Episode 2: Gestational Surrogate Screening Requirements

Join Carey Flamer-Powell, Founder and CEO of Surrogacy Mentor and Marielle Schuberth, Intake Coordinator for Surrogacy Mentor, as they discuss: 

• The screening that is required for all surrogate applicants
• Who sets the standards and screening criteria
• Why the screening process is so critical to a successful surrogacy
• How they help surrogates navigate the screening process at Surrogacy Mentor

Let's normalize surrogacy through education and open discussion! 

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• Take our easy 2 minute surrogacy quiz to see if you qualify!
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• Contact us with questions or comments at hello@surrogacymentor.com

Transcript

#NormalizeSurrogacy Podcast by Surrogacy Mentor

Episode 2: Surrogate Screening Criteria 

Carey Flamer-Powell: [00:00:00] Okay, welcome to episode two of the Surrogacy Mentor podcast. I'm your host Carey Flamer-Powell, experienced gestational surrogate, surrogacy agency founder, and founder of Surrogacy Mentor. With me today again, we also have Marielle Schuberth. Three time gestational surrogate, and the surrogate intake coordinator for Surrogacy Mentor. Hello, how are you? 

Marielle Schuberth: Doing well this morning. Just hanging in there. I think like everybody during these times, Yeah?

Carey Flamer-Powell:  Yes, that's all right. We're hanging in there. We're doing good these days. So good. So today our topic for today's podcast is gestational carrier screening steps. The requirements to be a gestational surrogate and as well as not only what are the steps, what do they entail, but why are they important then who actually sets these guidelines?

[00:01:00] So a lot of stuff to dig into. So we're going to go ahead and just jump right in. But before that, I just want to say that we do have some basic screening information on our website, which is surrogacymentor.com and people are always welcome to email us to ask questions about the screening process.

So that being said, let's just dive in. Marielle, do you want to just start and just without going into detail on any of them, just list the eight main steps of the surrogacy screening process, and then we'll go back and dig into each one?

Marielle Schuberth: Yeah, sure. So everything is going to start with your application.

Once you fill that out, you'll set up an interview with me to go over all the stuff on your application. Then we go through and we'll have you sign an agreement, then we'll get your background checks going,your medical records. And we'll need you to get your updated pap and OB sign-off form.

We'll go for your psych evaluation, fertility clinic clearance. And then there's a couple of other [00:02:00] factors thrown in there that we’ll come to here once we dive in a little deeper, but that's our basic stuff. 

Carey Flamer-Powell: Awesome. Yeah. So that all sounds easy and simple. And honestly it is. It's just a little more involved than that. So there's a difference between easy and simple. So the process is simple. There are steps that we need to follow, and we at Surrogacy Mentor, as well as, all the great agencies out there will guide all of the applicants through these steps. So in that sense, it's simple, but in terms of the details behind each of these, let's dig into that a little bit.

So let's talk about the application. The application is going to look a little different depending on whether you're applying with us, Surrogacy Mentor or with an agency directly. And each agency is going to have their own variation of what the application looks like. So for all of these steps, I'm just going to talk about how we do it here at Surrogacy Mentor, because my background is as a surrogacy agency owner.

And [00:03:00] so I come from having run an agency for years, and also now working and owning Surrogacy Mentor where we help surrogates match with great agencies. So our process here at Surrogacy Mentor is based on what I did as an agency owner. So it very much mirrors what most agencies do. So for the applications, a lot of times what an applicant will see before they'll see a full application, they'll see an inquiry or a quiz, which is what we use. Or email us to learn more. So there's not very often going to be a full application right off the bat.

So for us, we have a two minute quiz, super easy. I think there’s eight questions. And half of those are just your name, your email, what state you live in. But just very basic qualification criteria that we ask. Just to make sure that the very, very bare minimum qualifications are there. And those [00:04:00] are, are you at least 21 years old? Do you live in a surrogacy friendly state? Which we'll talk about in another episode. 

Yes, there are a few states that you cannot live in. If you want to be a surrogate because of laws and statutes. Some of the other questions that you might encounter on an initial application or on the initial quiz; and that's an important one, right? Have you given birth to at least one child of your own or have you had at least one uncomplicated pregnancy of your own?

