Being "pregnant" via a surrogate presents some unique challenges.
The first is relatively straight forward - how will you find out? You should agree in advance with your surrogate when and how she will tell you when she is pregnant, and what evidence you want before she does (an over the counter pregnancy test, or confirmation from a doctor?). Bear in mind that the surrogate may have to break bad news to you - how would you like this to be done? We asked Jennifer to tell us in a Skype call after taking an over-the-counter test. Hilarity ensued as we couldn't get the sound to work and desperately tried to read her body language. Fortunately in the end both the sound and the embryo transfer had worked and she was pregnant.
Thereafter, assuming the news is positive, the next challenge is how to build and maintain a relationship with the surrogate. Too much contact may suffocate her, too little may make her feel unappreciated. There is no perfect answer here, so you will just have to feel your way. We used WhatsApp as our main means of communication, and made sure that we didn't just use it to seek updates, but also to share news about our life, family photos etc. We supplemented this with occasional phone calls, and met Jennifer for the second time for the 20 week scan.
You will need to consider how frequently you will visit the States during the pregnancy. Again, there is no perfect answer. We only went out once, for the 20 week scan, but made sure we stayed a few days so we could meet Jennifer's family and spend some time with them. This was a very important part of building a relationship with our surrogate and we would recommend it to any couple going through the process. You may want to go more frequently.
Your surrogate should provide you with plenty of updates about her status. Our agency did a very good job of encouraging Jennifer to do so (or she was just naturally great at it), and Jennifer was also excellent at sending over scan photos and other updates. She took a video of the 12 week scan so we could watch and hear the doctor's commentary.
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It was during the 12 week scan that it was confirmed that Jennifer was carrying one baby, and not two. This was obviously sad news for us, but was more than off-set by our joy on hearing our baby's in-utero heartbeat and finding out that the scan was completely normal.
As the pregnancy progresses, it can be harder to maintain positive dialogue. If the surrogate is finding the pregnancy difficult, they may struggle to remain positive. And you may be a little frustrated if requests for an update are met with an unenthusiastic reply. Even if all is going swimmingly it can be hard to strike the right balance between being seen to care enough and being overwhelming. This is the stage in which maximum empathy is required - don't forget that your surrogate has her own life too, and that pregnancy is no picnic.
Finally, as the date of the birth nears you need to think about your plans for the birth. Babies are, of course, unpredictable in their timing and can come early or late. We planned to spend exactly one month in the US, arriving about 10 days before the due date and leaving three weeks after, to give us time to arrange a passport. As it happened, the dates worked perfectly for us. Emily arrived on her due date and we managed to obtain a passport for her 48 hours before we flew home. We were helped in our planning by the fact our surrogate's three previous children had all gone to term, so we had (possibly statistically spurious) grounds for optimism that Emily was not likely to be premature. But you should obviously consider how you would feel if you missed the birth.
Prior to the birth our agency arranged a call with us and our surrogate to discuss the birth plan. There is a surprising amount to think about and agree, including how many people will be in the room (natural birth and emergency caesarean), who will cut the cord, will the surrogate cuddle the baby, and if so when? And arrangements need to be made with the hospital to accommodate a surrogate birth - for example, you will want to be in a separate room getting to know your baby while the surrogate is recovering from the birth.
The other main challenge is how to prepare for a baby when you're not actually pregnant. It's a slightly surreal experience to be preparing for a baby when the evidence of pregnancy is two thousand miles away; and the absence of a growing bump can defuse the urgency of preparations. You will find your own way of dealing with this, but the main point is you need to plan in more or less the same way as any other couple, but with the added challenge that the first few weeks of your baby's life will be spent in the US, and you will therefore need either to take supplies with you or buy some when you arrive.
