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Rent Your Uterus!
June 26, 2007 permalink
Here is a new business opportunity for healthy Canadian women: rent your uterus to a foreign couple. Canadians have a price advantage over Americans because the Canadian health care system treats the pregnancy at no cost to the family. Canadian doctors are used to seeing a stranger take a newborn baby, so that won't attract any attention. Because there are regulations restricting compensation to surrogate mothers, a minor in money laundering is a helpful adjunct.
Health: CROSS-BORDER REPRODUCTION
Canada: destination for infertile couples
An increasing number of foreigners are choosing Canadian surrogates because the practice is illegal in their home countries
Infertile couples from France, Italy, Sweden and Australia are travelling to Canada to have a Canadian surrogate give birth to their children.
An increasing number of foreigners are making the choice because surrogacy is illegal in their home countries.
Between 200 and 400 couples from France alone have turned to Canada or the United States, according to Maia, a French association that supports infertile couples.
Christine and Thierry are one of those couples.
Christine, 28, has a birth defect that prevents her from carrying a child. She and Thierry, 30, her boyfriend of three years (they asked that their real names not be used), live in Paris and found out about surrogacy from another French couple who went through the process in Canada.
For Christine and Thierry, the long search led to a British Columbia woman. They met her once in March, and they talk with her daily over the Internet.
"We consider them [the surrogate and her husband] as friends," Christine said. "She is not just an oven."
In mid-June in Toronto, their new friend was implanted with two embryos, created using donor eggs and Thierry's sperm.
Christine said she is "happy to have a child who will look like the man I love." And she appeared pleased with the Canadian connection: "We feel more Canadian than American. I mean, I think their mentalities are more similar to ours."
Joanne Wright, who helps both Canadian and foreign couples connect with potential surrogates through her company, Canadian Surrogacy Options, said many foreigners "feel a real affinity to Canada - they almost feel at home."
Nobody keeps official numbers, but Ms. Wright estimated that, in the last five years, the number of international couples coming to Canada has more than doubled.
She said about 15 per cent of the 50 to 60 couples she sees each year come from abroad, many from France and Australia. They seem remarkably trusting.
"It surprises me how often I go to my mailbox, and there's just paperwork in there and a cheque, and nobody's called to say it's coming," Ms. Wright said.
Battling with the cost
Surrogacy can be expensive in Canada, and some couples struggle financially to cover drugs, embryo transfers, lawyers, psychological exams and other costs, with no guarantee it will work on the first try.
Some take out a second mortgage or ask their parents for money.
Foreign couples face the increased financial burden of travel. Christine estimated that the whole process, including flying the surrogate and her husband to France for a visit, will cost $60,000.
But surrogacy could cost foreigners much more if they break the law in their own country.
French couples could be fined $23,000 and face up to a year in prison.
In Italy, people risk a fine of up to $1.5-million and two years in jail.
Ms. Wright suggested there may be other reasons why foreigners are attracted to Canadian surrogacy, including the health-care system.
Ontario pays pregnancy and delivery costs of a surrogate who lives in the province, regardless of where the intended parents of the child come from.
"If an Ontario woman acting as a surrogate meets the eligibility requirements that the ministry demands for health insurance coverage, then she would be covered ... just as anyone else would," a spokesman for the Ontario Ministry of Health and Long Term Care said.
Delivering a child costs the system about $800, but the spokesman said the ministry does not track the cost of an entire pregnancy, from conception to delivery.
"In Canada, you get more bang for your buck," Ms. Wright said.
"In the States, it's really big business. It's just a lot more expensive."
Would-be parents who go to the United States have to pay hospital and medical fees that they wouldn't in Canada.
In the United States, surrogates can receive financial compensation. Canada's Assisted Human Reproduction Act prohibits surrogates from making a profit, but allows them to be reimbursed for expenses as long as they can produce receipts.
Health Canada is not sure yet what is an acceptable expense, or how much a potential cap could be.
"Right now there's no regulations, so ... basically as long as there is an expenditure, you can reimburse," said Francine Manseau, a senior official at Health Canada's Assisted Human Reproduction Implementation Office.
"My contracts say the [intended parents] pay all reasonable expenses - that doesn't include a trip to Europe to see what the finest maternity clothes look like," said Larry Kahn, of law firm Kahn Zack Ehrlich Lithwick, in Richmond, B.C.
Mr. Kahn is one of a handful of Canadian lawyers who draw up the surrogacy contracts, which ensure everyone is tested for diseases and has been psychologically assessed.
Mr. Kahn said costs can include food, transportation for doctor visits, folic acid, maternity clothes, massage therapy and fitness expenses. Couples also pay for postpartum care - expenses that can run up to $15,000.
Ms. Wright added that surrogates have claimed phone and Internet bills to keep in contact with the couple, and child care for their existing children.
Some surrogates make cash
Christine said she and Thierry will do everything in accordance with Canadian laws to make sure they bring their baby home.