And we'll talk about that in a moment. So very basic questions. And then if you fill out for us, that quiz comes through to us. If the very basic minimum is there, and in terms of criteria, then you'll get an email from us saying, great, you meet the very basic criteria. We'd love to chat with you. And that takes us to the next step in the screening, which is I'm sorry, before we chat with you, we have you fill out our full application.

Sorry. And that full application from us as well as most agencies is going to be [00:05:00] pretty involved. We're looking for a lot of background information, right? A lot of pregnancy history. Were there any complications who lives in your household? What do you do for a profession? Are you married? Single? If you're married, how does your spouse feel about this?

And then we're asking a lot of background history, as far as smoking, drugs, criminal activity, all the things that you would want to know, if someone might possibly be carrying your child. So the application is more involved. And it gives us a really good picture of whether we can move on to the next step.

So once we get that application, which again, all of this is done online, super easy to just go through the online form and fill everything out. If you are working with an agency or talking to an agency and all they have are forms that you have to print off and fill out by hand, then I would probably question the technology and the up-to-date-ness of their process because [00:06:00] everything should be done online at this point in time, in 2022. 

So the next step, and I'm going to let Marielle, I'm going to let you talk about this, because this is what you handle here at Surrogacy Mentor. And that is the video interview. If the application looks good, we send an email saying we'd love to chat with you. And that's just a brief,casual right? 30 minute or so interview over zoom, video chat. And I'm going to let you talk about what happens during that chat. 

Marielle Schuberth: Yeah, so it’s definitely pretty casual. I introduce myself and how to pronounce my name. Cause I know when people see it, they never really know. And then we just discuss what we do at Surrogacy Mentor, who we are, why we know what we're talking about.

What makes us different from a surrogacy agency? I always like to clarify that for women moving forward with us. And make it clear that,we're not an agency, but we bring together awesome qualified surrogates and awesome pre-vetted agencies together. So it's a big one for me in our call. And then I just go through the application that you filled out, any information or questions that I may [00:07:00] have about what you filled in your application. Sometimes I just need a little bit more information or to get some clarification on some information.  If you say you had high blood pressure, for instance, was it preeclampsia? Was it just one high blood pressure? Chronic things like that, just to get some more information. Then I always like to preface all of my chats by saying none of our questions come from a place of judgment. They're purely informational to gather information and to just get a good vibe on you.

I try to make it as easy and painless as possible with our video interview, as well as everything moving forward. And then I answer any questions that a potential surrogate may have from us as far as what we do at Surrogacy Mentor. If they have any questions about surrogacy in general, that I can help answer or about the agencies that we work with.

And it's just a brief kind of overview of what we do. And I try to just get my questions answered and answer any questions that they have and just get things going, because that's literally what we do here at Surrogacy Mentor is help guide and answer questions. That's why we're here.

And know, no question is too silly or too odd to ask us. We've been there, [00:08:00] done that several times. And it was a great way to just to kinda get everything out on the table and hopefully get off to a good start with starting a surrogacy journey. 

Carey Flamer-Powell: Awesome. Yeah. So one thing I hear a lot is that people are nervous for that first chat.

Oh, do I need to like, do my hair and makeup and dress up and make it like this, almost like a job interview. And no, you don't.  Obviously you know, we all want to put our best foot forward. But it's not something where we're expecting you to like, you know, put on your fanciest dress or something. Like really, the way we are at least here at Surrogacy Mentor, we're very casual.

And we only dress up and do our makeup if we have to. So really don't be nervous. It's really easy. The interview it's just to get a vibe for you as a person and help you really understand what the next steps are in the process, and then let you get a vibe for us as well. So it's pretty easy.

So if that goes well and all the questions have been answered during the interview, then we would [00:09:00] send and the next step would be an agreement. And each agency or Surrogacy Mentor , we're all going to have again, different process for the step. But what ours is just a very simple one page, one and a half page form that we asked you to sign.

And all it really says is you're giving us permission to start your screening process. And you're also allowing us at least 30 days to get that screening process complete because we are going to now start investing time and money into you as an applicant. And if we're going to do that, we're just asking for the courtesy of exclusivity for 30 days. Meaning please don't go apply to one or two or 10 other places while you're waiting for us to screen you because that's just money and time that we've invested, that could all be for nothing. We do ask for the courtesy of that exclusivity just for the 30 days so that we can have time to complete all of these steps and see if you qualify. So I will say though, the 30 days is [00:10:00] pretty concise. We're trying, we try to be really careful with the 30 days, but I've been tracking what our timing is for getting people all the way through.

