In the wake of the Supreme Court's decision to overturn Roe vs Wade on June 24th, Circle Surrogacy & Egg Donation saw the importance in providing information on how this decision will impact surrogacy at Circle Surrogacy and the industry.
Lauren Mello, Social Media & Culture Manager at Circle, hosts three members of the Circle Leadership Team as they discuss the legal and technical implications that overturning Roe vs Wade will have on surrogacy and answer questions we've gotten from intended parents and surrogates.
On the panel is Dean Hutchison Esq, VP of Legal Services, Solveig Gramann LICSW, Director of Surrogate Services, and Emily Sonier LICSW, Director of Culture and Program Support. Each share their expertise about the surrogacy process and what we can expect moving forward.
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Hello and welcome to The Family Circle, circle surrogacy and egg donations Podcast. I'm Lauren Mello and I'm the Social Media and Culture manager here at Circle surrogacy. On Friday, the Supreme Court overturned Roe vs. Wade holding that there is no longer a federal constitutional right to abortion. Chatting with me today are three members of our leadership team who have been working tirelessly this weekend to try and get as up to speed as possible about everything that we know about Roe versus Wade, and how this historic change is going to impact the surrogacy and egg donation industry. So sitting with me today is Dean Hutchison, our Vice President of legal services, Solvay gram and director of surrogate services. And Emily Sonia, Director of Culture and program support. Dean, would you mind kicking us off in introducing yourself?
Sure. So I do not just since I've been here and working with circle for the last 18 years have seen many momentous decisions and issues arise in this field and this is probably one of the biggest now so outside of circle I chair, the American Bar Association's assisted reproductive technology lock committee. So part of my position here at Circle is overseeing and working with the legal team, but also globally, working within the art community and legal professionals when issues like this arise.
What about yourselves? Would you mind introducing yourself?
Absolutely. My name is Salma Grumman and I'm the director of surrogate services at Circle surrogacy. I'm also a licensed social worker. I've been here for about nine years, and I oversee all of the teams that screen incoming surrogate applicants. And then once those surrogates are matched with intended parents, I oversee the social workers that provide social worker support to them throughout the duration of their surrogacy journeys. And so this topic in particular, it comes up, it's always come up in our screening process. I've done a lot of work on how to cater our screening process to this ever evolving situation. But also, you know, I've personally supported surrogates who've undergone terminations out there surrogacy and the social workers as well. So looking forward to chatting with with Emily and Dean today.
Excellent. Thank you so much for that. And Emily, last, but certainly not least, would you mind providing a quick introduction?
Certainly, thanks, Lauren. My name is Emily, Sonya. I am also a social worker and I, somebody at circle who oversees a different parts of the whole process here at circle to make sure we're providing good support and guidance to all of the people that we consider our clients both intended parents, surrogates and egg donors. But we also want to make sure we're providing adequate intended parents support, I often get pulled into situations where intended parents need to talk to get some extra support around issues that might occur in their journey. But this is also a topic that comes up a lot of our potential intended parents and our current intended parents ask a lot of questions about the likelihood of a pregnancy termination and what happens when those things happen. And like, Solvay, I have supported clients intended parents in our program as they as they've had to face the very difficult situation on making a decision about whether or not to terminate a pregnancy. So I'm happy to join today and to talk to everyone. And I think just as a place to start, before we get going on some of the legal aspects of this, I would like to state that we want to be as an organization and as an agency being very respectful that while this, this new news on Friday causes many people to have very strong feelings and reactions. Not everyone feels the same way about this news. And we certainly want to be respectful to how individuals feel. And think about this information. As an organization, we need to think about how this impacts the surrogacy worlds, our clients, all of the ones that are involved, not just the intended parents, but also the surrogates who go through these procedures and have to be part of these decisions. And we want to think kind of with a perspective of caring and support for the people that are involved without a personal feeling or bias towards any particular situation. So I'm going to let Dean focus now on some of the legal aspects and how we view this from an agency perspective and a legal perspective. But I did want to just start with acknowledging sort of the need to be respectful of everybody's different perspectives on this news. Dean, do you want to start?
