by Sara Connell
He interviewed my mother next about her health, medical history, and previous pregnancies. He jotted down her answers on a small notepad he had pulled from his lab coat pocket, writing in what looked like some kind of shorthand that included symbols, capital letter abbreviations, and hash marks.
“You’d need to pass my physical exam, an EKG, chest X-ray, stress test, blood pressure, and full gynecological exam for us to even consider it,” Dr. Allen said matter-of-factly. “We do have some experience with advanced maternal age pregnancies. Last year we had a woman in our practice deliver at fifty-four.”
I looked at my mother hopefully.
“There are some other things to consider,” he said. “Did you say you live in Virginia?”
My mother nodded.
“You’d need to move here for most of the pregnancy,” he said. “So we can monitor you closely. As the pregnancy progressed, I might recommend bed rest or even short stays in the hospital if blood pressure or any other issue arose. The blood volume doubles in pregnancy, more in the case of multiples—something to consider when deciding how many embryos to transfer.”
I looked at my mother again but said nothing. We hadn’t even begun to discuss those types of details.
“I realize that’s jumping ahead a bit,” Dr. Allen said. He leaned back in his chair and paused, resting his silver pen on his notepad, as if giving us some time to catch up with him. He cocked his head to one side and settled his sharp gaze on my mother.
“First, let’s find out if your body can handle a pregnancy.”
“You’re considering taking us on?” my mother said, her eyes hopeful.
“If you pass all the tests to my approval, I would be honored to handle this,” he paused for a moment, “mission.”
My mother bounced her legs under the desk. I restrained myself from hugging Dr. Allen. He told us he could do the initial gynecological tests immediately and excused himself to prepare the examination room next door. When we assured ourselves he was out of earshot, we called Bill and cheered into the phone. “You will love this man,” I said. “He talks like an army general.”
My mother stood up while I was on the phone and had turned toward the door. I hung up the phone and walked to her, reaching my hand out. She turned and I dropped my hand. Her eyes were shining and wide. “I feel like the ostrich,” she said. “I feel like I was made to do this.”
While Dr. Allen examined my mother, I met with Pam, Dr. Allen’s nurse practitioner, at the reception desk.
“My mother is in town for the next two days,” I informed her. “I have Dr. Allen’s list of tests here; we were hoping we could get them all done before her flight back to Virginia.”
Pam jerked her eyes up from the desk.
“This level of tests usually takes several weeks,” she said.
I attempted to keep my voice calm. My mother had made it clear that she wanted to attempt to become pregnant this fall.
“I’ve talked at length with your father,” she’d told me in the car on the way to our appointment. “I’m fifty-nine already. If I’m going to do this, I need to do it now.” Rachel at RMI had sent a heady typed list of items that needed to be completed before we even began treatment, with a note that the legal documents could take over a month to prepare.
“It takes longer than regular IVF,” she’d said over the phone. “A minimum of two months.” She went on to remind me that the legal documents could not be prepared until we had the medical okay.
“I just don’t see how this would be possible,” Pam said now, scrolling through the hospital’s master calendar.
“If there is anything you can do,” I said, laying my hands open on top of the desk console.
Pam set her hand on the phone. “Your mother’s the one who offered to be your surrogate?” she asked. I nodded.
“As soon as Dr. Allen finishes with your mother, come find me,” she said. “Be ready to run.”
Over the next forty-eight hours, my mother and I flew through the halls of Evanston Hospital with Pam, sometimes literally running from one floor or wing to another, while my mother underwent the battery of tests.
More than once, the rapid train we were riding threatened to halt. The doctors in radiology said they would not perform a new mammogram without viewing my mother’s most recent films, which were somewhere in an archive of some medical-records center in Alexandria. While my mother went to cardiology for her chest X-ray, I phoned four different doctors, tracing the paper trail from my her gynecologist to her primary care physician and ultimately to a medical-records center, where Tyrone, a saintly man, offered to personally go into the vaults, find the film, and FedEx them for same-day delivery.