And we're actually at 20 days or less right now as our average. So we almost never need the full 30 days. We try to do it as quick as we can. But as we'll talk about here in a second, there are a few things that are out of our control in terms of timing. Once you sign the agreement, which again, all done electronically that comes to us immediately.

We can do the next step the same day, and that is background checks. So it's super important that a criminal background check be run on on the surrogate applicant, as well as anyone age 18 and over that are living in her home. So 18 and over because that's legally an adult. So even if it's an 18 year old child that you might have, or a nephew or a niece everyone in the home does need to have a criminal background check and will have to consent to that.

If you do have someone living in your home that doesn't consent, unfortunately we [00:11:00] would not be able to move forward. Again, putting yourself into the place of the parent who's looking to work with the surrogate. You would want to know that the surrogate who was carrying your child was living in a home where there weren't- where there wasn't extensive criminal activity in their backgrounds.

It's just common sense. And what we're looking for here- obviously, no one's going to care if you have speeding tickets. No one's going to care if you were dumb when you were 16 and ordered a bunch of pizzas to someone's house to prank them stuff like that, obviously doesn't matter. What we're really looking for are no felonies and definitely nothing involving domestic violence, child abuse or drug or alcohol related charges.

And just a side note. DUI is a case by case. We know that, sometimes there's, again, five, 10 years ago in someone's past, maybe they had a lapse of judgment one night and they were barely over the legal limit and got caught. And did that. Their fines and their [00:12:00] classes. And haven't had one single issue since our typical guidelines for that, and what I see in the industry in general would be at least five years since that offense. That would only in our case, it would need to only be one offense. If there were multiple DUIs, we'd have a problem. But we're just looking for common sense stuff that's in the past, if at all. So if the- by the way, the background checks come back pretty quick.

Once I have the full name and email address for everyone, age 18 and over I can get those submitted online. There’s a consent form that needs to be signed digitally by the applicant. And once that's signed, I usually get those the same day. So, very easy and quick step there. And then the next step, I will turn back over to you Marielle, because again, this is your specialty here at Surrogacy Mentor, and this is the step that is the most time consuming.

And the one that's the most out of our control, but it is. [00:13:00] Probably one of the most critical steps and that is..

Marielle Schuberth: medical records- Yep. So what we'll do- once you get your agreement signed, you'll receive the email from Carey and there'll be a link in there to fill out a form that has listed all of your OB, prenatal, and hospital delivery information on there.

And then what I go and do is I locate- Most hospitals and clinics do have a clinic or hospital specific release of information form. So I go through and I find those. And then I'll send those to you through email to get an e-signature. And I'll also need a copy of your ID that I submit along with those requests.

Once they're assigned to each facility to start getting these records requested. So some of the stuff that is helpful for me to have is whether you've had your children under your maiden name or a different name than what is listed as your current legal name. Where? Specifically like clinic names, doctor's names are helpful. When and where you've had them.

And once I submit those, I'm pretty good [00:14:00] at staying on top of bugging them until we get them back. Sometimes, different states have different regulations as far as how long they have to give us medical records. Sometimes they will take all of the 90 days they have, but I'm pretty persistent in getting them and once we get those we review them and see if, everything kind of matches up with what we know.

And if there's any flags that would disqualify you as well. What we know that the clinics and agencies are looking for as far as medical history goes, and I try to make it as painless as possible, as far as filling out the forms. I try to get as much of it in there for you as possible. So really all you have to do is give me your okay and your ID. We really do try to make it as easy on you as we can here at Surrogacy Mentor, but it's definitely, some are really easy to get and other ones, can just be a pain. So just being as specific with the information that is given to me definitely helps. 

Carey Flamer-Powell: So you bring up a good point, which is that we try to make it as easy on the surrogate applicant as possible.

