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Following the Royal College of Midwives webinar on Surrogacy last week, a Midwife got in touch with us to share her experience and her concerns about what the promotion of surrogacy in midwifery means for her. To protect her identity we share the following without sharing her name.

As an RCM member for the past 28 years, I’ve always felt my union has had my best interests at heart. I’ve felt confident of their support and on the very few occasions I’ve needed their assistance, they haven’t let me down. But now I feel things may be starting to change, and I’m deeply concerned.

I attended their webinar last week which was advertised online as a discussion on surrogacy and how we, as midwives can support parents of babies born of surrogate mothers. The subject of surrogacy troubles me but the content shocked me.

Since I was a teenager at the start of my training, it is embedded into the heart of what it is to be a Midwife and that is to be ‘with mother’. Our role is to be her closest carer and her biggest advocate – yet here we were being told in this new way, she is not a mother, but a ‘carrier of a baby’. A baby who is to be given away at birth, and not only that, our care as midwives should be transferred over to these ‘intended parents’.

It was very clear as soon as the webinar started that this was not a discussion or a debate on surrogacy, but well thought-out propaganda on the wonders of surrogacy, with stories from a surrogate mother and two parents of children born through surrogacy.

There are no official stats on how many children are born through surrogacy in the UK. There is no disclosure on prospective parents and we know just by reading the news, that people from the UK are traveling abroad to buy babies. Although women in the UK are not paid for their ‘reproductive service’ there are incentives and ‘independant journeys’ (private arrangements) are being made online. If you’re lucky you get an Apple Watch and Ann Summers vouchers among other goodies from an agency. When someone in the chat questioned the ethics of this, they were told by the owners (two men) that it’s nice for the surrogate to have the Ann Summers vouchers to spice things up with her partner as she can’t have penetrative sex when pregnant. Oh how we laughed, does anyone want to tell them? Questions that criticised this controversial practice largely went unanswered.

The surrogate mother and CEO of another agency, Surrogacy UK, told her story of carrying 5 babies for other people, some her own eggs, some not and once during COVID. She was asked if she was concerned for her own health and well-being due to the risks of the amount of IVF pregnancies she’d put her body through. She said she made fully informed decisions by speaking to her obstetrician and was aware of the risks and happy to take them. It’s worth noting that the long term implications cannot be known but that multiple cycles of IVF have been shown to increase the risk of ovarian and uterine cancers. Not to mention the risk of vaginal/rectal/cervical prolapse in later years following so many pregnancies. Along with her other children this woman had a total of 8 pregnancies and births including 2 c sections.

The two men who were advocates for surrogacy having had two children by arranged births and egg donation and they have their own agency and have recently expanded into Mexico City. Promoting surrogacy and offering the incentives discussed, they talked about the horrendous experience they had of the surrogate being called the mother by a Midwife and that their name could not appear on the ID band of the baby in hospital. It’s worth noting that unless a couple have the same surname, the baby will always have the mother’s name on the ID band. This is not to offend or irritate but for the basic security and safeguarding of the baby in case of a mix up or kidnapping. They were quite proud to announce that the health board crumbled at their request and they got to put their names on the ID band. Who cares about safeguarding for babies anyway eh?

My biggest concern is the long term implications for the birth mother and the baby. A baby who has known nothing but their mother’s heartbeat, her voice, her body for 40 weeks, only to be taken away and placed with strangers. And for the mother, who needs her child close to her for both their wellbeing, to regulate temperature and heart rate, to stimulate feeding instincts, to contract the womb, minimise bleeding and to release oxytocin to reduce the risk of postnatal depression and complications.

I know there are instances where this is unavoidable, but we shouldn’t as midwives, be promoting this as the norm. I don’t provide postnatal care to adoptive parents or to foster parents, so why am I being asked to treat these ‘intended parents’ as if they are the ones who have given birth? That is not my role as a midwife.These people are not my patients.

I am heartened by the fact that the student midwives I’ve spoken to feel that surrogacy is a problem in modern society. This seems to be due to the boom in celebrity surrogacy where it is clear the rich and famous are exploiting poor and vulnerable women, using them as a ‘vessel’ to carry a baby to avoid putting their own bodies through the trauma of childbirth. And the grotesque fad of lying on a hospital bed, as through they have just given birth themselves, is doing nothing to convince our new recruits that this transaction is anything other than a horrendous experience for the mother who has just given birth, and for the baby who has been removed from his or her mother literally seconds after being born. Sickeningly, there are numerous photos of babies still attached to the umbilical cord with the placenta still inside the womb, as the smiling commissioning parents hold this newly delivered baby that is crying out for their mother.