Sure, so I'll just speak generally, I mean, I've read the decision already. I need to read it multiple times because it is close to 200 pages from just a very big 30,000 foot overview. I think some of the hysteria and media sensationalization of the decision led a lot to believe that this decision outright banned termination and abortion in the United States. That is not what happened. What happened was the decision basically stated that there is no constitutionally protected right to a termination. And therefore, states have the right to make laws defining when and if a termination can occur. So for those who are nervous just looking at this, that there is no termination anymore in the country, that's not the case, states will still be allowed to make own laws. Many states have already codified constitutional right under their state constitution to these procedures, and many will still have those protections. So I think at least half the country will have access and good luck concerning the right determination. And then you'll have another Samad states that either severely restrict or just restrict, in general the timeline. So just from that nature, that's what the decision to how it impacts the surrogacy world, most specifically, is obviously when someone matches intended parents match with gestational carriers. One of the big issues is when certain situations to the intended parents have rights to request and termination and situation, and will gestational carrier agree to set termination. And that's kind of at the heart of many of our contracts. We match parents and gestational carriers that so have similar views on these topics. And the expectation is, if these situations arise, that all the parties will come to a discussion, talk to the doctors and move forward on the best procedure from there. When we look at our history at circle. And when these issues have arisen probably doesn't happen as often as people expect. It would. I think, since we've been collecting data in 2012, or 2013, on all of our cases, somewhere in the range of 3500 plus cycles, probably close to 1500 or more children born, there's only been the need for I believe seven terminations. And if you include selective reductions, when there's more than one fetus, and there has to be a reduction for health purposes, it goes up to 11. So very small likelihood of these procedures being needed. But on top of that, in surrogacy because of the nature of this process, where a lot of screening is done in advance, particularly genetic screening on embryos, usually when a termination is needed in a surrogacy case, they tend to happen later in the pregnancy, because it is a malformation issue where testing doesn't come back until after week 16 to 20 from a scan and then from that scan, further testing needs to be done. And you're at potentially post 24 weeks in a lot of states prior to this decision had termination limitations to 24 weeks, because that was the real ruling was viability timeline and 24 Weeks was kind of the known liability timeline, and therefore a lot of states would restrict to that period. And really, in the last five to 10 years, we've seen a lot of states go above and beyond that 24 weeks and have more restrictions. So it's something we had been dealing with as a team at circle as well as a legal team that when we're putting these provisions in contracts, when we're speaking this screening, which is solving and Emily can speak to after making sure surrogates are aware that there's the potential for the need to travel and they're okay with that travel if necessary in certain situations. So what we'll change in our cases is probably, obviously, surrogates coming from states to have more restrictive termination law may only be considered a surrogate willing to terminate if they're willing to travel because their state has further restrictions and other states do. So I think that's kind of the very specific way the surrogacy world will change. And on a on a day to day basis with our parents and our carriers is now kind of waiting for each date that has a trigger law or that is now advancing legislation concerning termination to see where they fall, what their restrictions are, how it will impact the process, and then dealing with it on a state by state basis. So that's probably the most minutia detail of how it impacts our clients, our carriers and others.
Thank you so much, Dean for that overview. I also want to state that we're talking about a lot of numbers here. There's a lot of different elements at play when it comes to termination and surrogacy. But we want to say that these pregnancies are desperately wanted. This is never an easy decision to make. And the support required from the circle staff during an experience like this is really important. And Emily and Selvig. You both have a lot of experience. You've been here collectively for a couple of decades, you have quite a bit of experience dealing with these more difficult cases. Emily, would you mind providing a little bit more information about what it is like to support intended parents through this decision making process and this experience?
Sure. So as you said, Lauren, I do think it's really important to highlight we have intended parents coming to our program to have a baby and so whenever they go into ultrasound scan or something where they find out that there is an issue with the pregnancy there is a lot Out of things that happen, the majority of our intended parents are wanting to see how significant the issue is, is it something that would greatly impact potential child's quality of life or not, we have many intended parents who find out about something at a scan, and they continue the pregnancy, that it's something that could be fixed with a surgery or might be a lifelong issue. But that wouldn't greatly impact quality of life. So when people find out about these very significant medical issues, again, it's usually something that with a lot of medical advice, talking to specialists going to see maternal fetal specialist going to see specialists and whatever the diagnosis is, whether it be a cardiologist or a neurologist, the intended parents and the surrogate participate in many appointments to try to figure out what the best options are for them. And then it's a personal decision. And it's a very, very difficult decision. And so it's important to remember that because everyone intended parents and surrogates are devastated by these, this news, trying to figure out what to do. So from the circle perspective, the staff does an excellent job trying to make sure we're connecting with intended parents and surrogates still, they can talk a little bit more about that. But we want to make sure that everybody has as much information as possible that we're helping facilitate appointments if we need to, but mostly that's being handled by the surrogates OB. But we want to make sure we're providing emotional support guidance, how we've handled these things in the past things to consider. The attorneys are working on any kind of illegal aspects that need to be considered either through the Carrier Agreement or any information that's needed for a hospital or a medical facility. And we talk about and look at the options, we look at what's in the Carrier Agreement in regards to the timeline that we're dealing with, we have had surrogates have to travel out of state out of the state where they live to go to a facility, we are very careful. And again, sorry. So they can talk about this too. But we you know, we want to make sure that we're taking care of the intended parents and the surrogate, that the facility that we find is reputable is medically approved is a place that's providing support and guidance to the surrogate and her support person. So it's really the whole, the whole thing is devastating and traumatic for everyone involved. And we want to make sure that we're providing our expertise and guidance and being respectful of the decision that the intended parents are making. So we have social workers on staff for intended parents, we have a program coordination team that helps the attorneys that are assigned to the intended parents. So when we've had these things happen, which again, Dean said is very, it is very rare considering how many cases and families that we're helping to support. It's an all hands on deck situation. And the team works really closely together to make sure we're supporting everybody involved. And often, you know, we're providing extra support as they make these decisions during the timeframe where they're going through the procedure. And then afterwards, any intended parents do continue in our program to go on to do a future transfer and to have a child at the end of their journey. But we continue to provide support to them, because this is obviously a traumatic experience for them to go through. So I'll let Solavei talk a little bit about from the surrogate perspective. Go ahead there.