And that's important because I do actually know of a lot of agencies that ask the surrogate to [00:15:00] get her own medical records and it's a lot of work. It's a lot of chasing. It's a lot of phone calls. It's a lot of, I got half of the facts or they mailed them to me. And there's a lot of, it's like a part-time job for someone just to get their own medical records.

And it's truly a full-time job at many places. Agencies, my former agency definitely had someone that was their only task was medical records. And so I would say that's definitely one of the advantages of working with Surrogacy Mentor. That we're doing all of that leg work.

 And to answer a very common question. No, unfortunately we do not accept medical records directly from a surrogate anyway. 99.9% of people are super honest. But the other, 0.01% or whatever. Unfortunately we have had situations where people will submit only the good part of the records and leave out the bad parts. So we have to ensure the integrity of those records by making sure that we are getting them directly from the providers.

Yeah. So [00:16:00] medical records are the most time-consuming but most important part. And once we get those records, then Marielle goes through all of them and makes sure, like she said, that there aren't red flags that would be disqualifications. And we'll talk about what those disqualifications would be.

But basically we're just looking for no major complications in pregnancies or deliveries. The next step would be, if the records look good, then we will ask you if you haven't had a pap smear within the last six months. Just about every fertility clinic in the country is going to require that be updated and be current within the last six months.

And I know that A lot of doctors now are only doing them every three years. We would work with you on trying to figure out the timing and how to get that cost covered by your agency. But we do have a form that every clinic requires. Just about every clinic that I'm aware of in the country requires.

And that's a form that you have your OB or your provider fill out when you go to have your pap [00:17:00] updated. And basically, or if your perhaps already updated, then you could just send this form to whoever performed the pap and they could fill this form out. But basically it just has the findings of their report of their visit with you as well as your pap results.

Any blood work that was taken. And then just a place for the provider to state, whether there have been any known complications in your pregnancy or delivery or obstetrical or gynecological history. And then there's a place for them to sign at the bottom, basically saying that they agree that it is healthy for you to attempt to have another pregnancy.

And that is a form that the fertility doctors that you will eventually work with as a surrogate are going to want to see because they want to know that someone is physically seen you, or has some, either personal experience or care with you or has personally cared for you, I should say, as a doctor or has your chart and can look through as a medical professional and say, [00:18:00] I've seen this person I've seen their chart they look good.

So once that form is signed off, then this is actually where Surrogacy Mentor would introduce you to and match you with an agency that is the best fit for you. And that's a whole other podcast episode that we'll talk about as far as how that works. But the next steps that I'm going to mention actually happen once you are matched with your agency and your agency would take care of making sure these steps get completed.

But the next step- I'll talk about the psych eval which is the next one. And then Marielle, I’ll have you talk about fertility clinic clearance? Yep. So psych eval is a lot, sounds a lot scarier than it really is, but basically it's a psychological consultation and evaluation that is performed by a mental health therapist, who has experience working with surrogates and intended parents and essentially it's a two-part evaluation. So first of all, if you have a spouse or a [00:19:00] partner, they do need to participate in at least the first half or the consultation portion of the evaluation. I would say most of the time, especially now with COVID, these are all now happening over video chat.

They used to happen a lot. And mine personally, when I was a surrogate. And I'm sure for you Marielle. At least some of your journeys happened in the actual therapist office, but now we can do these over zoom chat, which is amazing. So what will happen is the therapist will set an appointment with the surrogate and if she has one her spouse or partner, and it will be about three hours, total is the average and the first half of that, or at least half of that, I'm not sure some therapists might do it first or second, but half of that is spent just discussing the dynamics of a surrogacy journey from a mental health perspective and talking with the applicant about. The dynamics between the relationship of a surrogate and the [00:20:00] parents that she's carrying for. And the different things that can come up during a surrogacy that might be difficult.

There will also be some discussion about how does your partner feel about this process? Are they truly supportive or does one of you feel pressured into this situation? The other things that are talked about, or any past trauma, or adoption or any kind of trauma that might be in the past that might become an issue during the surrogacy. As well as any postpartum, severe postpartum issues, if there were any. Anxiety or depression issues after deliveries.

So all of the things that you could think of with regard to the many dynamics of a surrogacy journey. That's what's talked about, and it's in my experience, it's just as much the therapist asking questions as they are answering them. It's not just a, like an educational consultation. It's truly you getting the opportunity as a potential surrogate to ask your questions [00:21:00] and get them answered, and your partner as well.