I have been taught a research-based approach throughout my career and to apply critical thinking whenever there is discussion or debate. Yet there was no other side to this webinar and the questions examining the other side were ignored. No known long term implications to the child born of surrogacy were discussed, no evidence of a long term follow up for women who have given their bodies and their babies to others. And no matter if surrogacy is commercial or altruistic, arranged on facebook or through an agency, if the mother uses her own egg or if the embryo has been conceived with a donor’s eggs, the social and moral outcome is the same.

A baby has been taken from his or her mother at birth.

Surrogacy in the Ukraine is not the focus of our campaign but the commodification of women, the buying and selling of babies and the tragic loss of life in Ukraine is impossible to ignore.

This is a short story piece intended to explore the desperately sad realities of surrogacy in Ukraine which has been in the news again since Russia invaded on 22nd February 2022. This is a fictional piece, based on what we understand to be the real-life situations women are facing.

We thank L K Agnes for sharing her creative skills with us.

Birthday Girl

The blanket Nataliya is lying on does nothing to mitigate the unforgiving marble floor, and the soft, sweeping curves of the metro station belie the cold, hard reality of her situation. She can’t get comfortable, she is sore, tender, ripped and stitched. There is no position that helps. She swallows another two painkillers, the one thing she made sure she had with her as she made her way underground, swept along on a dark tide of fear and determination. A woman touches her hand.

‘You’re bleeding, let me help.’

Nataliya sits up, wincing in pain as she does so, and sees her blanket soaked in blood. She doesn’t care she just wants to sleep. She tries to dismiss the woman with a weak wave of her hand as she lies down again. The woman calls out,

‘We need a doctor here, quickly!’

Another woman comes running over, puts a hand on her head, says she has a slight fever. They tell her she needs to sit up and stay awake as they prop her back against the wall. The second older woman points at her front.

‘Where is your baby?’

What can she say? Only a few days ago she was in the clinic, her baby still inside her. She wasn’t paying much attention to the news, just looking forward to getting all this over with. They would both have a good life, she would be able to afford to buy her own place, and baby would be sleeping in the beautiful nursery Mhairi had shown her in the photos on her phone.

‘We wanted to get away from all the pink and girly clichés, so we chose a soft dove grey. What do you think?’

Nataliya thinks grey a strange choice for a baby’s room but knows better than to say so. The wallpaper is an intricate design of flowers and birds, so she admires that and coos over the pretty white crib. This baby is one day over the due date but her contractions haven’t started so she is sitting up in bed, reading glossy magazines, waiting for her new life to begin. Mhairi and Donal are staying nearby, visiting three times a day. Mhairi keeps wanting photos of her, her hand on Nataliya’s bump, the two of them leaning in, a hand on each shoulder, Donal with his arm around Mhairi as she clasps Nataliya’s hands. Mhairi keeps saying how these will be precious memories to show her baby as she grows up. Nataliya wishes they would leave her alone. She pretends to sleep hoping they will take the hint and leave. She hears Mhairi whispering to the doctor as she dozes.

‘Can’t you induce her or do a membrane sweep or something? We need to get her out of here and we don’t know how much time we’ve got left.’

The doctor says he wants to give it one more day, give baby a chance to come of her own accord.

‘We might not have one more day,’ says Mhairi. Donal shushes her, says she’s over reacting, no-one seriously thinks they are in danger. For the first time Nataliya begins to feel uneasy, she checks the news on her phone when they’ve gone. It’s fine, nothing has changed.

That night she hears the explosions, far away in the distance but near enough for her to understand everything has changed and that the unthinkable has happened. Mhari and Donal arrive ashen faced, just after six o’clock in the morning. They have a smart looking Asian woman in tow, who they they introduce as their lawyer. She hears the lawyer woman arguing with the doctor outside her room, just before they come in to tell her she is going through for a caesarean. Her waters break as she is being prepped for theatre.

‘Tell them baby is making her own way here, after all,’ says the doctor.

