each case. Shannon, who’s 5’2″ and 110 pounds, stood to become be the mother of four babies in nine months’ time.
Sean, a competitive cyclist, was in a race in Kelowna, so Shannon called her mom first. Then she called Skye, who shrieked. She called Sean’s friend and left a message that she had a decorating question. Sean called back a couple of hours later.
“Hey, how’s it going?” he said cheerily. On learning that he’d soon be the father of four babies, he fell understandably silent.
Skye soon began to feel misgivings; she had volunteered to carry twins for infertile strangers. That they were going to have babies of their own made her role seem weirdly redundant. A few weeks later, that issue disappeared. Shannon had a blighted ovum; the cells had stopped dividing. She knew something was wrong, she said, even before she got the results.
“Ours took one for the team,” said Sean.
Shannon now turned her focus entirely on the two babies she would not deliver herself; she became oddly like the husband of an expectant wife. “If you’d told me six years ago I’d never be pregnant and carry my own babies,” she said, “I wouldn’t have been OK with that. At first, it was ‘I want to be pregnant,’ but it became ‘I want to have a baby.’ The surreal thing is not that someone else is carrying the babies, but that you’re actually going to have a family.'”
And yet, not pregnant herself, she didn’t quite believe she’d be a mother. She delayed buying cribs, car seats, baby clothes. Many first-time mothers say there’s a period in the pregnancy when the impending birth seems strange. Parenthood involves a complete change of life and identity, and it’s hard to believe an actual baby will arrive. But there’s an added twist in a surrogate pregnancy-the question of whether the intended mother will actually get to raise the babies. There have been many instances of surrogate mothers refusing to give up the babies they’ve carried.
Surrogacy in Canada is governed by the Assisted Human Reproduction Act, a federal statute. There’s a standard contract, which in Shannon’s case was drawn up by Larry Kahn, a Vancouver lawyer who’s been working in reproductive law for 35 years. “I’ve seen pretty much everything,” he says, including a couple of dozen cases a year of surrogacy, embryo donation and egg donor contracts. He says the expenses for gestational surrogacy (reimbursement for food, vitamins, rent, etc.) can run as much as $15,000 over and above IVF fees (which, at the Victoria clinic, are between $8,500 and $12,500, including drugs) and legal fees (about $2,500 for the contract, plus another $4,500 for the declaration of parentage so that the surrogate’s name is not put on the birth certificate.
The contract covers what will happen in case of disagreement-say, if the test for cerebral palsy at two months comes back positive. Custody reverts to the parents from the moment of delivery. What if a surrogate decides to keep the child? Kahn says the courts would enforce the contract. “But with Skye,” said Shannon, “it would be like worrying the babysitter would come in and take your kids home.”
“I didn’t even really feel pregnant,” Skye agreed. “I felt like it’s Shannon’s head on my body. I’m like a babysitter.” She said the idea of keeping the babies (both girls, they’d learned) never even arose. “It’s Shannon and Sean’s DNA. But I do have an instinct to protect these babies. Like, if a nurse wanted to stick a needle in them, that would worry me. I’d look to Shannon. It might be different if I didn’t think Shannon and Sean would be good parents.” Other surrogates had told Skye that when they delivered, they’d have an urge to hold their own children. So Skye planned to take her own son to the hospital.
She’d thought through these emotional complexities even before contacting Shannon. In fact, she’d first looked into surrogacy seven years earlier, when she was 25 and living in Nelson. “But I couldn’t have done it there. People would have been like, ‘Where’s your baby?’ I would have been on the front page of the paper.” Though the decision to carry Shannon’s babies was easy, she did sometimes feel a strange guilt. “Maybe it’s because the twins might think I gave them away, turned my back on them.”
But what really kept her awake at night during the late stages of the pregnancy-besides the rib pain, not uncommon in women carrying twins-wasn’t the why, but the how. There would be 16 people, including Shannon and Sean, with her in the delivery room.
At 36 weeks, complications arose. An ultrasound showed that the umbilical cord was wrapped twice around one of the baby’s necks. The obstetrician assured them that the twins were fine, but urged them to opt for a Caesarian section. Shannon and Skye both spent a few sleepless nights over the weekend, then Shannon called Dr. Nina Blumenthal, their obstetrician, on Monday morning. Blumenthal scheduled a C-section for that same day.
At 5:22 p.m. on Monday, March 19, Shannon and Sean waited nervously in the hallway at B.C. Women’s Hospital on Oak Street. (They were not in the delivery room because of the C-section.) “I kept hearing these cries,” recalls Shannon, “people in other rooms giving birth, wondering, are they ours? Are they ours?” Finally, two nurses approached them. “We have two babies,” one said, “and we’re looking for two parents.” As they held the babies for the first time, Shannon and Sean named the girls Willow Skye and Echo Skye. Any new parent feels joy, and parents who’ve been through years of disappointment feel tremendous relief as well.
“I cried when I heard the babies cry,” said Skye. “I do love them, I guess. But I looked at them and I didn’t feel like they were from me.” That night in hospital, she slept solidly for eight hours. “I snored. They called me the snoring surrogate,” she laughs. “After you have a baby, you wake up to every sound. I didn’t, but Shannon did.”
Skye has never dwelled on why she did it, a question she’s often asked. After her own son was born, she says, she had an unexpected desire to “give back.” She had an easy, enjoyable pregnancy that gave her “intense joy.” She knows women who have struggled with infertility and miscarriages, including someone in her own family, and was struck by their desperation. “I can’t go to Africa and help people with AIDS,” she says, “but I can help someone with my body this way.”
Counselors typically keep an eye on the surrogate for the first month or so, looking for signs of post-partum depression, which is not uncommon among surrogates. “They’ve had attention for nine months, then they’re ignored,” says Takefman. “And they’re hormonally compromised. But after the fact, they usually derive great psychological benefit. They’ve done a good thing. They have good karma.”
Skye certainly feels that way. “In Canada,” she says, “surrogates often end up feeling used.” But during the pregnancy, Shannon called every day, bought little gifts, sent her and Jason out for dinner. “We’ve now become really good friends.” Skye originally hoped for a Christmas card and photos of the babies each year; now, both women have no doubt they’ll remain part of one another’s lives.
In June, Skye and Jason moved to Castlegar. She and Shannon talk at least once a week on the phone, while Shannon holds her babies. And every time Shannon or Sean carries them past the big photo of a very pregnant Skye hanging on the wall in their home, they stop. Look, they tell the twins, pointing-you came from that tummy.