 And then the other half of that is an actual evaluation, which is typically going to be a standardized proctored test, which is either going to be the MMPI or the  PAI? PIA? I always get those mixed up. I think it's PAI. But those are acronyms for two very common psychological evaluations that are administered during these psych evaluations.

And it's just a bunch of questions asked like a bunch of different ways. That seem silly when you're doing it. Really odd questions, but they take all of these answers and then they spit out a formula basically that says to the therapist that, based on these tests you're, mentally fit to move forward or emotionally prepared to move forward.

And I apologize to any mental health professionals that are hearing me butcher the description of these tests, but from my experience, having taken them, this is [00:22:00] what I experienced and it's that I was asked a bunch of strange and funny questions. And then there is a report at the end that says yeah I'm good. I'm mentally okay. 

Marielle Schuberth: I remember that they always ask the same question. It was about like some poets or an author maybe. Cause I've had to take it quite a few times in all my journeys. And I finally asked one of the therapists and they were like, what? I don't know who that is. I'm like, it's a bad that I don't know who this person is?

Like what, who is that? And what would it be like if I said I did? And it's like some obscure, they just throw some obscure things in, but for whatever reason, this same author came up in all of my tests. So I was like, I don't know if it's good or bad that I don't know who this person is. 

Carey Flamer-Powell: That is so funny. I don't remember that.

I just remember questions about being in traffic or something. If you were in traffic, would you do this? And the same question kept getting asked four times. Anyway,  it's a little silly and it's really not as scary as it sounds. But it is super important because what happens is once this psychological evaluation is done, they generate a report.

That's a written report that talks [00:23:00] about their interaction with you and your partner. All the things you discussed, what the therapist's impression was of you during that consultation, as well as the results of the actual test and all of that comes to a report. And hopefully what we hope for is a recommendation from the therapist that you, as far as they can tell from the report, you are mentally and emotionally informed and prepared to move forward. And that's the report that your agency will get allowing you to move on to the next step and technically final step I would consider in the screening process. And that is fertility clinic clearance. So I will let Marielle talk about that. Cause she has done this many more times than I have. 

Marielle Schuberth: So this will be done once you're matched with parents.  You will be given a contact at their fertility clinic. It's usually the nurse- they'll go over your medical history and kind of start working on scheduling this fertility clinic [00:24:00] appointment that's usually done within a certain timeframe within your cycle because they like to see what your endometrial lining inside your uterus is doing within the normal peaks and flows of your hormones during your cycle. So it's usually, I want to say 10 or 11 days after your period. So usually what that means is you'll be in contact with the nurse or your contact at the clinic.

You'll let them know when you start the first day of your period, and then they will work with you on scheduling within that window of time that they need to do the tests. So  they're also looking at your lining and then they'll also be testing some levels and all of that. So you'll travel down to the clinic.

They get some blood work done. Usually a urine sample as well. And then they do some form of ultrasound or some way to look inside your uterine cavity. I've had it done actually. Three different ways. I've hit them all. I have just done the regular ultrasound. I've done. What's called a hysteroscopy where they put a scope with a camera [00:25:00] past your cervix up into your uterus.

And I have done a saline ultrasound where they actually fill your uterine cavity with saline too, to get a better view of all of that. It all sounds super invasive, but it's not, it really just feels like, just like a pap smear. 

Carey Flamer-Powell: With the saline, it feels like you're peeing your pants. 

Marielle Schuberth: Yeah.

It's not it sounds oh, they're sticking. Yes, they're going up in there, but it's not as aggressive as it sounds. It's really not too big of a deal. And so once you do that, the doctor will be able to pretty much see inside your cavity whether or not they see a polyp or, kind of anything that they see that may require intervention to move forward, or that may disqualify you from moving forward.

They want to get a good idea of what they're working with. There somethings they may find, or, uterine polyps on which can be super common. I had one that I had to have removed before I was cleared to continue with my twin surrogacy.

They found a little something I just had to go in and they were able to get it off. I then had to go back for one last ultrasound, all was good. Things can move forward. So I just want to make sure that they get a good view [00:26:00] of what's going on to anticipate and stuff moving forward. Once you do your travel for that, but it will, you gotta wait for your lab results that sometimes those take a little bit longer.