But other couples are dishing out more than expenses, and at least some surrogates are pocketing that extra money.
Penalties, which can include 10 years in jail and a fine of half a million dollars, are not being enforced until a new agency, Assisted Human Reproduction Canada, sorts out the details in the next few months.
The Health Canada agency, which held its first meeting in March, is designed to regulate the growing field of new reproductive technologies.
In rare instances, posts on infertility message boards tell surrogates looking to receive more than their expenses to use cash, the online payment system PayPal, or offshore bank accounts.
In a March post on an assisted reproduction message board, ivf.ca, a user conceded that some surrogates are receiving more money than their expenses, but denied doing so herself.
"The contracts are being 'done by the book,' but that is not what is going on. People are still making their own separate agreements verbally.
"Obviously, I can't speak for every arrangement, but all the people I know are not doing it for 'expenses only'... The law didn't stop compensation at all, people just figured out how to keep doing it ...
"The government hasn't enacted the board yet that will investigate and enforce the new legislation and I think that's another reason why people aren't too worried.
"If you watch these ads regularily (sic), you still see Canadian couples offering 'generous compensation' or surrogates writing 'fee negotiable.' "
Ms. Manseau said Health Canada will scrutinize clinics to make sure everything happens by the book.
"There are inspectors at Health Canada that have started to visit the clinic, and provide some information," she said.
But Carole Craig, manager at fertility clinic IVF Canada in Toronto, said that because the regulations have not been set, her clinic has not seen inspectors.
"If they found any clinic doing something outside the realm of what the legislation has proposed, they would not get very far with it because they have not provided anybody with any framework," Ms. Craig said.
Citizenship and Immigration Canada would not confirm what implications a surrogacy arrangement may have on the Canadian citizenship of the child.
"We don't comment on hypothetical situations," said Philippe Mailhot, the press secretary at the Citizenship and Immigration Minister's office in Ottawa.
"This is a very specific question as to potential review."
But Audrey Macklin, who teaches citizenship law at the University of Toronto, said birth by surrogacy is no bar to being Canadian.
"As long as the child is physically born in Canada," she said, "there's no question of citizenship."
Sharing the load
As for Christine and Thierry, they have learned to rely on the kindness of strangers - or at least, their new friends across the sea.
"We really had no other choice than trusting people so far away, and we were very lucky because we got along with the surrogate and her husband very easily," Christine said.
"We think it's a great experience to share such a journey with a couple from a foreign country."
But, she admitted, it isn't easy.
"We feel very alone in the process - it can be very risky because we could have met bad people who could take all our money."
Yet they are taking those risks, putting their faith in people a world away because, as Christine said, "Our desire for a baby is bigger than everything."
Larry Kahn, of law firm Kahn Zack Ehrlich Lithwick in Richmond, B.C., is one of a handful of lawyers who write surrogacy contracts. Mr. Kahn drafts up to 20 surrogacy contracts each year, with one or two of them for foreign couples. The contracts:
Require appropriate medical testing, including STD and psychological testing.
Call for the surrogate and intended parents to follow the advice of their obstetrician.
State the maximum number of children the couple wants from the pregnancy.
Outline any removal of embryos in case of disease or if there are more viable embryos than were agreed upon.
Clarify that although the surrogate mother is the legal mother at birth, she gives custody to the intended parents.
Cost up to $2,500 to be drawn up.
A SURROGATE'S TALE
Maria (who asked that her real name not be used) started researching surrogacy after seeing a friend suffer multiple miscarriages. Last year, the 33-year-old surrogate gave birth to a girl, who is now living with a couple in Australia.
"We're talking birth, labour, medication for four months, a complete interruption in your life," she said about the process.
She at first had reservations about working with an international couple, but liked the Australians because they spoke the same language.
She was aware of the risks associated with surrogacy - the same risks associated with any pregnancy - but still went through with it because she felt the couple would make good parents, and the risks weren't too high.
"Pregnancy is pregnancy; giving up your liver is forever," she jokes.
To prepare for the embryo transfer, she had to inject herself with drugs for four months and deal with some negative reactions from her neighbours.
"I was told it was against God from a lady down the street," she said.
She said people need to understand why she was a surrogate before they criticize her choice. "Until you humanize something, it's easy to be judgmental," she said.
After a healthy pregnancy, the Australians were with Maria when she gave birth in a Vancouver hospital.
In Canada, the mother who gives birth is the legal mother, and hospital staff asked Maria if she wanted to hold the baby. "I said, 'Ask the parents,' " she said. "In no way, shape or form did we emotionally, physically, mentally think that this baby was ours," she said about herself and her husband.
Since the birth, Maria talks with the couple on a monthly basis, and she and her family plan to visit them in Australia in five years.
Maria said she had such a good experience being a surrogate that she has now offered to be a surrogate for an American couple.
Source: Globe and Mail