Womb for rent: A peek into the world of surrogacy

Photo: babiesafter35.com

She asks me to switch off my phone to have the conversation. She doesn't want to risk a picture sneakily taken. I am at her home in Nairobi's leafy suburbs and her two children and husband are away; at school and work respectively. Her help has been sent away on an errand. This is the only way we can do an interview, in absolute privacy. Michelle Wangari* is an attractive woman in her mid-30s. She is also an executive at a local telecommunications firm. She doesn't fit the often perceived mold of a surrogate being 'out there for the money'. She is affluent. Three years ago, she decided to be a surrogate, not for the money, she is quick to point out, but for the principle.

"I did it for a friend. She moved away after the baby was born. It is better this way," she says with a fleeting smile.

"My best friend Ann* couldn't carry a baby to full term. She was desperate and asked me to help. At first I was hesitant, knowing that my husband would object, and that my children would not understand the situation. I declined. Then she got breast cancer and beat it. And I remembered a conversation we had as I held her hand during chemotherapy sessions; that if she recovered she would do her damndest to have a baby. She would adopt or go for IVF treatments. Seeing her fervour, and knowing how fertility treatments would wreck her body, I relented."

At the time, Michelle and her husband were separated and trying to work things out in counselling. This, Michelle knew could completely unravel their relationship.

"My husband had cheated on me. And he had deeply hurt me. We were working things out and no one, not even our babies in boarding school, knew that we were living separately. I told him that this was something I really wanted to do. And he agreed on condition that It was done in the greatest form of secrecy and I didn't have any sexual relations with the man involved."

So Michelle, Ann and her partner went to a fertility clinic in Hurlingham. They carried out some tests on Michelle and a month later, inoculation was done.

"We had an agreement drawn up by our lawyers and they were going to cover all my medical expenses. I continued working till the fourth month before the pregnancy showed and applied for a year-long work study leave. I had applied for this earlier in the year oblivious that it would serve me well later. I eventually got my certification through long distance learning."

After the fourth month, Michelle went to Zanzibar where Ann and her partner owned a beach villa; there she remained till the baby came.

"I am happy it all worked out. My children didn't get to see me for about seven months but they knew that mama was away in school.We would skype a lot. My husband would fly down there a lot and I can say the pregnancy made us closer. I gave birth via C- section and Ann was there. It was a baby boy. He isn't biologically mine but I love him as my own. It wasn't hard to hand him to Ann, because I know that he belongs to her. He will know me as his aunt. I didn't breastfeed him at all and had to take some tablets to cut off my lactation."

And was she paid for the experience? I ask.

"Yes. Ann insisted. I didn't want any payment, as I was helping out a friend. They transferred a one-acre piece of land to me. No one not even my family is aware of what happened. And whenever I look at C-section scar, I remember that I gave someone a great gift. And it makes me happy."

The custodian


She had been trying for a baby for twelve years but because of complications due to fibroids and later myomectomy (the surgical removal of uterine fibroids), Alice Adi'* couldn't carry a pregnancy to term. She would have miscarriages even before she knew she was pregnant.

She had tried in vitro fertilisation (IVF) twice but that didn't work out. Her last option for having a baby genetically related to her was via surrogacy.

"I didn't work with a surrogacy agency. I had friends look around for me without any strict specifications on what to look out for in the surrogate mother. I just wanted someone who would understand my struggle to be a mother and willing enough to carry a baby for me," Alice says.

At around that time, she had a relative in town who had separated from her husband and was looking for a job. "It occurred to me to ask her. I knew her, her family, her character and that of her family, and she already had two kids of her own. I felt secure asking someone who was kin."

The concept was new to the relative she spoke to; she didn't give immediate feedback. "I first told about my years of struggle and how everything else I had tried had failed. I told her I had friends looking for a surrogate for me. She told me she needed time to think and pray on it and even consulted her pastor. After a month, she told me she would do it," Alice says.

