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Surrogacy Requirements in Connecticut. Becoming a Surrogate in CT. Obstetrician—gynecologists caring for pregnant gestational carriers should communicate clearly to the patient the primacy of her right to autonomous decision making related to her health and her pregnancy, which includes the right to choose what information she does and does not wish to receive or share.
The obstetrician should not look for input from the intended parent s when medical decisions are being made during pregnancy, labor, or delivery. Once the gestational carrier is pregnant, it is helpful for the obstetrician—gynecologist to be familiar with pertinent preconditions and contingencies in her contract with the intended parent s that may specifically address certain aspects of her care. For example, an anticipatory plan often is made regarding prenatal genetic screening and response to abnormal findings on any ultrasound studies, pathology, or laboratory tests.
Regardless of the contractual details, however, the pregnant gestational carrier is the only one empowered and enabled to make independent decisions regarding any screening, testing, or procedure that may be indicated during her pregnancy. Such interventions include fetal chorionic villus sampling, amniocentesis, multifetal reduction, pregnancy termination, and invasive or fetal surgery.
Decisions counter to the contract may have financial or legal consequences, and the gestational carrier should be made explicitly aware of this fact and of the specific consequences that may result after a contract breach. There must be a clear understanding of how appropriate medical details related to the health of the fetus will be communicated to the intended parent s during the pregnancy, keeping in mind that such communications must take place only with the express consent of the pregnant patient.
Establishing where delivery will take place also is important because of the practical and legal ramifications of this decision. Obstetrician—gynecologists caring for pregnant gestational carriers are encouraged to assist in the development of hospital policies to address labor, delivery, postpartum, and neonatal care in anticipation of deliveries in their facilities involving gestational surrogacy arrangements.
It is particularly important to establish who will make decisions regarding care of the newborn from the time of delivery and to communicate this decision-making plan to the entire health care team. Although it is important to know whether any prebirth orders establish parentage of the newborn at the time of delivery, it is common and acceptable to allow the intended parent s to immediately take the lead in making decisions for the newborn 1.
Difficulties may arise if the newborn is transferred to a different hospital before final establishment of legal parentage, and this may require further efforts to inform all health care providers involved about the gestational surrogacy arrangement.
When an individual or a couple is considering gestational surrogacy, the obstetrician—gynecologist should provide counseling regarding the potential benefits and risks and the alternatives for family building. The unique ethical, medical, psychosocial, and legal complexities of gestational surrogacy may best be presented to intended parent s by an experienced subspecialist in reproductive endocrinology and infertility, a mental health counselor, and an appropriately qualified attorney, and this should be encouraged and facilitated.
There also are many nonprofit and for-profit agencies offering legal and administrative assistance to parties involved in gestational surrogacy arrangements. A reputable, ethical, and experienced agency may assist in coordinating travel and communication between parties, medical care, escrow payments, and psychosocial support.
An obstetrician—gynecologist may contract with a private gestational surrogacy agency to provide adjunctive services such as laboratory testing and ultrasound monitoring to the intended parent s if the physician has a good faith belief that the agency is medically and ethically reputable and the physician receives no more than standard compensation for these services.
Cross-border reproductive care refers to the rapidly growing practice of individuals seeking assisted reproductive technology treatment outside of their country of domicile Individuals may seek cross-border reproductive care to access more affordable treatment, to have a broader array of high-quality treatment options, to avoid legal restrictions in their country, or to protect their privacy The benefits of U.
Compared with domestic gestational surrogacy, cross-border reproductive care is particularly fraught with ethical and legal challenges and involves obstacles to ensuring optimal medical safety, preventing undue inducement of gestational carriers, and establishing parentage and citizenship status for offspring 3 Political, religious, and legal norms, as well as attitudes regarding assisted reproductive technologies, vary widely among involved countries, which makes it difficult to create an internationally acceptable framework for this global phenomenon Individual gestational carriers in countries outside of the United States may face severe stigma in their communities because of negative public opinion of this practice Although there is no ethical obligation for obstetrician—gynecologists to assist infertile patients seeking cross-border reproductive care, obstetrician—gynecologists should be aware of the existence of these types of gestational surrogacy arrangements, and those who counsel and care for these patients should encourage patients to seek legal advice from appropriately qualified legal counsel experienced in cross-border gestational carrier arrangements.
Patients should be counseled that the quality of health care may differ in other countries, and it may be difficult to ensure appropriate prenatal care for the gestational carriers with whom they have contracted and the resulting newborns. Physicians who treat pregnant gestational carriers from abroad have a duty to provide the same level of care to international patients as they would to their domestic patients.
However, this duty to international patients may be complicated by many factors, such as a lack of access to foreign medical records.
Gestational surrogacy is an increasingly common form of family building that can allow individuals or a couple to become parents despite circumstances in which carrying a pregnancy is biologically impossible or medically contraindicated. Obstetrician—gynecologists may become involved in gestational surrogacy either through caring for the gestational carrier or for the intended parent s.
State laws surrounding these arrangements vary and are evolving. The gestational carrier and the intended parent s should be cared for by independent obstetrician—gynecologists when possible. These physicians should take care to avoid potential conflicts of interest and may benefit from consultation with appropriately qualified legal counsel and experienced colleagues in reproductive endocrinology and infertility.
Likewise, potential intended parents and gestational carriers should be encouraged to seek independent expert medical, legal, and psychosocial advice when considering this family-building option.
Cross-border reproductive care involving gestational surrogacy involves special legal and sociocultural complexities. How-ever, physicians who choose to care for gestational carriers should provide the same level of medical care as they would to any patient, regardless of the complexities of gestational surrogacy and their personal beliefs regarding a particular parenting arrangement. Having an attorney well-versed in reproductive law can make the process much easier. If you use an agency to find a surrogate, they may be able to help you find a lawyer.
Our staff includes board-certified Reproductive Endocrinologists and Embryologists that can help you build the family of your dreams. Call us at to make an appointment in the Triad, or for our Charlotte office. Powered by TargetMarket Healthcare. Our Blog. Different People Choose Gestational Surrogates for Different Reasons The reasons people use gestational surrogates or carriers vary depending on individual circumstances.
To qualify to be a gestational carrier a woman must meet the following requirements: Between the ages of 21 and 39 different agencies may have different age requirements Have had at least one healthy, full-term pregnancy and delivery Have a BMI between 18 and 32 Has had no more than 2 c-sections Financially stable Other requirements vary by agency and more detailed requirements are covered during the screening process.
There are Strict Screening Processes Gestational Carrier Background screening Medical screening Psychological screening Intended Parent s Background screening Psychological screening Genetic screening for eggs and sperm used in IVF Financial information Some surrogacy agencies require more in-depth screening than others.
Because the eggs will be retrieved from one woman and implanted in another, this technique requires the use of in vitro fertilization IVF. IVF is when eggs are fertilized in the laboratory and a limited number of resulting embryo s are transferred into the uterus of the carrier. A GC is used when an intended parent wants to have a child and either does not have a uterus or has a medical condition that would prevent carrying a pregnancy safely.
Also, a GC may be considered for women who have a history that suggests a problem with her uterus such as recurrent miscarriage or IVF failure or when a female partner is absent single male or gay couple. The ideal GC is a healthy woman between the ages of 21 and 45 who has had a successful term pregnancy and has a supportive family environment to help her cope with the added stress of pregnancy.
The carrier should have no more than five previous vaginal deliveries or two previous cesarean deliveries. Prior to becoming pregnant, the GC should talk about the risks of pregnancy with her healthcare provider. The GC should have a complete history and physical examination performed to ensure that there are no reasons for her to avoid pregnancy.
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