Thanks, Emily. Emily really covered the the gist of all of it, you know what terms of how circle coordinates, you know how our staff works together really closely to make sure that all parties are supported. I think whenever these things do come up, sometimes it is the surrogate is the first one to find out and then supporting her and how you to communicate this with her intended parents. I think the other big thing that comes up for surrogates a lot, too, is just what will happen. I think there's there can be a lot of misinformation about what a termination entails. And we want to make sure that both our surrogates and intended parents have as factual information as possible to understand what will happen, we coordinate with the providers that they're working with to make sure that those explanations are given as early as possible. And like Emily said, Your the emotional piece of it is huge at Circle. Each surrogate has her own support social worker that she would have been working with from the time that she matched with the intended parents. So it's someone that she's familiar with someone that she's built a relationship with over time, and that supports social workers available to her daily if needed, you know, whenever whenever she wants to talk, and we're also able to help connect circuits outside resources as well, you know, mental health professionals in their community, you know, if they need resources for their family determination, like Emily said, it's devastating for all involved. And that also includes the surrogate family, you know, her partner, she has one her children. And so we want to make sure that we're really looking at situations like this as holistically as possible when we're offering support. And so I think, again, from just from my personal experience in supporting surrogates about these experiences, I think it's really just coordinating as much as we can with the team. I think these are situations that require the biggest lines of communication in terms of making sure everyone is hearing the same information that everyone's coordinating and collaborating as closely as possible to ensure that everyone feels as safe as possible and that they also have outlets to express how they're feeling because we expect to See the gamut? You know, it's devastating. It's sad, but it's also can be scary for people. And so we want to make sure that we are supporting everyone as much as possible.
I'll just guide to just in case people don't know this, I think the other piece of things is that for any potential surrogate to know, you know, we have things outlined in the carrier agreement so that if there is travel that's required, or anything, that's all covered cost. So it's not anything that a surrogate would need to worry about from a financial perspective. So we make sure that the surrogate travels with a support person and can have childcare and all the things that are necessary, including if there was any need for counseling, that would be something that that we would make sure it was all taken care of, and not be the surrogates responsibility.
Thank you so much, Emily, for including that and thank you both for everything that you do at circle for this topic. It's, it's very difficult, and having people like you at the helm make a huge difference. And I know that our clients feel that way as well. Moving away from you know, our current clients and what this means for them, I would love to hear a little bit more about how this is going to affect intended parents or people who are thinking about surrogacy, but haven't moved forward yet, what questions they might want to consider. Dean, do you want to share a little bit about how they can approach this from a legal perspective?