"We had an understanding. My husband and I were to take care of the medical expenses throughout the pregnancy. We would also pay for her living expenses including her rent as she didn't have a job. After that I was to pay her a token of appreciation. Other than that there were no conditions. I didn't tell her what to do or what not to do during the pregnancy. I was in no position to give conditions. I was just relieved that someone was willing enough to do this for me and didn't want her to think that because I was paying for her expenses and that of her children, I was the boss and could issue orders. If you start giving conditions the surrogate can do anything, including terminating the pregnancy and there is nothing you can do about it."

Alice, her husband and the surrogate had a lawyer draw up a contract based on the same understanding. They went to a doctor for a series of medical screening and checking for infectious diseases. An embryo was created by IVF using the sperm and ova of the couple and implanted in the surrogate's uterus.

"We got confirmation of pregnancy with the first try," Alice says. She accompanied her to every appointment and regularly checked in on her. They got to tell the surrogate's family about the arrangement when she was five months pregnant. "They were happy for us," she says.

By the time the surrogate mother went into labour, the couple was financially wiped out, so much that they could not afford a private facility or the private doctors they initially worked with. They had already spent close to a million shillings and had sold "pretty much everything." "She gave birth in a public hospital so neither my husband nor I was present in the delivery room. She gave birth on a Friday night and we had the baby with us on Sunday afternoon."

The couple and the surrogate went through counselling throughout the process. The counsellor advised us not to have the surrogate breastfeed the baby as this would create a strong bond which will make it distressing for the surrogate to give up the baby.

According to the Kenyan law, the birth mother is legally the mother of the child and the intended parents have to go through an adoption process for the intended mother to be recognised as the mother of the child. But because Alice and her husband couldn't come up with the money to go through the process, the baby's birth certificate still has the surrogate's name as its mother.

"It was a long process and the financial burden was the equivalent of labour pains, but once I held my baby in my arms, watching her grow and play, it makes it all worth it," she says, "we will go through adoption in due time."

Where does the Kenyan law stand in this matter?

According to the Children's Act, a mother is the one who gives birth to a child. The same Act provides that parental responsibility belongs to the parents. The person who gives birth has the rights over the child. So where does this leave surrogacy?

In early 2016, the Assisted Reproductive Technology bill was amended to include that a surrogate mum ought to be above 25 years of age. Other than that, there is really no other regulative measure thus opening up the process to corruption and other irregularities.

Surrogacy is relatively new in Kenya, with the very first one being in 2007 and with the stigma surrounding the practice, there are no definite figures on the prevalence However, Dr Wanjiru Ndegwa-Njuguna,a fertility specialist at Footsteps to Fertility Centre says that the use of surrogate mums is on the rise.

"Many won't admit to going that route because they will be shunned. That is despite the fact that they are giving a wonderful gift to couples who need their help.What complicates surrogacy is the financial implications and the fact that it is legally complex," she says.

Surrogacy, she explains, is of two types; partial and full. "Full surrogacy is the most common. It involves the creation of an embryo by IVF using the sperm and ova of the intended parents. Partial surrogacy involves the creation of an embryo using the sperm of the intended father and the ova of the surrogate."

"Normally, we refer clients who have considered the option to a surrogacy agency."

Once the couple has chosen a surrogate, even though the surrogacy agency has already conducted a series of interviews with the surrogate, she goes through another round at the doctor's. "We do interview the woman and background check that she is not doing it purely for the money, that it is actually for altruistic reasons, and a lot of them want to help," says Dr Wanjiru.

Requirements for a surrogate mum

1. She has to have had a baby before.

2. If married, she has to have the consent of her husband.

3. The surrogate also has to go through psychological and medical screening for infectious diseases like HIV and Hepatitis.

"If a candidate has had pregnancies that have been complicated by diabetes, hypertension, thyroid disease then she is not a viable candidate for being a surrogate, and sometimes if she's had two caesareans then that locks her out because there is likelihood for that pregnancy to complicate," Dr Wanjiru says.