Byline: Alex Kornswiet, as told to Amelia Edelman
For What to Expect’s “What I Wish I’d Known” series, moms and dads share the wisdom they’ve gained since first becoming parents.
When my husband and I decided to try for a baby, I figured we’d be pregnant in no time. But months passed, and a visit to the fertility clinic revealed I had a blocked fallopian tube. Our best chance to get pregnant would be with in-vitro fertilization (IVF). Thankfully, our insurance covered one full round — and miraculously, it worked on the first try. Our first son was born, healthy and perfect.
We had 14 frozen embryos remaining and assumed baby number two would come just as easily. But after several failed transfers and heartbreaking miscarriages, we were diagnosed with unexplained infertility.
After one more try that ended in a loss, we decided to proceed with surrogacy. We would use a gestational carrier — a clinic would implant one of our frozen embryos in another woman who would carry the pregnancy. I was grateful for the option, but so mad at my own body for letting me down. I desperately wanted to carry my children.
I went into surrogacy expecting to feel detached from the pregnancy, but it was actually the opposite. There is so much I learned along the way, both about the logistics and the emotions I’d feel at each step. Our experience turned out to be the most magical thing for our family. Here’s what I wish I’d known before I started the process.
Carrier selection can be a long, emotional journey
We worked with an agency to select a potential surrogate. Within a month of submitting our application, the agency sent us a potential option. But this isn’t common — we got lucky.
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“The process often takes at least a year or more to be matched with a surrogate, and then up to five months for screenings and legal contracts,” says Jessica Rubin, M.D., a fertility specialist in Atlanta.
Madison, the surrogate we matched with, felt like the right fit for our family from the start. She was a military wife, lived close by, and was motivated by pure compassion: She had friends who had been surrogates and a family member with infertility issues. She was a first-time surrogate, but enjoyed two healthy pregnancies of her own. It broke her heart that it was so hard for some people to have their children.
After our first in-person meeting and phone conversation with her, we all decided we wanted to move forward with the process. She was the one. We signed our contract on my birthday, and that felt like a sign. It felt surreal that we were bringing in another person to grow our family, but it was also exciting to think about the future of having more kids. When we first matched, my reaction was just pure hope that we would have another baby — and that Madison would help us do that.
The first try doesn't always work
When we transferred the first embryo, it didn't stick. I felt sad and devastated, just as sad and broken down about it as I was when my own body had miscarriages and failed transfers. We were also shocked — we knew this was a possibility, but when we had already endured so much loss, over and over again for years, we truly felt like surrogacy was the way we were going to have another child. When it failed, I fell back into hopelessness. It felt like nothing would ever work for us.
I also worried for Madison. I felt bad that I put her in this situation because she'd never experienced any kind of loss like that before. But she was willing to give it another try.
The second try worked.
Madison sent me a photo of her positive tests, and I remember thinking, could this really be happening?
We were excited but cautious.
I didn't have as much insight into the pregnancy as I thought I would
Working with a surrogate was difficult at times.
The agency created a huge lack of communication. For example, I didn’t find out until the day my son was born that Madison had a stomach flu at 35 weeks, started contractions, and was taken in an ambulance to the hospital. They just didn’t tell me. I expected to know everything — but that wasn't the reality with surrogacy.
It was also the spring of 2020, and because of the pandemic, we weren’t able to go to any of Madison’s doctor’s appointments. For the bigger appointments toward the end of pregnancy, I met Madison outside of the office in the parking lot, masked, just to say hi and see how it went. I was just glad she was okay, and so was our son.
Nowadays, the experience is usually a lot different. "Everything is now available in-person, says Tarun Jain, M.D., reproductive endocrinology and infertility (REI) physician and What to Expect Medical Review Board member. "The intended parent can usually visit with the gestational carrier regularly if desired, and all expectations can be individualized when working with the agency and gestational carrier."
Even though I know our circumstances were unusual, in hindsight, I still wish I had done more research before choosing an agency to make sure our communication style was similar.
