A surrogate's journey: Laura liked being pregnant

First of two parts.

Chapter I

It's 2009, and Laura Davis lies sweating with a fever of 104. Her lower abdomen aches, as an infection pummels her insides.

About six days ago, her uterus began hemorrhaging. Bleeding that started as troubling clots had transformed into a flood that sent her husband, Beau, scrambling to dial 911.

The pain, while intense, is worth it: Davis delivered healthy twins a little more than two weeks ago.

The bleeding didn't start until about 10 days after the babies went home with their mother, who is not Davis, and their father, who is not the man who rushed her back to the hospital.

That's because Davis is a surrogate — one of a rapidly growing number of women who have carried other parents' children as, experts say, the practice becomes more widely accepted and technologically precise.

Though this is Davis' first time as a surrogate, it will not be the last.

Soon, she'll decide that, like a running back laid out by a bone-shattering tackle, she will not let her story end this way, in blood and in pain.

Over the course of half a decade, Davis will carry five children for three sets of parents — not including her own son and daughter. Each time she uses what she calls that "supernatural super power," she will inch closer to her place in a new kind of family.

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The number of babies born each year through gestational carrier surrogacy in the United States is on the rise, from 738 in 2004 to 1,898 in 2012, according to the most recent data reported by the Society of Assisted Reproductive Technology.

That's still a tiny percentage of the 51,267 babies born nationwide in 2012 with help from assisted reproductive technology, which itself is only about 1% of all newborns, federal data show.

Nevertheless, the numbers represent a 157% increase in babies birthed by gestational carriers per year in less than a decade.

This increase can be attributed to a range of factors, from the prevalence of women waiting later in life to have kids, to the domino effect of states legalizing gay marriage.

Within the public consciousness, however, anxieties linger over the implications of allowing women to be compensated for risking their own bodies to carry other parents' children.

"We reassure parents when they enter into this process that it's their child, not the surrogate's child," said Amy Stewart Kaplan, founder of the agency that employs Davis, West Coast Surrogacy and Egg Donation in Irvine. "If anything, we've had surrogates ask, 'Is there something wrong with me, because I'm not having that attachment [to the baby]?'"

Kaplan and others have stressed that surrogacy isn't for everyone. It requires both complete intimacy and a kind of detachment that, for some, is inconceivable.

In Davis' case, surrogacy has satisfied impulses that are at once selfish and deeply altruistic. A former case manager for the state who for years helped HIV-positive inmates transition out of prison, Davis looks back at her journey with a social worker's matter-of-factness: Retreading past trauma accomplishes little.

Instead, she focuses on the moment when parents meet their newborn. Witnessing that moment, she said, is just about the next best thing to experiencing it for yourself.

And she wanted to help more parents to have it.

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Chapter II

It's 2001. Davis is 25 years old and finishing up her bachelor's degree at Cal State Fullerton.

She stumbles upon an ad in the campus newspaper seeking egg donors. As someone who worked her way through community college and is now running on student loans, the chance to make some extra cash piques her interest.

She thinks of shoring up the fund for her upcoming wedding to Beau. She decides to give it a try.

It is her first foray into the world of technologically assisted reproduction, and it is horrible. The daily injections are a pain, the cocktail of hormones leave her bloated. She and Beau reach a tacit understanding: Never again.

What Davis doesn't know now is how about four years — and the births of her son and daughter — will upend her perspective.

That time will not be without its challenges: Davis' first pregnancy, with her son, will result in a caesarean section. After the birth of her daughter about a year later, the weight of caring for two young children will lead her to suffer postpartum depression.

But with counseling, she'll get through it. Davis will come to realize that she loves being pregnant. She loves the look of a "big pregnant belly," she'll say. She will relish feeling a baby's movements.

When she is pregnant, the hormones that course through her body won't bother her. They will mellow her out, make her a little less "high strung." She will feel healthier.

By then, however, she and Beau will be done growing their family.

"I have this ability to create a life," Davis said. "And the thought of not being able to use that or feel that again made me feel very sad."