Yeah, I mean, you know, I think something I didn't mention earlier that all intended parents should understand before they enter this journey and think about it during it is immune, even if you're in the most bluest of blue states with wonderful law concerning abortion and termination to your liking. And everything's in your contract. There has always been the risk in this process that regardless of what the Supreme Court says, the gestational carrier has bodily autonomy rights, she has the patient, if she ever refused a termination or went and actually terminated a pregnancy on her own, there is no way for courts in any of those states to stop that from happening. And whether or not there'd be any damages resulting from that breach is a question. Nobody really knows. Because these court, these things don't come to the court. So you know, when people are thinking, you know, I want to be matched in a state with the best laws for all these purposes. It still doesn't fully protect you in these situations. I think the most well known case it was a triplet pregnancy in California. This wasn't a circle case. But it was a case it made news because someone tried to challenge the California surrogacy statute, and it was a case where initially a parent had requested a carrier reduce a triplet pregnancy to twin pregnancy. And she refused. And even though it was in her contract that you would so even in a state that probably has the longest history of law, in surrogacy, surrogates still was allowed to refuse a request in certain situations. So that's number one to think about, you know, if your carrier has gone through the screening, and it's agreed to these terms in the contract, I don't know if one state is better than the other. So as we've mentioned already, the likelihood of it occurring is so low, and that in the past, when it's been required, surrogates have been willing to travel in their situations, I'm not sure if the state matters as much, obviously, you'll feel more protected if there's laws where she resides. But as we said earlier, in those small number of cases where we needed terminations, travel was almost I think, required nearly all of them anyway, so it was still a necessary piece of it for same sex couples. This is far afield of what the decision did. But a lot of our fears when we were discussing this Dobbs case, prior to decisions coming down was that the right to termination was under what's called like the 14th amendment's silent rights. So things that aren't particularly in the Constitution, but they created this right to privacy that allowed things that he believed were to be rights to be rights, even though they weren't lifted. But among those rights are general rights to use contraception, certain sex outside of marriage laws, and then gay marriage, the Obergefell decision came under this right to privacy. And while the majority opinion said that those aren't an issue, one of the concurring opinions from Justice Thomas basically said that he doesn't believe in these 14th amendment rights and that those three things should potentially be looked at further down the line. So for our LGBTQ plus clients that are have recognized marriages or potentially thinking about marriage, probably not a bad idea to get married in your state, if you think it's a state that might potentially restrict those rights in the future. And what we've always talked about in consultations and when we talk with our same sex clients as well as even if you get some type of parentage order in the state where the surrogates delivering doesn't hurt to further protect that border with no what's known as second parent adoption or a confirmatory adoption or close parent adoption, just kind of the wording differ state to state but that gives you kind of a 50 state belt and suspenders protective approach to the parentage process. While this decision specifically targets one element of privacy, it has the potential to impact other rights come under that 14th amendment. So we want to look globally when we're thinking about this and the other piece which we're waiting to see if any laws come down as what's known around the country as personhood bills. And those are things that define when life begins, you know, whether it's certain week of pregnancy, whether it's fertilization, and that potentially could impact IVF as a whole as well, in certain states. If they say Life begins at fertilization, you then have this secondary issue that may come down the line, which, again, I would be, I don't want to opine on it. Now, because we haven't seen any of these yet. We don't know if it would be completely separate from the IVF situation. But we want obviously, to be on top of these laws as they're coming reach out to intended parents and potential intended parents. Part of the reason that this decision hits you hard as a practitioner in this field is that within 48 hours of that decision coming down, you hear from clients that are afraid just because they have embryos frozen in the state, you hear from clients that are afraid that their rights to their just being parents to a child they've been a parent to for years is impacted. So the initial impact, obviously, it's hard enough, but then when you hear from the secondaries, pieces of people that are scared of things that they've grown accustomed to, it's something that we want to help protect as much as we can.
Thank you for providing so much information about the potential things that might be coming. I know, I've seen it on social media from a lot of potential intended parents who have questions about IVF, and frozen embryos and things like that. So we will definitely continue to keep our clients posted. as things change, as decisions come down, we will continue to be updating our current clients. But that was a wonderful overview for intended parent Selvig. I'm going to direct the conversation back to you, I'm hoping that you can provide a bit more information about the surrogacy side for women who are interested in becoming surrogates or have already gone through the application process have been accepted and are now feeling some fears or have a lot of questions that are confused about how this will all unfold, would you mind providing some insight on what this will look like for surrogates moving forward? Sure.