The final item on the long list of tests was a glucose test—one I remembered from my own pregnancy. The test involved a blood draw before and after drinking a bottle of saccharine orange liquid to rule out gestational diabetes.
We reached the hospital’s lab at four forty-five. In our haste, we did not see the blue-and-white placard on the wall informing patrons that the lab closed at 5:00 PM. My mother had already managed to chug half the bottle of Glucola, when the nurse informed us of the cutoff time. My mother’s flight to D.C. was at eight o’clock the next morning. “No, she cannot do the test at a lab in Virginia and fax the results,” the nurse told us when we asked. The tests needed to be done as a unit, in one hospital—Dr. Allen’s orders. We would not be undone.
I called United Airlines and moved my mother’s flight to two o’clock the next day. She could come for the glucose test in the morning when the lab opened at nine, take the blood test by eleven, and make it to the airport in time for her flight.
One week to the day after our meeting with Dr. Allen, Bill and I received a letter by mail, with a note stating that a duplicate copy had been sent to my mother’s address in Virginia and another to Dr. Carolyn Colaum of RMI. The letter affirmed that my mother had passed all necessary medical testing and baseline boards and was “approved to begin fertility treatments with the intention of becoming pregnant as the surrogate for her daughter and son-in-law.”
There was a note from Dr. Allen himself, or perhaps from Pam, that read: “We wish you the very best and please keep us posted as you progress.”
That night, my mother called and we celebrated this milestone.
“I am so grateful for my body!” my mom said.
“You should be,” Bill said. “You’re a marvel.” I held the letter to my chest and took it to bed with me, placing it on my nightstand. The approval felt like a major validation. But lying in my bed that night, the sound of Bill’s breathing steady beside me, I felt doubts lurking in my mind like shadows. The tests we’d just completed were only putting us at a starting line. A surrogate pregnancy would be different, but we had no more guarantees than we did starting any other IVF cycle.
Dr. Allen and Colaum were quick to remind us that we really didn’t know how much age would affect chances of pregnancy and implantation as well.
In the morning I called Tracey to schedule our first “gestational host/IVF” appointment. We’d hoped to do an October cycle, but, based on the legal steps we still needed to complete our status, Tracey said the earliest we could start was November.
“And to make that, you’re going to have to hustle,” she said.
“We’ll do November,” I said, dialing my mother’s number on my cell phone while I was still thanking Tracey on the landline.
Bill and I met with Stacy Jacobs, a reproductive technology lawyer, the first Monday in October. Her office was located in a large, stone, art deco–style building on a dense block of the downtown Loop in Chicago’s financial district. Stacy wore a conservative brown wool suit and looked about my age, mid-thirties. She shook our hands and began to walk us through the legal document we would need to complete to be eligible for surrogacy.
“Your parents will need their own document,” she explained. “It has to be prepared by another firm, but I can recommend someone if y
ou’d like.”
We told Stacy that we wanted to pay for the legal fees for both sides.
“That’s fine,” she said. “Most people doing surrogacy within the family do the same.” She told us about other families she’d worked with, including an aunt-niece pair and sisters, who’d embarked on this very same process.
In the contract she would prepare, we’d be required to specify our decision if faced with a multitude of upsetting scenarios revolving around one core theme: What would we do in the event that we had to make a choice between the life of the baby or babies and the life of my mother?
In every case, we told Stacy, we would choose to save my mother’s life.
When Stacy completed the exhaustive list, she asked about the number of embryos we intended to transfer, recommending that we be conservative.
The doctors always say the risk of multiples is low, but I’ve seen it so many times.”
“Twins?” I asked
“And triplets,” Stacy said.
The thought of my mother’s becoming pregnant with triplets was sobering. Bill and my father were both advocating the transfer of one embryo. I felt comfortable transferring two. My mother said that she was on board for three, if Dr. Colaum would do it. When she said this, my father shook his head insistently at Bill, entreating him to be a tempering agent to my mother and me if he was not there.