It will be through this lens that she takes another look at egg donation.

This time, the discomfort will be a small inconvenience if it means sharing her ability to have children with people who would spend hundreds of thousands of dollars, sleepless nights and boundless emotional toil to have what had come easily to her.

She will donate once more before she turns 30 and ages out of the pool.

Still, Davis will feel she can do more.

So, in 2008, she'll start reading about surrogacy online.

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The demand for surrogates, Kaplan said, has far surpassed the number of women willing to be one. Her agency has seen exponential growth.

Mention surrogacy to almost anyone and the gut reactions can be, in large part, traced back to "Baby M," said Diane Hinson, founder and senior partner of Creative Family Connections, a Maryland-based law firm that focuses on assisted reproductive technology issues.

In the late 1980s, when in vitro fertilization was, as Hinson put it, "just a glimmer in the eye" of doctors and parents, the national media were captivated by a landmark case involving a surrogate who, shortly after giving birth, decided she wanted to keep the baby girl she had been contracted to carry for another couple.

What ensued was a bitterly fought custody battle that ended with the New Jersey Supreme Court deciding that the contract amounted to "illegal baby selling." Custody was awarded to the baby's father. The woman who gave birth was given visitation rights.

Assisted reproduction advocates today point out that the woman, Mary Beth Whitehead, was the child's biological mother — she was impregnated with the father's sperm. As a result, they say, her connection to the infant was stronger than that of most of today's surrogates, who have no biological ties to the children they carry.

In the decades since, advances in fertility technology have made it possible to choose an egg donor independently of choosing a surrogate.

The American Society for Reproductive Medicine has issued strict guidelines that recommend that gestational carrier surrogacy be undertaken only after a prospective surrogate has gone through rigorous mental and physical health checks, as well as family counseling.

West Coast Surrogacy requires carrier candidates to submit to interviews, criminal background checks, psychological evaluations and a review of previous pregnancy records.

The carrier must have had at least one child of her own, of whom she has at least half custody, and must be financially secure, Kaplan said, before legal contracts are drawn up between the surrogate and the intended parent or parents.

The process is expensive for parents; surrogate compensation accounts for only about a quarter of the money spent.

Kaplan tells parents to expect to pay well upward of $100,000 in medical bills, living expenses and legal fees. Of that, according to cost breakdowns on websites for agencies that work in California, between $25,000 and $40,000 will be surrogate fees, depending on a surrogate's experience level and whether she is carrying multiple children.

Then, the surrogate can begin the precisely timed embryo transfer process. Even given the fact that today's assisted reproduction technologies are much more successful than those of the past, a baby is still far from a sure thing — in 2012, 43.6% of gestational attempts involving carriers ended in births.

What's now known as traditional surrogacy, involving a biological connection to the carrier, as in the case of Baby M, today is discouraged and rarely practiced.

But the case's legacy, Hinson said, has contributed to an arcane legal patchwork nationwide.

In Washington, D.C., for example, surrogacy is still banned outright, according to an interactive map that Hinson compiled.

A few states, including California, Nevada and Illinois, have statutes that not only allow surrogacy but lay out a legal framework to complete the process. California, with its 2012 law that allows parents and surrogates to sign pre-birth orders that give legal custody to intended parents from the start, has a reputation as an ideal place for surrogacy.

Most states fall somewhere in between. Many have neither explicit bans nor statutes regulating legal surrogacy, leaving hopeful parents to navigate paths littered with hurdles that could leave them without parental rights.

"Technology is outpacing the laws, which were written at a time when the only way that conception occurred was behind closed doors," Hinson said.

Somewhere, though, buried under the challenges and uncertainty of reproductive technology, glimmers the beauty of human life's fundamental improbability, said Dr. Samantha M. Pfeifer, a reproductive endocrinologist who chairs the American Society for Reproductive Medicine's practice committee.

"When you think about it, it's a miracle that babies are actually born," she said.

In part two of the series: How Davis, in many ways an ordinary mother of two, delivered five babies for others.

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