So I'll start with the surrogates currently, in our program, you we've had many women reach out to their support social workers or their coordination team. And it was a right now, it's hard to say, You know what, exactly what this means, because it's so state dependent now. And so what we've been advising surrogates of who are in our program were matched is, again, this is an extremely rare event as it is. But we work very closely with the legal team to understand what's happening as it's happening. And so in the event that something like this would come up, these issues get escalated very, very quickly to myself to Dean to Emily so that we can start to problem solve as much as possible and figure out what are the options and really enact that whole, you know, team approach that Emily was describing earlier. So surrogates currently in our program, I think for now, it's letting them have an opportunity to express their fears their valid. And so we want to have spaces for them to express what they're feeling. Even if we don't have a lot of concrete answers right now, there's always a space for them to talk for applicants who are applying to us right now, you know, we've had, we've kind of had two different approaches to it. Some women have been very honest and said, I'd like to wait to actually move forward and matching with intended parents until there is a better understanding of what the laws look like in my state, which I think is fair, a completely valid, you know, response to a situation like this when there's such a big unknown. For a lot of women, they're moving forward at every stage of the surrogate screening process, they're asked about termination. And so there's many opportunities for us to discuss with them. And again, make sure that they understand what a termination could look like in a surrogacy, we want to make sure that these women are providing as much informed consent as possible going into a process like this. And understanding that everyone's experiences and thoughts and opinions about abortion can vary widely across the country. And so our screening process is really there to make sure that we understand exactly what their expectations are to make sure that we can provide education about you know, the need for travel, etc. And ultimately, all of that information is used so that we can match them appropriately with intended parents. When we match surrogates, we're never going to match a surrogate or intended parents together where they don't, you know, share similar thoughts and philosophies around termination from the start, because obviously, that could lead to a disaster later on. So it's really important that we have these conversations as in depth as possible. And do again, we do already have practice in terms of when laws do change, adapting our screening process to whatever that looks like last year when the change in laws happened in Texas, and we're recently Oklahoma, our social work team was in touch with our legal team within a matter of hours to make sure that we understood what exactly it was that we needed to be talking to surrogates about what type of language we needed to be using. And so I think that will continue to blow in into the screening process as we learn more specifically about what's happening in various states.
That's an excellent overview. Thank you so much. So take what you're seeing on your end and how we've experienced this in the past. Would you encourage women to hold off on applying? Or would you say that now it's still a safe time to apply?
I think it's ultimately what each individual's comfort level is, again, we have had a handful of surrogates St. Louis, they'd like to wait. And I totally get that perspective. It makes sense. But on the whole, we're seeing women continue to apply very regularly. We are doing just as many screenings as we were before. And again, this is an incredibly rare event. And so you know, I think most women approach it from their perspective of I know, this is a risk that could occur in surrogacy just as they understand the risks that pregnancy posed to them, overall, but they're very, you know, they're committed to helping a family, they're committed to helping others and we see that shine through and all of the screenings and the women that we support throughout their surrogacy journeys.
Wonderful. I was hoping that that would be your response, there is always a question of is now an Okay, time to apply. And I think circle does an extremely wonderful job and making sure that women feel supported. And from the legal side, Dean can speak a little bit more to this, but we have a full understanding of what's happening as it's happening and have a full team that's consistently checking to see how decisions are coming down and what that's going to mean, for surrogates. So Dean, I assume that you would agree with Celtics perspective on that one?
Yeah. I mean, there's no 100% right answer, because it's sort of extent, it's a subjective thing that we want everyone, both parents and surrogates to feel comfortable when they're moving forward, because obviously, it makes a better journey. But legally, my 18 years, we've seen the law has changed drastically, not only domestically. But internationally, we have lots of international clients where suddenly what they're doing is illegal or not illegal based on where they live. And even though they're doing it in the United States. So what we've always tried to do is when these situations arise, is get together and make sure we're reviewing what's happening, and giving the best advice for all of our parents and our carriers to move forward in the process without issues arising. We don't know we only know some of the laws that will come down, but we don't know all of them yet, and how they'll impact this process. But also, what should be known out there, some of these laws will be challenged. Even though there isn't a specific constitutional right to the termination anymore. The laws that are put forward by certain states could still face challenges that they are overboard or overburdening and they may not even work one of the I think one of the ones that has most specifically come up from both parents and carers is what if the state bans me from traveling termination, which I don't think and based on words in the opinions that would be upheld, because there is this constitutional right to travel. So therefore, you shouldn't be prosecuted for doing so state where it's legal versus your own state. But yes, we try and stay on top of everything we try and get the best advice out there when when the changes do occur.
So thank you all very much for being here today and helping to provide more information about this historic case and what it will mean for surrogacy, as we learn more information, we will be sharing it with our clients. But if you are a current intended Parent or Parent, surrogate egg donor with us, please reach out to your social worker or program coordinator or your point of contact here. If you have any questions or are feeling like you need more support. We are always here. And our goal is to be as transparent as possible with you and do everything that we can to support our parents and surrogates through this journey. So thank you all for being here. It is very much appreciated. And thank you for all that you've done, especially this weekend, as I know that it was a big information weekend, and you all had a lot to do. So thank you very much.
Thank you, everybody. Thanks, everybody.