“When do you start IVF?” Stacy asked.
I shared our November 1 appointment date.
“That’s tight,” she said. “The legal process is typically six to eight weeks.” But she promised to prioritize our contract and aimed to complete the first round by October 10.
As she walked us to the elevator, Stacy said, “You picked a good state to do this. Illinois is one of the only states in the country that recognizes biological parents as the parents, regardless of who carries the baby.”
If we were to have the baby in D.C. or Virginia, we would be required to file paperwork similar to that of an adoption.
“That is lucky,” Bill said, as we rode the elevator down to the street level.
We stepped out into the sunlight that cut between the high-rise buildings and the press of morning commuters who populated the offices in this part of the city. At the crosswalk, I stood next to Bill in a sunny patch on the sidewalk and allowed myself to feel gratitude for this small blessing. If—or, I tried to think, when—our baby was born, my name would be the one on the line that read “Mother” on the official birth certificate.
My mother returned to Chicago again for the psychological evaluation and baseline ultrasound with Dr. Colaum. Although we were still waiting for our legal documents to be completed, my mother could start her precycle monitoring. Once we began officially, I would undergo the full IVF cycle of injections and oral medications, until it was time for them to retrieve my eggs. While my injections stimulated my follicles, my mother would start whatever combination of hormones Dr. Colaum prescribed to create a nice, thick lining in her uterus. We scheduled our ultrasounds the same morning and then had back-to-back psychological evaluations with Dr. Lee-Ann Kula, one of the approved psychiatrists on Dr. Colaum’s list.
My mother, who had been therapy-averse most of her life, kept asking what I thought the psychiatrist would ask.
“We’re not going for therapy,” I reminded her. “I think she just has to verify that we’re sane.”
Normally, I would have been happy to speak to a psychiatrist. In my heart, and in our cozy discussions around our dining room table, I believed, the way my father did, that our vision was authentic and soul-inspired, but I also knew that to an outsider the idea could sound crazy. I hoped Dr. Kula was an open-minded sort of person.
We needn’t have worried. Dr. Kula met us at the door to her office with open arms that turned into a full two-arm embrace. She wore a peasant-style skirt with a wide leather belt, and her office was adorned with hanging plants, swirling colorful artwork, and a jumbled bookshelf overflowing with self-discovery and therapy books.
She motioned for us to take a seat on a low white-leather couch and said, “I must hear how you came to this incredible idea.”
My mother looked on guard. I wondered if she thought Dr. Kula’s effusive behavior was a technique to get us to say something that would cause her not to approve us.
“I’ve been so excited to meet you,” Dr. Kula continued. “I actually cried when I heard your daughter’s phone message.”
She sat in a well-worn chair opposite us and took a long sip of tea from a mug. “Why don’t you start, Sara?”
Telling our fertility story was beginning to feel like singing a sad ballad from my first album, one that I hoped to grow beyond but that was always requested at concerts. Dr. Kula made loud tsk-ing noises when I came to the part about the twins’ being stillborn and said “shit” when I told about the miscarriage. I was surprised and pleased by her transparent emotions. I decided I liked a therapist who swore. She also disclosed personal details about herself, telling us that she had tried to get pregnant for years, before, at age thirty-nine, adopting her son and then getting pregnant two years later. “My children have been my greatest gifts,” Dr. Kula said.
My mother and I nodded, understanding why. As Dr. Kula continued, she unfolded her hands and placed her bag next to her on the couch.
“And now you, Kris,” Dr. Kula said, turning her gaze on my mother. “How did you come to this vision?”
“It’s interesting you should use that word,” my mother said, seeming to release whatever reservations she had come in with. She told Dr. Kula about the vision workshop, her meditations at her rock in the woods, and the letter she wrote us offering to carry our child. She also said some things I had never heard before.