Cause some of the testing that they do. It takes a bit, but once they get their lab results back they get the information from the psychologist and some clinics also. I've had to do a psych eval with the clinic specifically as well as with the agency. So depending on what your day looks like there and once I get all the lab work back, then the doctor will review it.

And if they say everything looks good, then you get your medical clearance and then you're good to move on to the legal phase of everything. And your partner- COVID times I think has changed this significantly. As far as back in my day, I'll say that- your partner would travel with you for the medical evaluation.

So they could also do the testing because they'll also need to undergo drug and STD tests. But now I think that a lot of these clinics are sending kits or sending orders to have your partner or a companion do testing locally. So they don't have to go with you since they're really trying to limit numbers of [00:27:00] people in and out.

But your partner does also need to submit to some testing of some sort, whether that's in person with you there or from here, cause they're also considered part of your medical clearance as well. 

Carey Flamer-Powell: Yeah, for sure. And so just to back up a little bit, The reason a surrogate applicant would need to go to the fertility clinic is because surrogacy-being a gestational surrogate, obviously is going to require IVF and a process of getting someone's embryo into your uterus.

 Cause again, we talked about misconceptions, I think on our first podcast, which is. Your egg is not used as a gestational carrier. You are not biologically or genetically related. So somehow that embryo has to be created and then transferred into your uterus so that you can carry the pregnancy. And the way that happens is at a fertility clinic, working with the fertility clinic, doctors and staff to be on a medication cycle.

And have [00:28:00] doctor visits that will, are two visits specifically, but one that will actually get you pregnant. The one that we're talking about is just the initial visit to meet the clinic, let them meet you and let the care providers, the doctors physically examine you, which is required before they can say definitively.

Yes, we can work with her. The question that we get a lot is, okay, am I going to have to travel out of state or away from home and the majority of the time the answer's going to be? Yes. And that's because depending on who you match with which agency you work with and who you're open to matching with, there are fertility clinics all over the country.

A big majority of them being either on the west coast or on the east coast and then a sprinkling in the middle. So majority of the time, I would say it's very common to have to travel. So in your case, you were living in North Carolina and then traveled to Oregon and. 

Marielle Schuberth: And Vegas. Yeah, I got lucky with my first one.

It was in Colorado, like a two-hour [00:29:00] drive. So I was able to drive to that one, but know all the rest of them have been pretty far. You couldn't get any further from, North Carolina all the way to Oregon, but it was. 

Carey Flamer-Powell: Yeah. And mine was the same. I was living in Oregon and had to travel to Atlanta, Georgia twice or three times.

Geez. I know. Yeah, mine was a little bit different. One was a little bit longer, but yeah, so most of the time, yes, you're gonna have to travel and that's why we're talking about, your partner might go with you. They might stay home and do their tests near home. So there's a lot of detail that goes into that.

And that's what we do here at Surrogacy Mentor. We educate you, help you understand that process. And of course match you with an agency that's going to be super amazing at walking you through all the steps and making sure that all your questions are answered and all of your expenses are covered for any travel that you might have to do.

That is the basic outline of the screening. And so if you're listening now and you're considering applying as a surrogate and you're [00:30:00] thinking, man, that's a lot, it is, and you're not wrong. And there's a reason for that. And so I want to move on to talk about as we start to wind down the podcast episode and talk about why are these guidelines in place, and who sets them.  So there's a lot of answers. There's a lot in that answer, but the main part of that answer is there is an organization called the American Society for Reproductive Medicine, or as we call it ASRM in the industry. 

And while they're not a governing body.They don't have power over, surrogacy agencies or fertility clinics. They do set guidelines and regulations, and they are a very respected organization that is looked to, to help guide medical and other policies around all sorts of assisted reproduction, not just surrogacy, but they do have a specific guideline that [00:31:00] lays out, okay. Here are the things that should be done before someone is approved to be a gestational carrier. And that includes all of the things we just talked about. There's ASRM. And then there are the individual fertility clinics who ultimately make the medical decisions involved in a surrogacy, meaning the medical qualification decisions.