A surrogacy birth can be so magical
After one of Madison’s third-trimester appointments, I was standing outside waiting for her in front of the doctor's office building, and she came out with a big smile on her face and told me the induction was scheduled, and the date was my birthday. All of a sudden, we began crying and hugging.
We chose a very surrogacy-friendly hospital, and they let me be in the delivery room for the whole day, along with Madison's husband. My husband was in the waiting room until it was go time, and then he was allowed to come in the delivery room, too.
Madison went from 0 to 10 centimeters really fast — nothing was happening, and then all of a sudden everything was happening. I looked out the window and saw the doctor sprinting towards us across the parking lot.
My husband and I stood off to Madison's left side, near her head, to give her as much privacy as possible during such a vulnerable experience. She pushed twice, and our son came out. He started screaming right away and was perfectly healthy, the doctor said.
We got to do immediate skin-to-skin in the delivery room, and I was able to hold him first. The nurses gave us chairs to sit in and get comfy, and I made sure I was wearing a tank top that could come down and expose my chest so I could press his head on my chest easily.
He was crying as I held him, and I pulled him onto me, and we both took deep breaths together, and he just melted into me and fell asleep. Even though I hadn't been the one to carry him, I could tell he knew I was his mama — and we both felt an instant connection to one another. I calmed him, and that was all I needed to exhale. He even looked so much like his older brother. Tears were streaming down my face. My baby boy was finally in my arms after so many years.
All four of us stayed in the room since he was stable and healthy. They stitched Madison up, and then the nurses left us alone to just enjoy the first hour of our son’s life, something our hospital calls "the golden hour." All four of us got to hold him, and after the hour was up, they moved me, my husband, and our son to a separate recovery room. They even told Madison she could go home to her own daughters that night since everything had gone so well.
Over the next few days and weeks, I checked in with her to make sure she was recovering well. It was really important for me that she didn't feel sad or forgotten.
I still had postpartum anxiety and depression
Since I didn’t have the drastic hormone changes from giving birth, I didn’t expect to struggle with postpartum anxiety. I hadn’t carried the baby, so I didn’t think it applied to me — but it did.
I ended up having severe postpartum anxiety, with nightmares about people breaking in and taking my kids. I didn’t know I could have that without giving birth. Madison, too, felt that mental health support was lacking on her end. I wish I had seen a therapist and helped her find one.
"Anxiety can happen to anybody, regardless of whether you are pregnant or not, or regardless of hormone-related issues," says Dr. Jain. And it's especially common under these circumstances that, while beautiful, it can also be a bit stressful and uncertain, he adds. "It's so important to have mental health support in place."
And Dr. Rubin agrees. “Support from mental health professionals, clear communication between all parties, and strong support systems are critical to managing the emotional aspects of surrogacy," she says.
Surrogacy is a part of our story now, and we are forever grateful
Over time, Madison and I have naturally fallen into a rhythm of staying in touch, sending each other photos of our kids, and checking in to see how things are going.
Madison wanted to help our family in a very unique way, and we are so grateful. My son was always my son, but I want Madison to know we are internally grateful that she gave us the gift of life. I hope to have her meet my son again one day (she has since moved farther away), and I will ensure that he knows she is the wonderful woman who helped bring him into this world.
“When matched well and supported properly, the relationship is often described as one of the most rewarding aspects of the surrogacy journey,” says Dr. Rubin.
There are so many misconceptions about surrogacy, and so much stigma around the process. But we found it to be all love. It is people coming together because they want a child to exist. Surrogates are choosing to help families.
“Surrogacy is medically, legally, and emotionally complex, and it’s typically pursued after significant medical challenges, not out of convenience," says Dr. Rubin. "Many surrogates and intended parents develop a strong, positive relationship built on mutual respect, gratitude, and shared purpose.”
My older son knows his brother was born through surrogacy — and when we talked about it recently, he just said, “I’m so glad someone could help you.” To that I said, "I am, too."
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