Five hours later, after a rushed and brutal delivery, she produces a beautiful baby girl. Nineteen stitches, one for every year she has been alive. Aisling is not the name Nataliya would have chosen but it’s pretty nonetheless. As they wheel her back to the ward, she feels an unexpected surge of love for the child, overwhelming her with it’s force, and she starts to weep. She didn’t expect this. She’d felt nothing but relief after giving up her first baby for adoption two years ago. She was so ashamed, she just tried to ignore it and by the time Bushka finally saw what was going on, it was too late for her to have an abortion. She didn’t regret it, she knew she could never have loved a baby planted in her with such violence, it would have been a constant reminder of her defilement. She naively thought this would be the same, except this time she would be in control. She realised now what a terrible misconception that was.

Donal and Mhairi are sitting by the bedside, whispering about some Irish senator who has assured them she will get them all out. Nataliya feels lucky she has people to help her escape this, and no family to leave behind. She was brought up by her beloved Bushka, after her mother abandoned her, but Bushka died nearly a year ago now and Nataliya has been fending for herself as best she can since then. She’s not stupid, she knows what will happen., Bushka has been preparing her for this all her life. All her dreams are shattered and she’ll have to flee from this city and the only home she’s ever known but at least she’ll be safe and the money will help her make a new start. The lawyer woman asks her to sign some documents, a birth certificate stating Mhairi and Donal are Aisling’s parents. Nataliya shakes her head,

‘I can’t do it, not today. I need a little more time…’

‘There is no time and we need to get everyone out as soon as possible. Once you sign, you will be paid the final instalment. You don’t want to be left here with a baby to look after.’

She reluctantly signs, her tears dropping onto the document and making the ink run. At least they will be safe and together for a while. When the baby starts to cry, the nurse passes her to Nataliya without thinking, sensing that’s what the infant needs. When Aisling starts to nuzzle, she instinctively tries to put to her baby to her breast.

‘No!’ shouts Mhairi, grabbing the baby. ‘No! No, you must express, that was the agreement. You mustn’t bond with her.’ She runs to fetch the nurse who quickly attaches a pump to her left breast.

‘Can you do both together, ‘ asks Mhairi. ‘We need to get out as soon as possible.’ The nurse comes back and attaches another pump to her right breast. The machines continue their aggressive suction as Nataliya cries for her baby and her baby cries for her. Donal checks his phone as the nurse removes the pumps and hands the bottles over to him.

‘The transport will be here in a few minutes,’ he says. ‘Take this so we can feed her in the car and then we should have enough formula to last until we reach the border. We need to head downstairs to meet them now. There’s no time to spare.’

‘There is no worry. I can express milk on the journey,’ says Nataliya as she throws back the cover to try and stand. The nurse comes over and tells her to stay in bed.

‘But we are leaving, I must to get dressed.’

Mhairi looks at Donal, neither of them say anything. Nataliya feels her spine turn to ice when she finally understands the meaning of their silence. The lawyer rolls her eyes and places an envelope down on the hospital table, saying in a clipped tone,

‘Only Aisling will be leaving with us. That was the contract you signed. Here is the final payment. It’s in cash because there are problems with the banking system.’

‘But you said everyone need to get out?’

‘I meant Aisling and her parents.’

She hurls the envelope across the room. ‘She’s my baby, you can’t take her without me!’

‘Aisling is Mr and Mrs Donovan’s baby now. They have fulfilled their side of the contract We have people working 24/7 to get the babies out safely but there is no authorisation to take anyone else. You don’t have a visa and we need to go now. They’re expecting further shelling tonight.’

‘Then just take me with you to the border. Please, you can’t leave me here!’

The lawyer shakes her head. ‘I’m afraid that won’t be possible.’

Mhairi passes Aisling back to Nataliya as she picks up the baby bag, stuffed with the nappies, bottles, wipes and blankets and a cuddly koala bear with a joey in its pouch. Mhairi told her the bear is called Natty and will help Aisling understand what a surrogate is.

‘Here, you can kiss her goodbye – we’ll never be able to thank you enough for this, Nataliya. You’ve made all our dreams come true.’

She buries her face into her baby’s scalp, hugs her close and breathes her in for the last time. Donal reaches over to take her. Nataliya refuses to let her go but the nurses hold her arms as Donal prises Aisling from her grip and tucks her into the baby carrier. The three of them practically run out of the room without a backward glance, taking her beautiful daughter with them.

‘It’s for the best,’ says the nurse, injecting her with a sedative. ‘She’ll have a good life over there.’