Even if your OB says everything looks great, it's still up to the fertility clinic doctor to say. We feel like we can have a successful and healthy and safe gestational carrier cycle with this candidate. So, the individual clinics also set the medical guidelines and you will see that some of those will vary.

Some fertility clinics might say we will only accept gestational carriers with a BMI of maximum 30. If you have a BMI of 31, they won't accept you. Then you'll have other clinics that say we'll actually accept up to 32 and then you'll have other clinics that will say we accept up [00:32:00] to 34.

So it's very different. You might have some clinics that say, we'll accept someone who's had, three C-sections, but if they've had four C-sections no. And then you might have some that say we'll only accept one or two C-sections in their pregnancy history. So again, this is what Surrogacy Mentor exists to do, which is help you weed through all of these different criteria and work with agencies that are going to be a good fit for you and your particular situation.

So if we know that you, as an applicant have had. Two C-sections and your BMI is 32. We instantly know which agencies and clinics will and will not be able to work with you. So we can save you literally hours, days, weeks of interviewing and paperwork and hassle and help you weed through those. That's where the guidelines come from.

It's also important to know that the agencies don't have control over what the [00:33:00] fertility clinics set. If a fertility clinic says our BMI, max is 32, the agency is not going to change their mind and nor are they going to try. So the most important thing is to match with an agency that works with clinics that you meet the qualifications for. And obviously no clinic is going to accept someone who was not truly healthy and safe and able to be a gestational carrier. So it's not like you can pick an agency that's going to take a whole bunch of things that are not safe or healthy. It's just that there is enough of a variance and you have to know which agencies to work with in order to work with the right clinics.

And that's what we do. The other thing is. Each state is also going to have different requirements for surrogates. So again, surrogacy is not regulated in the United States on a federal or even in many cases, on a state level. So it's up to us as an industry [00:34:00] to self-regulate and set great guidelines and healthy, ethical Requirements.

But there are some states like New York, that just recently passed compensated gestational surrogacy laws. And so they have a very specific law and process for who can be a surrogate and even who can have an agency and in New York and they have specific. Criteria that surrogates must meet in order to fulfill that.

Washington state also has some specifics. There are different states. So again, that's our job here at Surrogacy Mentor, to help you figure out, okay, what state do you live in? What are the rules and qualifications that might be particular to you because that's where you live. And then. Why don't we talk about our last topic here is, what percentage of applicants actually get through all of this because it's a lot and it's a process for sure.

Why don't you talk about what you've seen just working at Surrogacy Mentor, but then also what you've learned in the industry as far as acceptance rate and what that looks. 

Marielle Schuberth: Yeah. So I [00:35:00] will start by saying we hate to have to turn anybody away. It's honestly one of the harder parts of the job because you see that there's somebody, who's got their heart in the right place, who wants to do something awesome for, helping grow a family, all of that.

So it's definitely, if we could approve everybody, we would, that's just, that comes down to it. But really it comes down to about five or 10% of applicants actually get approved and get through to being able to be matched with an agency and clinic and parents. Which is pretty low when you think of, that's not a big percentage.

But we do that for the safety of the unborn baby, the safety of the surrogate and the safety of the parents who are putting forth all this time. Effort, love, hope, all of that into doing this. So as much as we hate to have to turn somebody down, we really are doing it for the benefit of everyone.

And even if it doesn't feel that way, if you happen to be one of the people that we can't It's nothing personal. If we could just say yes to everybody, we would. But we would hate to say, sure, we'll find you an agency and then move you on and then have them be like, what? That's not fair either.

So we really need to stick to [00:36:00] these guidelines and stick for everybody's safety and wellbeing. It's just a necessity, but, 

Carey Flamer-Powell: and I will say at my agency that I used to own our acceptance rate was less than 5% and that's because I was super stringent on all of the criteria. And we worked with clinics who were also super stringent.

And one step that I did not mention in our steps of screening that we, that I used to do at our agency, that my agency that I owned and that a lot of agencies do, and that is a home visit with a social worker. So some agencies do it, some don't but just briefly, there are some agencies that will have a social worker;Because of COVID done over video chat a lot of times, but it used to be that we would have a social worker go to the surrogate's home and walk through the home and get their eyes briefly on each room of the house and the neighborhood, and talk briefly with the family, just to make sure that, she lives where she says she lives.