“I saw Sara suffering. And I thought, I don’t know if I can carry a baby, but I can get in there with her. She doesn’t have to do this alone.” She put her hand over mine. I couldn’t bring myself to look at her directly. My throat tightened around a hard knot of tears.
“Mom,” I whispered, starting to cry, not really caring what Dr. Kula thought or decided.
Dr. Kula handed me a box of Kleenex.
“I have another reason for doing this,” my mother said after we’d re-grouped. “If I am completely honest, I want to have this experience for me.” I felt a rush of gladness hearing my mother share this fact. It was something she’d shared with me, but it wasn’t something I’d heard her say to anyone else.
“All my life, I wanted to be called to something heroic, but I could never think what,” she said, her hands unclenching at her side.
“This is heroic,” Dr. Kula said. “You’d be giving a gift, literally, of life.”
For a couple of seconds, no one spoke. Dr. Kula looked between my mother and me, perhaps waiting to see if there was anything my mother wanted to add.
She looked at a digital clock on her bookshelf. We’d been in her office for close to two hours. She still needed to have a brief conversation alone with each of us, so we took turns waiting in the hallway while the other spoke to Dr. Kula alone. At the end, Dr. Kula hugged my mother while I wrote out her check.
“I’ll be faxing my approval to Dr. Colaum’s office and your lawyer’s as soon as I speak to your husbands. Bill’s appointment was the following day, and Dr. Kula had approved my father to do his consultation over the phone. “I especially cannot wait to meet your other half,” she said to my mother.
“I passed!” my mother said as soon as we got into the car. I smiled as she recounted our discussions, but I had to struggle to concentrate on the road. I felt spent from the day of appointments, and the emotion of retelling about the stillbirths and miscarriage.
The afternoon traffic was heavy coming out of Evanston, and we slowed to a creeping pace. My mind poked at something Dr. Kula had told me during my individual consultation. During her attempts to become pregnant, she’d met with an unorthodox doctor from South America who was doing a new kind of fertility treatment. “He took the l
ow bottom cases, those everyone else had written off,” Dr. Kula had said. “When I went to see him, he put his hand on my shoulders, looked me in the eyes, and said, ‘You will be pregnant within three months.’ I had my second son later that year.”
As I drove, I wished I could go see that doctor. I wished he could offer me that kind of assurance.
“You know what Dr. Kula said to me at the end of my session?” my mother said, interrupting my reverie.
“What?” I asked.
“She told me she thinks this is going to work. She said, ‘This is going to happen.’”
My parents flew back to Chicago together for a “signing party” once our legal contracts were finally processed. We also scheduled our first IVF appointment at RMI that week.
My parents told us that they had shared the surrogacy idea with exactly one couple, friends of theirs for over twenty-five years. “Janine’s first reaction was disbelief,” my mother said. “When she realized I wasn’t joking, she cried. And when she overcame her shock, she had so many questions.”
She’d asked my mother if my parents thought it would be hard not to keep the baby after carrying him or her for nine months.
“I am so clear that this is Sara and Bill’s baby,” my mother had said. “What I want now, more than anything, is to be a grandmother.”
Janine had continued to stare at my mother as if she were speaking to a stranger.
“There are lots of parents of grown children who want grandchildren,” my mother had said, trying to make a joke. “Maybe I’ll start a trend.”
“Don’t count on it,” Janine had replied, continuing to look at my mother in awe. “I don’t think most of us would do it.”
Meanwhile, Bill and I had told no one—not even Bill’s business partners, Kaitlin, Amanda, or any of our friends in Chicago. We’d experimented in our previous IVF cycles, telling a lot of people, or very few. This time, I fantasized about waiting to share the news until the baby had arrived. “Hey, look! It worked. Meet our baby!” Or at least until we were seven to eight months pregnant, long past the twenty-two week mark, when the baby would be fully developed and capable of surviving on its own even if it were to be born that day.