They send her home before dark, the shelling is getting nearer and they don’t have a bomb shelter at the clinic. As she lets herself into the tiny apartment, she’s bombarded by a barrage of emotions, grief, anger, fear, shock, shame and numbness. Numb she can cope with. She needs to focus on staying alive and so decides to move her bed into the windowless bathroom, no glass to shatter in the blast and a bath full of water to put out any fires. Advice from her Bushka who had always feared this day might come. Nataliya is glad her grandmother is dead now, that she doesn’t have to endure the terror of this for a second time in her life. She feels a pull on her stitches as she drags the small single mattress from her bedroom. She sits on an ice pack, glued to her phone, weeping as she scrolls through footage of a town less than an hour away being shelled. Blocks like hers, shattered and derelict in the space of a few seconds. She checks her bag. Pads, painkillers, blanket, bottled water, cereal bars and a polaroid of Aisling. They wouldn’t let her have a picture of Aisling on her own, so it is Aisling and Mhairi, Mhairi holding the baby like a trophy. She told her many times that Aisling would be told from the beginning about her ‘tummy mummy.’

‘She’ll always know what a gift you gave us. We’ll make a book with photos of you and pictures of Kharkiv. She’ll see what a beautiful city she came from. We will always be grateful to you.’

Not grateful enough to take me with you, she thinks, as she takes the nail scissors from the bathroom cabinet and snips Mhairi out the picture. She wonders if Aisling will hate them when she finds out they left her birth mother in a war zone and tries not to hope she does. She doubles over as she recalls the gut punch of pure love she felt when she first saw her, the savage cruelty of her attachment to a child she’d already sold. In that moment she knew she could never let her go and knew she had no choice. Aisling’s screams combined with her own, as they tore her from her arms, are echoing inside her skull as the air raid siren sounds. She didn’t believe this level of pain was possible. The tear she suffered has left her in agony but the emotional pain of having her baby snatched away from her is worse, and she has only herself to blame. Now her country is being ripped apart too, the world she knew is ended. She considers taking all the painkillers washed down with vodka but she can’t bring herself to do it, what if they get turned back and her baby needs her. She grabs her things and stumbles out into the street, heading for the subway.

Now she is bleeding and terrified in an underground station, no longer knowing whether she has a home to go back to. The second older woman shakes her again.

‘Where is your baby?’

She looks down and sees the milk leaking through her clothes. She forgot to pack the tablets to dry it up. Her breasts are hard and agonising to touch, she wishes she had the pump with her it would be such a relief to be rid of the pain in at least one part of her body.

The old woman speaks again. ‘My name is Olga, what’s your name?’

‘Nataliya,’ she whispers.

‘OK Nataliya. I used to be a midwife. We’re going to help you but please tell us where is your baby?’

A week ago she was proud of what she was doing. She was told it was an empowering choice and the most lovely gift she could give to Donal and Mhairi. Now she feels a shame deeper than the tunnels they are sheltering in. She sold her baby and she doesn’t want this kind woman to think badly of her.

‘My baby is dead.’

‘Oh my darling, I’m so sorry.’ She moves to hug her but Nataliya flinches from her touch. ‘I do need to examine you.’ She calls for help and people gather round, holding up blankets to create a screen. ‘OK, we need a doctor, as soon as possible. She needs blood and maybe antibiotics. Does anyone have any they can spare until we can get her to hospital?’

As people rush off to see if they can get hold of drugs, Olga undoes Nataliya’s top and gently helps her to start expressing her milk, the pain starts to ease. The first woman rushes over.

‘There is a hungry baby here, his parents left this morning to try to get their family out of Moskovskyi district. They should have been back hours ago but no news, no contact. His Bushka is frantic. Can we?’

Nataliya nods as they pass her a baby, bigger than Aisling maybe a few months old. The baby resists latching on, he doesn’t recognise her, the unfamiliar smell of her skin, but then he finds her nipple and suckles hungrily. Nataliya feels nothing at first but then she sees the little boys face, his big blue eyes, how greedy and determined he is to feed and to live. It soothes them both. His Bushka is sobbing, a mix of grief and gratitude. Olga rubs Nataliya’s back and gives her a sip of water.

‘Well done, good girl.’

He settles after his feed and his grandmother rocks him to sleep as Nataliya bleeds out onto the cold, hard marble. Olga wipes away her own tears as she gently closes Nataliya’s eyes and covers her face with the blanket.

Tag Archives: mothers

Words from a Midwife: Part One – Guest Post from Anonymous

“Birthday Girl” – Guest Post from L.K Agnes