The house is obviously not like in major disrepair and that there’s [00:37:00] just a healthy, normal living environment. We just, again, if you have someone who's carrying your child, you probably want to know that they live, where they say they live and that the house isn't falling down and the kids and the pets look well cared for.

Nobody's looking for a perfect house or no dishes dirty, or even the floor to be vacuumed every single day. We're just looking at, is this a normal, safe, healthy place to have a pregnancy? That's really it. Less than 5% acceptance rate, meaning 95% of the people that applied with us did not make it through.

And I will say that most of the time, that was because of medical records. Things will pop up in medical records that maybe you and I are anybody would think it wasn't a big deal, right? Like we had some high blood pressures at the end of our pregnancy, or, maybe they diagnosed us with gestational diabetes towards the end, or, something that maybe we didn't think was a big deal, but there are clinics, that would [00:38:00] definitely from a medical perspective, consider that a big deal for a gestational carrier.

 So there's, could you have a healthy pregnancy if you wanted to have another child of your own? Sure. You probably could. But if someone is going to have you carrying their child and you're going to go through IVF and there’s, like you said, so much hope and time and effort and love and fear and money on the line for so many people.The clinics and the agencies, and we want to be super careful and make sure that everyone is protected. And that includes the surrogate. We don't want someone to get into surrogacy and find out that, wow, this really wasn't a healthy situation either mentally or physically or otherwise.

So it is very- you're right. Extremely hard to turn anybody away, especially now when the demand for surrogates, the need for surrogates is so extremely high. [00:39:00] But these things are in place for a reason and compromising on them is not an option. Having said that, there are a few common misconceptions that I want to wrap up with just to answer real quick.

And we'll actually do an entire podcast episode about this topic, but I just want to say things that are not going to get you rejected as a surrogate: having your tubes tied. You are not going to get rejected for having your tubes tied. Why? Your tubes are not involved in the process of becoming pregnant as a gestational carrier.

Your tubes can be tied and your uterus can still be absolutely perfect. Again, remembering that your eggs are not used, right? So yes. Tubes can be tied. Yes, you can have C-sections. There just might be a limit on how many you have had depending on the clinic. I would say the overwhelming majority of the time, if you've had three C-sections it's going to be pretty difficult finding a clinic that will approve you. Not totally impossible, but difficult because [00:40:00] the uterus can only take so many C-sections right? And I think that happened to you Marielle. That's why you couldn't do any more journeys?

Marielle Schuberth: Yeah, my doctor told me the last time that no, we can't cut the scar open again.

She said so I know I told you before, this should probably be your last one, but I'm really telling you now- you can't do it. So my OB even said that even if I could find another clinic that would do the fourth. My OB was like, Nope, it's not safe. And that's another reason why your medical clearance needs to come from your OB or provider that sees you because they know you. That maybe a clinic on the outside would say, sure, three C-sections is fine, but she was in my uterus and knew that it was not fine.

So that's another reason for your medical clearance coming from your OB. Exactly. 

Carey Flamer-Powell: And that is for the health and safety and wellbeing of the surrogate. The baby and everybody involved. Again, when you're in doubt and you're not sure okay, could this thing disqualify me? Could it not? Just apply?

Just take our easy quiz, two minutes just apply and, and we'll let you [00:41:00] know early on. We're not going to drag you through a bunch of paperwork. I hate that a lot of agencies used to do this. I don't know if they do it so much anymore with how many applicants we're trying to all process right now.

It used to be that you would fill out so many forms and go through so much to just to find out you weren't even basically qualified. So we're going to let you know early if you don't meet the qualifications so that your time and our time isn't wasted. Go on to our website. As we wrap up this episode, episode, two of our podcast, go onto our website, check us out at Surrogacy Mentor.com.

You're going to find information there about us, who the heck we are, why we think we know what we're talking about here. Our background, and then you're also going to find our quiz right there on the front page and all throughout the website. It takes two minutes, fill it out and we'll let you know if this is something that you could definitely do.

So don't forget to subscribe to this podcast and come back to learn more about having a safe, ethical, [00:42:00] and enjoyable surrogacy journey with Surrogacy Mentor. Thanks, Marielle. Appreciate you. And we'll talk to you guys next week. Thank you.