Choosing Elective Surrogacy? How to Manage Expectations, Judgments, and Privacy

Introduction

I had lunch with a friend a few weeks ago while attending the Donor Egg Bank USA partner summit in San Diego. Like me, she’s a therapist working in reproductive health, so it was only a short time before our conversation turned to family building, specifically elective surrogacy, choosing to use a surrogate when there is no medical necessity. She asked for my perspective on choosing elective surrogacy, and the question that came to mind was, “Why would someone choose gestational surrogacy without a medical necessity?” But the more we discussed it, the more I realized that this choice could be right for some people for many reasons, including mental health reasons. Elective surrogacy, like other assisted reproductive fertility treatments, is a path to family building.

The further we explored the reasons one might choose elective surrogacy, my friend, who initially opposed the idea, began to see it differently. We agreed that the choice to pursue elective surrogacy is deeply personal. I reminded her that everyone may not have the desire to experience pregnancy. Some people who may want to expand their families may have had a challenging first pregnancy and may not wish to experience pregnancy again, viewing the experience as traumatic. Others may not want to experience the physical changes of pregnancy.

Let’s be honest—many people fear how pregnancy might change their bodies, how these physical changes could affect their relationship with their partner, and how they might perceive their own self-worth afterward.

What is Elective Surrogacy?

Elective surrogacy refers to the decision to use a surrogate or gestational carrier to carry and give birth to a child when there is no medical necessity or need. Reasons for choosing elective surrogacy might include career demands, personal preference, the desire to avoid the physical impact of pregnancy, or the lack of desire to experience pregnancy. In elective surrogacy, the decision is driven by personal choice rather than medical need.

Choosing elective surrogacy for nonmedical reasons is a complex and deeply personal decision. No one likely makes this choice without considerable thought or even some self-judgment. People might worry about being seen as shallow or selfish. But ultimately, the decision is theirs to make. Whether driven by career aspirations, concerns about the physical impact of pregnancy, or simply a preference not to experience pregnancy, this choice can sometimes attract societal scrutiny and judgment. As a reproductive psychologist, I understand the emotional challenges that can arise and the importance of maintaining privacy and setting boundaries.

Coping with Societal Expectations and Judgments

Society has long held specific expectations around motherhood, often emphasizing the importance of pregnancy and childbirth as essential experiences to becoming a parent. But what if the idea of being pregnant and giving birth doesn’t resonate with you, yet you still want to be a parent and have a biological connection with your child? Is elective surrogacy the right choice for you? When someone chooses surrogacy for nonmedical reasons, they may face questions or judgments from others who don’t fully understand or accept this choice.

Understanding Societal Pressures:

  • Traditional Norms: Many still hold traditional views on motherhood, believing that carrying a child is integral to being a parent. These views can create pressure for those who choose surrogacy, leading to feelings of guilt or inadequacy.
  • Judgment and Misunderstanding: Some may question the legitimacy of your decision, believing that surrogacy should only be used for medical reasons. This can lead to unsolicited opinions or outright criticism, making it challenging to navigate social interactions.
  • Internalized Expectations: Internalizing societal expectations is common, leading to self-doubt or questioning your choices. Acknowledging these feelings and understanding that external factors influence them can help you process and overcome them.

Now that you’ve considered your options and decided to move forward, how do you prepare for the naysayers and others’ opinions?

Strategies for Coping:

  • Reaffirm Your Decision: Remind yourself that your choice is valid and aligned with your personal values and life goals. Whether for career, physical, or personal reasons, your decision to pursue surrogacy is deeply personal and should be respected.
  • Educate and Inform: If you feel comfortable, educating others about your decision can help reduce misunderstandings and foster more supportive conversations. Sharing your reasons in a thoughtful and confident manner may help others see your perspective.
  • Seek Support: Surround yourself with a network of people who respect and understand your decision. Whether through friends, family, or support groups, having people who validate your choice can make a significant difference in managing societal pressures.

Protecting Your Privacy and Setting Boundaries

You don’t have to share your decision with anyone you don’t feel comfortable sharing it with. The decision to pursue surrogacy is intimate, and it’s essential to protect your privacy and establish boundaries with those around you. Not everyone needs to know the details of your decision, and it’s okay to set limits on what you choose to share.

Maintaining Privacy:

  • Choose What to Share: Decide in advance how much information you want to disclose and to whom. You are not obligated to share the details of your decision with anyone unless you feel comfortable doing so.
  • Use Boundaries: Setting clear boundaries is okay if you encounter intrusive questions or unsolicited advice. Phrases like “I appreciate your concern, but this is a personal decision” or “We’ve made a choice that works best for us” can help deflect unwanted inquiries.
  • Control the Narrative: Frame your decision in an empowering way. Focus on the positive aspects, such as how this choice allows you to build your family while staying true to your personal and professional goals.

Handling Judgments and Protecting Your Well-Being

Facing judgment from others can be emotionally taxing. Finding ways to manage these judgments effectively is important to protect your mental health and well-being.

Managing Judgment:

  • Emotional Resilience: Build emotional resilience by focusing on your reasons for choosing surrogacy and the positive outcomes you expect. Remember that your decision is about what’s best for you and your family, not meeting others’ expectations.
  • Therapeutic Support: Consider seeking support from a reproductive psychologist or therapist who can help you process any negative emotions that arise from societal judgments. Professional guidance can provide coping strategies and a safe space to explore your feelings.
  • Self-Compassion: Practice self-compassion by being kind to yourself and acknowledging that it’s okay to make decisions that are right for you, even if they go against societal norms. Embrace your choice with confidence and pride.

Conclusion

Choosing elective surrogacy for nonmedical reasons is a personal and valid decision, no matter the reason for your choice. Navigating societal expectations and judgments and maintaining your privacy can be challenging, but with the right strategies and support, you can protect your well-being and stay true to your choices. As a reproductive psychologist, I am here to support you along this journey, helping you manage these challenges as you build a family that aligns with your values and aspirations.

I am a fertility psychologist in Los Angeles and offer complimentary 15-minute initial consultations. If you are a woman, birthing person, or couple seeking infertility counseling, you may click here to schedule an appointment.

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